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Clinical Times: March 2009

Pharmacotherapeutic and psychotherapeutic addiction treatments

Dr Conor Farren | 31 March 2009 | Mental Health & CNS

Dr Conor Farren writes that different treatment interventions can have a major part to play in addiction treatment, along with patient motivation. Addiction treatment, for alcoholism and for drug abuse, has traditionally been seen as moderately effective. The only influence... Read more

Experts focus on sleep medicine

31 March 2009 | Respiratory

Sleep medicine is an area of huge public health and clinical significance, delegates attending the Cephalon Third Annual Sleep Disorder Symposium on Friday, February 27 were told. Welcoming attendants to the meeting in the Radisson SAS Hotel at Dublin Airport,... Read more

Back pain still a major problem

Dr Paul Sandys | 31 March 2009 | Musculoskeletal

Dr Paul Sandys wonders just how much have we really progressed in the treatment and management of low back pain in the last 30 years. It has been over 30 years since the late orthopaedic surgeon Dr Alf Nachemson (world... Read more

Brain circuit abnormalities may underlie bulimia nervosa in women

Archives of General Psychiatry | 30 March 2009 | Mental Health & CNS

Women with bulimia nervosa appear to respond more impulsively during psychological testing than those without eating disorders, and brain scans show differences in areas responsible for regulating behaviour, according to a new report. Certain pathways between nerve cells known as... Read more

Obesity during pregnancy linked with risk of birth defects

30 March 2009 | Women's Health

An analysis of previously reported studies has found that women who are obese during pregnancy have an increased risk of delivering a child with such birth defects as spina bifida and neural tube defects, although the absolute increase in risk... Read more

Poor women more likely to develop diabetes says study

30 March 2009 |

A new study has found that women from socially-deprived backgrounds are more than twice as likely as women from affluent backgrounds to develop type 2 diabetes. The finding, by researchers in the UK, followed a study into the use of... Read more

Gender dysphoria — a treatable condition in mainstream medicine

Sara-Jane Cromwell | 30 March 2009 | Mental Health & CNS

Sara-Jane Cromwell, CEO of Gender Identity Disorder Ireland, defines the condition of and treatments for gender identity disorder. Gender identity disorder (GID)/gender dysphoria is a little known but much misunderstood congenital intersex condition, which is clinically diagnosable and treatable. The... Read more

Depression in old age

Dr Stephen McWilliams | 30 March 2009 | Mental Health & CNS

Dr Stephen McWilliams looks at the reasons for depression in older people and why they are less likely to access mental health services. Opinions seem to differ on the virtues of old age. On his ninetieth birthday, William Somerset Maug-ham... Read more

Half of prematurely born children need extra school help

Disease in Childhood | 24 March 2009 | Mental Health & CNS

Over half of children born extremely prematurely need extra educational support in mainstream schools, according to new research. In particular, they struggle with maths, the research found. Those findings followed an analysis of the cognitive ability and academic prowess of... Read more

Bones of evidence present a picture of past lives

Ian McGee | 24 March 2009 | Musculoskeletal

Ian McGee discusses how osteoarchaeology can provide an insight into diagnosing health and illness in our ancestors and how doctors and archaeologists are combining their skills to investigate the medical mysteries of the past. Disciplines within the study of both... Read more

Treating Barrett's oesophagus

Prof Fergus Gleeson | 24 March 2009 | Gastro-intestinal

Prof Fergus Gleeson discusses the diagnosis and treatment of Barrett's oesophagus and the need to adopt a candid approach when informing patients about the condition. Norman Rupert Barrett was born in Adelaide, South Australia in 1903. Educated at Eton, he... Read more

Migraines increase stroke risk during pregnancy

BMJ Online | 23 March 2009 | Women's Health

Women who suffer migraines are at an increased risk of stroke during pregnancy as well as other vascular conditions such as heart disease, high blood pressure and blood clots, a new study has concluded. Migraine headache occurs in up to... Read more

Alcohol leads to depression risk in men and in women

Archives of General Psychiatry | 23 March 2009 | Mental Health & CNS

A statistical modelling study has suggested that problems with alcohol abuse may lead to an increased risk of depression, as opposed to the reverse model in which individuals with depression self-medicate with alcohol. A number of epidemiological investigations have shown... Read more

Obesity not linked to worseningcognitive function in older women

Archives of Neurology | 23 March 2009 | Women's Health

Older women with higher levels of fat do not appear more likely to experience declines in cognitive function over time, but men do, according to a new study. For men, however, obesity does put them at risk of decline in... Read more

Tissue screening is questioned

BMJ Online | 23 March 2009 | Women's Health

UK doctors have questioned the widespread practice of screening breast tissue for cancer after mammoplasty without patient consent. They raised the questions even after finding cancer after a routine cosmetic operation on a 37-year-old woman. The discovery led to further... Read more

Omega-3 polyunsaturated fatty acids in CV disease

18 March 2009 | Cardiovascular

Key speakers at a recent Solvay Healthcare meeting in Dublin outlined the role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the treatment of patients with cardiovascular disease. Dr Vincent Maher, a Cardiology Consultant at Adelaide and Meath Children’s Hospital,... Read more

Pharmacologic therapies in osteoporosis treatment

Dr Wan Aizad Wan Mahmood and Dr Malachi J. McKenna | 18 March 2009 | Musculoskeletal

Dr Wan Aizad Wan Mahmood and Dr Malachi J. McKenna look at the treatments for patients with osteoporosis in the second article of our two-part series. Approved therapies for the prevention or treatment of postmenopausal osteoporosis include bisphosphonates, calcitonin, oestrogen,... Read more

Ankylosing spondylitis: a brief review

Dr Muhammad Haroon and Dr Donncha O'Gradaigh | 18 March 2009 | Musculoskeletal

Dr Muhammad Haroon and Dr Donncha O'Gradaigh define the concept of spondyloarthopathy and outline the treatment and management options for patients with ankylosing spondylitis. In daily practice, the concept of spondyloarthopathy helps enormously in making earlier diagnosis. Early diagnosis of... Read more

Some tocolytic treatment for preterm labour linked to adverse drug reactions

BMJ Online | 16 March 2009 | Women's Health

The use of some tocolytic drugs to delay preterm labour is associated with a high rate of serious adverse reactions, a new study has found. The drugs most often used include beta agonists and nifedipine – to relax smooth muscles... Read more

Black women have double the risk of pregnancy complications

BMJ Online | 16 March 2009 | Women's Health

Black Caribbean and black African women have twice as much risk of experiencing severe pregnancy complications than white women, according to new UK research. The study, the first of its kind undertaken in the UK, also found that Pakistani women... Read more

MS treatment: time for a paradigm shift

16 March 2009 | Mental Health & CNS

A recent clinical meeting investigated whether MS patients should be treated early with natalizumab to try and prevent disease progression. At a recent clinical meeting in Dublin, the delegates heard that the monoclonal antibody natalizumab (Tysabri) offers not only significant... Read more

Risk assessment in bone health

Dr Wan Aizad Wan Mahmood and Dr Malachi J. McKenna | 16 March 2009 | Musculoskeletal

Dr Wan Aizad Wan Mahmood and Dr Malachi J. McKenna address the global practice issues in osteoporosis treatment regarding who should have a DXA and what patients need to be treated. Osteoporosis is defined empirically as a reduction in bone... Read more

Review disputes effect of new patch to boost sex drive

Drug and Therapeutics Bulletin | 11 March 2009 | Genito-urinary

A new testosterone patch designed to pep up a woman’s sex drive after uterus and ovary removal may not work, and its long term safety is not proven, according to a new review of previously published studies. The condition, hypoactive... Read more

Sleep-disordered breathing

Dr Ruairi Fahy | 11 March 2009 | Respiratory

Dr Ruairi Fahy writes about the best ways to diagnose and treat the sleep disorder called obstructive sleep apnoea-hypopnoea syndrome. Episodes of cessation of respiration (apnoea), or reduction in the tidal volume (hypopnoea), are commonly seen in adults during sleep.... Read more

Understanding bipolarity and mood disorders

Natalya Anderson | 11 March 2009 | Mental Health & CNS

Natalya Anderson reports from the Sixth National Conference on Bipolar Disorder in London, where delegates heard that better classification of bipolarity is needed to avoid misdiagnoses An ongoing discourse between healthcare professionals and their patients may be necessary to gain... Read more

Few women follow healthy lifestyle advice before getting pregnant

BMJ | 09 March 2009 | Women's Health

Very few women follow the nutritional and lifestyle recommendations before they become pregnant, even when pregnancy is in some sense planned, a new study has found. Nutrition and lifestyle advice is widely available for women during pregnancy, but much less... Read more

Pregnant women with diabetes at greater risk of feeling depressed

JAMA | 06 March 2009 |

Low-income pregnant women and new mothers with diabetes have nearly twice the risk of experiencing depression during and after pregnancy than women without diabetes, according to a new study. The researchers examined the association between diabetes and depression in the... Read more

Outcomes a priority over aesthetics

BMJ Online | 06 March 2009 | Women's Health

Minimally invasive breast surgery may be trading better cosmetic outcomes for worse rates of cure, according to a senior American oncologist. Effectiveness and safety, as well as aesthetic outcomes, need to be considered when planning surgery for breast cancer, according... Read more

Calcium linked to lower risk of cancer in women

Archives of Internal Medicine | 03 March 2009 | Cancer

Women with higher calcium intakes appear to have a lower risk of cancer overall, and both men and women with high calcium intakes have lower risks of colorectal cancer and other cancers of the digestive system, according to a new... Read more

Clinical consequences of poor asthma control

Dr Ross Morgan | 03 March 2009 | Respiratory

Dr Ross Morgan writes that failure to adhere to a regular self-management plan can result in major clinical consequences for people with asthma. Asthma is the most common respiratory condition in Ireland and we have the fourth highest prevalence of... Read more

Does Ireland need a constitution for our health service

Dr Brendan Kelly | 03 March 2009 | Mental Health & CNS

Dr Brendan Kelly looks at the UK's new Constitution for the National Health Service and asks whether Ireland needs a similar document. On January 21, 2009, the Department of Health in Eng-land published a Constitution for the National Health Service... Read more

Frequent coffee drinking associated with lower stroke risk

Circulation | 03 March 2009 | Women's Health

Long-term coffee consumption is associated with lower stroke risk in women who do not smoke, according to a 24-year follow-up study. The study’s researchers also found that regular coffee drinking may be associated with a modest reduction in stroke risk... Read more

Sudden cardiac death remains rare in young athletes

Circulation | 02 March 2009 | Cardiovascular

The rate of sudden cardiac death in young athletes is higher than previous estimates, but the problem is still relatively rare, according to the results of a 27-year registry. These data add to the debate about whether countries should implement... Read more