Volume 194 - Issue 8
In Other Journals
Author: Sophie McNamara
Med J Aust 2011; 194 (8): 426. || doi: 10.5694/j.1326-5377.2011.tb03042.x
Published online: 18 April 2011
Published online: 18 April 2011
Rethinking skull surgery
After traumatic brain injuries, decompressive craniectomy is an increasingly common procedure used to reduce intracranial pressure, but there have been few randomised studies of this invasive technique. Australian and Saudi researchers randomly assigned 155 adults with severe traumatic brain injuries and intracranial hypertension that had not responded to first-tier therapy, to either standard care or decompressive craniectomy. The latter did reduce intracranial pressure and length of intensive care unit stay, but increased the likelihood of a poor outcome 6 months after the injury. The proportion of people who died within 6 months of their injury was similar in both groups. Researchers were surprised that craniectomy was linked to fewer favourable outcomes. “Our findings differ from those of most non-randomized studies of decompressive craniectomy and are contrary to our hypothesis”, wrote Dr James Cooper of Alfred Hospital, Melbourne, and colleagues.
N Engl J Med 25 March 2011 (Online first)
Hep C treatment hope
There’s new hope for people with the most hard-to-treat strain of hepatitis C virus (HCV), known as genotype 1. Less than half of patients with this genotype do not respond to the standard two-drug treatment regimen, of peginterferon and ribavirin. But new international research shows that adding the protease inhibitor boceprevir to the mix significantly increases the proportion of people who clear the virus. The HVC RESPOND-2 Investigators led by Dr Bruce Bacon from the Saint Louis University School of Medicine, Missouri, randomly assigned 403 patients with previously treated HCV to one of three groups: the usual treatment regimen plus placebo for 44 weeks, the usual treatment plus boceprevir for 32 weeks, or the usual treatment plus boceprevir for 44 weeks. The rate of sustained virological response was significantly higher in the boceprevir groups compared with the control group.1 A related paper reports similar results for patients with HCV genotype 1 who had not previously received any treatment.2
1 N Engl J Med 2011; 364: 1207-1217
2 N Engl J Med 2011; 364: 1195-1206
Airport scanners radiation risk
The radiation risk from full-body airport scanners is extremely small, an American study has concluded. The analysis estimated that the amount of radiation emitted from the controversial backscatter scanners is equivalent to less than 1% of the radiation a passenger is exposed to on a 6-hour flight. Compared with medical procedures, a passenger would have to undergo 1000 airport scans to equal the exposure of a chest radiograph, or 4000 airport scans to equal the exposure of a mammogram. The research also estimated cancer risks from the scanners. It found that for the 100 million passengers taking 750 million flights each year, six cancers could result from the backscatter scanner radiation over these passengers’ lifetimes, compared with the background lifetime incidence of 40 million cancers that would be expected to develop in these individuals. Backscatter scanners are the most commonly used airport scanner in the United States, and the Australian Government is considering their use in Australian airports.
Arch Intern Med 28 March 2011 (Online first)
Will I get another cancer?
Only a small proportion of second cancers are related to radiotherapy treatment for a first cancer, according to an American analysis of almost 650 000 5-year cancer survivors. The researchers compared the relative risk of a second solid cancer in adult patients who had received radiotherapy with those who did not receive radiotherapy, during an average 12-year follow-up period. The study concluded that only about 8% of second solid cancers were related to radiotherapy treatment, suggesting that the remainder are due to factors such as lifestyle or genetics. The proportion of second cancers related to radiotherapy was lowest for patients initially treated for cancers of the eye and orbit (4%), and highest for those treated for testicular seminoma (24%). Researchers say the results should reassure patients that the risk of radiation-related cancer is small compared with the treatment’s benefits.
Lancet Oncol 30 March 2011 (Online first)
Guess who binges?
People who get a buzz from alcohol are more likely to become problem drinkers than those who simply feel sleepy after drinking, new research shows. Almost 200 drinkers aged 21-35 years attended three laboratory sessions where they were randomly assigned to receive either placebo, low-dose alcohol, or high-dose alcohol. Those who experienced more rewarding and stimulating effects from the stronger drink were more likely to increase their frequency of binge drinking during a 2-year follow-up than those who were more sedated by the strong drink. The research is at odds with the prevailing theory that people who experience a weaker alcohol response are more likely to misuse the booze.
Arch Gen Psychiatry 2011; 68: 389-399