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BMJ No 7119 Volume 315 Press Releases Saturday 22 November 1997 Embargoed: 00.01 hrs 21 November 1997 UK time Historical study shows no link between malnutrition in the womb and disease
in adulthood Historical study shows no link between malnutrition in the womb and disease in adulthood(Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results form the Leningrad siege study, a cross sectional study)Many studies have shown a link between low birth weight and adult diseases, such as hypertension, diabetes and cardiovascular disease and some have suggested that this may be as a consequence of maternal malnutrition during pregnancy. In this week's BMJ, Stanner et al report their findings from a study of people whose mothers were malnourished during pregnancy, at the time of the siege of Leningrad from 1941-44. The authors compared these people with subjects born before the siege began and a group that were born at the same time, but outside the area. The authors found that intrauterine malnutrition was not associated with such diseases in later life as has been previously suggested. See Paper (abstract only) (Stanner et al) p 1342 Contact:
Department of Medicine,
tel: 0171 288 5301 Regional trauma care system does not improve patients' chances of surviving major trauma(Effectiveness of a regional trauma system in reducing mortality from major trauma: controlled before and after study)The Royal College of Surgeons recommended the development of regional trauma centres along the lines of the American model, widely reported as successfully reducing trauma deaths. In this week's BMJ, Nicholl and Turner reveal the results of their four year study to evaluate the effect of an experimental regional trauma centre set up in the north west Midlands, on the survival of patients with major trauma. The authors found little evidence of the development of an integrated trauma system and the proportion of patients taken directly to the trauma centre, rather than to another accident and emergency department, increased only for those with multiple injuries. Compared with the results achieved in two control regions (where trauma patients continued to be taken to accident and emergency departments in the usual way), there was no reliable or consistent evidence that the regional trauma system improved patients? chances of survival from major trauma. See Paper (full text) (Nicholl and Turner) p 1349
Contact:
Medical Care Research Unit,
tel: 0114 222 5202
Negative results from West Midlands study do not tell the whole story(Regional trauma systems - the negative results from Stoke do not tell the whole story)In a related editorial in this week's BMJ, Yates welcomes the paper by Nicholl and Turner as an opportunity to rekindle the debate on the organisation of trauma care in Britain. Yates suggests that the negative results of their paper must be taken in the context of a "shire county" comparison, which may not be relevant to larger metropolitan areas. The author underlines Nicholl and Turner's observation that their report is limited to a review of mortality after major trauma and refers to their unpublished work on avoidable deaths from less severe injuries, the quality of life of the survivors and the cost of the service. Yates concludes that these data should be published as soon as possible, in order that the system can be better evaluated.
Contact:
Hope
Hospital,
tel: 0161 787 4843 Does stringent matching criteria mean unequal access to kidney transplantation(Effect of a strict HLA matching policy on distribution of cadaveric kidney transplants to Indo-Asian and white European recipients: regional study)Human leukocyte antigens (HLA) are proteins which help to provide defence against infections and influence the outcome of organ transplantation. In this week's BMJ, Higgins et al, release their study to assess whether their unit's policy of close HLA matching of donors and recipients was reducing the chances of ethnic minority patients getting a kidney donation. Higgins et al found that similar proportions of both groups were placed on waiting lists for transplants, with 33 per cent of Indo-Asians and 19 per cent of Europeans remaining on the list for over two years. The Indo-Asians had lower rate of organ donation, a different distribution of blood groups and a lower proportion in each blood group who received transplants. The authors conclude that Indo-Asian patients should not be denied access to renal transplantation because there is a low rate of organ donation from their ethnic group. The factors that may account for the low rate of donation among Indo-Asian patients include the age distribution of the Indo-Asian population, the lower number of Indo-Asians admitted to intensive care units and religious views about organ donation from cadavers. Since 1996 the Dialysis and Transplant Units at Walsgrave Hospital has loosened its HLA matching policy slightly to try to ensure that all patients waiting more than two years are offered a kidney - it is hoped this new policy will improve access to transplantation while maintaining some advantage from HLA matching.
Contact:
Dialysis and Transplant Units,
tel: 01203 602020 x7249
Reception staff can improve uptake of breast screening(Improving uptake of breast screening in multiethnic populations: a randomised controlled trial using practice reception staff to contact non-attenders)The uptake of breast screening is inadequate and inequitable in some deprived areas - often those with large minority ethnic populations. In this week's BMJ, Atri et al found that a two hour training session for general practice reception staff made a small but important improvement in attendance. The authors found that this improvement was most pronounced among Indian women, which was perhaps due to the fact that most practices in the study employed staff who spoke an Indian language. Atri et al conclude that resources of local general practices could be used as part of a multifaceted programme to increase screening rates in areas of low uptake. See Paper (abstract only) (Atri et al) p 1356
Contact:
Health Eastenders Project,
tel: 0171 982 6974 Patients with implants should be given implant cards for referenceIn a letter in this week's BMJ Purkayastha advocates that patients who have had implants, such as artificial joints, metal plates, rods and screws, should be given a card detailing their particulars along with the date, site and type of implant inserted. The author suggests that the cards could be of immense value - not only would they be a permanent record, but they would help hospitals when a patient needs further surgery. There are many different types of implants, with variable dimensions and with constant modifications, made by a variety of manufacturers, and thus it is difficult for hospitals to be equipped with the different types of instruments required.
Contact:
Department of Orthopaedics, tel: 0181 289 7000/7161 fax: 0181 289 7125 See Letter (Purkayastha) p 1377
Embargo: 00.01 hrs Friday 14 November 1997 Please contact Public Affairs Division for the text of the paper & the authors for further comment For further information, please contact:
Jill Shepherd on 0171 383 6254
After 6pm & at weekends: 0181 651 5130
0181 241 6386
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0181 997 3653 Or fax requests to Public Affairs Division, BMA on 0171 383 6403. If you currently receive your British Medical Journal press release by mail and you would like it faxed to you please telephone (0)171 383 6123, Fax: (0)171 554 6123 or E-mail: LRiviere@mail.bma.org.uk When dialling the UK from abroad, remember to delete the first zero from the local area code, eg, (00 44) 171... BMA on Internet page: http://www.bma.org.uk If you intend to use any article publicised in this press release, ensure you quote the British Medical Journal as source
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