TB risk continues for immigrants
A SUBSTANTIAL risk of tuberculosis (TB) persists in some immigrants long after their arrival in Australia, according to research in the MJA. The longitudinal study of the incidence of active TB in Victorian immigrants who arrived in Australia between 1975 and 2007 found the highest risks were in immigrants from South Asia and sub-Saharan Africa. For those from high-risk regions the incidence of active TB infection was 100–150 per 100 000 person-years in the first 6 years following immigration (compared with 1.5/100 000 person-years in the Australian-born population). The researchers estimated that 50% of TB occurred within 7 years of arrival but the increased risk persisted for at least 35 years. They said the results of the research could be used to target public health strategies.

Age for stroke decreasing
A US population-based study published in Neurology has found trends of increasing stroke incidence at younger ages. The data were based on strokes among the 1.3 million people in the Greater Cincinnati/Northern Kentucky region. The researchers found that mean age at stroke significantly decreased from 71.2 years in 1993/1994 to 69.2 years in 2005, with significantly increased stroke incidence rates in both black and white people in the 20–54 year age group. The proportion of all strokes occurring at age less than 55 years increased from 12.9% to 18.6% in the same period. The researchers said the findings were of great public health significance because strokes in younger patients carried the potential for greater lifetime burden of disability. An editorial in the same issue said that the increase in incidence among the young suggests an unknown and potentially daunting future trajectory.

Parents want ADR information
MANY parents were generally disappointed with how clinicians communicated about suspected adverse drug reactions (ADRs), according to the results of a qualitative study published in PLoS One. The study, based on interviews with parents of 44 children who had had a suspected ADR, found that most parents reported receiving little or no advanced explanation about problems that might be associated with medicines. The researchers said the findings would help guide clinicians on discussions with families about medicines and ADRs. At the time of prescription, parents wanted to know the potential risks associated with medicines, and in the event of a suspected ADR, they wanted to understand what had happened to their child.

Drugs have long shelf-life
NEW research published in Archives of Internal Medicine has added to evidence that that many prescription pharmaceuticals retain their full potency for decades beyond the manufacturer’s recommended use-by date. The researchers found that 12 of 14 medications tested retained full potency for at least 336 months, and eight of these for at least 480 months. They said the results supported the effectiveness of broadly extending expiration dates for many drugs. “Given the potential cost savings, we suggest the current practices of drug expiration dating be reconsidered”, they wrote.

Heart benefits from HRT
THE authors of a Danish randomised controlled trial say hormone replacement therapy (HRT) initiation in women early after menopause significantly reduces the risk of mortality, myocardial infarction or heart failure. The study, published in the BMJ, also found early initiation and prolonged HRT did not result in an increased risk of breast cancer or stroke in their sample. The trial involved 1006 healthy women who were aged 45–58 years and recently postmenopausal or had perimenopausal symptoms at recruitment in 1990–1993. Women in the intervention group were given either triphasic oestradiol and norethisterone acetate or oestradiol alone (for those who had undergone hysterectomy). The intervention was stopped after about 11 years owing to adverse reports from other trials, but follow-up continued. After 10 years of intervention, 16 women in the treatment group had cardiovascular events compared with 33 in the control group, and 15 died compared with 26 in the control group. The benefits were maintained after 16 years and there was no associated increase in any cancer.

Posted 15 October 2012

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