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(2) BEING
UNDERWEIGHT OR OVERWEIGHT REDUCES
FERTILITY IN
WOMEN
(3) TRANSMISSION
OF HIV REMAINS HIGH AMONG
HOMOSEXUAL
AND BISEXUAL MEN
(1) HIGH CHOLESTEROL
IS UNDERTREATED IN
ENGLAND
(Lipid concentrations and the use
of lipid lowering drugs:
evidence from a national cross sectional
survey)
http://bmj.com/cgi/content/full/321/7272/1322
(Treating dyslipidaemia in primary
care)
http://bmj.com/cgi/content/full/321/7272/1299
At least a quarter of English adults have
cholesterol levels
above the ideal, yet only one in 50 take
cholesterol lowering
drugs, finds a study in this week's BMJ.
National guidelines recommend that cholesterol
lowering drugs
should be used for people with a history
of coronary heart
disease, or those with the highest risk
of developing coronary
heart disease. Using data from over 13,500
English adults,
researchers in London found that only
30% of people with a
history of coronary heart disease were
taking cholesterol
lowering drugs, with only one in eight
reaching the
recommended cholesterol target. Among
those high risk people
identified, only 3% were taking cholesterol
lowering drugs.
The authors estimate that if cholesterol
lowering was achieved
in the remaining 70% of untreated adults
with a history of
coronary heart disease, about 7,000 fatal
or non-fatal heart
attacks and about 2,500 fatal or non-fatal
strokes would be
avoided each year.
Fortunately, the use of cholesterol lowering
drugs is rising, say
the authors. They hope that the new NHS
national service
framework will reinforce guidelines on
cholesterol
management, so that the use of these drugs
continues to grow
and the huge benefits in terms of preventing
cardiovascular
events can be realised, they conclude.
Contact:
Paola Primatesta, Royal Free and University
College Medical
School, London, UK
Email: paolap@public-health.ucl.ac.uk
(2) BEING UNDERWEIGHT
OR OVERWEIGHT REDUCES
FERTILITY IN WOMEN
(Body mass and probability of pregnancy
during assisted
reproduction treatment: retrospective
study)
http://bmj.com/cgi/content/full/321/7272/1320
Extremes of weight are associated with
reduced probability of
achieving pregnancy in women receiving
assisted reproduction
treatment, finds a study in this week's
BMJ.
Over 3,500 Australian women, who received
assisted
reproduction treatment between 1987 and
1998, were divided
into five groups according to their weight:
underweight,
moderate, overweight, obese and very obese.
Fertility was
defined as the probability of achieving
at least one pregnancy
throughout the treatment.
The fertility of the moderate group was
almost 60% higher
than that of the very obese group, and
the fertility of the
underweight group was also significantly
lower than that of the
moderate group. When factors, such as
age, number of
embryos transferred and type of treatment
were accounted
for, the pregnancy rate among very obese
women was half
that of the moderate group.
Ways in which extremes of weight can affect
fertility include
menstrual disturbance and inability to
ovulate, but these
problems can be overcome through assisted
reproduction
treatment, say the authors. They suggest
that other
mechanisms, such as disturbance to the
lining of the uterus,
may cause reduced fertility.
Contacts:
Jim Wang, Department of Obstetrics and
Gynaecology,
University of Adelaide, Queen Elizabeth
Hospital, Australia
Email: jwang@medicine.adelaide.edu.au
Michael Davies, Department of Obstetrics
and Gynaecology,
University of Adelaide, Queen Elizabeth
Hospital, Australia
Email: michael.davies@adelaide.edu.au
(3) TRANSMISSION
OF HIV REMAINS HIGH AMONG
HOMOSEXUAL AND BISEXUAL MEN
Serosurveillance of prevalence of
undiagnosed HIV-1 infection
in homosexual men with acute sexually
transmitted infection)
http://bmj.com/cgi/content/full/321/7272/1319
The level of undiagnosed HIV-1 infection
among homosexual
and bisexual men did not fall between
1993 and 1998,
indicating a high level of continuing
transmission, finds a study
in this week's BMJ.
Samples from over 32,000 homosexual and
bisexual men,
attending 15 genitourinary clinics in
England and Wales with
sexually transmitted infections, were
tested for HIV-1
infection. In London, the level of HIV-1
declined among men
attending with an acute sexually transmitted
infection, such as
gonorrhoea and chlamydia, from 16.5% in
1993 to 9% in 1998:
an average decrease of 9% a year. However,
when samples
from men known to be HIV-1 positive were
excluded, there
was no such trend. In contrast, the level
decline in prevalence
of HIV-1 among men attending with a non-acute
sexually
transmitted infection was significant:
17% a year overall and
11% a year when men known to be HIV-1
positive were
excluded. Outside London, the level of
HIV-1 infection was
lower and, similarly, a significant decline
(11% a year) was
seen only in men with a non-acute sexually
transmitted
infection.
The findings suggest that men with acute
sexually transmitted
infections represent a significant risk
for HIV-1 transmission.
These men probably have more partners
and engage in riskier
sex than those without such infections,
say the authors. Health
promotion directed at this group of men
should be intensified,
they conclude.
Contact:
Michael Catchpole, Consultant Epidemiologist,
Public Health
Laboratory Service, Communicable Disease
Surveillance
Centre, London, UK
Email: mcatchpole@phls.nhs.uk
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