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Drug firms urge link-ups with PCOs

Adding aspirin raises bleeding risk

Adding aspirin to clopidogrel for the secondary prevention of cardiovascular disease increases the risk of major bleeding without significantly reducing vascular events, a new study finds.

The Europe-wide MATCH trial compared aspirin with placebo alongside 75mg/day clopidogrel in patients who had recently suffered from a stroke or ischaemic attack and had at least one additional vascular risk factor. In the aspirin group, 15.7 per cent of patients suffered a vascular event, compared with 16.7 per cent with placebo, but the incidence of major bleeds doubled to 2.6 per cent.

Lancet 2004;364:331-37

Anaemia warning in GI cancer cases

GPs risk missing cases of gastrointestinal cancer because they do not adequately investigate iron deficiency anaemia, a new UK study finds.

Researchers in Nottingham studied 431 patients, 43 per cent of whom had investigations within three months. Nearly a third of patients had their diagnosis of cancer delayed by three months or more, and 40 per cent were still anaemic after this period.

The authors said GPs need to be aware of the potential significance of anaemia, but that many patients in general practice were unsuitable for invasive investigations.

Postgraduate Medical Journal 2004;80:405-10

Growth monitoring misses adrenal risk

Monitoring the growth of children who are taking steroids for asthma does not identify those at risk of serious adrenal suppression, according to a Northern Ireland study. Researchers studied 35 prepubertal children aged four to 10 who were treated with at least 1000µg/day of inhaled budesonide or equivalent potency glucocorticoid for at least six months.

Height standard deviation scores predicted a change of -0.5 in adrenal insufficiency with a specificity of 95 per cent, but a sensitivity of just 13 per cent.

Archives of Disease in Childhood 2004;89:713-6

Breast-feeding cuts BRCA1 cancers

The protective effect of breast-feeding extends to some hereditary forms of breast cancer but not others, a new study finds. US researchers conducted a case-control study of women with BRCA1 and BRCA2 mutations, surveying the past breast-feeding habits of 1,927 women with invasive breast cancer and 2,032 controls.

Breast-feeding for one year reduced the risk of breast cancer among women with BRCA1 mutations (odds ratio 0.55) but not those with mutations in BRCA2.

Journal of National Cancer Institute 2004;96:1094-98

High mortality in south Asian diabetics

South Asians with diabetes have a significantly worse mortality than other ethnic groups, according to a new study. Researchers conducted a prospective cohort study of 828 south Asians and 27,962 non-south Asian patients with insulin-treated diabetes.

For south Asians with young-onset disease, diagnosed before the age of 30, the standard mortality ratio was 3.9 in men and 10.1 in women compared with ratios of 2.7 and 4.0 respectively in non-south Asians. More than 70 per cent of south Asians with older-onset diabetes died of cardiovascular disease.

Diabetic Medicine 2004;21:845-51

'Silent' strokes mar cognitive function

A significant proportion of elderly people suffer from 'silent' strokes, which impair cognitive function but are never diagnosed, new research suggests.

The community-based study in Germany screened 267 men and women aged 65-83. Silent stroke was identified in 12.7 per cent of participants and was associated with significant mental impairment. The risk of silent stroke was linked to history of hypertenion, heart surgery and elevated c-reactive protein.

Journal of the American Geriatric Association 2004;52:1045-50

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