BMJ  2005;331:804 (8 October), doi:10.1136/bmj.331.7520.804

BMJ family highlights

What's new this month in BMJ Journals

Probiotic may treat eczema in infants

A probiotic supplement, Lactobacillus fermentum powder, reduces the severity and extent of atopic dermatitis in infants in the short term. In a double blind randomised controlled trial, an Australian team compared the probiotic with a placebo in 56 infants with moderate or severe atopic dermatitis. All but one had been breast fed and all but one had a family history of allergy. The children continued with their usual treatment, which for 88%, was the use of topical corticosteroids. After eight weeks' treatment, the probiotic group had less extensive dermatitis, and this improvement was still apparent two months later. Steroid use and parental perceptions were similar in the groups, but parents in the probiotic group reported significantly less respiratory illness. Longer term studies are needed.

Arch Dis Child 2005;90: 892-7[Abstract/Free Full Text]

Nervous Swedes die early

Three random samples of Swedes (35 000 in all), taken at intervals of about eight years, were asked if they had problems of nervousness, anxiety, or uneasiness. At five year follow-up, 1025 patients had died. Those who had answered the question in the affirmative had two to three times the risk of death from all causes, even after potential confounders were eliminated. Those who had reported severe problems did worse than those who had mild distress. Although psychiatric disorder and suicidal attempts were higher in the "anxious" group, so were ischaemic heart disease and other causes of death. Over the 15 years of the study, more people reported problems with anxiety; the authors say this is an alarm signal society should take seriously.

J Epidemiol Community Health 2005;59: 794-8[Abstract/Free Full Text]

Rock climbers are prone to Dupuytren's

Credit: PHOTOS.COM

Rock climbers have a high incidence of Dupuytren's disease, supporting the hypothesis that its contractures are caused by repetitive trauma to the palmar fascia. A survey of the Climbers' Club of Great Britain shows nearly a fifth of male climbers have developed the condition, which started in some as early as their 20s. Excluding those with a family history still left 16% affected, much higher than in a normal population of similar age. Those who have the disease climb more, and in a more extreme way, than those who do not. Handholds which put a strain on tendons, pulleys, and the soft tissues of the hands are the probable precipitants.

Br J Sports Med 2005;39: 639-44[Abstract/Free Full Text]

Bleach may cause asthma in cleaners

Credit: IMAGE SOURCE/REX

A community based survey of Spanish women employed in domestic cleaning shows that those with asthma or chronic bronchitis had had greater exposure to bleach than those with no respiratory symptoms. Controls were less likely to have accidentally inhaled vapours or gases while cleaning and less likely to regularly use degreasing sprays, atomisers, and solutions containing ammonia—but the greatest odds ratio for the risk of respiratory symptoms was for the use of materials containing bleach. The authors point out that, to their knowledge, this is the first study calling attention to occupational respiratory morbidity in domestic cleaners. They recommend further study of the possible public health impact of cleaning materials, as well as avoiding irritant cleaners such as bleach. Earlier, a European study showed that in several countries bleach is used at least once a week by more than half of homemakers.

Occup Environ Med 2005;62: 598-606[Abstract/Free Full Text]

Condoms prevent Chlamydia infection

Patients attending a sexually transmitted diseases clinic who had been exposed to a partner infected with Chlamydia trachomatis were tested for the presence of the organism. Those who had declared that they used a condom consistently had a 90% lower prevalence than those who reported inconsistent use or not using condoms. Previous studies reporting lower levels of protection had not restricted analyses to a similar high-risk population. The authors point out that their conclusion may not be generalisable to patients outside sexually transmitted disease clinics.

Sex Transm Infect 2005;81: 323-5[Abstract/Free Full Text]

Ambulance services may be failing children

A survey of the 32 NHS ambulance trusts has shown that effective paediatric immediate care is limited by lack of training and equipment as well as failure, in some cases, to adhere to nationally recommended guidelines. The recent trend to expand and standardise paramedics' practice with adults has not extended to children. The survey's authors provide a list of recommended materials and skills.

Emerg Med J 2005;22: 572-6[Abstract/Free Full Text]

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