MinervaBMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b734 (Published 24 February 2009) Cite this as: BMJ 2009;338:b734
The podcast revolution seems to be hesitantly reaching the medical journal fraternity. Podcasting is the broadcast of audio and video files on the internet in a format that allows users to download and listen to them at their own convenience. A systematic review identified that of the “top 100” journals—ranked by impact factor— just eight (including the BMJ) offered a regular podcast. Standards are “acceptable”, but not high, and interviews make for more interesting listening than a single voice (JRSM 2009;102:69-74, doi:10.1258/jrsm.2008.080245).
Do children with asthma really miss more school than other children? Rates of absence in 19 inner city schools in Dallas over one year suggest not. The absence rate for all children in the district was 2.95%, and 2.85% in the study schools. For children identified as asthmatic by the school nurse the rate was 2.86%, and for those who were diagnosed as asthmatic by a positive exercise challenge, the rate was 2.54% (Chest 2009;135:303-6, doi:10.1378/chest.08-1642).
The old Chinese saying “one hundred steps after a meal make you live to be 99 years old” is borne out by the observation that 30 minutes of light exercise after eating seems to blunt the rise in blood sugar and insulin in people with impaired glucose intolerance (Open Nutrition Journal 2008;2:94-9, doi:10.2174/1874288200802010094). These people are most at risk of developing type 2 diabetes and of early death, and these results suggest that the onset of full blown diabetes may be postponed by adoption of such a strategy.
Researchers reviewed over 10<thin space>000 airborne medical and surgical emergencies that took place over five years on European aircraft. Only four of 32 airlines could provide the necessary data. Syncope was the most commonly reported medical condition, followed by gastrointestinal disorders. Thrombosis was the most common surgical issue, followed by appendicitis. In 86% of cases a medical professional was on hand, and the aircraft was diverted in just 2.8% of cases (Critical Care 2009;13:R3, doi:10.1186/cc7690).
“Punding” is defined in neurological literature as the prolonged and purposeless complex stereotypical motor behaviour seen in people who misuse amphetamines. A comparison of punding with some of the behaviour described in the novel Catch-22, by Joseph Heller, suggests similarities, although the novel was written 11 years before the term was officially described. Orr, for example, is “hung up” in a purposeless complex behaviour: taking apart a faucet, arranging the pieces, and putting it back together. Heller says Orr shows no sign of fatigue, loss of interest, or indication of stopping (Neurology 2009;72:574-5 doi:10.1212/01.wnl.0000342159.54977.82).
Therapeutic trials in Duchenne muscular dystrophy are difficult to interpret because the disease presentation varies so widely. Analysis from a meticulous, retrospective, long term follow-up of patients with the disorder identified four clusters, all with distinctive intellectual and motor outcomes. Patients in the early infantile cluster—with severe intellectual and motor outcomes—had the most severe heart and lung involvement. The researchers say that simple criteria can reliably predict which patients with Duchenne muscular dystrophy are likely to suffer similar outcomes, enabling better interpretation of future therapeutic trials (PLoS ONE 2009;4:e4347 doi:10.1371/journal.pone.0004347).
Here’s a chance for medical students who are budding writers to write a biography of 5000 words and win £200. The Society of Medical Writers offers the Roger Bacon biography award every two years, and the closing date for the next one is 1 December 2009. Entry is free, and the biography can be about anyone with medical connections—from family and friends to the famous. The winning entry will be published in The Writer. Contact Dr Dorothy Crowther, Corner Croft, Lonsties, Keswick, Cumbria CA12 4TD for entry forms.
In rats, early experiences affect stress responses in later life through long-term changes in gene expression, and now there’s evidence that something similar happens in people. Children who’ve been abused have altered stress responses and are at increased risk of suicide. Researchers found that, at post mortem, the brains of people who were abused in childhood and committed suicide had lower levels of mRNA for glucocorticoid receptors than did those of controls and of suicide victims with no history of abuse (Nature Neuroscience 2009; published online 22 February, doi:10.1038/nn.2270).
Another study that links early programming with long term changes comes from the Dutch Hunger Winter Families Study (International Journal of Epidemiology 2009;38:101-9, doi:10.1093/ije/dyn158). Fingerprints are permanently established in early pregnancy, and this study reports that diabetes diagnosed over the age of 50 is associated with a quantitative fingerprint marker established in early gestation, irrespective of birthweight. Fingerprints, suggest the authors, may be useful in researching early fetal metabolic programming.
The internet is a popular source of direct to consumer advertising. But the quality of information is variable. A review of hip resurfacing websites found a positive correlation between the overall score of a website (assessed by a tool designed to assess quality) and the score of each website in each assessment category—credibility, usability, “currentness” of information, content relevance, content accuracy/completeness, and disclosure/bias. Websites by implant companies, doctors, and hospitals scored badly. Websites with an independent credibility check, such as Health on the Net, scored twice the total scores of websites without (Scottish Medical Journal 2009;54:10-3, http://smj.org.uk).
Cite this as: BMJ 2009;338:b734