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At the heart of general practice since 1960

Bitter dispute between GPs hits new low

Few side-effects from levonorgestrel

Adolescents experience only transient side-effects when using the emergency contraceptive levonorgestrel, according to a new US study.

Researchers studied 52 females aged 13-16, who each took one 0.75mg levonorgestrel tablet, followed by a second tablet 12 hours later. Only minor side-effects including nausea, fatigue and vomiting, were observed.

AJOG 2004;191:1158-1163

ECT effective in depression

Electroconvulsive therapy (ECT) improves the quality of life and functioning in people with severe depression, a new study has found.

US researchers treated 77 depressed adults with antidepressant medication for a month following ECT treatment and measured depression severity and cognition one to three days before, immediately after, and two and four weeks after ECT.

The study found that 66 per cent of participants responded positively to ECT, displaying statistically significant improvements in mood, cognition and quality of life.

British Journal of Psychiatry 2004;185:405-409

Optimism wards off heart death

Being optimistic can reduce a patient's chance of dying from heart disease, a US study has found.

During the study 941 65-to-85-year-olds completed a questionnaire on health, self-respect, morale, optimism and relationships and were graded on their levels of optimism.

Over the nine-year follow-up period participants reporting higher levels of optimism had a 55 per cent lower risk of death generally, and a 23 per cent lower risk of cardiovascular death.

Arch Gen Psychiatry 2004;61:1126-1135

INRs do not predict haemorrhage

International normalised ratios (INRs) are poor predictors of haemorrhagic events, new research finds.

The Harvard Medical School study examined the relationship between serial INRs and the onset of warfarin-associated bleeding complications in 2,391 patients on long-term anticoagulation therapy. Some 32 patients had warfarin-related haemorrhages.

INRs were higher in patients with haemorrhages than controls at the time of bleeding but only increased shortly before bleeding began.

Arch Intern Med 2004;164:2176-2179

Antibiotics no benefit in IHD

The use of macrolide antibiotics does not reduce recurrent cardiac events or mortality in patients with known ischaemic heart disease (IHD), a new report has found.

A US meta-analysis of nine studies involving 11,015 participants found no benefit from the use of macrolide antibiotics for C. pneumoniae in cutting heart attacks or deaths in IHD patients.

But researchers noted that different types or timing of antimicrobial agents could eventually prove beneficial.

Arch Intern Med 2004;164:2156-2161

Iron deficiency markers in infants

Low total or mean cell haemoglobin levels are specific markers of iron deficiency in early childhood, new research has found.

The University of Glasgow study treated 126 13-month-old children with at least one abnormal value for mean cell volume, haemoglobin, mean cell haemoglobin (MCH), ferritin or zinc protoporphyrin with oral iron and dietary modification and re-tested them three months later.

Children with low haemoglobin or MCH levels showed a large therapeutic response to iron, whereas the other markers were only predictive of iron deficiency when found in combination with other abnormal values.

Archives of Disease in Childhood 2004;89:1028-1031

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