MinervaBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7404.1466 (Published 26 June 2003) Cite this as: BMJ 2003;326:1466
It's hard getting people to take regular exercise, but here's one group of patients who seemed really to benefit. Twenty patients with stable—but quite severe—chronic obstructive pulmonary disease were put through their paces with an exercise training programme. Their aerobic capacity improved and they became more tolerant to stimuli that had usually caused them to become breathless. Both factors led to considerable relief of exertional dyspnoea and leg effort after exercising (Chest 2003;123: 1794-802).
The British are known for being crazy about football. Sometimes fans get so excited that it's been postulated they may precipitate an acute coronary or cerebral event. A five year retrospective study comparing mortality on days of football matches in northern England with football scores revealed that when the home team lost at home, deaths due to acute myocardial infarcts and strokes increased significantly in men (Journal of Epidemiology and Community Health 2003;57: 429-32). Perhaps women don't take these things so seriously because they didn't fare so badly.
“Do it yourself” screening tools for dementia have found a ready market in the United States. But the early alert Alzheimer's home screening test raises profound legal and ethical issues—not least the effect the test might have on a consumer public that, because of heightened apprehension about what happens to people with dementia, could be described as a group that is already “vulnerable, bordering on desperate” (Gerontologist 2003;43: 292-4).
The maleness-conferring Y chromosome has been genetically sequenced and the results published in the latest issue of Nature (2003;423: 825-37). This historic event is apparently an important evolutionary document because it records 300 million years of genetic change since the Y chromosome went its own way from the X chromosome. Most of the Y chromosome is made up of repetitive DNA segments, making its sequencing a “nearly heroic” achievement.
Sustaining the debate about whether allergy and asthma can be prevented by allergen avoidance in infancy, a randomised controlled trial found that strict avoidance of allergens in high risk children reduced allergic sensitisation to house dust mite (Thorax 2003;58: 489-93). Allergen avoidance measures included breast feeding with mothers on a low allergen diet, use of acaricides, and mattress covers. The authors are cautious but say this strategy may prevent some cases of childhood asthma.
A fifteen year follow up of over 90 000 radiology technicians in America (of whom 77% are women) found a modestly raised risk for breast cancer, melanoma, and thyroid cancer. The authors believe that the excess of breast cancer may be related to workers' exposure but that the observed excess of skin and thyroid cancers may be in part due to earlier detection because of easy access to health care (Cancer 2003;97: 3080-9).
Let's face it—our perception about what other people do doesn't always match up to what they say they do, and sex is no exception. A study of how well people can discern their sexual partners' risk behaviour in Sexually Transmitted Infections (2003;79: 197-201) found that among people with gonorrhoea or chlamydial infection, patients' perceptions of their partners' behaviours often disagreed with their partners' self reporting. Agreement was lowest over issues of quality of communication within the partnership and the number of other sexual partners.
Eating is another aspect of life where we're not always the best judge of behaviour. A randomised controlled trial of giving tailored feedback to influence awareness of dietary habits found that giving feedback about fat, fruit, and vegetables was the only strategy that had an immediate impact. Self reporting wasn't nearly as successful at improving eating habits (Preventive Medicine 2003,36: 429-39).
Everyone experiences and describes pain differently. Using functional magnetic resonance imaging and an established scoring system for rating the intensity of a painful heat stimulus, researchers have confirmed that there's a neural basis for these differences. The levels of brain activity in patients who reported similar pain scores were similar—and the higher the subjective scores, the more neural activity detected in the cerebral cortex (Proceedings of the National Academy of Sciences 2003, www.pnas.org/cgi/doi/10.1073/pnas.1430684100).
When Minerva lies in the sun (liberally smothered with sunscreen), she always feels better. It's as if the soothing rays offer a healing touch. Far-infrared rays on full thickness wounds in rats seem to be biologically healing. Irradiating the rats didn't alter skin blood flow or temperature, but did promote fibroblast infiltration of the area and collagen regeneration. Skin healing in the irradiated rats was much quicker, too (Experimental Biology and Medicine 2003;228: 724-9).
An attempt to measure the level of distress in people referred to infertility clinics found that the prevalence of emotional disorder was actually quite low. About a quarter of the women and 10% of the men who responded to the questionnaire had high anxiety scores, and depression was less evident. The results didn't change much over time. Women reported more concerns about life satisfaction, sexuality, and avoidance of friends than did men (Journal of Psychosomatic Research 2003;54: 353-5).
Guidance at bmj.com/advice