A momentum seems to be building up in research (British
Journal of Nutrition 1997;78:1-3) into the effects of green and
black tea on cardiovascular risk factors (and on the bowels). Minerva
recalls reading dozens of papers on coffee made in various ways and
cholesterol and suspects that a similar flood of tea papers will emerge
in the next few years. No doubt we need to know the answers, but it may
prove a laborious process.
For some years epidemiologists have been expecting mortality
from breast cancer to decline in the United States because of advances
in screening and treatment. At last this has happened (American
Journal of Public Health 1997;87:775-81). Between 1989 and 1992
mortality fell by 1.6% a year - but only in white women. No change was
seen in deaths from breast cancer in black women.
A new diagnostic entity, complicated grief disorder, has been
suggested in the United States (American Journal of
Psychiatry 1997;154:904-10). The criteria include the
experience of intense intrusive thoughts more than a year after a
death, pangs of severe emotion, feeling excessively alone, excessively
avoiding tasks reminiscent of the deceased person, and maladaptive
levels of loss of interest in personal activities.
About 1,500 chimpanzees are living in colonies in research
laboratories in the United States, and the National Research Council
has now called for the government to take over responsibility for their
welfare and guarantee them a secure old age
(Science 1997;277:471). Scientists are agreed that
chimpanzees are not like other laboratory animals and deserve better
than euthanasia when their research usefulness is finished.
Greek women have lower rates of osteoporosis and fewer
fractures of the hip than women in northern Europe (Preventive
Medicine 1997;26:395-400). One factor may be their diet; recent
research in Athens found a positive correlation between bone mineral
density and the intake of olive oil.
French gastroenterologists have reported two patients who became
infected with hepatitis C virus during colonoscopy examinations
(New England Journal of Medicine 1997;337:237-40). The
patient-to-patient transmission was confirmed by sequencing the
nucleotides in the virus isolates. Several failures were identified in
the disinfection procedures, but the official guidelines are known
often to be ignored.
Minerva likes research projects that last for ages. The
Framingham study began in 1948 with 2,336 men and 2,873 women who have
been followed ever since and examined every two years. So far 215 men
and 166 women have developed intermittent claudication
(Circulation 1997;96:44-9). Among people over the age of
70 the most important risk factor was smoking, with hypertension and
raised cholesterol concentration coming up behind. Predictable? Yes,
but how often is it predicted?
Victorian scientists spread their curiosity over an amazing
range of species (Eye 1997;11:207-94). William Bowman,
who described the capsule around the glomerulus, did so on the basis of
his own study of horses, rabbits, parrots, badgers, lions, squirrels,
tortoises, frogs, and eels.
Neuroblastoma may be diagnosed before birth by ultrasound
examination: usually the discovery is made after 32 weeks' gestation.
The outlook is excellent. A review of 55 infants in
Cancer (1997;80:304-10) found that 47 had been treated
by surgery alone, and of the 50 for whom follow up data were available,
45 were alive up to 10 years later.
The amount of blood transfused during surgical operations has
gone down dramatically in the past 20 years as concern has grown about
the risks of blood borne infections. Even open heart operations can be
done without transfusion provided that full use is made of treatment
with erythropoietin and techniques of intraoperative cell salvage. A
series of 50 patients who were Jehovah's Witnesses having zero
transfusion heart operations in New York is reported in the
Journal of the American College of Surgeons
(1997;184:618-29). The outcome was as good as in controls; two patients
died, but neither of the deaths was thought to be associated with
anaemia.
Minerva has a lot of faith in German engineering, so she was
encouraged to read in German Research (1997;1:19-20) a
description of a virtual paraplegic patient that is being used to
develop a neuroprosthesis that will stimulate the denervated muscles
and so allow patients to stand up and sit down and perhaps eventually
to walk.
In a study of university students in the United States around
one quarter of men who realised that the condom they were using had
broken did not tell their woman sex partner that this has happened
(JAMA 1997;278:291-2). The reasons given included
unwillingness to interrupt intercourse because orgasm was approaching
and a desire to minimise the partner's anxiety - weasel words for
evidence that a minority of men only pretend to care about the hazards
of unprotected sex.
China is the biggest market for tobacco in the world. The
tobacco industry is likely to do all it can to encourage smoking, says
an editorial in Tobacco Control (1997;6:77-9). One
depressing statistic is that in China at present 57% of male doctors
smoke.
Surgeons at the Mayo Clinic, (Mayo Clinic
Proceedings 1997;72:551-8) have for years being using a gastric
bypass procedure to treat patients with morbid obesity. Now they hope
that they may be able to achieve equally good results with a minimally
invasive procedure of gastric banding. Minerva is somewhat sceptical,
but she will wait for the evidence to emerge.
Women who have been treated for breast cancer need not be
advised against becoming pregnant, according to a study in the
Lancet (1997;350;319-322). Of 5,725 Danish women
with breast cancer followed for up to 18 years, 173 became pregnant
with no increased risk of death.
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