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BMJ No 7105 Volume 315 This week in brief Saturday 16 August 1997 CJD surveillance data show no new links with BSE Young people consumed more burgers than older people in 1980s and 1990s Low birth weight is linked to cardiovascular disease in women Fetal growth may affect cognitive performance in young adults Not all tissue excised by GPs needs laboratory testing CJD surveillance data show no new links with BSE The announcement in 1996 of cases of a new form of Creutzfeldt-Jakob disease in young patients in the United Kingdom and the possibility that they resulted from exposure to the causative agent of bovine spongiform encephalopathy received worldwide attention. Cousens et al (p 389) analysed data on Creutzfeldt-Jakob disease in the United Kingdom during 1970-96 to see if other changes had occurred that could be linked to bovine spongiform encephalopathy, but point out that many cases were in elderly people and thus might be due to better ascertainment and that dairy farmers throughout Europe have a high incidence. The cause of the variant form of Creutzfeldt-Jakob disease in young people remains unestablished, and the authors cite its future incidence and mouse transmission studies as important in judging whether the agent infecting cattle has infected humans. Young people consumed more burgers than older people in 1980s and 1990s In a commentary accompanying the paper by Cousens et al, Gore argues that age analysis of cases is important, and a paper by Gore et al analyses age trends in consumption of mechanically recovered meat - that most likely to have harboured the agent responsible for bovine spongiform encephalopathy (p 395). A dietary survey of British adults in 1986-7 showed an age gradient in the proportions of people eating burgers and kebabs (and the amount they ate), from 45% of those aged 18-24 to 13% of those aged 50-64. No differences occurred in the consumption of sausages and beef. They argue that such data may be relevant given the fact that new variant Creutzfeldt-Jakob disease occurs in young people. Low birth weight is linked to cardiovascular disease in women Birth weight is inversely associated with death and illness from cardiovascular disease in men. On p 396 Rich-Edwards et al document an inverse association between birth weight and risk of non-fatal coronary heart disease and stroke in over 70,000 American women in the nurses' health study. Adjustment for adult lifestyle and childhood socioeconomic group did not explain the increased risk among women with a low birth weight (2495g and under). The association was not entirely explained by the putative intermediate variables, hypertension and diabetes mellitus, also inversely associated with birth weight. Fetal growth may affect cognitive performance in young adults Nutritional deprivation in pregnancy may have an impact on the growth of the fetal brain, and low birth weight in humans has been linked to poorer cognitive function in early childhood. Little is known about the influence of fetal growth on cognitive performance in adults. On p 401 Sørensen et al relate the results of a test of cognitive function (the Boerge Prien test) in 4,300 Danish conscripts with information about their birth weight in the Danish birth registry. They found that the mean test score increased up to a birth weight of 4200 g and then decreased slightly. Not all tissue excised by GPs needs laboratory testing Many general practitioners who perform minor surgery use pathology services selectively. There have been repeated calls for this practice to be stopped because clinical diagnoses may be wrong and malignancies may be missed. Lowry et al (p 406) applied a "send everything" policy to a national sample of 257 practices and observed a large increase in laboratory workload but no increase in detection of serious lesions. This suggests that general practitioner surgeons successfully identify trivial lesions which can safely be discarded. Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline