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(2) DEATHS
AFTER FRACTURE HAVE NOT
DECLINED IN
20 YEARS
(3) SEXUAL
PLEASURE IMPROVES AFTER
HYSTERECTOMY
(4) ARE UK CONSENT RULES TOO RESTRICTIVE?
(1) DIETARY FAT
NOT LINKED TO RISK OF
STROKE
(Dietary fat intake and risk of stroke
in male US
healthcare professionals: 14 year
prospective cohort
study: )
http://bmj.com/cgi/content/full/327/7418/777
Unlike heart disease, dietary fat does
not seem to be
associated with risk of stroke, finds
a study in this
week's BMJ.
Researchers followed 43,732 healthy middle-aged
men
for 14 years to examine the association
between intake
of total fat, specific types of fat, and
cholesterol and the
risk of stroke. They assessed dietary
intake by using
recognised food frequency questionnaires.
After adjusting for age, smoking, and other
factors that
could affect the results, they found no
evidence that the
amount or type of dietary fat affects
the risk of
developing stroke.
They also evaluated risk of strokes according
to
consumption of selected foods rich in
fat or cholesterol,
including red meat, high fat dairy products,
nuts and eggs
and found no significant link with stroke.
"These findings do not support associations
between
intake of total fat, cholesterol, or specific
types of fat and
risk of stroke in men," conclude the authors.
Contact:
Ka He, Department of Preventive Medicine,
Northwestern University, Feinberg School
of Medicine,
Chicago, USA
Email: e-crown@northwestern.edu
(2) DEATHS AFTER
FRACTURE HAVE NOT
DECLINED IN 20 YEARS
(Time trends and demography of mortality
after fractured
neck of femur in an English population,
1968-98:
database study)
http://bmj.com/cgi/content/full/327/7418/771
Death rates among elderly people after
fracturing a thigh
bone (neck of femur) have not declined
appreciably
during the past 20 years, finds a study
in this week's
BMJ.
Researchers analysed NHS statistics on
hospital
admissions for 32,590 people aged 65 years
or over
who were admitted with fractured neck
of femur
between 1968 and 1998. They calculated
death rates
during the first month and first year
after fracture.
They found that death rates after fracture
fell significantly
from the late 1960s to the early 1980s,
but have not
declined any further in the past 20 years.
Death rates also rose sharply with increasing
age, were
higher in men than women, and were higher
in lower
social classes. In the first month after
fracture, death
rates were 16 times higher in men and
12 times higher in
women than in the general population of
the same age.
It is unclear whether death after fractured
neck of femur
has declined to an irreducible minimum
or whether there
is still scope for further reduction,
say the authors.
The high death rates after fracture, and
the fact that they
have not fallen in 20 years, reinforce
the need for
measures to prevent osteoporosis and falls
and their
consequences in elderly people, they conclude.
Contact:
Stephen Roberts, Statistician, Department
of Public
Health, University of Oxford, UK
Email: stephen.roberts@uhce.ox.ac.uk
(3) SEXUAL PLEASURE
IMPROVES AFTER
HYSTERECTOMY
(Hysterectomy and sexual wellbeing:
prospective
observational study of vaginal hysterectomy,
subtotal
abdominal hysterectomy, and total
abdominal
hysterectomy)
http://bmj.com/cgi/content/full/327/7418/774
Many women are concerned that hysterectomy
may
affect their sexual attractiveness, but
a study in this
week's BMJ finds that sexual pleasure
improves after
hysterectomy.
Researchers in the Netherlands compared
the effects of
three types of hysterectomy (vaginal,
subtotal abdominal,
and total abdominal hysterectomy) on the
sexual
wellbeing of 413 women.
All women completed a questionnaire before
and six
months after surgery about their sexuality,
frequency of
sexual activity, and problems during sexual
activity.
Sexual pleasure significantly improved
in all patients,
regardless of the type of hysterectomy.
The persistence
and development of bothersome problems
during sexual
activity were also similar for all three
surgical techniques,
conclude the authors.
Contact:
Jan-Paul Roovers, Registrar, Department
of Obstetrics
and Gynaecology, University Medical Center,
Utrecht,
Netherlands
Email: j_proovers@hotmail.com
(4) ARE UK CONSENT RULES TOO RESTRICTIVE?
(Editorial: Consent to using human
tissue)
http://bmj.com/cgi/content/full/327/7418/759
Regulations on the use of human tissue
in the United
Kingdom are now more restrictive than
any other
European country. Is the UK leading the
way or
overreacting to recent publicity about
inadequate consent
procedures?
The new regulations require explicit consent
from every
patient. Explicit consent is appropriate
for the use of
emotionally important samples such as
post-mortem
tissue, but the new regulations also apply
to all samples
from living patients, including resected
tumours, tiny
biopsies, even blood and urine.
Although this takes due account of the
autonomy of the
few who object, it is now inhibiting work
done for the
good of everyone and has other ethically
undesirable
consequences, says Professor Peter Furness,
in this
week's BMJ.
Recording the wishes of all patients whenever
samples
are taken would resolve this problem but
this has major
resource implications, he writes. So is
implied consent -
asking the few who object to make their
wishes known ±
a reasonable possibility for the use of
tissue from living
patients for research?
Implied consent was recommended by the
Nuffield
Council on Bioethics in 1995, but has
since been
rejected by the Medical Research Council,
despite
evidence that patients thought it was
appropriate. The
Department of Health for England has so
far taken a
similar line to the MRC.
"If we are serious about empowering patients
to control
the use of their tissue samples, resources
must be
allocated irrespective of whether implied
or explicit
consent is regarded as appropriate," says
the author.
"Without such resources our laboratories
are forced into
paralysis or continuing paternalism. At
present we have
both."
Contact:
Peter Furness, Professor of Renal Pathology,
Department of Pathology, Leicester General
Hospital,
Leicester, UK
Email: pnf1@le.ac.uk
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