BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7018.1514 (Published 02 December 1995) Cite this as: BMJ 1995;311:1514
  1. C B KOAY, registrar,
  2. C A MILFORD, consultant ear, nose, and throat department
  1. Radcliffe Infirmary, Oxford OX2 6HE

    The higher the plasma homocysteine concentration the higher the prevalence of vascular disease in the coronary, cerebral, and peripheral arteries. A study of 16000 men and women in Norway (JAMA 1995;274:1526-33) has shown that concentrations of homocysteine were higher in men than women, rose with age, and rose with the number of cigarettes smoked—but were lower in those who took regular exercise. What is not yet known is whether plasma homocysteine is directly concerned in the pathogenesis of vascular disease or is just a marker for increased risk. There is some evidence that lowering the plasma homocysteine concentration reduces the incidence of thrombotic events.

    Clinicians who are anxious about the recent upsurge in multiple drug resistance in bacteria should take some comfort from a report in “Science” (1995;270:724-7) headed “Antibiotics that resist resistance.” Large pharmaceutical companies have put a lot of money into at least 25 new drugs with chemical structures and actions unfamiliar to bacteria. The hope, says the report, is that because bacteria haven't yet come across these new types of antibiotics they will not be able to use their established methods of developing resistance.

    Trials in Sweden of an …

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