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Clinical Times: February 2010

Update on vitamin D and calcium

Prof Moira O’Brien | 26 February 2010 | Musculoskeletal

Osteoporosis Supplement: Prof Moira O’Brien discusses the growing awareness of vitamin D as being essential to bone health and its necessity in the adequate absorpotion of calcium, as well as the most current research on calcium supplements... Read more

Evaluating treatment options

Prof Gerald H. Tomkin | 26 February 2010 | Musculoskeletal

Osteoporosis Supplement: Prof Gerald H. Tomkin looks at recent studies investigating the merits of different osteoporosis treatments and stresses the importance of compliance... Read more

It takes guts to build bones

26 February 2010 | Musculoskeletal

Osteoporosis Supplement: Researchers have found a potential new treatment for osteoporosis... Read more

Reducing vertebral fractures

Natalya Anderson | 26 February 2010 | Musculoskeletal

Natalya Anderson reviews a study which found that the risk of vertebral fracture in young postmenopausal women could be reduced with strontium ranelate treatment... Read more

Osteoporosis can strike at any age

26 February 2010 | Musculoskeletal

Osteoporosis Supplement: The Irish Osteoporosis Society, with the support of an unrestricted educational grant from A.Menarini Pharmaceuticals Ireland Ltd, has launched a new patient information leaflet on calcium and vitamin D3.... Read more

Dairy dangers — the milky way to osteoporosis?

Rory Hafford | 26 February 2010 | Musculoskeletal

Osteoporosis Supplement: Rory Hafford examines the findings of a number of studies into the rise of osteoporosis and looks at a new and controversial book on the condition... Read more

Minimising the risk of venous thromboembolism

Gary Culliton | 25 February 2010 | Musculoskeletal

Clinical Update: Hip and knee surgery - It is not practical to screen every hip and knee replacement patient post-operatively for the low risk of possible silent venous thrombosis, a leading orthopaedic surgeon has stated.... Read more

Aftercare regime key for patient recovery

Gary Culliton | 25 February 2010 | Musculoskeletal

Clinical Update: Hip and knee surgery - All going well, patients remain for a week in hospital after hip and knee replacements. However, some are administered warfarin for up to six weeks after they return home from hospital.... Read more

Need to distinguish between venous and arterial disorders

Gary Culliton | 25 February 2010 | Musculoskeletal

Clinical Update: Hip and knee surgery - As we have seen, patients who have undergone hip and knee replacement surgeries are at a significant and clear risk of clotting.... Read more

Improved outcomes for patients with oesophageal cancer

Prof John Reynolds | 24 February 2010 | Cancer

Prof John Reynolds, of St James's Hospital, Dublin and TCD, examines the causes of oesophageal cancer and the enormous advances which have taken place in the management of the disease in recent years... Read more

Defeatism undermines treatment of chronic fatigue syndrome

24 February 2010 | Infections & Immunology

An air of defeatism exists within the medical profession about chronic fatigue syndrome that is undermining evidence that it can be treated, according to leading doctors in the field. The recent acquittal in Britain of Kay Gilderdale, who had been... Read more

Chronic migraineurs sicker and poorer than episodic sufferers

24 February 2010 | Eye, Ear, Nose & Throat

Chronic migraine sufferers tend to be in poorer general health, less well off, and more depressed than those with episodic migraine, reveals research published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry. The findings are based on... Read more

Performing single ultrasound to detect DVT may be sufficient

24 February 2010 | Cardiovascular

An analysis of previous studies has suggested that for patients with a suspected deep vein thrombosis (DVT), withholding anticoagulation therapy after a negative whole-leg compression ultrasound is associated with a low risk of developing a DVT during the subsequent three... Read more

Age may affect efficacy of antiresorptive drugs

24 February 2010 | Women's Health

Patient age may affect the relative efficacy of oral bisphosphonates in postmenopausal women, research has suggested. A team from the VCU Medical Center in Richmond, Virginia, carried out a post-hoc analysis of postmenopausal women /=55 years old with low bone... Read more

Effective alternative for emergency contraception

24 February 2010 | Women's Health

The emergency contraceptive drug ulipristal acetate provides women and healthcare providers with an effective alternative that can be used up to five days after unprotected sexual intercourse, a study in The Lancet has stated. Emergency contraception can prevent unintended pregnancies,... Read more

Genetic mutations link with suicide in depression

24 February 2010 | Mental Health & CNS

Single mutations in genes involved with nerve cell formation and growth appear to be associated with the risk of attempting suicide among individuals with depression, according to a new report. Doctors led by colleagues at the Max Planck Institute of... Read more

Hypertension link to dementia in certain cognitive deficits

23 February 2010 | Cardiovascular

High blood pressure appears to predict the progression to dementia in older adults with impaired executive functions but not in those with memory dysfunction, according to a new report. In light of evidence that hypertension is a major risk factor... Read more

Proteinuria linked to increased mortality

23 February 2010 | Genito-urinary

Patients with high levels of proteinuria in addition to another marker of reduced kidney function had an associated increased risk of all-cause death, heart attack or progression to kidney failure, according to a new study. Doctors investigated the association between... Read more

Impact of PPI on antiplatelet activity of clopidogrel

23 February 2010 | Cardiovascular

Careful treatment planning is required when administering omeprazole, a proton pump inhibitor (PPI), to patients on clopidogrel, new research has recommended. PPI use with clopidogrel was recently shown to result in increased risk of major cardiovascular events compared to clopidogrel... Read more

Narcolepsy hugely underdiagnosed

Suzanne McCormack | 19 February 2010 | Mental Health & CNS

Sleep disorders were the focus of a recent symposium held as part of the Irish Thoracic Society's Annual Scientific Meeting, writes Suzanne McCormack... Read more

E-learning tool to help breakthrough cancer pain

18 February 2010 | Cancer

A new software package aims to provide medical professionals and patients with information on breakthrough cancer pain and how to treat it... Read more

Antidepressant may result in improved cognitive function

17 February 2010 | Mental Health & CNS

Patients who received the antidepressant escitalopram following a stroke appeared to recover more of their thinking, learning and memory skills than those taking placebo or participating in problem-solving therapy, according to a new report. In the study, doctors investigated the... Read more

Maternal hypertension linked to restricted growth in first trimester

17 February 2010 | Women's Health

Factors such as maternal high blood-pressure and high haematocrit levels are linked to a greater likelihood of restricted foetal growth during the first trimester, with restricted growth linked to an increased risk of preterm birth and low birth-weight, says a... Read more

Better adherence to statins needed for prevention of CVD

17 February 2010 | Cardiovascular

A 50 per cent improvement in people sticking to long-term treatment with statins would stave off twice as many deaths from stroke and heart attack as giving the drugs to a wider range of people, according to new research. The... Read more

New study links radiation exposure and circulatory disease

17 February 2010 | Cardiovascular

Exposure to moderate levels of radiation may increase the rates of heart disease and stroke, but the degree of risk at lower doses is unclear, according to a new study, which provides the strongest evidence available to date of an... Read more

Clear genetic targets emerge for understanding biploar

Gary Culliton | 12 February 2010 | Mental Health & CNS

Clinical Update - Bipolar Disorder: Bipolar is a complex condition that is not caused by one gene alone.... Read more

Bipolar disorder poses treatment challenges

Gary Culliton | 12 February 2010 | Mental Health & CNS

Clinical Update - Bipolar Disorder: Bipolar disorder remains a largely under-recognised illness despite an estimated 2 per cent of the population suffering from the condition.... Read more

New guidelines issued on treatment options

Gary Culliton | 12 February 2010 | Mental Health & CNS

Clinical Update - Bipolar Disorder: There are a number of approaches to the treatment of bipolar disorder. A conservative approach works for most patients, in the view of Prof Brian Leonard, Emeritus Professor of Pharmacology at NUI Galway.... Read more

The quest for better wisdom on depression

Dr Aine Tubridy | 11 February 2010 | Mental Health & CNS

When treating depression, Dr Aine Tubridy believes it is worthwhile considering the 'quest' perspective adopted by psychotherapists... Read more

Warnings about atypical antipsychotics have reduced their use among elderly

10 February 2010 | Mental Health & CNS

The use of atypical anti-psychotics to treat elderly patients appears to have decreased following a 2005 Food and Drug Administration (FDA) advisory regarding the risks of these medications in this population, according to a new report. Clozapine, the first second-generation... Read more

Specialised catheter treatment results in better outcomes

10 February 2010 | Cardiovascular

Use of catheter ablation – in which radiofrequency energy is emitted from a catheter to eliminate the source of an irregular heartbeat – results in significantly better outcomes in patients with paroxysmal atrial fibrillation who have not responded previously to... Read more

Women's heart risk rises with every ten-beat pulse increase

10 February 2010 | Cardiovascular

A woman’s chance of dying from a heart attack rises 18 per cent for every ten-beat-per-minute increase in her resting heart rate up to the age of 70 years, according to new research from Norway. The Norwegian doctors based their... Read more

Levodopa remains the staple for Parkinson's

Gary Culliton | 05 February 2010 | Mental Health & CNS

Clinical Update: Parkinson's Disease - In his latest Clinical Update, Gary Culliton reports on the various treatment options available for patients with Parkinson's disease, and examines the latest research targeting diseased neurons and the potential of stem-cell transplantation... Read more

Stem-cell therapy has potential role

Gary Culliton | 05 February 2010 | Mental Health & CNS

Clinical Update: Parkinson's Disease - There have been important new developments in stem-cell transplantation into Parkinson’s disease patients. A clinical trial, which was followed up recently, showed that the position in the brain into which the stem cells are transplanted... Read more

Research aims to halt disease progression

Gary Culliton | 05 February 2010 | Mental Health & CNS

Clinical Update: Parkinson's Disease - About 80 per cent of the neurotransmitter dopamine can be depleted from the affected region of the Parkinsonian brain before symptoms begin to develop. Thus, it is imperative that treatments be found to prevent further... Read more

The Endocrinology Clinic: the metabolic syndrome

Prof T Joseph McKenna and Prof Frances Hayes | 04 February 2010 | Cardiovascular

Concluding their series on ‘Notes from the Endocrinology Clinic’, Prof T Joseph McKenna and Prof Frances Hayes examine the global health threat from the metabolic syndrome... Read more

No labouring of point on use of epidurals

Brian Herron | 04 February 2010 | Women's Health

A leading UK authority says more women should experience the natural pains of labour without pain-relieving medication, writes Brian Herron... Read more

Morbidly obese would live longer with surgery

03 February 2010 | Nutrition

A computerised model has suggested that most morbidly obese individuals would likely live longer if they had gastric bypass surgery, according to a new study. Available evidence suggests that dietary, behavioural and pharmacologic treatments frequently do not result in meaningful... Read more

Fatty acid levels linked to telomere length in coronary patients

03 February 2010 | Cardiovascular

Patients with coronary heart disease who had higher omega-3 fatty acid blood levels had an associated lower rate of shortening of telomere length, a chromosome marker of biological ageing, according to a study. Several studies have shown increased survival rates... Read more

Prevalence of obesity may be slowing down

03 February 2010 | Nutrition

The prevalence of adults who are obese is still high, with about one-third of adults obese in 2007-2008, although new data suggest that the rate of increase for obesity in recent decades may be slowing, according to a new report... Read more

Elderly on psychotic drugs likely to stay on them in nursing homes

03 February 2010 | Mental Health & CNS

Older adults newly admit-ted to nursing homes with high rates of antipsychotic prescribing in the previous year are more likely to receive antipsychotic agents, according to a new report. Of these, some had no identified clinical indication for this therapy.... Read more

Weekend strokes more aggressively treated

03 February 2010 | Cardiovascular

Stroke patients admitted to the hospital on the weekend appear more likely to receive the clot-dissolving medication tissue plasminogen activator than patients admitted during the week, according to a new report from the United States. The researchers found that stroke... Read more