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“When Andre's Maria took him into the Luxembourg, he would often meet a boy of his own age who they nicknamed `Mouton' on account of his white sheepskin jacket. Mouton was a quiet, gentle, rather sickly child who wore thick, tinted spectacles. Since they could not play together, they were content to walk around the gardens, hand in hand saying nothing. After a while, Mouton no longer appeared on their walks. The young Gide realized how attached he had become to his strange friend. He was horrified to learn that Mouton was going blind. `I went to my room and cried, and for several days I would keep my eyes shut for long periods, moving around without opening them, trying to feel what Mouton must have been feeling.'”(Allen Sheridan. Andre Gide. A light in the present. Cambridge, MA; Harvard University Press, 1998:12–13)

The morbidity and mortality associated with tobacco smoking is well documented. Now, a small California biotechnology company, LSBC, is using tobacco as a means to produce a lymphoma vaccine. LSBC takes a sample from a lymphoma patient's tumour, extracts an antibody gene, and inserts it into a TMV system. With this, they infect the tobacco plant, which produces customised antibodies in small individual batches in a greenhouse. It would appear that tobacco plants can be converted into machines for producing potentially useful medical compounds.(

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A study by researchers from the United States Department of Veterans' Affairs has found that a new protocol could rule out myocardial infarction in 90 minutes compared with the 6–24 hours that are currently necessary. The protocol includes blood tests to measure three cardiac enzymes—troponin, creatine kinase-MB, and myoglobin I—that are released by ischaemic heart tissue during myocardial infarction. In this study the blood tests had a 100% correlation with electrocardiographic diagnoses. This protocol led to a 40% drop in critical care admissions.(

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Deafness is a relatively common disability among premature infants. Known causes include infections, especially meningitis, and toxic side effects to drugs. Now a study from the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts suggests that selective inner hair cell loss is a common finding in deaf premature infants. Histological studies suggest that more than one cause accounts for this. Some of the hair cell loss is compatible with in utero damage.(

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Several studies suggest that alterations in human behaviour could be associated with an increase in life expectancy. These include a carefully selected diet, routine exercise, control of body weight, as well as cessation of smoking. A study of seventh day adventists shows how striking these behavioural changes may be. In this study, Californian adventists had a higher life expectancy by 7.28 years at age 30 than other similar Californians. The longevity experience of the adventists probably documents the beneficial effects of optimal human behaviours.(

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A report from Johns Hopkins University Medical Center suggests that measuring blood pressure during exercise rather than at rest is a better predictor of who will have a heart attack or stroke. A high pulse pressure during exercise (the difference between the systolic and diastolic) appears to be strongly correlated with subsequent cardiovascular and cerebrovascular accidents. High pulse pressure results when ageing arteries stiffen. A new drug called ALT-711 appears to be able to soften rigid vessels. This experimental drug breaks up chemical bonds formed between sugars and proteins, which lead to loss of elasticity in the arteries.(

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Many older adults use aspirin on a daily basis to help prevent vascular thrombosis. Now a study from the Cleveland Clinic, USA, suggests that up to 6% of patients are aspirin resistant and nearly a quarter are semiresponders. Aspirin resistance was based on failure to prevent platelet aggregation whereas aspirin semi respondance was defined as only partial interference with platelet aggregation. The trend towards aspirin resistance increased with age and was more common in women.(

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The debate continues as to whether or not coffee consumption increases the risk of heart disease. Now a study from Oslo, Norway, suggests that those who quit drinking caffeinated filtered coffee reduce their blood levels of homocysteine as well as total cholesterol. Such decreases might correlate with a reduction in the homocysteine attributed risk of coronary artery disease by about 10% and the cholesterol attributed risk by about 15%.(

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In a population based case controlled study from Atlanta, Georgia, 905 infants with cardiac defects were compared with a control group of 3029 normal infants. Febrile illness in the mothers during pregnancy was positively associated with heart defects in their offspring. An additional finding of this study suggests that routine use of multivitamins during the periconceptual period reduced the risk of congenital heart defects in infants.(

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The use of automated defibrillators is expanding into the workplace. In a study from emergency medical services data in Seattle, Washington, the authors calculated the annual incidence of cardiac arrest per type of medical practice. This study suggests that if automated external defibrillators are to be used they are particularly needed in cardiology, internal and family medicine clinics, and urgent care centres. All other medical and dental practices had a low incidence of cardiac arrest and the expense of automated external defibrillators may not be justified at these sites.(

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There is wide acceptance of alternative medical therapies in almost all Western cultures (see

). A recent national representative telephone survey in the United States shows how widely accepted alternative therapies have become. At least two thirds of respondents had used alternative therapy in their lifetime and more than half continued to use it for many years. The growth in alternative therapy was seen in all major sociodemographic sectors in this study.(

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