BMJ  2006;332:1102 (6 May), doi:10.1136/bmj.332.7549.1102

Minerva

Minerva

Minerva is happy to report that older women have good sex. A questionnaire study of more than 2000 women (mean age 55.9 years) found that at least 75% were sexually active and 60% reported having sex at least once a month. The research found that satisfaction with sexual activity was associated with African-American ethnic origin, lower body mass index, and good mental health, whereas sexual dysfunction correlated with a college degree, poor health, being in a "significant relationship," and a low mental health score (Obstetrics and Gynecology 2006;107: 755-64[Abstract/Free Full Text]).

Female doctors may find themselves treated with contempt by nurses when they become inpatients themselves. A GP whose uterus perforated because she was so determined not to express any pain while having a coil fitted went on to be virtually ignored when she was admitted for an emergency laparoscopy to fish the device out. Don't tell anyone you're a doctor, she writes, and take your own bedpan with you (Journal of Family Planning and Reproductive Health Care 2006;32: 131[CrossRef]).

Our love of omega-3 fatty acids may diminish after a recent meta-analysis that found a poor association with cardiovascular improvement. Their benefit for the nervous system has been reaffirmed, however (Nature 2006;440: 813-17[CrossRef][Medline]). Researchers found that omega-3 and omega-6 fatty acids stimulate neuronal membrane expansion by acting on a plasma membrane protein called syntaxin 3. This protein has an important role in the development of synaptic connections in the brain.

The scientific study of meditation is gathering momentum. Increasing numbers of neuroelectric and imaging studies indicate that, overall, brain activity slows subsequent to meditation, and the blood supply is reallocated to specific areas of the brain, particularly the anterior cingulate cortex and dorsolateral prefrontal areas. Researchers also found that the physiological states of the brain during meditation and sleep were closely linked (Psychological Bulletin 2006; 132: 180-211[CrossRef][ISI][Medline]).

Obesity may be all in the head. Rat models of obesity were used to confirm the hypothesis that obese animals have impaired lipid sensing mechanisms in the hypothalamus, which in normal animals would inhibit excessive food intake. This also provides an opportunity to normalise food intake, body weight gain, and glucose homoeostasis. The key is to inhibit an enzyme that would increase the levels of esterified fatty acids in the hypothalamus (Journal of Clinical Investigation 2006;116: 1081-91[CrossRef][ISI][Medline]).

The recent announcement of an experimental vaccine against human papillomavirus raised great hopes in the fight against sexually transmitted infections and cancers, but it also raises an ethical dilemma. Arguing her case in The Oncologist (2006;11: 393-6[Abstract/Free Full Text]), an ethicist says it's wrong to consider the vaccine as a panacea, because the complexity of immunisation includes matters of public knowledge, disparities in health care, and parental consent for vaccination.

Psychoanalysis of a cohort study of the psychological development of 76 people from birth to age 30, of whom 10 underwent severe maltreatment in childhood in the form of rejection or physical abuse at the hands of their parents, shows that these adults had significantly more anxiety and depression, less maturity in their handling of psychological problems, and insecure mental representations of attachment to their parents. Although many made relatively successful adaptations, this resilience came at the price of emotional vulnerability (International Journal of Psychoanalysis 2006; 87: 471-96).

In the aftermath of the withdrawal of rofecoxib (Vioxx) and subsequent halting of the adenoma prevention with celecoxib trial, researchers say the increased risk of acute myocardial infarction relates to the general mechanism of action of cyclo-oxygenase-2 inhibitors. These conclusions were drawn from a nested case-control study of more than 480 000 people who had at least one prescription for an anti-inflammatory between 2000 and 2004. The authors postulate that the increase in risk of heart attack may be dose dependent (Circulation 2006; 113: 1950-7[Abstract/Free Full Text]).

Fruit outperforms vegetables in protecting against bowel cancer. Using data from more than 34 000 women who had had colonoscopy or sigmoidoscopy, researchers found a significant inverse correlation between the frequent consumption of fruit and the risk of being diagnosed as having polyps. The association with consumption of vegetables proved non-significant (Cancer Research 2006;66: 3942-53[Abstract/Free Full Text]).

Research from California confirms that the incidence of violent assaults is higher near places where alcohol is sold. This is true even where poverty and disorganisation—two other characteristics associated with violence—are not high. Bars were particularly important, and the authors say that special efforts should be made to reduce the potential for violence in these establishments—although in stable, wealthy neighbourhoods bars had the opposite effect, perhaps because they attract drinkers who are less prone to violence (Addiction 2006;101: 666-77[CrossRef][ISI][Medline]).

A 47 year old man presented to the dermatology department because his hair and moustache, which had been brown with some grey, turned white suddenly over a period of 36 hours (left). The mechanism behind this unusual but fabled occurrence is alopecia areata, an autoimmune process which causes acute non-scarring hair loss, preferentially affecting pigmented hair, leaving grey and white behind. Our patient noticed clumps of pigmented hair loss just before the colour change. Six months later his hair had returned to its original colour (right). Jessie R Felton, specialist registrar (Jessie.felton{at}bsuh.nhs.uk), Meg L Price, consultant dermatologist department of dermatology, Brighton and Sussex University Hospitals Trust, Brighton BN2 3EW

There's now evidence that stem cells (or progenitor cells) exist within pancreatic tissue and, under appropriate conditions, can differentiate into insulin positive endocrine beta islet cells. The researchers (Nature Medicine 2006;12: 310-6[CrossRef][ISI][Medline]) had removed all traces of islet tissue from adult pancreatic tissue. Thus they believe that the appearance of insulin positive cells during the research can be explained only by the existence of endocrine stem or progenitor cells within the epithelial component of the adult pancreas.

Marketing for vitamins and food supplements generally implies that even healthy children benefit by taking them. But a German study reports that the intake of usual and fortified foods already meets or exceeds 80% of the recommended dietary allowances for most vitamins in all age groups. It's not possible, say the authors, to evaluate the true benefits or risks arising from unrestricted consumption of supplements (Journal of Nutrition 2006;136: 1329-33[Abstract/Free Full Text]).

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