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Clinical Times: November 2008

Dealing with the psychological effects of cancer

Dr Shawn Steggles | 30 November 2008 | Cancer

Dr Shawn Steggles writes that the psychological effects of cancer on patients and their families cannot be overlooked and that 'getting better' includes both mental as well as physical health. The psychological effects of cancer on patients and their families... Read more

GPs questions answered

Dr Robert Coughlan | 27 November 2008 | Musculoskeletal

In the fourth instalment of Irish Medical Times’s new 'Ask the Consultant' series, Dr Robert Coughlan answers some questions from general practitioners on rheumatological disorders. 1. When should disease-modifying agents be introduced in rheumatological disorders?... Read more

Testosterone deficiency remains underdiagnosed

27 November 2008 | Men's Health

Other than type 2 diabetes, testosterone deficiency syndrome (TDS) is the most common endocrine disorder in men and yet is the least commonly diagnosed and treated, according to the President of the Society for the Study of Androgen Deficiency. Speaking... Read more

Parenting programmes help raise sexually healthy kids

BMJ Online First | 25 November 2008 | Mental Health & CNS

‘Let’s talk about sex’ programme helps parents raise sexually healthy young people. Parenting programmes in the workplace can significantly improve parents’ ability to talk with their children about sexual health and may provide a unique way of promoting healthy adolescent... Read more

What's coming up in MIMS Ireland

25 November 2008 | Infections & Immunology

With World AIDS Day coming up on 1 December, the Clinical Special of December’s issue will present updated recommendations on antiretroviral treatment of adult HIV infection. These 2008 guidelines have been updated by the International AIDS Society-USA panel following new... Read more

Time and surgery help with Ménière’s

Archives of Otolaryngology and Head and Neck Surgery | 25 November 2008 | Musculoskeletal

Episodes of dizziness tend to become less frequent over time in patients with Ménière’s disease, and draining fluid from the inner ear appears to reduce vertigo in three-fourths of patients with the condition, two new studies have found. In the... Read more

Good prognosis for patients with West Nile virus

Annals of Internal Medicine | 25 November 2008 | Mental Health & CNS

The long-term prognosis of patients infected with West Nile virus is good, according to a new study. The study found that physical and mental functions returned to normal about year after infection. The researchers noted that 20 per cent of... Read more

Gingko biloba does not prevent dementia or Alzheimer’s

JAMA | 21 November 2008 | Mental Health & CNS

Use of the herb ginkgo biloba, claimed to have beneficial effects on memory and cognition, was not effective in reducing the rate of dementia or Alzheimer’s disease among more than 1,500 elderly study participants after several years of use, according... Read more

Cancer drug linked to increased blood clot risk

JAMA | 21 November 2008 | Cancer

An analysis of randomised controlled trials indicates that use of the cancer drug bevacizumab is associated with an increased risk of venous thromboembolism, according to a new meta-analysis of existing studies. To determine the risk of venous thromboembolism associated with... Read more

Indigo ointment may help treat patients with psoriasis

21 November 2008 | Skin

An ointment made from indigo naturalis, the dark blue plant-based powder used in traditional Chinese medicine, appears effective in treating plaque-type psoriasis, according to a new report. In the study, doctors in China conducted a randomised trial of an ointment... Read more

Growing optimism in advanced kidney cancer

Dr John McCaffrey | 20 November 2008 | Cancer

There have been many changes in advanced kidney cancer over the past decades. Until recent times, this had not included any improvement in survival. During these years, a greater understanding of the genetic basis and potential molecular targets has yielded... Read more

Systemic treatment of psoriasis

Dr Benvon Moran, Prof Sarah Rogers | 19 November 2008 | Skin

Dr Benvon Moran and Prof Sarah Rogers explain the range of systemic treatments available for patients with psoriasis in the first part of a two-part article and discuss dosage, side-effects and monitoring. (Part 2 next week). Psoriasis affects one per... Read more

Keeping a watch on eye health

Helix Health | 17 November 2008 | Eye, Ear, Nose & Throat

A new UK online prevalence model is helping clinicians and health planners to improve patient services for those affected by four major eye conditions. UK health planners and clinicians can now improve patient services and anticipate the changes when new... Read more

Kids who live with smokers less likely to get good food

Archives of Pediatrics and Adolescent Medicine | 17 November 2008 | Nutrition

Children and adults living with adult smokers appear less likely to have daily access to enough healthy food compared with those living with non-smoking adults, according to a new report. The report followed a study in which American doctors analysed... Read more

Precipitation levels may be associated with autism

Archives of Pediatrics and Adolescent Medicine | 17 November 2008 | Mental Health & CNS

Children living in counties with higher levels of annual precipitation appear more likely to have higher prevalence rates of autism, according to a new report. The results raise the possibility that an environmental trigger for autism may be associated with... Read more

Folic acid, B vitamins do not appear to affect cancer risk

JAMA | 17 November 2008 | Nutrition

A daily supplementation combination that included folic acid and vitamin B6 and B12 had no significant effect on the overall risk of cancer, including breast cancer, among women at high risk of cardiovascular disease, according to a new study. In... Read more

Diabetes questions answered

Prof Greald Tomkin | 17 November 2008 | Diabetes

Continuing our Ask the Consultant series, Prof Gerald Tomkin answers questions from general practitioners on diabetes and how best to treat the condition. 1. Is there a case for advocating earlier insulin introduction in the poorly controlled type 2 diabetic?... Read more

Management of rectal cancer

Dr Julian Tsang and Mr Eadhbhard Mulligan | 17 November 2008 | Cancer

Dr Julian Tsang and Mr Eadhbhard Mulligan, of the Hermitage Medical Clinic, writes about the challenges of treating rectal cancer, which accounts for 30 per cent of all colorectal cancers. Surgical resection is the principal treatment modality in rectal cancer.... Read more

Klinefelter’s syndrome: a male infertility disorder

Dr Muhammad Arshad, Prof Michael Fitzgerald | 17 November 2008 | Men's Health

Dr Muhammad Arshad and Prof Michael Fitzgerald write about the causes of and the treatment options for Klinefelter's syndrome, a trisomy disorder that is found in approximately one in 700 male births. Klinefelter’s syndrome (KS) is the most common cause... Read more

Study brings hope for Parkinson's

Mary Anne Kenny | 14 November 2008 | Mental Health & CNS

Results from a new study have the potential to change the way Parkinson’s disease (PD) is treated, delegates at the 12th Congress of the European Federation of Neurological Societies in Madrid heard in August. The results from the ADAGIO (Attenuation... Read more

Oestrogen relieves symptoms in women who have schizophrenia

Archives of General Psychiatry | 13 November 2008 | Mental Health & CNS

When combined with antipsychotic medications, the oestrogen estradiol appears to be a useful treatment in women with schizophrenia, according to a new report. According to the report, doctors conducted a randomised, double-blind study involving 102 women of child-bearing age with... Read more

Whatever happened to the thallium scan?

Dr Martin O'Connell | 13 November 2008 | Cardiovascular

Dr Martin O’Connell, Consultant Radiologist, Mater Hospital, writes on the usage of the thallium scan in cardiology investigations. The thallium scan is a well-known part of the diagnostic algorithm for investigation of myocardial ischaemia. In the era of wider availability... Read more

Turning a spotlight on lung cancer

Norma Cronin | 13 November 2008 | Cancer

Norma Cronin, Health Promotion Manager, Irish Cancer Society, emphasises the need for both healthcare professionals and the public to be more aware of the signs and symptoms of lung cancer. A collaborative effort is needed to fight lung cancer. Every... Read more

Suicide laws may overlook depressed patients

BMJ Online First | 11 November 2008 | Mental Health & CNS

One in four terminally ill patients in the American state of Oregon who opt for doctor-assisted suicide has clinical depression and the Death with Dignity Act may not be adequately protecting them, a new study has concluded. In 1997, the... Read more

Early diagnosis saves lives

Dr Barbara O'Beirne | 08 November 2008 | Cancer

Dr Barbara O'Beirne, GP, writes that the burden of lung cancer can be lessened if general practitioners take the steps to ensure that the disease is diagnosed as early as possible. Lung cancer is one of the most common cancers... Read more

Longer-duration psychotherapy better for complex disorders

JAMA | 07 November 2008 | Mental Health & CNS

Long term psychodynamic psychotherapy (LTPP) for at least a year is effective and superior to shorter-term therapy for patients with complex mental disorders, according to a meta-analysis of existing studies. German researchers conducted the meta-analysis to examine the effectiveness of... Read more

Psychotropic-induced SIADH and associated treatment challenges

Dr Azhar Zia | 07 November 2008 | Mental Health & CNS

Dr Azhar Zia writes about the causes of psychotropic-induced SIADH and the best approach to take in treating the condition. The syndrome of inappropriate secretion of anti-diuretic hormone (SIADH) has numerous aetiologies, including medical illness, stress and various pharmacologic agents... Read more

Voluntary exercise 'doesn't alleviate anxiety and depression'

Archives of General Psychiatry | 06 November 2008 | Mental Health & CNS

Voluntary physical activity does not appear to cause a reduction in anxiety and depression, but exercise and mood may be associated through a common genetic factor, says a new report. The report followed a study of 5,952 twins from the... Read more

Nitric oxide and asthma in chidhood

Dr John Widger and Dr Basil Alnazir | 06 November 2008 | Respiratory

Dr John Widger and Dr Basil Elnazir write that the nitric oxide test may be useful in the management of selected patients with allergic asthma. Allergic asthma is characterised by chronic inflammation of the airways and is caused by a... Read more

End-of-life discussions with doctors can benefit patients and caregivers

JAMA | 05 November 2008 | Mental Health & CNS

Terminally ill patients who had end-of-life discussions with doctors were not more likely to experience emotional distress, received less aggress-ive medical care in their final week of life and had a better quality of life as they neared death, compared... Read more

Vitamin D deficiency more common in patients with Parkinson’s disease

Archives of Neurology | 04 November 2008 |

Patients with Parkinson’s disease appear more likely to be vitamin D deficient than healthy adults of the same age or patients with Alzheimer’s disease, according to a new study. In the study, doctors compared vitamin D levels of 100 patients... Read more

Aerobic exercise can reverse brain decline

British Journal of Sports Medicine | 04 November 2008 | Mental Health & CNS

Regular aerobic exercise not only staves off the decline in brain power associated with ageing, but it can also reverse it, according to a leading American cognitive neuroscientist. Prof Art Kramer of the Beckman Institute at the University of Illinois,... Read more

Drinking alcohol linked to reduced brain volume

Archives of Neurology | 04 November 2008 | Mental Health & CNS

The more alcohol an individual drinks, the smaller his or her total brain volume, according to a new report. The report followed a study in which doctors investigated 1,839 adults whose average age was 60 years. Between 1999 and 2001,... Read more