BMJ  2003;327:125 (19 July), doi:10.1136/bmj.327.7407.125

BMJ family highlights

What's new this month in BMJ Journals

BMJ family highlights

Merely reducing smoking may not prevent myocardial infarction

A Danish pooled cohort study has followed more than 19 000 adults for a mean of nearly 14 years, with full information on smoking habits at five year intervals. During the course of the study, 2179 were diagnosed as having a myocardial infarction. As expected, heavy smokers (more than 15 a day) were at greater risk. However, contrary to previous assumptions, those who reported having reduced the amount of tobacco they smoked did not reduce their risk, whereas fewer myocardial infarctions than expected occurred among those who had quit. This is a new finding and implies that persuading people who are unable or unwilling to quit smoking that they should reduce their habit is not likely to be a useful strategy, at least as far as cardiovascular protection is concerned.

J Epidemiol Community Health 2003;57: 412-6[Abstract/Free Full Text]

Omeprazole does not increase the risk of dying

A major multicentre general practice study of more than 18 000 patients treated with omeprazole was linked with the central register of the NHS in Britain. Although all cause mortality was higher in the first year of treatment, this has proved to be due to pre-existing illness rather than to drug treatment. After the first year, death rates fell to expected population levels. Theoretical concerns that omeprazole might predispose to gastric cancer or hinder disease recognition have been discounted.

Gut 2003;52: 942-6[Abstract/Free Full Text]

Unexplained symptoms mostly stay that way

Ninety people attending a neurological clinic were assessed as having symptoms unexplained or only "somewhat" explained by organic disease. Of 66 followed up eight months later, over half failed to recover or felt worse. No diagnosable illness had come to light in the 58 who gave consent to access their general practice case notes. The authors say large scale trials are urgently needed to determine what factors predict poor outcome and what can be done to help these unfortunate individuals.

J Neurol Neurosurg Psychiatry 2003;74: 897-900[Abstract/Free Full Text]

Light exercise doesn't protect against heart disease

The whole population of middle aged men (or at least 90% of them) living in Caerphilly, Wales, has been followed up for 11 years. One variable measured was how much exercise they took, and outcome measures included deaths from coronary heart disease and cardiovascular disease generally. Heavy intensity exercise (such as swimming or jogging) reduced risk, with a significant dose-response relation. Light and moderate intensity exercise (walking, golf, dancing) showed no such protection.

Heart 2003;89: 502-6[Abstract/Free Full Text]

Young smokers deterred by virtual ageing

US students were photographed and the images subjected to virtual ageing by the age progression image launcher (APRIL), computer software designed to add about 30 years of wrinkling to an adolescent's face. Students are presented with two versions–one assuming abstinence from smoking and the other based on a 20 a day habit. The demonstration has provoked strong reactions (including stunned silence). Response to questionnaires before and afterwards suggested the images have a major beneficial influence on attitudes to smoking.

Tobacco Control 2003;12: 238[Free Full Text]

View larger version (32K): [in this window] [in a new window]   Forty two Iranian patients with Alzheimer's disease were randomised to^M take extr act of Melissa officinalis (lemon balm) or placebo. After four months^M the study group sh owed better cognitive function and less agitation. J Neurol Neurosurg Psychiatry 2003;74: 863-6[Abstract/Free Full Text]

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Rapid Responses:

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Not discounted yet!

Angus Henderson
bmj.com, 18 Jul 2003 [Full text]

The long-term safety of PPIs is not yet proven

Derek Gillen, et al.
bmj.com, 2 Aug 2003 [Full text]