Pneumonia, warts and obesity

Too busy to read the journals? Let Dr Simon Hunter guide you through the latest research

Research of the week

Smoking, drinking and Raynaud’s
Am J Med 2007; 120: 264–71

It has been mooted that Raynaud’s phenomenon may share the same risk factors as cardiovascular disease of smoking and excess alcohol consumption.

This study found that men and women seemed to react differently to different stimuli. Smoking made no difference to women, but it increased Raynaud’s in men. Heavy alcohol increased the risk in women, whereas moderate consumption reduced the risk in men.

One thing that was the same was that red wine reduced the risk in both sexes. This may be a good piece of advice for Raynaud’s patients, for whom there never seems to be anything we can really do. 

Single or double dose amoxicillin in pneumonia
Arch Dis Child 2007; 92: 291–7 

Conducted in Pakistan, this study determined whether standard-dose amoxicillin (45mg/kg/day) was as effective as double-dose (90mg/kg/day), both for three days, in non-severe pneumonia, in under five-year-olds. This is because it is believed that some amoxicillin resistance can be overcome with higher doses. No microbiological testing was performed.

No significant difference was found between the two groups after three days and also at a 14 day follow-up clinic, with about 5 per cent treatment failure at day three and 7 per cent at day 14. From this, normal-dose amoxicillin for just three days seems a reasonable treatment option.

Bad news for low carbs
J Int Med 2007; 261: 366–74 

One of the most famous diets in recent times has been one based on low carbohydrate and high protein input. There was certainly some success with this approach, but also some caution that it may be harmful. This Swedish study based on the long-term dietary habits of 40,000 people over 12 years found a direct correlation between higher protein/lower carb input and mortality, especially cardiovascular mortality. The effect was much more noticeable in women.

However, I would not say this is the death knell for this genre of diets, as this study looked at people adopting this diet over a long period, rather than for a short-term weight reduction programme.

Being fat is nothing new
Am J Med 2007; 120: 242–50 

It is generally felt that the current epidemic of obesity is a modern phenomenon but this study, set in America, shows it has been occurring for at least five decades.

The data was gleaned from the Framingham Study participants. It showed that in the 1950s 22 per cent of men were overweight, which rose to 35 per cent in the 1990s while obesity went from 5.8 per cent to 14.8 per cent and stage II obesity from 0.2 per cent to 5.4 per cent. The level of obesity has risen steadily over the last five decades, although rates have escalated in the last decade. This also demonstrates that the increase in obesity is not slowing.

Duct tape and warts
Arch Dermatol 2007; 143: 309–13 

The use of duct tape as a treatment for warts has always fascinated me. Not the question of does it work, but why did someone try it in the first place? Previous studies that have shown up to a dramatic 80 per cent success rate, have been countered by this larger study where it was tested again a ‘placebo’ tape — in this case something called Dr Scholl’s Moleskin Plus.

Over a nine-month period, both had a 21 per cent cure rate — which might even have been natural resolution. I am genuinely disappointed in the results.

BP charts for children
Arch Dis Child 2007; 92: 298–303 

One of the reasons that BP in children is rarely measured is the lack of decent reference data. This British study took a cross-section of children who were selected to represent different sexes, ages, social class and geographic location.

The BP was taken with the same type of machine nationwide following a strict reproducible protocol.

This has lead to BP charts for different ages of boys and girls showing the centiles in a similar manner to the widely used height and weight charts. The charts can be viewed at http://adc.bmj.com/cgi/reprint/92/4/298 and I think are well worth downloading for future reference. 

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