eMJA: In Other Journals, 2 February 2009

Happiness appears to be contagious, according to US researchers. In a longitudinal social network analysis observing over 4500 participants for 20 years, happiness was measured in each individual and in people in his or her social network. Analysis of the results showed that happy people tend to be connected to each other in happy clusters. Happiness was observed to spread across an array of social ties, including family relationships and friendships, with clustering occurring in groups of people separated by up to three degrees of separation (ie, friends of friends). Also, happier people tend to be in the centre of their local social networks, and these individuals are more likely to stay happy in the future, an effect that remained significant even when the researchers controlled for age and education. The authors comment that their research has relevance for public health, with the health and wellbeing of one person clearly affecting that of others.

Rock-a-bye coronary

The benefits of a good night’s sleep are becoming ever more compelling, with US researchers finding a correlation between longer sleep duration and a lower incidence of coronary artery calcification. Using 495 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, the trial measured changes in coronary artery calcification, a predictor of future coronary heart disease events, over a 5-year period. Information on sleep patterns, including objective data from wrist activity monitors, was also collected. Longer measured sleep duration appeared to be significantly associated with a reduced incidence of coronary artery calcification. Potential mediators including lipids, blood pressure, and body mass index did not seem to alter the significance of sleep. The authors acknowledge the limitations of the study, in particular the lack of clinical apnoea diagnosis, but the overall import of the findings appears to remain significant.

JAMA 2008; 300: 2859-2866

More fish, less itch

Introducing fish into the diet of infants before 9 months of age may be beneficial in reducing their risk of eczema, according to Swedish researchers. In a prospective longitudinal study of almost 5000 infants, families were questioned in detail about environment, perinatal history, breastfeeding, food introduction, and diseases. At 1 year of age, parents reported that 20.9% of the infants had previous or current eczema, with familial occurrence of the disease a strong independent risk factor. Introduction of fish into the diet before 9 months appeared to reduce the risk of eczema, although breastfeeding did not seem to provide protection, a result that is not in agreement with previous studies. Despite the obvious limitation of the self-reported nature of the data, the findings raise interesting questions about the effect of diet on eczema.

Arch Dis Child 2009; 94: 11-15

Schizophrenia: which drugs?

Antipsychotic drugs have long been split into two classes: first-generation drugs and second-generation or atypical drugs, which have been regarded as producing fewer side effects and being more efficacious. A group of international researchers has performed a meta-analysis of 150 randomised controlled trials to compare the effects of the two classes of drugs in patients with schizophrenia. The results suggest that, as a class, newer second-generation antipsychotic drugs do not appear to offer widespread benefits over older first-generation medications. Although second-generation drugs induced fewer extrapyramidal side effects than did haloperidol, this effect did not apply to low-potency first-generation drugs. Differences in sedating properties and weight gain were observed within the second-generation class. The authors conclude that atypical antipsychotics are not a homogeneous class of drugs and that treatment should be tailored to the individual in terms of efficacy, side effects and cost.

Lancet 2009; 373: 31-41

ICU and infections

Decontamination of the digestive tract and oropharynx in the intensive care setting appear to decrease mortality, according to Dutch researchers. The effects of two infection-prevention measures — selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) — were evaluated in a crossover cluster randomisation study of almost 6000 intensive care unit (ICU) patients. Mortality at Day 28 was the endpoint. The interventions included regimens of oral and topical antibiotic therapy for the SDD and SOD treatment groups. The mortality rate associated with the standard-care (control) group was 27.5% at Day 28, with a reduction of 3.5% and 2.9% in the SDD and SOD groups, respectively. The authors comment that, considering the importance of antibiotic resistance in the ICU, regimens using lower volumes of topical antibiotics and less widespread systemic prophylaxis are more desirable.

N Engl J Med 2009; 360: 20-31

Dr Tanya Grassi, MJA

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