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Gold, incentives and meh

Migrant women missing smears

Antioxidants increase GI Ca mortality

Antioxidant supplements do not prevent gastrointestinal cancers and could actually increase mortality, according to a Cochrane review of the evidence.

The meta-analysis looked at randomised trials on the effects of ?-carotene, vitamins A, C and E, and selenium on various types of cancer including oesophageal, gastric, and colorectal. ?-carotene and vitamin A in combination and ?-carotene and vitamin E together significantly increased mortality, by 29 per cent and 10 per cent.

Lancet 2004; 364: 1219-28

Exercise test beats Framingham tables

Combining an exercise test with the European SCORE system for assessing cardiovascular risk is better at predicting all-cause mortality than the traditional Framingham risk charts, research suggests.

A US study followed up 3,554 asymptomatic patients between 50 and 75 for eight years and recorded 114 deaths. A combination of the highest third of patients on the SCORE system with impaired functional capacity or abnormal heart rate recovery identified a moderate risk of 1 per cent over a year.

Death was predicted significantly by the SCORE system (RR 1.07), as was impaired functional capacity

(RR 2.95) and abnormal heart rate recovery (RR 1.59).

JAMA 2004;292:1462-1468

Depression link with chronic illness

The incidence of depression is particularly high among people with chronic diseases such as asthma and epilepsy, according to a new study.

Questionnaires sent to patients in New York showed 36.5 per cent of epilepsy patients and 27.8 per cent of asthma patients were depressed compared with only 11.8 per cent of controls.

In epilepsy, depression was significantly associated with being female, young and on low income as well as with adverse drug events and ability to work. The authors concluded doctors should look for reversible causes of depression in patients with chronic disease.

Neurology 2004; 63: 1008-14

South Asians take least exercise

South Asian populations in the UK are substantially less active than the general population. University of Edinburgh researchers analysed results from 12 studies in adults and five in children. Indian, Pakistani and Bangladeshi men were 14, 30 and 45 per cent less likely than the general UK population to meet guidelines for physical activity.

Researchers concluded that the lack of physical activity might contribute to increased risks of diabetes and coronary heart disease in these populations.

Journal of Public Health 2004; 26: 250-58

Fall in consultations cuts antibiotic use

Antibiotic prescribing for respiratory conditions has fallen in recent years largely because of a drop in consultations for the conditions.

UK researchers analysed the general practice research database and found that consultation rates for the common cold had declined by 50 per cent, laryngitis by 43 per cent and sore throat by 43 per cent.

The research also found GP prescribing for such conditions had declined ­ prescriptions for flu by 52 per cent, URTIs by 33 per cent and laryngitis by 30 per cent.

Journal of Public Health 2004;26:268-274

Blood test predicts risk of stroke

Blood testing could accurately predict the risk of death and stroke in patients with atrial fibrillation, a study finds.

Researchers from Birmingham conducted a pilot study in 77 atrial fibrillation patients and found that over six years of follow-up 10 per cent had strokes and 22 died.

They found high levels of plasma IL-6 independently predicted stroke or death, suggesting inflammation in atrial fibrillation may predict a poor prognosis.

American Heart Journal 2004;148:462-466

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