News in brief

Calcium reduces hyperparathyroidism risk
THE first prospective study of the relation between calcium intake and risk of primary hyperparathyroidism, published in the BMJ, shows higher daily calcium intake is independently associated with a reduced risk of the condition in women. During 1 475 978 person-years of observation of women in the Nurses Health Study over a 22-year period, the researchers confirmed 277 cases of incident primary hyperparathyroidism. The relative risk for women with the highest intake of dietary calcium compared with women with the lowest intake was 0.61. An accompanying editorial raised the possibility of calcium supplementation, saying that even a dose as low as 500 mg a day was associated with a decreased incidence of primary hyperparathyroidism. “This is important because such a modest dose is less likely to be controversial”, the editorial said.

Discrimination barrier
A CROSS-sectional survey of people with a major depressive disorder has found that discrimination acts as a barrier to social participation and successful vocational integration for many people with depression. The research, published in The Lancet, involved 1082 people with depression in 35 countries, including Australia, who were interviewed with the discrimination and stigma scale. It found 79% experienced discrimination in at least one life domain, including 37% who had stopped themselves from initiating a close personal relationship and 25% from applying for work. Higher levels of discrimination were associated with several lifetime depressive episodes, at least one psychiatric hospital admission and lower willingness to disclose a diagnosis of depression, An accompanying editorial by Anthony Jorm and Nicola Reavley, of the School of Population Health at the University of Melbourne, said evidence from such studies could provide input into the design of anti-discrimination interventions, such as public education about human rights and the effect of discrimination on people with depression.

Cranberry juice no use in UTIs
AN updated review of evidence from The Cochrane Library has found that cranberry juice is less effective at preventing urinary tract infections (UTIs) than previously thought. The updated review, which included 24 studies with 4473 participants, showed that, compared with placebo, water or no treatment, cranberry products did not significantly reduce the occurrence of symptomatic UTI overall or for any the subgroups — women with recurrent UTIs, older people, pregnant women, children with recurrent UTI, cancer patients or people with neuropathic bladder or spinal injury. The review authors said that based on their findings, cranberry juice could not currently be recommended for the prevention of UTIs.

Alzheimer relapse
PATIENTS with Alzheimer disease who respond to risperidone therapy to control psychosis or agitation are likely to relapse when treatment is discontinued, according to research publish in the New England Journal of Medicine. The study, based on 112 patients who had responded to an initial open-label course of risperidone, found rates of adverse events and deaths did not differ between groups receiving placebo and those continuing risperidone treatment but those switched to placebo were about twice as likely to relapse over the following 4 months. The researchers said the findings should be weighed against the risk of adverse effects with continued antipsychotic treatment. They also found that although discontinuing risperidone resulted in an increased risk of relapse, the treatment “was not highly effective in achieving and maintaining a reduction in symptoms of psychosis and agitation in patients with Alzheimer’s disease”.

No benefits in sedation interruption
DAILY sedation interruption for critically ill patients receiving mechanical ventilation offers no additional benefits, according to research published in JAMA. The researchers found that for critically ill patients receiving mechanical ventilation, when nurses implemented a sedation protocol that targeted light sedation, daily sedation interruption did not reduce the duration of mechanical ventilation, offered no additional benefits for patients, and may have increased both sedation and analgesic use. The multicentre randomised trial of 430 critically ill, mechanically ventilated adults in 16 tertiary care medical and surgical ICUs in Canada and the US found that patients in the daily interruption group received more opioids and benzodiazepines than those in a control group. They also found that the self-assessed nursing workload was higher for patients in the daily interruption group than the control group. However, the researchers said their findings were of uncertain clinical importance.

Posted 22 October 2012