Releases Saturday 15 January 2000
No 7228 Volume 320
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(1) RELATIVES OF PATIENTS WITH SUBARACHNOID
HAEMORRHAGE ARE AT INCREASED RISK OF
CONDITION
(3) REDUCTION
IN PENICILLIN COURSES FOR SORE
THROAT IS DISCOURAGED
(4) SHOULD
SUN PROTECTION FACTORS ON
SUNSCREENS
BE ABANDONED?
(1) RELATIVES
OF PATIENTS WITH SUBARACHNOID
HAEMORRHAGE ARE AT INCREASED RISK OF
CONDITION
(Risk of subarachnoid haemorrhage
in first degree relatives of
patients with subarachnoid haemorrhage:
follow up study
based on national registries in
Denmark)
http://www.bmj.com/cgi/content/full/320/7228/141
First degree relatives of patients who
have experienced
subarachnoid haemorrhage have a three
to fivefold increased
risk of suffering the same type of haemorrhage
compared
with the general population, suggest researchers
in this
week's BMJ.
Dr David Gaist from Odense University in
Denmark and
colleagues investigated records of over
9,000 (9,367)
patients in Denmark who were admitted
to hospital between
1977 and 1995 with subarachnoid haemorrhage
[a type of
brain haemorrhage in which blood from
a ruptured blood
vessel spread over the surface of the
brain]. Having identified
individuals who had suffered subarachnoid
haemorrhage, the
authors then conducted follow-up research
to ascertain
whether any first degree relatives (parents,
siblings or
children) had also experienced such a
haemorrhage.
Gaist et al found that first degree relatives
of patients who
have experienced subarachnoid haemorrhage
are at a
threefold to fivefold increased risk of
experiencing such a
haemorrhage themselves compared with the
general
population, but that the incidence rate
of subarachnoid
haemorrhage is low.
Contact:
Dr David Gaist, Postdoctoral Fellow, Epidemiology
Institute
of Public Health, University of Southern
Denmark, Odense
University, Denmark
Email: dgaist{at}health.sdu.dk
dgaist{at}health.sdu.dk
(Extent of misclassification of death
from Creutzfeldt-Jakob
disease in England 1979-96: retrospective
examination of
clinical records)
http://www.bmj.com/cgi/content/full/320/7228/145
The increase in the number of cases of
Creutzfeldt-Jakob
disease (CJD) recorded at the end of 1998
was genuine and
not down to better awareness and detection
of the disease as
has been previously claimed, report researchers
in this
week's BMJ.
At the end of 1998, the UK CJD surveillance
programme
recorded a rise in the number of cases
of variant CJD, but it
was unclear whether this was a real increase
or a result of
better ascertainment of the disease. In
order to clarify
whether better identification of deaths
from CJD was the
cause of the increase, Dr Azeem Majeed
from the Office for
National Statistics along with colleagues
from the National
Creutzfeldt-Jacob Disease Surveillance
Unit and the London
School of Hygiene and Tropical Medicine
examined the
medical records of people aged 15-44 who
had died in
England during 1979-96, from neurological
disorders that
could have been confused with CJD.
The authors found no previously unsuspected
cases of CJD in
the records they analysed and say that
this means the
surveillance programme is unlikely to
have missed a significant
number of cases. Majeed et al conclude
that the recent
increase in cases of variant CJD is real
and not due to better
identification of the disease.
Contact:
Dr Azeem Majeed, Medical Epidemiologist,
Office for
National Statistics, London
Email: azeem.majeed{at}ons.gov.uk
azeem.majeed{at}ons.gov.uk
(3) REDUCTION
IN PENICILLIN COURSES FOR SORE
THROAT IS DISCOURAGED
(Penicillin for acute sore throat:
randomised double bind trial
of seven days versus three days
treatment or placebo in
adults)
http://www.bmj.com/cgi/content/full/320/7228/150
Penicillin treatment for seven days is
better than a three day
course (or placebo) in resolving the symptoms
of an acute
sore throat (streptococcal pharyngitis)
report a team of
researchers from the Netherlands in this
week's BMJ.
Dr Sjoerd Zwart from the University Medical
Center Utrecht
and colleagues studied a total of 561
patients aged 15-60
years with a sore throat for less than
seven days and they
found that in those patients taking penicillin
for seven days
symptoms resolved between 1.9 and 1.7
days earlier than
those not taking the same course of penicillin.
In patients with
group A streptococci the authors found
that symptoms
resolved 2.5 days earlier with a seven
day course. They
found that penicillin was also effective
in patients with bacteria
other than group A streptococci. Zwart
et al report that a
three day penicillin course was not effective
in treating acute
sore throat and even tended towards an
increased recurrence
rate in the following six months.
They conclude that, based on their findings,
the tendency in
western Europe to reduce the duration
of penicillin treatment
for streptococcal pharyngitis should be
discouraged.
Contact:
Dr Sjoerd Zwart, Senior Researcher, Julius
Center for
General Practice and Patient-oriented
Research, University
Medical Center Utrecht, Netherlands
Email: szwart{at}knmg.nl
szwart{at}knmg.nl
(4) SHOULD SUN
PROTECTION FACTORS ON
SUNSCREENS BE ABANDONED?
(Has the sun protection factor had
its day?)
http://www.bmj.com/cgi/content/full/320/7228/176
Numerical indicators of sun protection
on sunscreen
packaging can cause more confusion than
clarity in users and
this system should be abandoned in favour
of terms such as
"low", "medium" and "high" protection,
suggests Professor
Brian Diffey from Newcastle General Hospital
in this week's
BMJ.
Professor Diffey argues that the numerical
indicators are
popularly interpreted as how much longer
skin covered with
sunscreen takes to burn and this encourages
prolonged
exposure to the sun. Even those people
who use high factor
sunscreens get sunburnt, says Diffey,
but this is because they
do not apply enough sunscreen. If sunscreens
were applied
properly, there would be no need for sun
protection factors
higher than 15 to prevent sunburn, argues
the author.
He concludes that to overcome the confusion
caused by the
numerical sun protection factors a better
system of labelling
would be "low", "medium", "high" or "ultrahigh"
- whereby
children and people in strong sunshine
for many hours use
high or ultrahigh protection sunscreen
and those who wish to
tan or are in shady areas might prefer
medium or low
protection products. This, says Diffey,
would shift the focus
more to protection rather than encouraging
prolonged
exposure to sunlight.
Contact:
Professor Brian Diffey, Regional Medical
Physics
Department, Newcastle General Hospital
Email: b.l.diffey{at}ncl.ac.uk
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