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BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7545.842 (Published 06 April 2006) Cite this as: BMJ 2006;332:842
  1. Alison Tonks, associate editor (atonks@bmj.com)

    Vitamins do not stop pre-eclampsia

    Academics from the United States have urged researchers to get back to basics in their search for a preventive treatment for pre-eclampsia, arguing in an editorial that limited research funds should be diverted away from expensive clinical trials until we know more about just what causes pre-eclampsia and how.

    Credit: LANCET

    Large trials of various treatments have so far failed to deliver—including trials of aspirin, calcium supplements, and the antioxidant vitamins C and E.

    In the latest trial, antioxidant vitamins did not prevent pre-eclampsia in women at high risk and may even have made it worse. Pre-eclampsia happened earlier in women who took the vitamins, and their babies weighed less at birth than women who took a placebo. Worse, the supplements were associated with significantly more unexplained fetal deaths after 24 weeks (19/1393 (1%) v 7/1391 (0.5%); risk ratio 2.7, 95% CI 1.0 to 7.1).

    Credit: LANCET

    Without a better understanding of the complex pathophysiology of pre-eclampsia, trials of preventive treatments are little more than a stab in the dark, says the editorial, even if they are driven by plausible theories and hopeful hints from small preliminary studies. But trials of antioxidant vitamins are already well underway. Their investigators have been warned.

    Being a mosaic protects women

    Men are generally more vulnerable to disease and death than women. Sex chromosomes are behind at least some of the difference, says one geneticist, who argues that women are protected from many diseases by their genetic mosaicism. Women have two X chromosomes, one from each parent. Men have only one, and it always comes from their mother. Although each of a woman's cells has only one working X chromosome (because one is disabled), can be from either parent, creating cellular diversity that protects women from disease. Ultimately, when women inherit a defective X linked gene, they have a …

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