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At the heart of general practice since 1960

GP gets set to grill Opposition leader

Hay fever ups asthma A&E visits

Patients with asthma who also have allergic rhinitis are at increased risk of asthma attacks and A&E visits, a new study suggests. Swedish researchers conducted a post hoc, resource-use analysis of the IMPACT study of 1,490 patients aged 15-72 with chronic asthma. Some 60 per cent reported concomitant allergic rhinitis.

During follow-up, 21.3 per cent of patients with allergic rhinitis and 17.1 per cent of those without the condition suffered an asthma attack. A&E treatment was needed by 3.6 per cent of patients with allergic rhinitis but only 1.7 per cent of those without.

Clinical and Experimental Allergy 2005;35:723-727

Hysterectomy safe long-term

Hysterectomy does not increase all-cause mortality in the medium- to long-term, a UK study concludes. The RCGP oral contraception study compared 3,705 women flagged at the NHS central registries for cancer and death who had a hysterectomy and 3,705 who were flagged but did not have the operation.

After an average of more than 20 years of follow-up, 308 women had died in the hysterectomy group and 315 among the controls. Among younger women, hysterectomy appeared to reduce the risk of mortality by 18 per cent, although this fell short of statistical significance.

BMJ 2005;330:1482-1485

Drug combination cuts AF risk

ACE inhibitors and angiotensin receptor blockers (ARBs) appear to reduce the risk of atrial fibrillation.

Canadian researchers conducted a meta-analysis of 11 randomised controlled trials on 56,308 patients. The trials examined the use of ACE inhibitors and ARBs in heart failure, hypertension, myocardial infarction or secondary prevention of atrial fibrillation.

Overall, ACE inhibitors reduced the risk of atrial fibrillation by 28 per cent and ARBs by

29 per cent. The drugs reduced the risk of atrial fibrillation by 44 per cent in patients with heart failure, although they did not significantly reduce risk in patients with hypertension.

Journal of the American College of Cardiology 2005;45:1832-1839

Acne may protect against CHD

Acne in adolescence appears to decrease the risk of dying from coronary heart disease.

UK researchers evaluated 11,232 male students who attended the University of Glasgow between 1948 and 1968.

Men with a history of acne were at a 33 per cent reduced risk of dying from coronary heart disease. Their risk of all-cause mortality also appeared to be lower than men without a history of acne, although their risk of prostate cancer seemed slightly higher.

American Journal of Epidemiology 2005;161:1094-1101

'UTIs trigger coronary syndrome'

Urinary tract infections may trigger acute coronary syndrome, US researchers conclude.

Their case-control study evaluated the incidence of UTIs in 100 consecutive patients with acute coronary syndrome and a contemporary control group undergoing elective coronary artery bypass graft surgery.

The rate of UTIs was three times as high in patients with acute coronary syndrome as in controls. The researchers concluded that infection might trigger an acute event by causing systemic inflammation.

American Heart Journal 2005;149:1062-1065

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