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BMJ No 7123 Volume 315

Press Releases Saturday 20/27 December 1997


Embargoed: 00.01 hrs 19 December 1997 UK time

Warning: starring in a soap opera could seriously damage your health
It's official - men who have more sex live longer!
Patient's hallucinations that diagnosed her tumour
How drinking could help your heart this christmas
Doctors and nurses might know their onions, but do they know their chocolates?
Do overweight people remove their shoes before being weighed?
Experienced mums don't plan births for christmas!
Inaccurate guesstimates of distance could be costing us millions

Warning: starring in a soap opera could seriously damage your health

(Death rates of characters in soap operas on British television: is a government health warning required?)

The most dangerous job in the UK is not a bomb disposal expert, a steeplejack, a Formula One driver but in fact a role in a well known soap opera! In an analysis of deaths over twelve years in EastEnders, Coronation Street, Brookside and Emmerdale in this week's BMJ, Crayford et al found that 14 characters died in Coronation Street, 17 in EastEnders, compared to 29 in Brookside and 28 in Emmerdale.

The authors conclude that Brookside Close, Coronation Street, Albert Square and Emmerdale are highly dangerous places to live, where characters tend to die young and from variety of obscure and often violent causes. They recommend that in future characters in these soap operas would be advised to wear good protective clothing, designed to withstand sharp implements, sudden impacts and fire and to receive regular counselling for the psychological impact of living in an environment akin to a war zone.

See Paper p 1649

Contact:
Dr Tim Crayford, senior clinical fellow,
Department of Public Health and Epidemiology,
King's College,
London

tel: 0171 346 3559/3170
fax: 0171 737 3556
email: t.crayford@kcl.ac.uk

It's official - men who have more sex live longer!

(Sex and death: are they related? Findings from the Caerphilly cohort study)

A paper by Davey Smith et al in this week's BMJ, brings good news for sexually active men....... men who have frequent orgasms live longer! In their study of nearly 1,000 men in Caerphilly the authors found that the risk of death in men with high orgasmic frequency (twice a week or more) was half that of men with low orgasmic frequency (less than monthly). The authors conclude that sexual activity seems to have a protective effect on men's health, but an accompanying commentary says that the association could be the otherway around - people who are ill are less likely to have sex.

See Paper p 1641

Contact:
Professor George Davey Smith, Professor of clinical Epidemiology,
Department of Social Medicine,
University of Bristol

tel: 0117 928 7329/7201
fax: 0117 928 7325
email: zetkin@bristol.ac.uk

Patient's hallucinations that diagnosed her tumour

(Diagnosis made by hallucinatory voices)

In a paper in this week's BMJ, Azuonye recounts the case of a female patient who visited him complaining of voices in her head, claiming that they were trying to help her. Fearing she had gone mad, the patient, was pleased to be given counselling and medication. To her relief the voices disappeared and she went on holiday to celebrate. Whilst she was away, the voices returned - they told her she was to go back to England immediately as there was something wrong with her for which she should have immediate treatment.

The patient returned to Azuonye's clinic, distressed that the voices had told her that she had a tumour. After some negotiation, the patient underwent a brain scan (it was suggested to Azuonye that there was no good clinical reason to conduct a scan and that he had gone overboard believing what his patient's hallucinatory voices were telling her). The scan confirmed that the patient did indeed have a brain tumour, which was duly operated on successfully and the patient made a full, uneventful recovery. On regaining consciousness from the operation the patient heard the voices for the final time, when they told her, We are pleased to have helped you. Goodbye.

See Education and debate p 1685

Contact:
Ikechukwu Azuonye, consultant psychiatrist,
Adult Mental Health Unit,
Lambeth Healthcare NHS Trust,
London

tel: 0171 346 5401 x5680/5
fax: 0171 346 5426

How drinking could help your heart this christmas

(One for the heart)

In a review paper in this week's BMJ, Doll examines the health benefits of drinking moderate amounts of alcohol in later life. The author draws upon his experience as a newly qualified house physician in 1937, when alcohol was still occasionally prescribed therapeutically. Now it seems, say Doll, there is massive evidence to suggest that alcohol can play a large role in preventing disease.

Doll finds that after the age of 45 years, men who drink two or three units a day can reduce their risk of death from vascular disease by about a third. The optimum level of consumption by women is somewhat less, not only because of their smaller size but because of their lesser age specific risk of heart disease, greater susceptibility to liver damage and higher risk of breast cancer, which increases by about 10 per cent for each additional unit drunk on average per day.

Doll suggests that the health benefits of alcohol derive from its ethanol content. And the good news for Christmas tipplers is that the benefits aren't derived from one specific type of beverage: they are the same for beers, wines and spirits!

See Clinical review p 1664

Contact:
Sir Richard Doll, emeritus professor of medicine,
Clinical Trial Service
Unit and Epidemiological Studies Unit,
Radcliffe Infirmary,
Oxford

tel: 01865 558379/557241
fax: 01865 558817

Doctors and nurses might know their onions, but do they know their chocolates?

(Do you know your chocolates? Recognition survey among medical staff in various grades)

Gifts of chocolates are common on hospital wards, but are doctors and nurses able to recognise popular chocolates' In this week's BMJ, Cooke and Morse reveal that in a chocolate recognition test, post-registration house officers and nurses performed the best amongst their colleagues. Consultants, despite knowing which chocolates were yucky ones or yummy ones were the worst at chocolate recognition. The authors conclude that there seems to be a steep learning curve for chocolate recognition during the pre-registration house officer year, which may largely be due to exposure time. However, they find that as medical experience progresses, so chocolate recognition worsens. Cooke and Morse have a final warning: some managers are considering using the chocolate recognition test as a surrogate measure of time spent by consultants on the wards!

See Paper p 1655

Contact:
Dr Rhian Morse, consultant physician,
Department of Integrated Medicine,
University Hospital of Wales,
Heath Park,
Cardiff

tel: 01222 747747
fax: 01222 744707

Do overweight people remove their shoes before being weighed?

(Do overweight people remove their shoes before being weighed by a doctor? Consecutive study of patients in general practice)

In a study of 122 patients Harlow attempted to test the hypothesis that people who are overweight remove their shoes before being weighed by their doctor. In this week's BMJ, he reveals his findings that even though nearly 40 per cent of patients took their shoes off to be weighed, they were no more, or less overweight than patients who kept them on. Disappointed at the slaying of an interesting hypothesis, Harlow hopes to now study the suggestion that removal of car keys from a pocket before weighing, is a certain sign of obesity!

See Paper p 1663

Contact:
Dr Timothy Harlow, general medical practitioner,
The College Surgery,
Cullompton,
Devon

tel: 01884 32373
fax: 01884 841958

Experienced mums don't plan births for christmas!

(Births at Christmas are different: population based survey of 2 million deliveries)

In a study of two million births in Denmark, between 1960 and 1994, Melbye et al aimed to evaluate whether births at Christmas are different from births taking place at other times of the year. In this week's BMJ they reveal their findings, which suggest that older women were significantly less likely than younger women to give birth around Christmas. This resulted in a particularly high proportion of firstborn children around Christmas. Melbye et al ponder the question: could it be that older women, who are already mothers, carefully plan their births to take place at other times of the year?

See Paper p 1645

Contact:
Professor Mads Melbye, Head,
Department of Epidemiology Research,
Danish Epidemiology Science Centre,
Statens Serum Institut,
Copenhagen

tel: 00 45 3268 3163
fax: 00 45 3268 3165

Inaccurate guesstimates of distance could be costing us millions

(Reliability of distance estimation by doctors and patients: cross sectional study)

The assessment of a patient's walking ability is a simple and practical method of evaluating general health. The two most common methods for patient assessment are the maximum distance a patient can walk, or the distance they can walk until the onset of symptoms. Doctors have traditionally relied on their own or patients' estimates of distance, but how accurate are these guesstimates. Not very, say Sharrack and Hughes, in this week's BMJ. The authors found that in their survey of 100 consultants and 100 patients, estimates were up to 15 times greater or shorter than the measured distance (for example, 10 metres was estimated to be up to 150 metres or vice versa). The difference between minimum and maximum estimates was up to 63 fold.

The authors conclude that people are inaccurate at estimating distances and a medical education is no safeguard. They stress that any decisions about health, based on estimating distance, are unreliable. Moreover the economic implication of distance estimation is considerable.

Over 1.2 million people in the UK receive the higher rate component of the disability living allowance, including people who have difficultly in walking - a person is eligible for this allowance on the basis of a self assessment questionnaire.

See Paper p 1652

Contact:
Professor Richard Hughes, professor of neurology,
Department of Neurology,
United Medical and Dental Schools of Guy's and St Thomas's Hospital,
Guy's Hospital,
London

tel: 0171 955 4398/4897
fax: 0171 378 1221
email: r.hughes@umds.ac.uk


Embargo: 00.01 hrs Friday 19 December 1997

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