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Gold, incentives and meh

GPs' beliefs hamper CFS management

GPs' beliefs about chronic fatigue syndrome (CFS) are

putting up barriers to effective management, researchers suggest.

A study of 135 GPs found many did not refer patients with symptoms of CFS because they believed mental health interventions were either unnecessary or unavailable.

Researchers found GPs often held 'pejorative' views of CFS compared with their opinions of another chronic disorder – irritable bowel syndrome.

BMJ early online publication, May 28, 2004

Exercise programmes prevent bone loss

Exercise programmes with an emphasis on bone strength can significantly reduce bone loss and back pain in early postmenopausal women with osteopaenia, German researchers have found.

In a trial of 50 participants, the exercise arm took part in two group and two home training sessions per week.

A battery of tests found that fitness, strength, bone mineral density, back pain and serum cholesterol and triglycerides all improved over 26 months in response to exercise.

Archives of Internal Medicine 2004;164:1084-91

Heart risk lower with celecoxib in elderly

Older people's increased risk of congestive heart failure with the Cox-2 inhibitor celecoxib is smaller than with other NSAIDs, according to a major Canadian study. The study looked at the use of NSAIDs in more than 130,000 people over the age of 66.

In users of rofecoxib and non-selective NSAIDs,

hospital admissions for heart failure were significantly higher than controls, whereas users of celecoxib did not have an elevated risk.

Lancet 2004;363:1751-6

Fibre reduces cholesterol levels

A moderate increase in soluble fibre in the diet can significantly reduce both LDL-cholesterol and glucose levels in healthy people, a new study concludes.

The Spanish study randomised 53 participants to a control diet or a diet enriched by high-fibre content and followed them up after three months.

LDL-cholesterol fell by 12.8 per cent and fasting glucose by 12.3 per cent in the intervention group, according to study findings.

Diabetes Research and Clinical Practice 2004;65:7-11

Echinacea ineffective in URTIs

The herbal remedy echinacea purpua is ineffective for treating upper respiratory tract infections in children, according to a new US study.

The trial of 66 children aged two to 11 found that both duration and severity of infection were the same with echinacea as with placebo.

Reports of side-effects were more common in the children taking echinacea.

Evidence-Based Healthcare 2004;8:165-7

Further doubts on PSA as screening tool

Further doubts have been cast on the validity of the PSA test as a screening tool by a US trial of 18,882 older men.

The trial found that in men with no abnormal digital

rectal examination and a 'normal' PSA of less than 4.0ng/ml, 15.2 per cent had prostate cancer confirmed by biopsy seven years later.

Among those diagnosed, 14.9 per cent of cancers had a Gleason score of seven or more, indicating a high-grade tumour.

New England Journal of Medicine 2004;350:2239-224

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