The inside edge

Antioxidant vitamin supplements may help to reduce the altered cardiovascular function that occurs during a dive. Researchers assessed the effects of a 30-minute open sea dive to a depth of 30m in a small group of divers, finding major changes in their endothelial function and mild changes in cardiac function. Giving divers 2g vitamin C and 400IU vitamin E before another dive significantly improved post-dive endothelial function compared with the control dive, although other cardiac parameters were unaffected. Obad A, Palada I, Valic Z et al. J Physiol 2007; 578: 859-70

Glycaemic targets for UK patients are higher than for those in other European countries, according to data presented at this year’s Diabetes UK conference in Glasgow. Questionnaires were sent to 622 primary care doctors in the UK, France, Germany, Italy and Spain, and the HbA1c of 2,531 patients was measured. Mean HbA1c was 7.7 in the UK, compared with 7.2–7.3 in the other countries; 29 per cent of UK patients had HbA1c >8 compared with 14 per cent across the other four countries. The lead author on the study suggested that the current GMS HbA1c audit target of 7.5 could be to blame.
Ambery P, Pandya B, Benford M, Evans M. Poster presentation; 14 Mar 2007

Just four drug groups account for about half of preventable medicines-related hospital admissions, UK researchers suggest. A review of data from 13 studies showed a median 3.7 per cent of drug-related admissions were preventable. An analysis of data from nine papers showed that 51 per cent of the preventable admissions involved antiplatelets (16 per cent), diuretics (16 per cent), NSAIDs (11 per cent) or anticoagulants (8 per cent). About 30 per cent of preventable admissions were associated with prescribing problems.
Howard RL, Avery AJ, Slavenburg S et al. Br J Clin Pharmacol 2007; 63: 131-5, 136-47

NICE recently issued guidance on the use of inhaled insulin, advising that it could be considered for patients unable to initiate or intensify their insulin therapy because of needle phobia. However, the authors of a review in Drug & Therapeutics Bulletin have concluded that, based on current evidence, they see few situations where the potential benefit of inhaled insulin outweighs safety concerns and the ‘considerable’ expense associated with treatment.
DTB 2007; 45(1): 5-8

Clinical cardiopulmonary exercise testing is rarely used in the UK but should be employed more widely. New evidence-based recommendations from a European task force on exercise testing in heart and lung disease highlight the prognostic value of testing and its use in assessing treatment interventions. The task force says the guidance will help clinicians decide when to use exercise testing, which form of test to use and which variables to measure when assessing prognosis or the effectiveness of an intervention.
Palange P, Ward SA, Carlsen KH et al. Eur Respir J 2007; 29: 185-209

The benefits of activity in improving and limiting CVD progression are largely unrecognised by women of South Asian origin, the results of a qualitative study suggest. Women of varying South Asian ethnicity aged 26 to 70 years, with CHD and/or type-2 diabetes, were interviewed. Respondents were uncertain what type of activity was appropriate and safe for them and operated within their own threshold for activity, although they emphasised the cultural importance of being active day-to-day. Specific guidance from health professionals was lacking, prompting the researchers to call for better advice on appropriate physical activity, its health benefits and safety for this patient group.
Sriskantharajah J, Kai J. Fam Pract 2007; 24: 71-6

Low LDL cholesterol appears to be associated with greater risk of Parkinson’s disease. Researchers at the University of North Carolina found that, compared to people with LDL cholesterol of M3.57mmol/L, those with 2.41–2.95mmol/L were 3.5 times more likely to develop the disease. Use of statins or other cholesterol lowering drugs was associated with lower occurrence of Parkinson’s disease. Huang X, Chen H, Miller WC et al. Mov Disord 2007; 22: 377-81

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