Job strain a small CVD risk
JOB strain is associated with a small, but consistent, increased risk of coronary heart disease, according to research published in The Lancet. The researchers said their findings suggested that prevention of workplace stress might decrease disease incidence, but would have a much smaller effect than tackling standard risk factors, such as smoking. The research was based on individual records from 13 European cohort studies of men and women without coronary heart disease who were employed at the time of baseline assessment. “The population attributable risk [PAR] in our study suggests that if the recorded association were causal, then job strain would account for a notable proportion of coronary heart disease events in working populations”, they said. However, they said the PAR in the study of 3.4% was substantially less than for standard risk factors, such as smoking (36%), abdominal obesity (20%) and physical inactivity (12%).

Hyponatraemia predicts postoperative risks
PREOPERATIVE hyponatraemia is common and predicts postoperative morbidity and mortality, even in relatively healthy patients and those undergoing non-emergency surgery, research published in the Archives of Internal Medicine shows. The researchers said even mild perturbations of serum sodium were not inconsequential and should not be ignored. They said the presence of hyponatraemia preoperatively should alert physicians to increased risk and the need for closer surveillance in the perioperative period. The cohort study used data from the American College of Surgeons National Surgical Quality Improvement Program to identify 964 263 adults undergoing major surgery from more than 200 hospitals who were observed for 30 days for perioperative outcomes.

Case management best for heart patients
A COCHRANE review of 25 clinical trials examining different methods of care of patients with chronic heart failure (CHF) after leaving hospital has found case-management interventions involving telephone calls and home visits are most effective. The review involved nearly 6000 patients who were classified into three models of care — case management, where patients were intensively monitored by telephone calls and home visits, usually by a specialist nurse; clinic interventions involving follow-up in a specialist CHF clinic; and multidisciplinary interventions. Patients who received case-management interventions had less all-cause mortality a year after discharge than patients who received usual care, and were less likely to be readmitted to hospital for heart failure .

Drinking impacts on fetal brain
MATERNAL heavy and binge drinking affects information processing and has a significant impact on the stability of brain functioning in fetuses, which may be a result of both structural damage and acute exposure, according to research published in Alcoholism: Clinical and Experimental Research. The researchers said both effects might have long-term consequences for the individual, as the altered brain function might influence development after birth. They examined five groups of fetuses based on maternal alcohol consumption patterns, from no alcohol through to heavy drinking (defined as more than 20 units of alcohol consumed evenly across a week or as a binge). Fetal habituation performance was examined using ultrasound and a fetal acoustic stimulator on three occasions, separated by 7 days, beginning at 35 weeks of gestation.

Micro-organisms link in chronic rhinosinusitis
PATIENTS with chronic rhinosinusitis (CRS) not responding to medical treatment should undergo endoscopically directed sinus cultures for micro-organisms, including fungi, non-tuberculosis mycobacteria (NTM) and other bacteria, according to research published in Emerging Infectious Diseases. The researchers found CRS patients can be infected by NTM in their household plumbing. They said the role of NTM in infectious disease processes is only starting to be recognised. Their work showed a proportion of patients with CRS could be infected with NTM and that sinus samples should be cultured for NTM. They recommended CRS patients avoid sinus irrigation with tap water because the water might contain NTM. Sterile saline should be used instead.

Arousal mutes disgust
WOMEN who are sexually aroused are less likely to have feelings of disgust than other groups according to research examining the link between sex and disgust published in PLoS One. The researchers said their findings “enhance our understanding of how sexual arousal interplays with disgust and disgust eliciting properties of both sex and non sex related disgusting stimuli in women”. The 90 healthy women studied were randomly allocated to groups — sexually aroused, non-sexually aroused, or a neutral control group. Behavioural tasks involving sex-related (eg, lubricate the vibrator) and non-sex-related (eg, drink juice with a large insect in the cup) stimuli, which were used to measure the impact of sexual arousal on feelings of disgust and actual avoidance behaviour.

Posted 17 September 2012

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