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“Pepys gave it up because he feared he was going blind. His eyes had started to be painful when he did close work or reading by candlelight as early as 1663—‘and so to bed, being weary, sleepy, and my eyes begin to fail me, looking so long by candlelight upon white paper’—but over the next few years he mentioned the problem very rarely, and it was only from 1667 that it became a frequent complaint. By then his eyes were suffering from his years of close work; increasingly they hurt if he read for too long, they reacted badly to bright light, and they felt sore and watered. None of the remedies he tried—spectacles, lotions, eye drops, pills, purges, the use of a paper roll when reading—did much to help. Modern medical opinion is that he had long sight (hypermetropia), which made reading difficult and some astigmatism. He was not going blind and his eyes deteriorated no further. (

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Public health agencies and governmental health organisations continue to publish recommended dietary guidelines. These are meant to address the growing problem of diseases related to poor diets. In a random digit dial telephone survey in Olmstead County, Minnesota, the results suggest that these guidelines are ignored by the vast majority of the population. In this study only 16% of the population of Olmstead County reported meeting the standard dietary recommendations for consuming both five or more servings of fruit and or vegetable per day and no more than 30% of total calories from fat. More effective interventions are needed to improve dietary habits in most communities. (

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The epidemiology of Chlamydia trachomatis infection in men has not been well defined. In women established screening programmes have demonstrated the benefit of routine screening to reduce the prevalence of this infection over time. In a cross sectional study of C trachomatis prevalence and associated risk factors among men tested at sexually transmitted disease clinics in Alaska, Idaho, Oregon, and Washington the overall prevalence of C trachomatis was found to be 10.3%. Using either the presence of clinical signs or report of a sexual partner with a sexually transmitted disease in combination with selective screening of all men 25 years of age or less detected the majority of infections in this population. (

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Since ganciclovir resistant cytomegalovirus (CMV) disease was initially described in a patient with AIDS in 1986 its incidence appears to be increasing in immunocompromised patients. More recently, there have been sporadic reports of the disease in solid organ transplantation. In a retrospective analysis of the lung transplant recipients at Loyola University Medical Center, 12 of 212 transplant recipients developed ganciclovir resistant CMV. This is a higher incidence of ganciclovir resistant CMV disease than previous reports. (

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Hyperhomocysteinaemia is a risk factor for vascular disease and potentially for dementia and depression. The most common cause of elevated of homocysteine level is deficiency of folate or vitamin B-12. However, patients with Parkinson’s disease may have elevated homocysteine levels resulting from methylation of levodopa. In a study of 235 patients with Parkinson’s disease, followed in a movement clinic at the University of Texas Southwestern Medical, levodopa therapy rather than Parkinson’s disease appears to be the cause of hyperhomocysteinaemia in these patients. Deficiency of folate or vitamin B-12 levels does not explain the elevated levels seen in these patients. These findings have implications for treatment of Parkinson’s disease patients in whom a risk for vascular disease is noted. (

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High blood pressure is a common powerful and independent risk factor for cardiovascular disease. Approximately 25% of the US adult population have hypertension. In a randomised trial with enrolment at four clinical centres studying patients with above optimal blood pressure participants were randomised into one of three intervention groups. The first a behavioural intervention that implemented established recommendations; the second established these recommendations as well as dietary adjustments; and the third was an advice only comparison group. In this study weight loss, sodium reduction, increased physical activity, and limited alcohol intake were all effective in reducing blood pressure in patients with modest levels of hypertension. Multiple lifestyle changes can lower blood pressure and reduce cardiovascular risk. (

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Wound healing has been noted to be impaired in some patients with diabetes. The underlying mechanism for this has not been defined. In an experimental study using a human wound healing model investigators in Copenhagen, Denmark, studied 34 patients with type 1 and 25 patients with type 2 diabetes. In this study collagen deposition in acute wounds was impaired in type 1 diabetes probably the result of a decreased fibroblast proliferation. In type 2 diabetes collagen deposition was normal. Control of glucose levels did not influence collagen deposition in this acute wound repair study in either type 1 or type 2 diabetics. The decrease in collagen depositions seen in wound repair in type 1 diabetics is independent of blood glucose levels. (

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People older than 65 years of age are the fastest growing segment of the population in many developed countries. They account for the majority of cardiovascular disease morbidity, mortality, and healthcare expenditure. Moreover, the influence of dietary habits on risk may be less pronounced in elderly patients when atherosclerosis is more advanced. However, in a population based multicentre study of 3588 men and women 65 years of age or older cereal fibre consumption was associated with a lower risk of cardiovascular disease. In a post hoc analysis dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident cardiovascular disease than other cereal fibre sources. (

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Although the SARS epidemic in some countries appears to be waning, in others especially in China it continues to be a major healthcare problem. Two websites are available for up to date information on this epidemic. Go to http://www.who.int/csr/sars/en/ or http://www.cdc.gov/ncidod/sars/clinicianlinealert.htm

Although the incidence of peanut allergies has been increasing in recent decades the reason for this has been unclear. Recent findings from scientists in London, UK, suggest that some of this increase sensitisation from peanut proteins found in creams or lotions containing peanut oil. This study also found no evidence of prenatal exposure playing a part in allergy in children; 84% of children who were allergic to peanuts and 91% of those with a positive peanut challenged result had been exposed to creams with peanut oil in the first 6 months of their life. (

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