BMJ  2004;329:1412 (11 December), doi:10.1136/bmj.329.7479.1412

Minerva

Healthy newborns are traditionally given sponge baths in many parts of the world. A randomised controlled trial of tub bathing for newborns conducted in a Canadian hospital now suggests that tub bathed babies experience significantly less temperature loss, and were significantly more content (as judged by a tried and tested neonatal behavioural assessment tool), compared with sponge bathed babies. Mothers who used the tub also reported greater pleasure ( JOGNN 2004;33: 704-12[Medline]).

Teaching an old dog to learn a new trick apparently depends on the trick. A study in Neurology ( 2004;63: 1818-24)[Abstract/Free Full Text] compares how the brains of people with different brain lesions reorganise themselves. The authors used magnetoencephalography, a noninvasive imaging tool used to study cortical function, and their findings strongly suggest that different pathological changes of the brain result in different propensities for cortical reorganisation. They've yet to discover why, though.

A BMJ reader believes that the Atkins diet is a simple plagiarism of a pamphlet published in 1863 by a "corpulent London undertaker" called William Banting. In it Banting describes how he lost 46 pounds and 12 inches of girth by abstaining from most foods except meat. Apparently the word "Banting" is used to mean "dieting" in some circles.

A comprehensive assessment of the psychological and social wellbeing of a sample of 1285 gay men, lesbians, and bisexual men and women has found high levels of mental disorder—possibly, suggest the authors, linked with discrimination. Overall, 43% had mental disorder, and 31% had attempted suicide. The markers of discrimination included a recent physical attack and school bullying ( British Journal of Psychiatry 2004;185: 479-85[Abstract/Free Full Text]).

Two health publications are among the winners of this year's Plain English Campaign awards for clear communication (www.plainenglish.co.uk). Cancer, Any Age, Any Time is written in the style of a traditional and familiar car manual, leaving readers less likely to experience the dreaded feeling of being back at school. The other award went to two general practice leaflets that helped to portray the practices as being "approachable, helpful and accessible to all."

By removing a critical gene from Plasmodium, the parasite that causes malaria, scientists have found a way to weaken it. The gene is needed for the parasite to progress to the next stage of its life cycle and eventually to cause the disease. Mice injected with the weakened parasites developed immunity against normal infectious Plasmodium, leading the way to a potential new human vaccine ( Nature 2004; doi:10.1038/nature03188).

A new handbook for people caring for someone with cancer, written by carers, is now available free. It's called Hello & How Are You? and was launched by Macmillan Cancer Relief on International Carers' Rights Day (3 December). It holds lots of information about where to find support, how to get the best from your healthcare team, how being a carer can affect your relationship, how to cope with fluctuating moods and emotions, how to handle the side effects of treatment, and bereavement. Contact the Macmillan Cancerline on freephone 0800 808 2020 (Monday to Friday, 9 am to 6 pm) or email cancerline{at}macmillan.org.uk

A nurse has just won more than £400 000 in compensation after claiming that lifting patients had ruined her sex life. The total bill to the NHS, including legal costs, came to almost £1 million. The case was brought because she was forced to ignore the employer's policy on lifting because of lack of staff and equipment. At present, one nurse in four experiences back pain, and 100 000 are off sick with backache each year; 3000 eventually leave the NHS because of back problems ( Independent Healthcare Journal November 2004: 6).

The more alcohol we drink, and the earlier we start drinking heavily, the more likely we are to develop metabolic syndrome. A study presented at the American Heart Association's recent meeting in New Orleans found that drinkers in the highest intensity category have a 60% greater risk than those in the lowest category, independent of other risk factors. The syndrome is a cluster of cardiovascular disease risk factors including high blood pressure, raised triglycerides, low levels of high density lipoprotein, impaired fasting glucose, and excess abdominal fat.

An idea expounded in Medical Hypotheses ( 2004;63: 968-73)[CrossRef][ISI][Medline] is that psychotherapy is a form of assisted homoeostasis. The ability to sustain focused attention on emotionally important mental events and their somatic, cognitive, and biographical components may activate a homoeostatic process that resolves distress. The anterior cingulate cortex may be the part of the brain that effects psychotherapeutic relief of distress, an idea supported by functional neuroimaging studies.

A 56 year old man was admitted to the accident and emergency department with diabetic ketoacidosis. The top picture shows a sunken anterior chamber of the eye in this patient, who was severely dehydrated. The bottom picture shows the return to a normal glistening cornea and turgid anterior chamber within 30 minutes of resuscitation with two litres of intravenous fluids. Simon H Burnell, specialist registrar, anaesthetics/intensive treatment unit, Martin Smyth, specialist registrar, Vibhore Gupta (Vibhore_gupta{at}hotmail.com), specialist registrar, accident and emergency department, City Hospital, Birmingham, B18 7QH

UK residents who backpack in Latin America are bringing back more than souvenirs for their friends and loved ones. Cases of cutaneous leishmaniasis (CL) are also arriving in increasing numbers. Between 1995 and 2003, the number of cases seen at the Hospital for Tropical Diseases in London rose from four per year to 18 per year. The number of travellers to Latin America increased 3.5-fold. The infections were acquired in Bolivia, Colombia, and Belize ( QJM 2004;97: 781-8[Abstract/Free Full Text]).

The NHS comes in for a lot of stick at times, but it also has a lot of support. The NHS Support Federation is an independent organisation that works to promote a comprehensive NHS and to raise the involvement of NHS staff and the public (www.nhscampaign.org). As part of the Right to Care campaign, the organisation has launched a public consultation on people's experiences of long term care over the past three years (go to www.righttocare.org.uk).

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Rapid Responses:

Read all Rapid Responses

Dehydration: systemic or local?

Krishnappa C Madhusudhana, et al.
bmj.com, 18 Dec 2004 [Full text]

Depressed cornea: external pressure rather than dehydration.

Gerry T Fahy
bmj.com, 2 Jan 2005 [Full text]