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BMJ. 2007 August 25; 335(7616): 406.
PMCID: PMC1952522

Minerva

The accumulation of wealth and socioeconomic status in their family has more influence on the health of the child than social mobility or variability in socioeconomic status. In a prospective longitudinal study families with a lower cumulative family income were more likely to have a child developing a condition that required treatment by a doctor at age 10 or 11 years or that limited activities in childhood (Pediatrics 2007;120:e297-303 doi: 10.1542/peds.2006-3098). The findings were similar among teenagers in the 14-15 year old sample. Evening out disparities in wealth among families with young children could bring about better health.

The detection of disgust occurs in the basal ganglia and insula in the brain, and patients with pre-symptomatic or symptomatic Huntington's disease are less able to recognise disgust as an emotion. But this isn't the only emotion these patients find difficult to identify. Studies indicate that the identification of anger, fear, surprise, and sadness—but not happiness—is also limited (Brain 2007;130:1732-44 doi: 10.1093/brain/awm107). People with more pronounced motor problems find recognition of emotion more difficult, although this doesn't seem to be related to striatal volume.

A reader has alerted Minerva to the hidden dangers of a toxic mould called Stachybotrys chartarum, which can be found in flooded homes that have not been properly cleaned, or when builders take inadequate precautions to prevent the problem occurring. The mould has been blamed for causing alarming symptoms, particularly in babies, who may cough up blood. It may be important to consider this mould where a lack of insurance means that people are left to clear up their own properties after flooding.

SOX9, a protein found in melanocytes, is important in the regulation of pigmentation. Antibodies to SOX9 have been associated with vitiligo, and researchers may have now found out why (Proceedings of the National Academy of Sciences USA 2007 Aug 16 doi: 10.1073/pnas.0705117104). Ultraviolet B light up-regulates SOX9, leading to more production of melanin in cells. Similarly, agouti signal protein, a factor known to decrease pigmentation, acts by down-regulating expression of SOX9. Understanding SOX9 may lead to the development of treatments for pigmentation disorders, such as vitiligo.

The caffeine hit is experienced by most coffee drinkers, but it seems that caffeine may offer more than just a transient psychostimulant effect. Evidence from a sample of adults in the community aged at least 65 shows that caffeine intake seems to reduce cognitive decline in women who do not have dementia, especially in older women (Neurology 2007;69:536-45 doi: 10.1212/01.wnl.0000266670.35219.0c). No effect on the incidence of dementia was seen, but drinking more than three cups of coffee a day may yet prove useful for prolonging the period of mild cognitive impairment in women before a formal diagnosis of dementia.

Fifty one years ago a young woman died from cervical cancer. Eight months before her death two scientists kept a sample of her tissue biopsy to try to grow human cells continuously in a laboratory. They succeeded. The patient was Henrietta Lacks, and her cell line, known as HeLa, started a wave of research that looks at the relation between cancer and ageing. A review in Nature summarises the developments in the past 50 years and looks at more recent research that links cancer biology to normal ageing (2007;448:767-74 doi: 10.1038/nature05985).

It's common practice to inject mixtures of steroid and local anaesthetics into patients who have arthritis. The stability of mixing methylprednisolone and lidocaine has been established, but what about triamcinolone and hydrocortisone when mixed with lidocaine and bupivacaine? Analysis by high performance liquid chromatography shows that these agents are also stable in combination—and that continued use is safe (CME Orthopaedics 2007;4:87-9).

The new CONSORT website has been launched (www.consort-statement.org). CONSORT, which started in 1996, stands for Consolidated Standards of Reporting Trials, and was developed to alleviate problems that arise from inadequate reporting of randomised controlled trials. The statement is endorsed by more than 200 journals and editorial groups worldwide and has now been extended to cover specific data, interventions, and designs of trials.

Adding edible fish (Oreochromis niloticus) to ponds in western Kenya has proved rather successful at controlling mosquito populations. Larvivorous fish have been used for more than a century in mosquito control, and although this breed of tilapia is commonly farmed and eaten, it's not been previously tested as a tool against mosquitoes. After correcting for the natural tendency of mosquito density to increase in the control pond, the results showed that after 15 weeks there was a reduction of more than 94% in mosquitoes in ponds with the fish added than otherwise (BMC Public Health 2007;7:199 doi: 10.1186/1471-2458-7-199).

We'd all probably prefer to have our “own” obstetrician present when giving birth, but a comparison of obstetrical outcomes between on-call and patients' own obstetricians shows that our preference brings little advantage (CMAJ 2007;177:352-6 doi: 10.1503/cmaj.060920). Rates of caesarean section were higher in the on-call group, mainly in the first stage of labour, caused by worrying fetal heart tracings, but rates of episiotomy were lower. The rates of instrumental vaginal delivery were similar.


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