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ACE inhibitors reduce renal deaths

ACE inhibitors significantly improve survival in patients with diabetic nephropathy but angiotensin II receptor blockers do not, according to an Australian study.

Researchers conducted a meta-analysis of 43 trials investigating the effects of the drugs in a total of 4,500 patients.

Both agents had similar effects on renal outcomes but ACE inhibitors reduced all-cause mortality by 21 per cent compared with placebo, while angiotensin II receptor blockers had no significant effect.

BMJ 2004;329:828

Tests predict sudden heart death

An index of three widely available non-invasive investigations can identify patients who are at a high risk of sudden death from heart failure, new UK research suggests.

The prospective study assessed 553 patients with mild to moderate heart failure for cardiothoracic ratio, presence of ventricular tachycardia and QRS dispersion by 12-lead ECG. Patients were followed up for 2,365 patient-years. A 10 per cent rise in cardiothoracic ratio, 10 per cent rise in QRS dispersion and presence of non-sustained ventricular tachycardia increased risk of sudden death by 43 per cent, 11 per cent and 10.3 per cent respectively.

Heart 2004;90:1137-43

H. pylori link to autoimmune disorder

Infection with Helicobacter pylori may play a role in the autoimmune condition idiopathic thrombocytopenic purpura, a study suggests.

Japanese researchers detected H. pylori in 39 of 53 patients with the condition and successfully eradicated the infection from 27 patients of them.

Eradication increased platelet count significantly in 10 patients and partially in another five, while none of those who failed to respond to eradication treatment recorded an increase in platelet count.

Archives of Internal Medicine 2004;164:1904-7

Eczema stigma harms quality of life

Perception of stigma has a strongly adverse effect on the quality of life of eczema patients, according to new research. The UK study used questionnaires to assess the impact of psychological and clinical factors on the quality of life of 125 patients with atopic dermatitis.

Perceiving stigma was related to the severity of disease and affected psychological well-being and quality of life. After controlling for disease severity, perceptions of stigma and depression together accounted for 45 per cent of the variance in quality of life.

Journal of Psychosomatic Research 2004;57:195-200

Bipolar syndrome highly heritable

Bipolar I disorder is highly heritable, according to a new twins study.

Finnish researchers studied 26 pairs of twins ­ seven monozygotic and 19 dizygotic ­ born between 1940 and 1957. Of these, 27 individuals had bipolar I disorder and another 22 cases of the condition were diagnosed over 20 years of follow-up.

The study estimated that heritability was 0.93, with a correlation in vulnerability of 0.85 for monozygotic twins and 0.41 for dizygotic twins.

American Journal of Psychiatry 2004:161:1814-21

Small changes turn flu virus deadly

Tiny genetic changes to the influenza virus could transform it into a strain as deadly as the one that killed millions in 1918.

US researchers engineered an unmodified strain of influenza A virus with genes for haemagglutinin and neuraminidase extracted from the infected lung tissue of patients who died in the 1918 epidemic.

The new strain of flu bound to human-type receptors and was able to rapidly kill mice by causing severe inflammation and haemorrhaging.

Nature 2004;431:703-7

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