News News News
WATER BIRTH IS EFFECTIVE
Water births can reduce the need for augmentation (such as breaking the waters or giving oxytocin) and other forms of obstetric intervention in women with slow or difficult labour. Compared to women given standard augmentation, those who labored in water had a lower rate of epidural analgesia, and fewer required augmentation. The authors believe that water births can increase satisfaction, reduce pain, and optimize use of resources. (BMJ 2004;328.7435.0-a).
New research indicates that smoking has a much more serious effect on sexual health than previously thought, and is responsible for thousands of cases of impotence, cervical cancer, miscarriages, and infertility every year. The researchers calculate that around 120,000 British men are impotent because of smoking, and that smoking is implicated in over 1000 cases of malignant cancer of the cervix and between 3,000 and 5,000 miscarriages annually. They also say that women who smoke, reduce their chances of conception by up to 40% each month, and couples who smoke are less likely to respond to infertility treatment. In pregnancy, smoking can increase the risks of miscarriage, certain fetal malformations such as cleft lip and palate, and stillbirth and death of the newborn. It can also triple the chances of having a low birth weight baby and reduce the quality of breast milk. In infants and children passive smoking can cause sudden infant death syndrome, respiratory infections, and asthma. (BMJ 2004;328:364).
More recent research on smoking has shown that smokers are up to four times more likely to become blind in later life from age related macular degeneration (AMD) than non-smokers. AMD is the most common cause of adult blindness, which results in severe irreversible loss of central vision. Quitting smoking can slow the development of age related macular degeneration, whilst continued smoking can affect the long term response to treatments such as laser therapy. (BMJ 2004;328:537-538). Lung cancer in women rose 600% from 1930 to 1997, and is now the leading cause of cancer death in women in the USA, exceeding deaths from breast cancer and all gynecological cancers combined. By contrast, lung cancer deaths in men have been declining. (JAMA.2004;291:1763-1768). New research shows that smoking can trigger the onset of systemic lupus erythematosus (SLE), making it 1.5 times more likely that a person will develop the disease. SLE is primarily a genetic disorder, with a 5-12 % risk of developing the disease if there is a family history. Stopping smoking reduces the risk back to normal, and the study authors suggest that anyone with a known family history of SLE avoid smoking. (Arthritis & Rheumatism, vol. 50, issue 3: 849-857). New research has contradicted earlier studies that suggested one of the very few benefits of smoking was to delay cognitive decline. In a long-term European study that followed over 9,000 subjects, 65 or more years old, non-smokers registered a 0.03 point annual decline in cognitive functioning, compared to 0.13 among smokers. (Neurology 2004 62: 920-924).
OTITIS MEDIA IN CHILDREN
A recent Finnish study has shown no statistically significant difference between adenoidectomy, daily use of the antibiotic sulfafurazole (sulphisoxazole) or placebo in preventing recurring attacks of otitis media in 180 children aged 10 months to 2 years. (BMJ 2004;328:487).
ASTHMA & ASPIRIN
21% of asthmatic adults and 5% of asthmatic children are sensitive to aspirin, yet many are unaware that they are at risk of a potentially life threatening reaction. Most of these patients were also sensitive to over the counter non-steroidal anti-inflammatory drugs (NSAID’s) such as ibuprofen, naproxen, and diclofenac, but only 7% of them were sensitive to acetaminophen. (BMJ 2004;328:434).
The GlaxoSmithKline antidepressant paroxetine (marketed as Paxil in North America and Seroxat in the United Kingdom) has been banned for pediatric use in many countries because of evidence that it can increase the risk of suicide. Now it has been revealed that the giant drug company advised its staff in 1998 to withhold findings that the drug had no benefit in treating adolescents. The evidence appeared in two studies, one of which showed the drug to be no more effective than placebo in treating depression, whilst the second showed it to be less effective than placebo. (BMJ 2004;328:422). Meanwhile the prescribing of antidepressants to children continues apace, even though the evidence for their effectiveness and safety in children and adolescents is scant and widely debated, particularly for selective serotonin reuptake inhibitors (SSRIs). In a study of over half a million prescriptions written in Italy during 2002, it was found that 28,000 adolescents (mostly girls) were given antidepressants. Apart from sertaline for obsessive compulsive disorder, all the SSRIs prescribed are unlicensed for children. However even these prescribing rates pale in comparison with the USA where 1-2% of adolescents receive antidepressants.(BMJ 2004;328:711-712). Seroxat, which globally earns its makers GlaxoSmithKline £2 billion a year, is prescribed to 400,000 people in Britain, while SSRIs in total are taken by about 3 million Britons. Currently 4,000 Britons are bringing a class action against Seroxat’s manufacturers for addiction and side effects caused by the drug. Four out of five British GPs admit to over-prescribing SSRIs, but say that they have no choice, in view of the severe shortage of therapists and counseling. (Daily Mail, 19th April 2004).
DIABETES RISKS IN THE USA
New US government figures suggest that 41 million Americans (2 out of every 5 40-74 year olds) have blood sugar levels that will put them at risk of developing diabetes. This is twice the previous estimate and is based on a revised, more accurate definition of pre-diabetes made by an international expert committee of the American Diabetes Association. Currently there are 18 million diabetics in the USA, and 200,000 annual deaths from the disease. Responding to the new estimates, Human Services Secretary Tommy Thompson said “We need to help Americans take steps to prevent diabetes or we will risk being overwhelmed by the health and economic consequences of an ever-growing diabetes epidemic.” It is known that changing dietary and exercise habits to counter obesity can restore people with a pre-diabetic state (fasting blood sugar levels above 100mg of glucose per deciliter of blood) to normal. The American Diabetes Association recommends 30 minutes of daily exercise and avoidance of high-calorie, high density foods.
JUNK FOOD, SUGAR & OBESITY
For those to whom it would seem self-evident that excessive sugar intake is a contributory factor to obesity, the World Health organization’s proposal that added sugar should not exceed 10% of a healthy diet, was very welcome. Even 10% seems astonishingly high. The US government however, under intense lobbying from US junk food manufacturers, has rejected the idea of a link. A letter from William Steiger, special assistant at the Department of Health and Human Services, questions the scientific basis for the “linking of fruit and vegetable consumption to decreased risk of obesity and diabetes.” He adds ... “The assertion that heavy marketing of energy- dense foods or fast food outlets increases the risk of obesity is supported by almost no data.” The National Soft Drink Association, based in Washington, argue that 25% added sugar in the diet is not harmful, whilst US congressmen recruited by the food industry have urged the secretary of health, Tommy Thompson, to cut off the $406m annual US contribution to the WHO. (BMJ 2004;328:185).
OBESITY IN CHINA
More than 200 million Chinese are overweight, of whom 30 million are obese, according to Xinhua news agency. Among schoolchildren, 18% are classified as obese – double the figure recorded a decade ago.
BLOOD PRESSURE RISE IN THE YOUNG
Between 1988 and 2000, systolic blood pressure rose by a mean of 1.4mm Hg, and diastolic blood pressure by a mean of 3.3, in children and adolescents aged 8 to 17 years. The authors of the study say that the rises are at least partially attributable to an increased prevalence of overweight. (JAMA. 2004;291:2107-2113).
TUBERCULOSIS IN CHINA
Shanghai is to offer reduced price medicine for tuberculosis (TB) patients after warnings that China is not dealing effectively with the disease. TB is the second most prevalent infectious disease worldwide, after AIDS, and the World Health Organization cites China as losing ground in curing TB patients since the year 2000. There are 150,000 TB deaths a year in China, with drug-resistant TB becoming prevalent in some parts of the country. There is growing concern about the interwoven nature of TB and AIDS. The weakened immune systems of AIDS patients renders them more likely to contract TB and then pass it on to others.
SUCH GOOD NEWS ON CHOCOLATE
Pregnant women who ate chocolate daily, gave birth to babies that they rated at 6 months to be more active, more positively reactive (smiling and laughing), and less fearful of new situations. Women who rated themselves as more stressed during pregnancy, and who ate little chocolate, rated their children more negatively at 6 months. The Finnish researchers speculate that the effects they observed could result from chemicals in chocolate associated with positive mood being passed on to the baby in the womb. (Early Human Development vol 76, p 139).
INTIMATE RELATIONSHIP & THE HEART
In a one-year follow-up of 583 men and women, all aged about 60, who were hospitalized with heart attacks, it was found that whilst patients who reported depression before their heart attack were not more likely to die in the subsequent year, those who had a close personal confidant were around 50% less likely to die. A close confidant was defined as someone with whom all concerns could be shared, not just someone to talk to. Those without a close confidant were more likely to have had a previous history of heart attack, to have had more severe attacks with more complications, and to have been smokers, heavy drinkers or illegal drug users. (Heart 2004;90:518-522).
BETTER NEWS FOR ECHINACEA
After a batch of recent studies cast doubt on whether Echinacea was effective either for preventing or treating colds in children, a new Israeli study has found that a mixture of equal amounts of Echinacea and propolis, plus a small dose of vitamin C, does seem to have prophylactic effects. 430 children aged 1 to 5 years were randomized to receive either the mixture or a placebo. The group that took the echinacea had less than half the number of colds over a 12-week period than the placebo group. (Arch Pediatr Adolesc Med. 2004;158:217-221).