TMR's picks from the leading medical journals
TMR has searched the top medical journals for the latest insights. Here’s what we found:
Forget suicide-risk criteria
Classifying patients into high, medium, or low risk of suicide does not assist in suicide prevention, a review of meta-analyses shows.
None of the meta-analyses found that any individual clinical risk factor, including suicide thoughts and behaviours, was sufficiently accurate to be useful as the basis to allocate interventions, the researchers found.
All patients with suicidal thoughts or behaviours should be offered evidence based therapies for the treatable problems associated with suicide, the authors wrote.
“The difference in risk is so small that labelling people as high or low risk can’t possibly helpful in managing them. In fact, it may be dangerous to do this, since it can provide false reassurance,” they said.
BMJ Open; online 18 October
Males develop AF earlier
Men develop atrial fibrillation 10 years earlier, on average, than women, an analysis of community-based studies has found.
Researchers followed-up nearly 80,000 middle-aged people in four European cohorts, none of whom had AF at baseline. Over a median of 12.6 years, there were 4.4% of women with AF and 6.4% of men.
Males developed AF a decade earlier, with the incidence increasing sharply after age 50 compared with age 60 for females.
Risk factors for developing AF were the same as for developing acute coronoary syndrome, apart from diabetes mellitis and blood levels of BNP. But a high BMI was more strongly associated with new onset of AF in men than in women.
Circulation; online 16 October
Lamotrigine and pregnancy
The epilepsy drug lamotrigine is safe for women to use in the first trimester of pregnancy, a long-term Israeli study has found.
The study assessed neurodevelopmental symptoms in children up to the age of 12 whose mothers took the drug, either as a monotherapy or in combination with other anti-epilepsy treatments, during their pregnancy.
The study of 83 women, who gave birth between 2004 and 2014 at a hospital in Israel, found no major malformations found in the newborns and rates of minor malformations were similar to the general Israeli population.
The authors suggested larger prospective studies were needed to corroborate the findings.
British Journal of Clinical Pharmacology; 18 October
Avoid those traffic jams
Exposure to traffic congestion can raise both systolic and diastolic blood pressure by a clinically significant margin, according to research of drivers in Lebanon.
The study found systolic blood pressure increased by 19mmHg to 142mmHg in people driving on very congested roads compared with people driving on the same road in light traffic conditions. Diastolic blood pressure lifted by 9mmHg to 87mmHg.
“The increases in blood pressure were clinically significant, and repetitive exposure to such a clinically significant stressor might eventually result in the development of hypertension,” the researchers wrote.
Journal of Clinical Hypertension; online 10 October
