News in brief

HPV success as genital warts decline
EARLY data published in the BMJ show significant declines in the proportion of young women diagnosed with genital warts since the quadrivalent human papillomavirus vaccination (HPV) program started in Australia in 2007. The researchers, from the University of NSW and Melbourne Sexual Health Centre, found that less than 1% of women aged under 21 years presenting at sexual health services were found to have genital warts in 2011, compared with 10.5% in 2006. “By 2011, no genital warts were diagnosed in women aged under 21 who reported being vaccinated. A significant decline also occurred in genital wart diagnoses in 21–30 year old women, a trend not observed in older women”, the researchers wrote. The data were based on the records from 2004 to 2011 at eight sexual health services. The researchers predicted that the recent decision in Australia to vaccinate 12–13-year-old boys against the virus would lead to control “if not elimination, of the target human papillomavirus types in young people”. An accompanying editorial described the results as “exciting times in the science of HPV” saying the world could look forward to “the virtual elimination of genital warts”.

Resistance to healthy lifestyles
RESEARCHERS have found a low prevalence worldwide of people who adopt a healthy lifestyle after a coronary heart disease (CHD) or stroke event, particularly in poorer countries. The Prospective Urban Rural Epidemiology (PURE) study, published in JAMA, was a large, prospective cohort study of 153 996 adults aged 35–70 years from 628 urban and rural communities in three high-income countries, seven upper-middle-income countries, three lower-middle-income countries and four low-income countries. It examined three important healthy lifestyle behaviours — avoiding or stopping smoking, eating a healthy diet and undertaking regular physical activity. Overall, 52.5% of smokers quit smoking (ranging from74.9% in high-income countries to 38.1% in low-income countries). Levels of physical activity rose with increasing country income, but the trend was not statistically significant. Adopting healthy diets had the lowest prevalence, ranging from just 25.8% in low-income countries to 43.4% in high-income countries. The research also found more women than men adopted two or three healthier lifestyles. The researchers said development of “simple, effective, and low-cost strategies for secondary prevention” of CHD and stroke were needed worldwide.

Fibroids linked to vitamin D deficiency
SUFFICIENT vitamin D is associated with a reduced risk of uterine fibroids, according to research published in Epidemiology. The US study involved 1036 women aged 35–49 years who underwent ultrasound screening for fibroids, with blood samples used to measure 25-hydroxyvitamin D (25(OH)D) and questionnaires on sun exposure. The researchers found that only 10% of black woman and 50% of white women had levels of 25(OH)D regarded as sufficient (>20 ng/ml). Women with vitamin D levels above 20 ng/ml had an estimated 32% lower odds of fibroids compared with those with a vitamin D insufficiency. “Self-reported sun exposure ≥ 1 hour per day (weather permitting) was also associated with reduced odds of fibroids …”, the researchers wrote. “The consistency of findings for questionnaire and biomarker data, the similar patterns seen in blacks and whites, and the biological plausibility provide evidence that sufficient vitamin D is associated with a reduced risk of uterine fibroids.”

Exercise may help heavy drinkers
NEW research appears to confirm the notion that regular aerobic exercise has a protective effect against brain damage. The small study, published in Alcoholism: Clinical and Experimental Research, included 60 individuals who underwent a diffusion tensor imaging session and completed self-reported measures of alcohol consumption, loss of control over drinking, and aerobic exercise participation. The researchers observed a “significant interaction” between alcohol consumption and aerobic exercise participation on white matter. “In the models examining loss of control over drinking, a significant interaction between aerobic exercise and alcohol consumption was observed, such that alcohol consumption was associated with loss of control more strongly for low exercisers than high exercisers”, the researcher wrote. However, they said because the study used retrospective, self-reported data to quantify exercise, further research would need objective measures of duration, intensity, frequency, or type of aerobic exercise to address the “dose” needed to obtain neuroprotective benefits.

Hostile mothers may predict child abuse
A PROSPECTIVE longitudinal study examining the extent of pregnant women’s beliefs that their infants would behave with negative intentions (such as deliberately dirtying their nappy), showed a hostile reaction can predict child maltreatment. The research, published in JAMA Pediatrics, found that the mothers’ hostile attribution to the infant was not only predictive of child maltreatment and harsh parenting behaviours but also associated with demographic and psychosocial indicators of risk (eg, younger maternal age, lower educational level and social isolation). The study of 499 women also found that multiparous mothers made more hostile attributions than primiparous mothers. The researchers said this finding further implicated “attributions as a maternal psychological characteristic, possibly exacerbated by increasing childrearing responsibilities, and not necessarily tempered by child-rearing experience”. They said their study highlighted the value of medical practitioners attending to mothers’ and expectant mothers’ attributions about infants’ intentions. “This practice can be accomplished on informal and formal bases. Informally, if a new mother reports, for example, that her baby is repeatedly waking her up during the night because he is ‘spoiled’ or ‘naughty’, a practitioner might immediately probe that mother’s attributions and responses”, they wrote.

Fainting a family trait
VASOVAGAL syncope (VVS) may not be rare, with new research showing an autosomal dominant form in some families. The Australian research, published in Neurology, included 44 families with multiple family members with VVS, of which six families were found to have an autosomal dominant inheritance, including one with 30 affected members over three generations. “Affected individuals reported typical triggers of VVS (sight of blood, injury, medical procedures, prolonged standing, pain, frightening thoughts)”, the researchers wrote. The triggers varied considerably within the families. A significant link to chromosome 15q26 was found in one family. “The identification of 6 families with autosomal dominant inheritance out of 44 multiplex families with VVS suggests that autosomal dominant VVS is not rare”, the researchers wrote. “Identification of the causal mutations will help to identify the molecular pathways underlying VVS, which will illuminate pathophysiology and guide further genetic research in common VVS.”

Posted 22 April 2013