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BMJ No 7123 Volume 315 This week in brief Saturday 20/27 December Christmas 1997 issue Sex may protect men against death (or dying may protect them against sex) Winter outbreaks of acute diarrhoea in France are not caused by shellfish consumption Soap opera characters have higher mortality than steeplejacks Neither doctors nor patients can assess distances Once over middle age some alcohol is good for you - and it doesn't matter what type Fat people are not more likely to take their shoes off before being weighed Sex may protect men against death (or dying may protect them against sex) Except in the context of sexually transmitted diseases, few studies have been done on sexual behaviour and mortality. On p 1641 Davey Smith et al describe the association in a cohort of 918 Welsh men who were examined first at the age of 45-59, had risk factors for coronary heart disease assessed, and provided information on the frequency of sexual intercourse. Over 10 years' follow up 150 men died, and mortality risk in the group with two orgasms a week or more was less than half that in those with less than one a month: adjusting for social class, smoking, blood pressure, and existing coronary disease attentued the associations only slightly. The authors concede that confounding could account for their findings, and in an accompanying commentary Hotopf and Wessely argue that their study is equally susceptible to confounding (age, activity, alcohol, depression) and reverse causality. Winter outbreaks of acute diarrhoea in France are not caused by shellfish consumption Each year since 1991 an epidemic of acute diarrhoea has occurred in France at the beginning of January. Suspect causes included the high rate of shellfish consumption, particularly raw oysters, in January and the consumption of contaminated tap water, as a consequence of floods during that period. From a population based matched case-control study conducted within a national network of doctors, Letrilliart et al found that winter diarrhoea was not caused by consumption of shellfish or tap water, but mainly by contact with an affected person, which is compatible with a viral origin (p 1645). In addition, penicillin and cephalosporin intakes were confirmed as risk factors for acute diarrhoea. Soap opera characters have higher mortality than steeplejacks Investigators from King's College London have quantified the size of the pinch of salt which people who watch soap operas should take before taking them to heart (p 1649). A cohort analysis of characters revealed that they are more likely to die than steeplejacks or Formula One racing drivers, making Coronation Street, Albert Square, Brookside Close, and Emmerdale some of the most dangerous places in the United Kingdom. Could all this hyperbole be contributing to our national neurosis about death and violence? Neither doctors nor patients can assess distances Assessing how far a patient can walk is a common part of clinical assessment in many conditions. On p 1652, however, Sharrack and Hughes show that both doctors and patients are hopeless at guessing distances. 100 consultants at one hospital and 100 patients assessed the distances of familiar sites in a hospital. The mean estimates for both groups correlated moderately with the measured distances (consultants r=0.73, patients 0.56), but estimates for the whole group differed by up to 14.6 fold from the measured distances and the difference between minimum and maximum estimates was up to 62.5 fold. Once over middle age some alcohol is good for you - and it doesn't matter what type The evidence is now overwhelming, argues Doll on p 1664, that small amounts of alcohol have a protective effect against vascular disease and death. His review looks at the evidence for a beneficial effect of alcohol in middle age and also considers the remaining unanswered questions. These include the level of consumption at which minimum mortality is attained, the variation in the balance of risk with age and sex, and the difference between the effects of different types of drink. He concludes that one to four drinks a day in people aged 45 and over is about the right level, and it doesn't matter whether they drink wine, beer, or spirits since the benefit is derived from ethanol. Fat people are not more likely to take their shoes off before being weighed Speculating that overweight people would be more likely to remove their shoes when being weighed, Harlow tested this on 122 consecutive patients (p 1663). He found, however, that both the 74 who kept their shoes on and the 48 who removed them had similar body mass indexes (27.8 (SD 6.0) and 28.8 (6.0) respectively), thus demolishing his hypothesis. Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline