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BMJ. 2007 June 2; 334(7604): 1172.
PMCID: PMC1885338

Minerva

Women who chew betel quids are putting themselves at risk of heart disease. A population study in Taiwan found the prevalence of use was higher in men than women (31% v 2.4%), but there was no significant difference in the prevalence of heart disease between the sexes (American Journal of Clinical Nutrition 2007;85:1229-35). The daily rate of betel use was independently associated with prevalence of heart disease, consumption of 10 quids a day being associated with an odds ratio of 1.37 in women (95% CI 1.1 to 1.6, P=0.003).

Your kitchen worktop may be dirtier than your toilet seat, and your baby's high chair is probably dirtier than the floor it stands on, according to the Hygiene Council's (www.hygienecouncil.com) 2007 survey. In fact, the average kitchen surface has about 10 times more bacteria than the toilet seat. A rather disgusting list of statistics reveals that only 3% of British people think the home is a more likely source of infection than public places, and only a third of Brits wash their hands properly after sneezing, handling pets, before eating and handling food, and after using the toilet.

On the basis that magnesium has been suggested as a useful adjunct to postoperative analgesia, researchers randomised 200 adults who were undergoing ambulatory hernia repair or varicose vein surgery under general anaesthesia to receive an intravenous bolus of either magnesium sulphate or saline after anaesthesia was induced. The incidence of postoperative problems was similar in both groups, and magnesium had no impact on postoperative pain or consumption of painkillers (Anesthesia & Analgesia 2007;104:1374-9, doi: 10.1213/01.ane.0000263416.14948.dc).

A study of a large diabetes-free cohort of adults aged 40-60 reveals that the combined intake of fructose and glucose (but not sucrose, lactose, or maltose) in sweetened fruit and soft drinks predicts the risk of type 2 diabetes (Journal of Nutrition 2007;137:1447-54, http://jn.nutrition.org). During a 12 year follow-up, 177 new cases of diabetes were identified from the cohort of 4304 men and women, and the relative risk of developing diabetes in those with the highest combined intake of fructose and glucose, compared with those with the lowest intake, was 1.87 (95% CI 1.19 to 2.93, P=0.003).

The Race Equality Foundation has announced a work programme designed to improve the lives of black and minority ethnic users of health and housing services. The foundation is targeting frontline healthcare staff and managers in particular, holding seminars and workshops. It has developed topical Better Health briefing papers to address what needs to change. The papers set out key messages for staff written by experts on such topics as racism and health, mental health, racial harassment, and terminal illness. The papers can be accessed at www.raceequalityfoundation.org.uk

Alcohol based gels for hand rubbing improve compliance with hand hygiene and produce better skin condition than do liquid hand rubs, according to a prospective intervention study published online in Critical Care (2007;11:R52, doi: 10.1186/cc5906). Instant access, including its availability in healthcare workers' pockets, was the strongest predictor of use.

The ageing of the population and greater life expectancy mean that more elderly patients are undergoing oesophagectomy for cancer these days. But the effect of age alone on the outcome and survival of surgery is negligible. An Italian study reports that increased expertise and experience and better perioperative care explain the current better outcome in elderly patients. Both short and long term outcome measures in patients aged more than 70 were similar to those in younger patients. Age alone, say the authors, should not be a contradiction to surgery (Journal of Thoracic and Cardiovascular Surgery 2007;133:1186-92, doi: 10.1016/j.jtcvs.2006.12.040).

Four new susceptibility genes for breast cancer have been identified (Nature 2007, doi: 10.1038/nature05887). BRCA1and 2, the two genes already identified, account for less than 25% of the familial risk of breast cancer. Most susceptibility genes are involved in DNA repair, but the four newly identified seem to relate more to the control of cell growth or to cell signalling. One of them, FGFR2, is specifically associated with the risk of sporadic postmenopausal breast cancer (Nature Genetics 2007, doi: 10.1038/ng2075).

Being single in Japan comes with a health warning, but few studies have actually teased out the impact of being single, divorced, or widowed. A prospective study of nearly 100 000 Japanese adults aged 40-79 found that, compared with married men and after adjustment for relevant confounding factors, men who had never married had a higher risk of death from heart and lung diseases. Women who had never married had a smaller but still significant risk of death from all causes. Divorced and widowed men had a slightly higher risk of death than married men, but this wasn't seen among women (BMC Public Health 2007;7:73, doi: 10.1186/1471-2458-7-73).

As yet, there's no recognised prenatal treatment for intrauterine growth restriction (IUGR) although experiments in sheep offer promising leads. Scientists have found that fetal and amniotic supplements with insulin-like growth factor-1 improve the growth rate in fetal sheep with restricted growth, without changing fetal plasma concentrations of the growth factor or of insulin (Endocrinology 2007;148:2963-72, doi: 10.1210/en.2006-1701).

Do the sexes get treated differently in US managed care plans? Apparently so, according to a study of the management of cardiovascular disease and diabetes in Women's Health Issues (2007, www.jiwh.org/content.cfm?sectionID=170&detail=55). Data from 10 commercial and nine Medicare plans found significant sex differences—on five of 11 measures with Medicare, with four favouring men, and on eight of 11 measures with commercial plans, with six favouring men. The largest disparity was in control of low density lipoprotein cholesterol in people with diabetes, with women being 19% less likely to achieve control in the Medicare group and 16% less likely in the commercial group.

Rashes are reported quite often among patients taking antiepileptic drugs. A study in Neurology (2007;68:1701-9, www.neurology.org/cgi/content/full/68/20/1701) claims that the average rate of rash associated with antiepileptic drugs is 2.8%. The only non-drug predictor that was significant in a multivariate analysis was the occurrence of another rash associated with the drugs (odds ratio 3.1 (95% CI 1.8 to 5.1), P<0.0001). The rate in this group was 8.8%, compared with 1.7% in those without another such rash. Rash rates were highest in those taking phenytoin, lamotrigine, and carbamazepine.


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