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Trends in antibiotic prescribing for sore throat
Australian research published in Family Practice suggests “current educational interventions and the apprenticeship model of training is not fostering appropriate practice” when it comes to prescribing antibiotics for sore throat. A group of researchers from Newcastle, Brisbane, Darwin, Adelaide and Melbourne performed a cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. “Data from 856 individual trainees were analysed. Sore throat was managed in 2.3% [of] encounters. Antibiotics were prescribed for 71.5% of sore throat diagnoses. The variables associated with prescribing were inner-regional location and higher socio-economic area. There was no significant association with younger age of patient or greater trainee experience. If an antibiotic was prescribed, the trainee was more likely to seek information from guidelines or a supervisor.” The authors concluded that the “high frequency of antibiotic prescribing and the lack of attenuation in prescribing with increased experience” suggested inadequate training in the area. “Targeted educational interventions, for supervisors as well as trainees, are indicated.”
Yoga increases QoL for patients with paroxysmal AF
A Swedish study published open access in the European Journal of Cardiovascular Nursing shows that “yoga with light movements and deep breathing may lead to improved QoL [quality of life], lower blood pressure and lower heart rate in patients with PAF [paroxysmal atrial fibrillation] compared to a control group”. In the trial, 80 patients diagnosed with PAF were randomised to standard treatment (control group, n=40) or standard treatment in combination with yoga (yoga group, n=40) during a 12-week period. QoL, blood pressure and heart rate were measured at baseline and at the end of the trial. “At the end of the study, the yoga group had significantly lower heart rate … and systolic … and diastolic blood pressure … compared to the control group. Yoga could be a complementary treatment method to standard therapy.”
Standing desk won’t fix a couch potato, says Cochrane
An updated Cochrane Review, published in the Cochrane Library, says that the benefits of a variety of interventions intended to reduce sitting at work are very uncertain. A team of Cochrane researchers updated a systematic review that looked at the effects of different strategies to encourage people to reduce the amount of time they spend sitting at work. They looked at 20 studies with a total of 2174 participants from the US, the UK and Europe. They included evidence from both randomised and non-randomised studies. The researchers found very low quality evidence from three non-randomised studies and low-quality evidence from three randomised studies, with 218 participants, that people who used them sat between 30 minutes and 2 hours less, compared to when they used conventional desks during the working day. Sit-stand desks also reduced total sitting time, both at work and outside work, and the durations of sitting episodes that last 30 minutes or longer. Co-author Jos Verbeek, from the Cochrane Work Review Group, said, “It is important that workers who sit at a desk all day take an interest in maintaining and improving their well-being both at work and at home. However, at present, there is not enough high-quality evidence available to determine whether spending more time standing at work can repair the harms of a sedentary lifestyle. Standing instead of sitting hardly increases energy expenditure, so we should not expect a sit-stand desk to help in losing weight. It’s important that workers and employers are aware of this, so that they can make more informed decisions.”
Managing diabetes with a wearable patch
A wearable, sweat-sensing patch that can monitor and regulate blood glucose levels is described in an article published in Nature Nanotechnology. The graphene-based patch is shown to deliver metformin, a drug used to treat diabetes, through the skin to reduce high blood glucose levels in diabetic mice. The researchers added gold particles to graphene and combined it with a gold mesh to create a flexible, semi-transparent patch and demonstrated its potential for diabetes monitoring and feedback therapy in diabetic mice and two healthy human males. The patch contains a variety of sensors that detect humidity, glucose, pH and temperature. Because the enzyme-based glucose sensor is affected by pH changes in sweat, the pH and temperature sensors correct the glucose measurements by taking into account pH and temperature in real time, improving its reliability. Finally, when the patch senses a high glucose concentration in sweat, heaters embedded in the patch trigger microneedles to dissolve their coat and release the drug metformin.
Dysentery-causing bacteria mapped from Gallipoli
Researchers from the Institut Pasteur in France, and the University of Melbourne, have discovered that the dysentery bacteria Sd1 has existed since at least the 18th century and that it swept the globe at the end of the 19th century, diversifying into distinct types associated with the First World War, Second World War and various conflicts or natural disasters across Africa, Asia and Central America, according to a letter published in Nature Microbiology. Most of the 120 000 casualties evacuated from Gallipoli in 1915 were suffering from dysentery and now, 100 years after the event, the researchers have used the dysentery bacteria samples taken from the hospital to which Gallipoli soldiers were evacuated, to help map the spread of the bacteria across the globe. The researchers examined samples collected between 1915 and 2011 from 66 countries across four continents, including 14 samples collected by Captain EGD Murray during the First World War. “We also provide a unique historical perspective on the evolution of antibiotic resistance over a 100-year period, beginning decades before the antibiotic era, and identify a prevalent multiple antibiotic-resistant lineage in South Asia that was transmitted in several waves to Africa, where it caused severe outbreaks of disease.”
New test for early detection of eye disease
Researchers at the School of Optometry and Vision Science at the University of Auckland, the University of Ulster, and Moorfields Eye Hospital in London, have collaborated to develop a new eye test chart designed to be more sensitive to the early signs of age-related macular degeneration (AMD). In an article published in the British Journal of Ophthalmology, researchers describe how a chart that uses “vanishing” letters (where each letter is made up of a black core with a white surround) is more sensitive than a conventional chart at detecting loss of vision in 80 patients with AMD. “The design of the new charts is such that letters that are too small to read, appear to vanish,” the lead author, Professor Steven Dakin from the University of Auckland said. “This means that your score on this chart is limited not just by your ability to read the letters, but by your ability to tell they are even there. AMD causes retinal cells to die and this seems to affect patients’ ability to read the letters, more than their ability to spot they are there. These patients perform worse on the new chart even though they might still be able to read conventional eye charts.”