BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2454 (Published 11 May 2010) Cite this as: BMJ 2010;340:c2454

Why do so many branded drug names contain an X or a Z? Think Xanax, Zantac, Zocor, and Zoladex. Apparently, it is because short, zappy names with X or Z tend to be associated with technology and innovation and are thought to convey a subliminal indication of power. Other favoured consonants are D and a hard C, which harden the sound of the product name, conveying greater efficacy (The Pharmaceutical Journal 2010:284:322 www.pjonline.com).

After several failed attempts to be included in Medline, Deutsches Ärzteblatt—the journal of Germany’s medical association and a popular read among German doctors—finally made the grade in 2008. The reasons given for being excluded from Medline included its dominant appearance as a political magazine rather than a scientific journal. Exclusion meant it failed to attract good quality papers. The solution was to launch a separate online edition in English of just the scientific section of the journal. Free of political material and advertising, Deutsches Ärzteblatt International was finally accepted into Medline’s coveted sanctum. At the fourth attempt, polite persistence may also have played a part (European Science Editing 2010;36:12-3, www.ease.org.uk).

Is robot assisted laparoscopy better than conventional laparoscopy? In this experimental study involving 20 medical students with no surgical experience, the complex task of “tying a knot” was performed faster with the robotic technique than with conventional laparoscopy. Shorter operating times were recorded when changing from conventional laparoscopy to robotics, but there were differences between the techniques for the simpler tasks of grabbing the needle and continuous suturing, and no, there were no gender differences. Skills acquired through conventional laparoscopy were transferable, but the lack of tactile feedback with robotics seemed to hinder transferability (Annals of Surgical Innovation and Research 2010;4:3 doi:10.1186/1750-1164-4-3)

At last there is a decent mouse model of male pattern baldness. The cause of alopecia is unknown, but it involves androgen signalling mediated by the androgen receptor. A transgenic mouse model over-expressing human androgen receptor in the skin and exposed to high levels of 5α-dihydrotestosterone showed delayed hair regeneration, mimicking a typical androgenetic alopecia scalp. Treatment with an androgen receptor antagonist inhibited the effect of dihydrotestosterone. These observations support the idea that androgen-mediated hair loss is androgen receptor dependent and the model can be used to test new drugs for androgenetic alopecia (Endocrinology 2010;151:2373-80 doi:10.1210/en.2009-1474).

While Scandinavian studies have shown that parental immigration may be linked with an increased rate of autism in offspring, studies from North America tend to find no such link. A British study now reports that mothers born outside Europe have a notably higher risk of having a child with an autism-spectrum disorder than mothers born in the UK (British Journal of Psychiatry 2010;196:274-81 doi:10.1192/bjp.bp.109.065490). Mothers of black ethnic origin had a much higher risk than white mothers. An analysis suggested the increased risk was predominantly related to immigration.

Cognitive dissonance is the discomfort that comes from holding two opposing ideas simultaneously. A study of students ranking 10 compact discs as part of a consumer survey and taking home their fifth or sixth choices showed that those who washed their hands after choosing made the same choice later. However, those who didn’t wash their hands, later ranked their chosen compact disc much higher than the one they rejected, suggesting a process of rationalisation was helping them cope with their disquiet. The researchers say that, as with past immoral behaviour, washing can also help put decision making behind us (Science 2010;328:709 doi:10.1126/science.1186799).

Experiencing one or more traumatic events changes our epigenetic profiles—the system that switches human genes on and off—which may be the underlying biological mechanism that alters the way our immune system works (Proceedings of the National academy of Sciences 2010;doi:10.1073/pnas.0910794107). Compared with people with no diagnosis of post traumatic stress disorder, those with the condition showed six to seven times more unusually expressed genes, which were predominantly related to the immune system. The post traumatic stress disorder group also displayed an increased immune response to a common herpes virus that acts as an immune health biomarker.

When life sustaining support is withdrawn, what determines how long it takes to die? A retrospective analysis of 149 patients found that earlier death—that is, cardiac arrest in under 60 minutes—tended to occur more in older men, with a diagnosis of ischaemic stroke or internal bleeding. Earlier death was also associated with absent corneal and cough reflexes, extensor or absent motor responses, and an oxygenation index greater than 4.2 (Neurology 2010;74:1380-5 doi:10.1212/wnl.0b013e3181dad5f0). Identifying patients likely to die earlier may help recognise those who will be more suitable for organ donation.


Cite this as: BMJ 2010;340:c2454

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