MinervaBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2695 (Published 06 July 2009) Cite this as: BMJ 2009;339:b2695
Living near roads with heavy traffic is not good for your health. Apart from the obvious concerns about accidents and respiratory problems, living in such polluted places is also associated with an increased risk of deep vein thrombosis. Logistic regression modelling revealed that the increased risk of a deep vein thrombosis with proximity to a busy road is approximately linear over the observed distance range (from 718 to 0 metres), and was not modified after adjusting for background levels of particulate matter. Distance from roads was used as a proxy for exposure to traffic (Circulation 2009;119:3118-24, doi:10.1161/circulationaha.108.836163).
Intensive smoking cessation programmes started while patients with coronary heart disease are still in hospital can achieve high abstinence rates. The 12 month self reported rate of abstinence was 62% in the intensive group, compared with 46% in those who received a minimal smoking cessation intervention; rates of confirmed abstinence were 54% and 35%. Interestingly, those who were admitted for a coronary artery bypass graft were more likely to abstain than those who’d been admitted after an acute myocardial infarction, even if they received the same intensive smoking cessation intervention (CMAJ 2009;180:1297-303, doi:10.1503/cmaj.080862).
A comparison of the vitamin status of patients who have undergone bariatric surgery for obesity shows that those who undergo the “duodenal switch” operation have lower concentrations of vitamin A and 25-hydroxyvitamin D and a steeper decline in thiamine concentration than those who have “gastric bypass” surgery. Duodenal switch patients also had lower mean haemoglobin levels, lower total cholesterol levels, and a lower body mass index one year after surgery than those who had a gastric bypass (American Journal of Clinical Nutrition 2009;90:15-22, doi:10.3945/ajcn.2009.27583).
After a stem cell transplant, the ability of the immune system to recover depends on the patient’s thymic function and is affected by graft versus host disease (GVHD). A cohort study of 93 patients who underwent stem cell transplantation from a sibling, mostly for malignant conditions, showed that acute GVHD was associated with lower absolute T cell counts and that both age and acute GVHD affected thymic function independently. Patients aged under 25 had recovered their thymic function almost completely at one year (Blood 2009;113:6477-84, doi:10.1182/blood-2008-09-176594).
Does it matter what time anti-hypertensive drugs are taken? Blood pressure during sleep predicts cardiovascular and cerebrovascular ischaemic events better than blood pressure when awake, which predicts haemorrhagic strokes. Current evidence suggests that if anti-hypertensives are taken at night they achieve better control throughout the 24 hours than if they’re taken in the morning, and that angiotensin converting enzyme inhibition is increased during sleeping hours. Successful titration to give full effect throughout 24 hours relies on night-time administration and morning blood pressure recording (Hypertension 2009;54:23-4, doi:10.1161/hypertensionaha.109.131912).
Nut consumption is associated with a reduced risk of heart disease in women with type 2 diabetes. A study in the Journal of Nutrition reports that after adjusting for conventional cardiovascular risk factors, consumption of at least five servings a week of nuts or peanut butter was significantly associated with a lower risk of cardiovascular disease (2009;139:1333-8, doi:10.3945/jn.108.103622). Nut consumption was also associated with a more favourable plasma lipid profile, including low density lipoprotein, but not inflammatory markers.
Liquorice gargles as a way to ameliorate postoperative sore throat were put to the test in a prospective, randomised, single blind study (Anesth Analg 2009;109:77-81, doi:10.1213/ane.0b013e3181a6ad47). Participants gargled five minutes before anaesthesia. Both the incidence and severity of postoperative sore throat were reduced in the liquorice group compared with the water gargle group, except in terms of severity at rest (as opposed to when swallowing) at 24 hours, when the two groups were similar.
Advice about whether it’s safe to drink alcohol in pregnancy remains confusing to many women. A study of semistructured interviews with 20 pregnant women recruited from community organisations identified three themes: the perceived risk of drinking, coupled with the fact that few women actually abstained altogether; the influence of friends and family and of their own previous pregnancies; and the fact that few had received any overt advice about drinking from their GPs or midwives. There was a dearth of consistent advice, and a lack of evidence and detail (BMC Public Health 2009;9:175, doi:10.1186/1471-2458-9-175).
A device that externally compresses the aorta was tested as first aid to control postpartum haemorrhage in women whose deliveries were complicated by bleeds. The intervention group—120 women with an atonic postpartum haemorrhage who received first aid from the device and traditional management—was compared with a group of the same size that received just traditional management. Women in the intervention group stopped bleeding more quickly, and none needed hysterectomies or died. There were five hysterectomies and one death among controls (The Journal of Obstetrics and Gynaecology Research 2009;35:453-8, doi:10.1111/j.1447-0756.2008.00975.x).
Cite this as: BMJ 2009;339:b2695