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Use high-dose steroids in smokers with mild asthma

Raloxifene curbs breast cancer risk

Raloxifene can significantly decrease the risk of breast cancer, according to results of the Continuing Outcomes Relevant to Evista trial.

CORE involved 5,213 participants who were randomised to raloxifene 60mg/day or placebo.

Raloxifene reduced the four-year rate of overall breast cancer by 59 per cent and ER-positive breast cancer by 66 per cent. It had no effect on the risk of ER-negative breast cancer and doubled the risk of thromboembolism.

Journal of National Cancer Inst 2004; 96: 1751-1761

Maternal BP affects babies' mortality

Babies are at increased risk of being born small or dying around the time of birth if their mothers have either higher or lower than usual diastolic blood pressure.

Researchers at Imperial College London followed 210,814 pregnancies where first singleton babies were delivered between 24 and 43 weeks' gestation and weighed more than 200g. The mothers had no hypertension before 20 weeks' gestation. Maternal blood pressures that differed from the optimal level of 82.7mmHg were responsible for 11.4 per cent of infant mortality, researchers calculated, with low blood pressure responsible for the majority of these deaths.

BMJ Dec 2004; 329:1312-4

Regular red meat increases RA risk

Eating red meat regularly can increase the risk of rheumatoid arthritis, a study concludes.

University of Manchester researchers recruited 25,000 patients from GP lists between 1993 and 1997 and used food diaries to assess their diets. By 2002, 88 people had developed rheumatoid arthritis and their diets were compared with 176 healthy controls.

People who ate red meat daily were twice as likely to develop rheumatoid arthritis than those who ate it twice a week.

Arthritis and Rheumatism: early online publication

BP falls countered by drinking water

The fall in blood pressure caused by standing up can be countered by drinking water, UK researchers suggest.

They studied 14 patients whose bodies had trouble regulating blood pressure, seven of whom had pure autonomic failure and the rest multiple system atrophy.

Five minutes after drinking 480ml of tap or bottled water, patients with pure autonomic failure registered a significant increase in blood pressure, sufficient to counteract the effects of standing up. Patients with multiple system atrophy also registered an increase, but after 13 minutes.

Journal of Neurology, Neurosurgery and Psychiatry 2004;75:1737-1741

Epilepsy raises brain tumour risk

Patients with epilepsy are at significantly increased risk of developing brain tumours, dementias and psychiatric conditions.

The study used data from the UK general practice research database to compare estimated prevalence rates for selected conditions in epileptic adults and non-epileptics. Adults with epilepsy were twice as likely as non-epileptics to suffer psychiatric disorders and six times as likely to suffer dementias. Young adults with epilepsy were 70 times as likely as normal to develop brain tumours.

Epilepsia 2004 45:1613-22

Familial fracture independent of BMD

Parental history increases the risk of fractures in a manner that is independent of bone mineral density, according to a new study. Researchers studied 34,928 patients from seven cohorts, examining the effect of first-degree relatives, bone mineral density and age on all clinical fracture, osteoporotic fracture or hip fracture. Parental history of fracture increased the risk of any fracture by 17 per cent after controlling for bone mineral density.

Bone 2004;35:1029-1037

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