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Osteopaths take a hit, a new study into arthritis and fish on anti-depressants could hold the key to autism

Osteopaths feature in some of this morning's papers following a clash in the BMJ over whether the risks of spinal manipulation are worth the benefits.

Neil O'Connell from Brunel University in London and colleagues say a manoeuvre in which the back or neck is clicked to relieve pain carries a small but significant risk of tearing the lining of the vertebral artery or causing a stroke.

A report in The Independent says the benefits are short term and do not provide lasting improvement.

The technique "may carry the potential for serious neurovascular complications" and is "unnecessary and inadvisable" the researchers say.

But David Cassidy, professor of epidemiology at the University of Toronto, Canada, and colleagues argue this would be tantamount to throwing the baby out with the bathwater.

They claim there is high quality evidence suggesting spinal manipulation can help patients with neck pain and it should be retained as a treatment option, along with other interventions such as exercise, the paper says.

The Daily Telegraph reports that thousands of rheumatoid arthritis patients could live longer if they were given anti-tumour necrosis factor drugs which cut the death rate in sufferers by almost 50%, according to a new study.

Patients taking rituximab had about a 40% lower chance of dying than those who had only taken disease modifying antirheumatic drugs, according to the study.

Researchers from the German Rheumatism Research Centre in Berlin studied the death rate amongst almost 9,000 sufferers of rheumatoid arthritis and presented their findings at the annual conference of the European League Against Rheumatism.

The scientists estimated that 21 in every one thousand people using the standard drugs would die over a 12-month period within the three-year study, compared with 11 using anti-TNFs and 13 taking rituximab.

On a slack day for health headlines, the Daily Mail has found a study in fish which suggests autism could be triggered by very low doses of anti-depressants or other chemicals found in the water supply.

The paper says experts from the University of Idaho in the US were "astonished" to find that just traces of common medication such as anti-depressants can bring on the disorder.

They made the discovery by observing the changes in the genetic pathways of fish swimming in water contaminated with psychoactive drugs.

The fish were exposed to two kinds of anti-depressants - Prozac and venlafaxine - and a drug used to control seizures, called carbamazepine the paper says. Concentrations were comparable with the highest estimated environmental levels.

They found patterns of gene activity in the fathead minnows that mimicked those seen in humans susceptible to autism.

The findings were published in the online journal Public Library of Science ONE.