12 December, 2008
Interesting article on drug makers and journals
The New York Times has an interesting article on HRT and a drug maker.
09 December, 2008
Flu immunisation in pregnancy
Pregnant women should be vaccinated against influenza viruses. Being immunised reduces their chances of being hospitalised during pregnancy and decreases the risk of fetal anomalies. Although immunisation with inactivated flu vaccine is recommended by the World Health Organisation and national health bodies, few mothers receive the vaccine and little is known about its effect on neonates.
What is known is that natural maternal antibodies protect babies in the first few months of life but there are no data on whether vaccinating the mother also offers protection. Zaman et al (NEJM 2008;359:1556-64) now report on a trial that looked at the effectiveness of a trivalent inactivated vaccine in reducing flu in pregnant women and their offspring for 6 months after delivery.
Compared to mothers and infants not given the vaccine, babies whose mothers received the vaccination intervention had a two-thirds reduction in the risk of having laboratory- proven flu while the mothers had a one-third reduction in their likelihood of respiratory fever. The study was carried out in Bangladesh and showed that the remarkable effectiveness of the vaccine conveyed infant immunity for a longer duration than that offered by passive antibody acquisition from the mother. The “two for the price of one” benefit to mother and infant is an additional incentive, with 5 pregnant women needing to be treated to prevent one illness in her or her baby.
What is known is that natural maternal antibodies protect babies in the first few months of life but there are no data on whether vaccinating the mother also offers protection. Zaman et al (NEJM 2008;359:1556-64) now report on a trial that looked at the effectiveness of a trivalent inactivated vaccine in reducing flu in pregnant women and their offspring for 6 months after delivery.
Compared to mothers and infants not given the vaccine, babies whose mothers received the vaccination intervention had a two-thirds reduction in the risk of having laboratory- proven flu while the mothers had a one-third reduction in their likelihood of respiratory fever. The study was carried out in Bangladesh and showed that the remarkable effectiveness of the vaccine conveyed infant immunity for a longer duration than that offered by passive antibody acquisition from the mother. The “two for the price of one” benefit to mother and infant is an additional incentive, with 5 pregnant women needing to be treated to prevent one illness in her or her baby.
The cost of time saving
In developed countries people turn their clocks forward in spring and backwards in autumn. Forward-turning in spring means an hour is “lost” which usually means an hour less sleep and this reduction can be stressful until people's physiology adjusts. But can losing one hour of rest have a real effect? It seems so if the incidence of myocardial infarcts is anything to go by.
Janszky & Ljung from Sweden (NEJM 2008;359:1966-8) showed that coronary events are more common when people are deprived of their extra hour when they turn their clocks forward. Hospital admissions for infarcts rose significantly across the land, especially 2 days after change-over, compared to 2 weeks earlier or 2 weeks later. The effect was consistent over many years and most pronounced in people younger than 65 years old.
As if to prove the point, the opposite effect was found in autumn when the Swedes had fewer than average heart attacks immediately after the “extra hour” was added. The work suggests there are subtle relationships between sleep patterns, stress and cardiac events.
Janszky & Ljung from Sweden (NEJM 2008;359:1966-8) showed that coronary events are more common when people are deprived of their extra hour when they turn their clocks forward. Hospital admissions for infarcts rose significantly across the land, especially 2 days after change-over, compared to 2 weeks earlier or 2 weeks later. The effect was consistent over many years and most pronounced in people younger than 65 years old.
As if to prove the point, the opposite effect was found in autumn when the Swedes had fewer than average heart attacks immediately after the “extra hour” was added. The work suggests there are subtle relationships between sleep patterns, stress and cardiac events.
03 December, 2008
The Six Habits of Highly Respectful Physicians
A good article on The Six Habits of Highly Respectful Physicians in the New York Times.
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