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At the heart of general practice since 1960

Labs are swamped as mumps soars 10-fold

Babies show SSRI withdrawal

Babies born to mothers who were taking selective serotonin reuptake inhibitors may occasionally suffer from neonatal withdrawal syndrome, according to a new study.

European researchers used the WHO database to screen for unexpected adverse drug reactions. They assessed cases of neonatal convulsions and neonatal withdrawal syndrome with drugs in the chemical groups N06AB and N06AX.

By November 2003, 93 suspected cases of SSRI-induced neonatal withdrawal syndrome had been reported. Of the cases, 64 were associated with paroxetine, 14 with fluoxetine, nine with sertraline and seven with citalopram.

Lancet 2005;365:482-87

Varicella vaccine cuts mortality

Universal vaccination of children with varicella can cut mortality rates from the disease by 66 per cent, according to a US study. Researchers reviewed national death records before and after introduction of the varicella vaccine in 1995.

Annual varicella deaths fell from 145 in 1990 to 66 in 2001. Age-adjusted mortality dropped from 0.41 to 0.14 deaths per million population.

The decline was seen in all age groups under 50 years of age and included a 92 per cent fall in deaths among children aged one to four.

New England Journal of Medicine 2005;352:450-58

DEXA screening cuts hip fractures

Screening older patients with DEXA scans can significantly reduce the risk of hip fracture, a US study suggests.

The non-concurrent cohort study compared 1,422 screened patients over the age of 65 with 1,685 who had 'usual care'. Researchers analysed 31 different characteristics such as medical history and incidence of hip fracture over six years of follow-up.

The incidence of hip fractures per 1,000 person-years was 4.8 in the screened group and 8.2 in the usual care group. Screened patients were 36 per cent less likely than unscreened patients to suffer a hip fracture.

Annals of Internal Medicine 2005;142:173-181

Dangers of stopping aspirin

Discontinuing aspirin therapy can lead to new coronary events in patients with coronary heart disease, a French study suggests.

Researchers questioned 1,236 patients who had been hospitalised for acute coronary syndrome about their aspirin use.

In 51 cases, acute coronary syndrome occurred within one month of aspirin withdrawal, representing 4.1 per cent of all coronary events and 13.1 per cent of recurrences. Incidence of ST-segment elevation acute coronary syndrome was 39 per cent in patients who had stopped aspirin but only 18 per cent in those who had continued aspirin treatment.

Journal of the American College of Cardiology 2005;45:456-459

Atrial flutter ups blood clot risk

Atrial flutter does increase the risk of thromboembolism, a new meta-analysis confirms. Canadian and Swiss researchers analysed 16 studies, including 13 that reported the risk of thromboembolism associated with attempted cardioversion of atrial flutter.

Sustained atrial flutter appeared to cause an annual rate of thromboembolism of around 3 per cent, according to four long-term studies. History of thromboembolism further increased risk.

American Journal of Medicine 2005;

118:101-107

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