BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7043.1430 (Published 01 June 1996) Cite this as: BMJ 1996;312:1430

The itching that causes such distress to patients with cholestasis seems not to be due to retained metabolites irritating the skin. The explanation currently favoured (Gut 1996;38:644-5) is that cholestasis induces changes in the central nervous system that result in increased opioidergic tone. The serotonin neurotransmitter system may also be disturbed, and there is some evidence that one effective treatment for cholestatic pruritus may be the serotonin receptor antagonist odansetron.

Doctors responsible for the health of the United States ground forces in the former Yugoslavia are warning that the spring brings new health hazards. A news story in “JAMA” (1996;275:1465) says that the potential threats include tick borne encephalitis, Lyme disease, and Hantavirus infections, which may be acquired by the inhalation of dust contaminated by excretions from infected rodents.

In the United States the Centers for Disease Control and Prevention claim that most of the health benefits from exercise can be achieved by someone walking three kilometres briskly most days of the week. Research in California (New England Journal of Medicine 1996;334:1298-303) has now shown that women who run regularly can reduce their plasma concentrations of high density lipoprotein cholesterol by 0.003 mmol/l for every additional kilometre. The only limit to this progressive benefit is that …

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