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GPs to face scrutiny on CHD care

ACE inhibitors aid cognitive function

ACE inhibitors may increase cognitive function in elderly patients with heart failure, a new study finds.

Italian researchers assessed the impact of ACE inhibitor therapy on cognition in 12,081 elderly people, including 1,220 with heart failure.

Cognitive performance increased in 30 per cent of 446 patients with heart failure who took an ACE inhibitor, compared with 22 per cent of controls.

The effect was dose dependent, but was not observed in patients without heart failure.

European Heart Journal 2005;26:226-233

H. pylori infection linked to COPD

Infection with Helicobacter pylori may increase the risk of developing COPD, a study suggests.

Greek researchers studied 126 patients with COPD, of average age 61 years, and an equal number of age-matched controls.

They used ELISA tests to evaluate rates of infection with H. pylori and with virulent cytotoxin-associated gene-A strains.

Some 77.8 per cent of COPD patients were infected with H. pylori compared with 54.7 per cent of controls.

Prevalence of cytotoxin-associated gene-A strains was 53.9 per cent in COPD patients and 29.3 per cent in controls.

Respiratory Medicine 2005;99:279-84

HIV therapy can lose efficacy

A substantial proportion of HIV patients receiving antiretroviral therapy risk treatment exhaustion, UK researchers conclude.

The multicentre cohort study followed up 16,593 HIV-positive patients between 1996 and 2002 and recorded their drug schedules and responses to treatment.

By 2002, 38 per cent of patients had been tried on all three main classes of antiretrovirals. In a quarter of patients there was evidence of treatment failure against all three types, with viral loads significantly higher than in the remaining patients.

BMJ 2005 early online publication

Diabetes raises liver cancer risk

Diabetes increases the risk of liver cancer, even when other risk factors are taken into account, according to a US study.

Researchers studied 2,061 patients with liver cancer and 6,183 non-cancer controls. Some

43 per cent of liver cancer patients had diabetes but only 19 per cent of controls.

Patients with diabetes were three times more likely than those without the condition to develop liver cancer, after adjustment for hepatitis infection, alcoholic liver disease and haemochromatosis.

Gut 2005;54 533-539

Endometrial cancer link to tibolone

Tibolone may increase the risk of endometrial cancer relative to other forms of HRT, researchers suggest.

UK researchers compared tibolone use in 162 women who developed endometrial cancer and two sets of 972 controls, matched by age and GP practice.

Users of tibolone were 54 per cent more likely to develop endometrial cancer than users of combined HRT in the age-matched comparison and 58 per cent more likely in the practice-matched comparison.

The risk estimates remained after sensitivity analysis.

Drug Safety 2005;28:241-249

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