eMJA: In Other Journals, 17 November 2008

Children who are bullied are at greater risk of developing psychosomatic and social adjustment problems than uninvolved children, according to the results of an Italian study. The cross-sectional study of 565 primary school children assessed responses to questionnaires measuring bullying, victimisation and psychosomatic complaints. Children were classified as “bullies”, “bully victims”, or “victims of bullying”. Teachers supplied ratings of each child on a strengths and difficulties scale. Victims and bully victims had a higher risk of conduct symptoms and hyperactivity, with victims also reporting more symptoms with peers. All groups of children involved in bullying had a higher risk of psychosomatic symptoms, but interestingly, bullies manifested the fewest adjustment problems. The author concludes that health assessments of paediatric patients should include evaluation of peer victimisation.

Flu fighters

Immunising pregnant women against influenza may result in significant health benefits for both the women and their infants, according to a study carried out by US and Bangladeshi researchers. A total of 340 pregnant mothers were randomly assigned to two groups, receiving either an influenza vaccine or a pneumococcal vaccine (the control group). Mothers were followed up weekly until 24 weeks after birth, and sick infants were tested for influenza antigens. Fewer cases of confirmed influenza were seen in the infants of mothers immunised against influenza, with the vaccine reducing proven influenza by 63% in infants up to 6 months of age. The immunised mothers also showed a significant reduction in the rate of febrile respiratory illness. The researchers comment that vaccination of pregnant women against influenza may prove beneficial, particularly in areas with limited financial resources.

N Engl J Med 2008; 359: 1555-1564

Vitamin B and Alzheimer’s

A regime of high-dose vitamin B supplementation does not appear to slow the decline of cognitive function in patients with Alzheimer’s disease (AD), say US neuroscientists. Working with the previously observed association between high homocysteine levels and AD, researchers set out to find whether the homocysteine-lowering properties of vitamin B could be translated into a beneficial effect on people with mild to moderate AD. The trial involved 340 participants who were randomly assigned to two groups; one of which received high-dose vitamin B supplements and the other a placebo. The main outcome measure was change in the cognitive domain of the Alzheimer’s Disease Assessment Scale. Despite the effectiveness of vitamin supplementation in reducing homocysteine levels overall, no difference in the cognitive score was observed between the groups. Adverse events involving depression were more common in the active treatment group, a result which the authors found surprising, and which they felt warranted further investigation.

JAMA 2008; 300: 1774-1783

AAA in women

Clinically relevant events such as repair and rupture of abdominal aortic aneurysm have been studied in a large prospective observational cohort study of postmenopausal women.1 In an analysis of potential risk factors for abdominal aortic aneurysm events, over 161 000 postmenopausal women were followed up for a mean of 7.8 years. Events were strongly associated with smoking and age in particular, but also with height, hypertension and coronary and peripheral vascular disease. A negative association was noted with diabetes, a finding also shown in men in previous studies. There was also an apparent negative association with hormone replacement therapy, a finding that the authors suggest needs further consideration. An accompanying editorial suggests that the results of this large study are significant, as although abdominal aortic aneurysm is less common in women, mortality after repair is greater, and the prognosis is worse in women.2

1 BMJ 2008; 337: a1724

2 BMJ 2008; 337: a1894

Dr Tanya Grassi, MJA

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