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Clinical Times: July 2009

A revolution in blood-pressure management?

30 July 2009 | Cardiovascular

Is the 'polypill' really a panacea for cardiovascular disease and should it be routinely prescribed to patients aged over 55 years? Erica Mills examines the issues and asks some experts for their opinions... Read more

High density lipoprotein – higher is better?

Dr Neville Wilson | 30 July 2009 | Cardiovascular

Dr Neville Wilson writes that a shift to a new treatment paradigm that embraces HDL cholesterol enhancement is necessary in the management of coronary heart disease... Read more

Croi MyAction – a new CVD

Dr Jim Crowley | 30 July 2009 | Cardiovascular

Dr Jim Crowley, Dr Susan Connolly, Irene Gibson and Neil Johnson outline the thinking behind Croi MyAction — a community-based preventive cardiology programme... Read more

Verbal instruction fails to increase physical activity

29 July 2009 | Cardiovascular

Repeated encouragement and verbal instruction do not motivate older stroke survivors to be physically active, and other more intensive strategies need to be found, a new study has concluded. According to background information cited in the study, counselling on physical... Read more

Active commuters have fewer heart risk factors

29 July 2009 | Cardiovascular

Men and women who walk or ride a bike to work appear more fit, and men are less likely to be overweight or obese and have healthier triglyceride levels, blood pressure and insulin levels, according to a new report. The... Read more

Biomarkers may help predict Alzheimer’s risk in elderly with cognitive impairment

29 July 2009 | Mental Health & CNS

Several cerebrospinal fluid biomarkers have shown good accuracy in identifying patients with mild cognitive impairment who progressed to Alzheimer’s disease in old age, according to a new study. Biochemical changes in the brain are reflected in the cerebrospinal fluid (CSF),... Read more

Diagnosis and treatment of anal fissures

Mr Javaid Butt | 24 July 2009 | Gastro-intestinal

Mr Javaid Butt describes the causes of anal fissure and looks at both the medical therapies and the surgical options that are available in the management of the condition... Read more

Elderly at higher risk of dementia if they lived alone in middle-age

BMJ Online | 20 July 2009 | Mental Health & CNS

A new study has found that elderly persons who lived alone in middle-age had twice the risk of developing dementia and Alzheimer’s disease compared with people who were married or cohabited in middle-age. The study also found that elderly persons... Read more

Amino acid may help with hair-pulling condition

Archives of General Psychiatry | 19 July 2009 | Mental Health & CNS

The amino acid N-acetyl-cysteine appears to reduce symptoms of compulsive hair-pulling in patients with a condition of trichotillomania. Study authors undertook their study of the basis of previous studies that found that N-acetylcysteine had shown promise in treating repetitive and... Read more

Surgery for sciatica does not give better outcomes

JAMA | 18 July 2009 | Musculoskeletal

A study comparing surgical treatments for sciatica has found that the minimally invasive procedure known as tubular diskectomy does not provide a significant difference in improvement of functional disability compared to the more common surgery, conventional microdiskectomy. In the multicentre... Read more

Balance training found to prevent ankle sprains

BMJ Online | 17 July 2009 | Musculoskeletal

A simple training programme, based on a series of balancing exercises, can cut the risk of recurrent ankle sprains by 35 per cent and could lead to huge savings in medical and lost productivity costs, a new study has concluded.... Read more

Migraine may cause changes in the brain

June Shannon | 17 July 2009 | Mental Health & CNS

New studies have shown that migraine — previously thought to have no long-term consequences — may cause pathological changes in the brain, reports June Shannon Women who suffer from migraine with aura in middle age are more likely to have... Read more

Rabies: a new awareness in Ireland

Dr Jack Lambert | 17 July 2009 | Infections & Immunology

Dr Jack Lambert writes on the dangers of rabies — which is no longer endemic in Europe. However, global travel patterns mean that the disease always poses a threat. Rabies is one of the oldest zoonotic diseases affecting humans. It... Read more

Depression linked with chest pain in elderly

Circulation | 11 July 2009 | Mental Health & CNS

Anxiety and depression are associated with more frequent angina in older patients with coronary artery disease, researchers have reported. Heart patients with at least moderate anxiety were more than four times likely to have chest pain, while patients with clinical... Read more

Type 1 diabetes in children

June Shannon | 10 July 2009 | Diabetes

June Shannon examines the reasons why growing numbers of children are developing type 1 diabetes and looks at the Irish situation, which is now being monitored through a national childhood diabetes register. A disturbing but incredibly important study in a... Read more

Spinal-fusion surgery agent linked to complications

JAMA | 10 July 2009 | Musculoskeletal

A new American study has found that bone-morphogenetic protein (BMP), which is used in 25 per cent of spinal fusion procedures there, is associated with a higher rate of complications than in fusions that did not use BMP. BMPs promote... Read more

Diet of fatty fish found to curb progress of age-related macular degeneration

Online First British Journal of Ophthalmology | 10 July 2009 | Nutrition

Two to three portions of fatty fish eaten weekly could help stave off progression of age-related macular degeneration (AMD), according to researchers. The researchers based their findings on almost 3,000 people, all of whom were taking part in a supplements... Read more

Biomarkers of little benefit in predicting cardiovascular events

JAMA | 10 July 2009 | Cardiovascular

Use of several older and newer biomarkers appears to offer minimal added benefit in the prediction of cardiovascular events, compared to conventional risk factors such as high cholesterol and high blood pressure, according to a new study. In the study,... Read more

Managing and treating dementing illnesses

Dr Farhan Haq and Dr Atif Ijaz | 06 July 2009 | Mental Health & CNS

Dr Farhan Haq and Dr Atif Ijaz examine the different types of dementia and take a look at the various options of pharmacological and non-pharmacological treatments that are available. Dementia refers to a group of illnesses characterised by progressive and,... Read more

Combination therapy does not improve Bell's outcome

Archives of Otolaryngology and Head and Neck Surgery | 03 July 2009 | Mental Health & CNS

Adding an antiviral agent to corticosteroids for the treatment of Bell’s palsy does not improve the recovery of facial movement function, according to a new meta-analysis of previously published studies. According to the researchers who performed the analysis, the current... Read more

Cognitive impairment reduces survival of the elderly across racial lines

Archives of Neurology | 03 July 2009 | Mental Health & CNS

Alzheimer’s disease and its precursor, mild cognitive impairment, appear to be associated with an increased risk of death among black and white elderly patients, according to a new report from the United States. In the study, doctors studied 1,715 older... Read more

Psoriasis linked to increased mortality and cardio-vascular disease in elderly

Archives of Dermatology | 03 July 2009 | Skin

Psoriasis is associated with atherosclerosis and an increased risk of death, according to a new report. Doctors analysed the computerised records of 3,236 patients with psoriasis and 2,500 individuals without psoriasis who were seen at the same hospital. Patients in... Read more

Monitoring bone density in older women is unnecessary and also potentially misleading

BMJ Online | 03 July 2009 | Musculoskeletal

Monitoring bone mineral density in postmenopausal women taking bisphosphonates is unnecessary and potentially misleading, a new study has concluded. According to the study’s authors, some guidelines recommend regular monitoring of bone mineral density in postmenopausal women, but it is costly... Read more