Press Releases Saturday 26 September 1998
No 7162 Volume 317
Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on
the
journal's web site (http://www.bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URLs are given under titles).
(1) ORLISTAT IS NOT A MIRACLE DIET PILL
(2) WINE DRINKERS MAY BE AT
LOWER RISK OF CERTAIN CANCERS
THAN
BEER OR SPIRITS DRINKERS
(3) GPS NEED ELECTRONIC ASSISTANCE TO STOP THEM DROWNING IN PAPER
(4) DOCTORS' HANDWRITING IS THE WORST
(1) ORLISTAT IS NOT A MIRACLE DIET PILL
(Flushing away the fat)
BMJ Volume 317, 26 September 1998, pp830-1
http://www.bmj.com/cgi/content/full/317/7162/830
Thirteen per cent of men and sixteen per cent of women in the UK are
obese.
Obesity is a serious disease which predisposes people to problems such
as
heart disease, hypertension, stroke, diabetes and osteoarthritis.
It
accounts for two to seven per cent of total health care costs and a
substantial proportion of disability pensions.
In this week's BMJ John Garrow, a former Professor of Human Nutrition,
notes that there have been misplaced claims that the new obesity drug,
orlistat, will enable fat people to eat what they like and still lose
weight. He stresses that this is highly misleading and that anyone
taking
orlistat who eats a high fat diet will receive a powerful incentive
to
reduce their fat intake (owing to foul smelling, fatty stools).
Garrow explains that orlistat works by causing 30 per cent of dietary
fat
to be excreted in faeces rather than being digested. But he claims
that
over half of the weight loss achieved in patients taking the drug is
down
to changes in diet and he believes that similar rates of weight loss
could
be achieved with well supervised outpatient dieting whereby energy
intake
is reduced.
The author highlights the potential irony if orlistat succeeds in its
aims
by exactly the action which it was said not to have - by inducing obese
people to keep to a low fat reducing diet, because the side-effects
of
having a high-fat intake are so unpleasant!
Contact:
Professor John Garrow,
Carolyn Summerbell, Principal Lecturer in Human Nutrition,
School of Health, University of Teeside, Newcastle
(2) WINE DRINKERS MAY
BE AT LOWER RISK OF CERTAIN CANCERS
THAN BEER OR SPIRITS DRINKERS
(Population based cohort study of the association between alcohol intake
and cancer of the upper digestive tract)
BMJ Volume 317, 26 September 1998, pp844-847
http://www.bmj.com/cgi/content/full/317/7162/844
It is well known that there seems to be a strong link between alcohol
intake and cancers of the upper digestive tract, because of the
carcinogenic effect of alcohol. But does the type of alcohol
we drink make
a difference? In this week's BMJ Dr Morten Gronbaek from the
Copenhagen
Centre for Prospective Studies and colleagues from Denmark report that
a
moderate intake of wine is better than beer or spirits, which increase
the
risk of upper digestive tract cancers considerably.
In their study of over 28,000 (28,180) men and women in Denmark, the
authors found that wine drinkers may be at a lower risk of developing
upper
digestive tract cancer than drinkers who have a similar intake of beer
or
spirits. They suggest that this may be due to the presence of
resveratrol,
a substance found in grapes, which has been shown to inhibit the
initiation, promotion and progression of cancer.
Contact:
Dr Morten Gronbeak, Senior Research Fellow, Copenhagen Centre for
Prospective Studies, Danish Epidemiology Science Centre at the Institute
of
Preventive Medicine, Kommunehospitalet, Copenhagen, Denmark.
email: mg{at}ipm.hosp.dk
(3) GPS NEED ELECTRONIC
ASSISTANCE TO STOP THEM
DROWNING
IN PAPER
(Guidelines in general practice: the new Tower of Babel?)
BMJ Volume 317, 26 September 1998 pp862-863
http://www.bmj.com/cgi/content/full/317/7162/862
(Where's the chief knowledge officer?) p832
http://www.bmj.com/cgi/content/full/317/7162/832
General Practitioners in the UK are being swamped with so much guidance
that it has become unmanageable. An electronic medium is needed to
combat
this problem, say Dr Arthur Hibble and public health colleagues from
Cambridge, in this week's BMJ.
In their study undertaken at 65 practices within the Cambridge and
Huntingdon Health Authority, the authors found 855 different
sets of
guidelines (a pile weighing 28 kg!). They define guidelines as
"any
written material used by a doctor or nurse in primary care to assist
decision making in relation to health care, excluding medical textbooks
and
electronic databases". GPs manage 90 per cent of patients without
referral
elsewhere and therefore guidelines help them to manage the difficult
and
complex decisions that they make. They complain that the
mass of paper
they have is unmanageable and does little to aid decision making.
Hibble and colleagues conclude that an electronic medium is needed as
it
would assist in searches for information, could be kept up to date
and
copied. However, they conclude that this would require careful
management.
This message is supported by Dr Muir Gray, the Director of Research
and
Development at the NHS Executive, Anglia and Oxford. In his linked
editorial Gray writes that clinicians are caught in an information
paradox.
He says that the probability that a disseminated document will arrive
on
someone's desk the moment it is needed is infinitesimally small and
the
probability that the same document will be found when it is needed
three
months later is even smaller.
Gray suggests that what is needed is a Chief Knowledge Officer
- someone
who can decide what knowledge comes into the organisation; how
it is
distributed and what should be passed on. He says that "We have
managed
money and buildings and people and energy. Now we need to manage...
knowledge and know-how".
Contact:
Dr Arthur Hibble, Acting Director General Practice Postgraduate Education,
General Practice Office, NHS Executive Anglia and Oxford, Fulbourn
Hospital, Cambridge.
email: ahibble{at}angliagp.org.uk
Dr Muir Gray, Director of Research and Development, NHS Executive Anglia
and Oxford, Oxford.
(4) DOCTORS' HANDWRITING IS THE WORST
(Legibility of doctors' handwriting: quantitative comparative
study)
BMJ Volume 317, 26 September 1998, pp863-4
http://www.bmj.com/cgi/content/full/317/7162/863
Is a doctor's handwriting really so bad? Yes, say Ronan Lyons
and
colleagues based on their study of the handwriting of 92 healthworkers
in
the Swansea area, published in this week's BMJ. The authors found
that
even when asked to write as neatly as possible, doctors produce handwriting
that is worse than that of other health professions. However,
the study
also found that legibility was confined to letters of the alphabet
rather
than numbers which perhaps indicates the importance attached by doctors
to
the legibility of drug doses.
Contact:
Ronan Lyons, Consultant, Department of Public Health, Iechyd, Morgannwg
Health, Swansea
email: chris_payne{at}compuserve.com
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London WC1H 9JR
(contact Jill Shepherd;jshepher{at}bma.org.uk)
and from:
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Advancement of Science
(http://www.eurekalert.org)
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