This week in the BMJ

Volume 332, Number 7539, Issue of 25 Feb 2006

[Down]Students may have a higher risk for meningococcal disease than other adolescents
[Down]Are you standing comfortably?
[Down]Use a combined strategy in prenatal chromosomal diagnostics
[Down]Don't plan to quit, just do it
[Down]Anticholinergic drugs may cause cognitive decline in elderly people

Students may have a higher risk for meningococcal disease than other adolescents

Risk factors for meningococcal disease in adolescence differ from those in childhood. In a prospective matched cohort study with 144 case-control pairs aged 15 to 19, Tully and colleagues (p 445) found that being a student, intimate kissing with multiple partners, a history of preceding illness, and preterm birth were independently associated with higher risk of meningococcal disease. Attending religious ceremonies and meningococcal vaccination were associated with protection. Changing personal behaviours could reduce the risk of the disease in adolescence, but developing further effective meningococcal vaccines remains a key priority, say the authors.


Figure 1
 Credit: IMAGE SOURCE/REX

 



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Are you standing comfortably?

Uncomfortable working positions and physically heavy work increase the risk of long term sickness absence for both women and men. In a prospective cohort study, Lund and colleagues (p 449) interviewed more than 5000 employees from Denmark and followed them for 18 months. In the 7% who had long term sickness absence, it was associated with extreme bending or twisting the neck or back, mainly standing while working, and lifting or carrying loads. For female employees, the negative effects of physical exposures were increased by exposure to psychosocial factors.


Figure 1
 Credit: VILLE MYLLYNEN/REX

 



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Use a combined strategy in prenatal chromosomal diagnostics

A combined strategy where quantitative fluorescent polymerase chain reaction (qf-PCR) is used in all pregnancies screened for trisomy 21 and full karyotyping is reserved only for those with increased fetal nuchal translucency thickness would be sensitive and cost effective. Lund and colleagues (p 452) analysed more than 17 000 chorionic villous samples (taken after measurement of fetal nuchal translucency thickness) by full karyotyping and by qf-PCR for chromosomes 13, 18, 21, X, and Y. They found that this strategy identified 99% of important chromosomal abnormalities and cost 60% less than karyotyping everyone.


Figure 1
 Credit: L WILLAT/SPL

 



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Don't plan to quit, just do it

The prevailing model of smoking cessation, in which smokers typically prepare their attempts to quit in advance, believing that doing so increases their chances of success, may not be correct. In a cross sectional household survey by West and Sohal (p458), 918 smokers who had tried to quit at least once and 996 ex-smokers reported their most recent attempt to stop smoking: 49% involved no previous planning, and unplanned quit attempts had a greater chance of succeeding for at least six months.


Figure 1
 Credit: SHEILA TERRY/SPL

 



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Anticholinergic drugs may cause cognitive decline in elderly people

Anticholinergic drugs may be associated with non-degenerative mild cognitive impairment in elderly people. Ancelin and colleagues (p 455) carried out a longitudinal cohort study of 372 people aged over 60 without dementia at recruitment. After one year, 80% of those who had used anticholinergic drugs continuously met the criteria for mild cognitive impairment, compared with 35% of non-users. However, after eight years, anticholinergic drug users were not at increased risk of developing dementia.


Figure 1
 Credit: CONOR CAFFREY/SPL

 



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