BMJ  2006;333:52 (1 July), doi:10.1136/bmj.333.7557.52

Minerva

Minerva

"In a typical week, how many days do you get drunk?" This single question identifies college students who have a higher than normal risk of injury as a result of their own and others' drinking. Researchers report that 54% of students got drunk at least once a week, and that this group had higher odds of being hurt or injured at least once during the past year than those who didn't get drunk that frequently. They were also more likely to cause injury to others—severe burns, falls, and motor vehicle crashes. Questions about binge drinking were not as useful at identifying students at high risk (Academic Emergency Medicine 2006;13: 629-36[CrossRef][ISI][Medline]).

A bust of the late EM Jellinek and C$5000 are up for grabs for the winner of the 2007 Jellinek Memorial Award. Research into the effects of alcohol, specifically "epidemiology and population studies," should be forwarded by 30 November 2006 to www.jellinekaward.org, where you can also discover more about the great man himself and his pioneering work on the science and treatment of alcoholism.

The offspring of depressed parents followed up for an average of 20 years had a three times greater risk for anxiety, depression, and substance dependence than the offspring of non-depressed parents (American Journal of Psychiatry 2006;163: 1001-8[Abstract/Free Full Text]). The most vulnerable time for developing a depressive disorder was between the ages of 15 and 20, especially for women. The offspring of depressed parents also started to show higher rates of medical problems and mortality around the age of 35.

The death of children in sub-Saharan Africa has been waning since 1950, but not as quickly as hoped, with an average decline of just 1.8% (Bulletin of the World Health Organization 2006;84: 470-8[CrossRef][ISI][Medline]). Improvements in health have occurred smoothly in many countries, but some are in chaos owing to political and economic crises, in addition to coping with emerging diseases such as AIDS. Eight countries had periods of major increases in child mortality, and in seven countries mortality stopped declining for several years.

There's now another 12 step programme in the US to add to the list—Workaholics Anonymous. It has self help branches in 35 cities, and data show that employees are working three hours a week more than their parents did—equivalent to nearly four extra weeks a year (Times, times2, 21 June 2006, page 3).

A new use for cardiac glycosides may have been discovered. Scientists used a cardiac glycoside on rat and mouse brain slices, and found that it protected the tissue from the worst effects of ischaemia—which occurs when the blood supply is cut off during strokes (Proc National Acad Sci www.pnas.org/cgi/reprint/0600930103v1). The drug neriifolin protected brain tissue against ischaemic damage for six hours or more after the onset of stroke-like effects; currently, to be effective, clot busting drugs must be given within three hours of stroke.

Forensic tools developed as a result of the terrorist attacks on 11 September 2001 will be used to help reunite Jewish families separated by the holocaust. The DNA Shoah project has compiled a database of the DNA of holocaust survivors. It aims to match the sequences to ones extracted from human remains dating from the holocaust era that have surfaced in Poland, Germany, and elsewhere in Europe. Another aim is to try to reunite with their families orphans who were sent to Israel, the US, and the UK between 1945 and 1950 (Nature 2006;441: 673[CrossRef][Medline]).

Is one shock as effective at resuscitation as three? In a study of 44 domestic pigs with induced ventricular fibrillation, giving one shock rather than three increased survival and minimised differences in outcome caused by variations in the design of automated external defibrillators. With a three shock protocol, the choice of defibrillator had a statistically significant impact on the outcome of resuscitation attempts (Circulation 2006;113: 2683-9[Abstract/Free Full Text]).

Here's a study Minerva would like to have participated in—an investigation into what makes us stop eating chocolate (American Journal of Clinical Nutrition 2006;83: 1297-305[Abstract/Free Full Text]). Twenty four men and women fasted overnight and were then given two functional magnetic resonance imaging scans while tasting chocolate milk, first before eating bitter chocolate until they had had enough, and again afterwards. The two sexes differed in their cerebral responses to satiation, suggesting that the brain's regulation of food intake varies in men and women.

Green and black tea may help prevent prostate cancer. In a study in the Journal of Nutrition (2006;136: 1839-43[Abstract/Free Full Text]), 20 men scheduled for radical prostatectomy were randomly assigned to drink 1.42 litres a day of green tea, black tea, or a caffeine matched soda control for five days. Researchers found higher concentrations of tea polyphenols in prostate samples from men who had drunk tea rather than soda. These results show that tea polyphenols and theaflavins, which are potent anti-cancer agents, are bioavailable in the human prostate.

A 32 year old woman presented to the emergency department with a painful, cold, pale hand 36 hours after having her arm tattooed. On examination, her hand was cold and oedematous, with paraesthesia and a capillary refill of four seconds. Her radial pulse was not palpable but was detected on Doppler ultrasound examination. The tattoo almost circumscribed her proximal forearm. The tattoo pigment had a constrictive effect and was acting as a tourniquet. The symptoms resolved after keeping her arm raised overnight. Deep tattooing may have similar effects to full thickness burns, and escharotomy may be needed if the tattoo circumscribes a compromised limb. T W Briant-Evans (tbriantevans{at}hotmail.com), senior house officer, L Verjee, senior house officer,B Jemec, consultant in plastic and reconstructive surgery, Chelsea and Westminster Hospital, London SW10 9NH

A large national US survey reported that, compared with never attending a religious service, attending a service at least once a week is significantly associated with a lower prevalence of hypertension and reduced blood pressure (Psychosomatic Medicine 2006; 68: 382-5[Abstract/Free Full Text]). No age or sex modifications were seen.

More doctors are desperately needed, so is training more doctors the best option (Journal of the Royal Society of Medicine 2006;99: 281-7[Free Full Text])? One obvious limitation to this approach is the time it takes between taking on more medical students and producing fully trained doctors. Also, simply training more doctors doesn't necessarily result in their efficient or equitable distribution, geographically or by expertise.

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'wait & watch' policy lacks evidence

Saurabh Rai, et al.
bmj.com, 7 Jul 2006 [Full text]