Volume 195 - Issue 1
In Other Journals
Author: Sophie McNamara
Med J Aust 2011; 195 (1): 51. || doi: 10.5694/j.1326-5377.2011.tb03193.x
Published online: 4 July 2011
Published online: 4 July 2011
Colorectal surgery clot risk
The incidence of venous thromboembolism (VTE) is significantly higher among patients undergoing open colorectal resections compared with those undergoing laparoscopic colorectal resections (0.8% v 1.4%; P < 0.001), according to new research of nearly 150 000 patients in the US. The findings persisted after stratification for surgery site and pathological condition. A possible explanation is the fact that the laparoscopic procedures are linked to less pain and postoperative ileus, leading to earlier ambulation and shorter hospital stays. The researchers also looked at what conditions were associated with VTE, and found higher blood clot rates among patients with inflammatory bowel disease, followed by cancer and diverticulitis.
Arch Surg 2011; 146: 739-743
Dying young in the USA
Although the US has the highest levels of health spending per capita, new research shows that its citizens are not living as long as people in many other countries. In 2007, the US life expectancy at birth was 75.6 years for men and 80.8 years for women, ranking 37th in the world for both sexes. The research found vast disparities between American counties, with life expectancy ranging from 65.9 to 81.1 years for men, and from 73.5 to 86.0 years for women. During the period from 2000 to 2007, the increase in life expectancy in most of the US counties fell behind that in other nations. In some parts of the US, life expectancy in 2007 was equivalent to the life expectancy in 1957 in the world’s best-performing countries. The authors comment that improving risk factors such as smoking, adiposity, high blood pressure and elevated blood glucose could substantially improve life expectancy.
Popul Health Metr 2011; 9: 16 (Online 15 June)
Statins: still a wonder drug?
Statins have sometimes been described as “wonder drugs” for their ability to cut cholesterol, with recent suggestions that everyone over 55 should be taking the pills.1 However a new meta-analysis finds that intensive-dose statin therapy is associated with an increased risk of new-onset diabetes compared with moderate-dose statin therapy.2 The research looked at five randomised clinical trials providing data on 32 752 non-diabetic patients, over an average follow-up of 4.9 years. Among patients assigned to the intensive statin treatment (eg, atorvastatin 80 mg), there were 416 fewer patients with cardiovascular events, but 149 more cases of incident diabetes. The authors comment that the “net cardiovascular benefit in high-risk individuals will still strongly favour statin therapy”; however, they suggest that clinicians should be vigilant for the development of diabetes in patients receiving statin therapy.
1 PLoS ONE 2011 6 (5): e18742 (Online 4 May)
2 JAMA 2011; 305: 2556-2564
The reluctant sickie
Taking a “sickie” is arguably something of an Australian tradition, but a comment piece in the BMJ suggests that health care professionals may be reluctant to stay home when they are unwell. The article refers to recent research which found that over a 4-week period, one-third of doctors and nurses worked when they should have taken sick leave (a phenomenon known as “presenteeism”). Presenteeism is said to be more common among those who have a greater responsibility for patient care, a lack of back-up and an accumulating workload during absence. Stimulating workplaces can also promote presenteeism among workers with high job satisfaction. The comment piece points to evidence suggesting that presenteeism increases morbidity including musculoskeletal pain, fatigue, depression and serious coronary events. Going to work when sick is of particular concern in health care settings because of the risk of spreading infections, the author comments.
BMJ 2011; 341: d3446
“Coming out” without coming down
Doctors who are counselling gay, lesbian or bisexual people about coming out may be interested in new research which found that revealing one’s sexual identity does not always confer psychological benefits. The psychological pay-offs of coming out, such as reduced anger and depression and increased self-esteem, only occur in supportive settings. The qualitative study of 161 gay, lesbian and bisexual people in the US found that among hostile groups, the costs and stigma of identifying as gay cancelled out the benefits. The research found that friends, then families, were perceived as the most supportive and accepting groups, while religious communities and schools were rated as more controlling and judgemental.
Soc Psychol Personal Sci 20 Jun 2011 (online)