Intended for healthcare professionals

Minerva Minerva


BMJ 2000; 320 doi: (Published 12 February 2000) Cite this as: BMJ 2000;320:456

Two papers in Gastroenterology (2000;118:22-30,31-5) convince at least one commentator that familial clustering of gastric cancer is due not to genes but to infection with Helicobacter pylori. If others agree, these studies draw to a close over 150 of years of debate over the aetiology of gastric cancer in families, which began when Napoleon Bonaparte, his father, brother, and two sisters died of the disease. Ironically, historians have since decided that the French emperor probably died from arsenic poisoning.

Non-compliance with prescribed treatment for asthma is a serious problem worldwide, although some countries' citizens are more compliant than others (European Respiratory Journal 1999;14:288-94). In an international survey, the worst performers included Americans, Swedes, and Australians, with a compliance rate of less than 50%. The best performers were Belgian, Icelandic, and Dutch.

One way of improving compliance is to train patients in communication skills to help them get more out of a consultation, although it seems to work better for lifestyle changes such as diet and exercise than for drug treatments (Archives of Family Medicine 2000;9:57-64). It's cheap too. The patients in one study just received a booklet in the post a few days before their …

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