Releases Saturday 10 March 2001
No 7285 Volume 322
Please remember to credit the BMJ as source when publicising
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(1) MOST ELDERLY PEOPLE CANNOT USE FLU INHALER
EFFECTIVELY
(2) EATING
LESS AND EXERCISING MORE MAY REDUCE
RISK OF BREAST
CANCER
(3) EYE
COLOUR LINKED TO DEAFNESS AFTER
MENINGITIS
(1) MOST ELDERLY PEOPLE CANNOT USE FLU INHALER
EFFECTIVELY
(Randomised controlled study of elderly
people's inhaler
technique using a dry powder device
to deliver zanamivir)
http://bmj.com/cgi/content/full/322/7286/577
Most elderly people cannot use the inhaler
device that delivers
the anti-influenza drug zanamivir (Relenza).
Reporting in this
week's BMJ, the researchers suggest that
improvements should
be made to the inhaler.
Seventy-three patients aged over 65 years,
who were unfamiliar
with the use of an inhaler, were recruited
from seven wards in a
large district general hospital. Patients
were randomly allocated
the Relenza Diskhaler or an alternative
device (Turbohaler).
Patients were assessed after 15 minutes'
tuition and again 24
hours later, using a point scoring system
of five aspects of inhaler
technique.
After tuition, 50% of patients allocated
the Diskhaler were
unable to load and prime the device and
65% were unable to do
so 24 hours later. In contrast, only two
patients were unable to
load and prime the Turbohaler after initial
review and one after
24 hours.
These findings show that zanamivir treatment
for elderly people
with influenza is unlikely to be effective
unless the delivery system
is improved, say the authors. Particular
attention should be paid
to the loading and priming of the device,
they conclude.
Contacts:
Paul Diggory or Valerie Jones, Department
of Elderly Care
Medicine, Mayday Hospital, Croydon, UK
Email: Pdiggory{at}aol.com
/
Valerie.Jones{at}mhc-tr.sthames.nhs.uk
(2) EATING LESS
AND EXERCISING MORE MAY REDUCE
RISK OF BREAST CANCER
(Research pointer: Lifestyle, hormones,
and risk of breast
cancer)
http://bmj.com/cgi/content/full/322/7286/586
A research pointer* in this week's BMJ,
suggests that there is an
important link between the risk of breast
cancer and nutritional
status, through its influence on concentrations
of ovarian
hormones (oestrogen and progesterone)
produced during the
menstrual cycle. These findings are consistent
with the view that
the level of breast cancer is much higher
among women in
industrialised countries (where food is
virtually unlimited) than
among women in countries with more traditional
lifestyles.
Previously published data on hormones from
saliva samples
collected from women in Bolivia, the Democratic
Republic of
Congo, Nepal, Poland and the United States
were used to
investigate the relation between hormone
concentrations and the
level of breast cancer in each country.
The relationship of mean
total energy intake in each country with
hormone concentrations
was also examined.
Higher concentrations of ovarian progesterone
were strongly
associated with an increasing level of
breast cancer, confirming
the expected relation between hormone
concentration and risk of
breast cancer in these populations. High
energy status in a
population was also associated with high
hormone
concentrations. Conversely, poor energy
status was associated
with impaired ovarian function and, consequently,
a lower
hormone concentration in women.
These findings confirm the view that women
from populations
with a high risk of breast cancer are
expected to have
comparatively high concentrations of ovarian
hormones, say the
authors. Furthermore, since ovarian function
responds to
nutritional status, a woman's risk of
breast cancer may be
modified by eating less and exercising
more, they conclude.
Contact:
Grazyna Jasienska, Assistant Professor,
Institute of Public
Health, Jagiellonian University, Krakow,
Poland
Email: jasienska{at}post.harvard.edu
(3) EYE COLOUR
LINKED TO DEAFNESS AFTER
MENINGITIS
(Research pointer: Light eye colour
linked to deafness after
meningitis)
http://bmj.com/cgi/content/full/322/7286/587
People with light eyes are more prone to
deafness after
meningitis than those with dark eyes,
according to a research
pointer* in this week's BMJ. Could these
findings help us
understand why some survivors of meningitis
experience hearing
loss whereas others fully recover?
Helen Cullington, an audiological scientist
at Southampton
University, classified eye colour in 130
deaf patients into "dark"
(pure brown eyes, and all other shades
of brown) and "light"
(blue, green, grey and hazel eyes). Of
32 patients who were
deafened by meningitis, only two (6%)
had dark eyes, with 30
(94%) having light eyes. When compared
to a sample UK adult
population, these results showed that
people with light eyes were
5.8 times as likely to be deafened by
meningitis than those with
dark eyes.
A higher melanin content protecting the
inner ear from damage
caused by meningitis could explain these
findings, proposes the
author. Alternatively, perhaps people
with light eyes are more
vulnerable to meningitis or those with
dark eyes are more likely
to die from meningitis, thus distorting
the data for eye colour in
the survivors and giving misleading results.
Further research may suggest a genetic
basis; some kind of link
between the genes determining eye colour
and the inflammatory
response to infection, she concludes.
Contact:
Helen Cullington, Audiological Scientist,
Hearing and Balance
Centre, Institute of Sound and Vibration
Research, University of
Southampton, UK
Email: hec{at}isvr.soton.ac.uk
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