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BMJ 1998; 316 doi: (Published 14 March 1998) Cite this as: BMJ 1998;316:872

In the 1960s surgeons in Perth, Australia, did an average of two operations a year for primary hyperparathyroidism, usually in patients with renal calculi. By the late 1990s the annual total had risen to an average of 73 (Medical Journal of Australia 1998;168:153-6). The most common indication nowadays is a low bone mineral density detected by osteodensitometry: this finding alone seems to be an accepted justification for surgery.

A five year longitudinal study of 1007 adults aged 21-30 has shown that those who smoked daily were twice as likely as the non-smokers to develop major depression (Archives of General Psychiatry 1998;55:161-6). Those who had been depressed before the study started were more likely than the rest to become daily smokers. The authors suggest that depression and smoking have shared aetiologies, possibly genetic as well as behavioural.

An analysis of the places of birth of 9363 British children who had developed cancer found that the highest rates were in those born in areas with inhabitants of high social class, with high incomes and good housing, but with high population densities (British Journal of Cancer 1998;77:842-9). These findings applied to solid tumours as well as leukaemias. The factors operated independently. The authors say that their data provide further support for the …

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