CME activities associated with positive job satisfaction

According to an article published in BioMedCentral in May 2007, participation in CME activities has been shown to be associated with positive job satisfaction and negatively with job stress.

As advances in information technology, coping with hugh amount of medical knowledge is a major challenge to most doctors, a follow up questionnaire study was carried out in 2004 involving 1005 Norwegian doctors to investigate their CME activities and their perceived ability of keeping themselves updated and their job satisfaction.

They found that Norwegian doctors spent less time on attending courses but more on medical reading, however both were regarded the most important sources of information. Those with 5 or more CME course days were significantly more likely to be able to obtain sufficient information for keeping updated in their daily work than those who had not attended courses. There was a strong positive effect of the number of hours spent per week on medical reading. They also found that high job satisfaction was strongly associated with doctors' perceived ability to obtain sufficient information to keep professionally updated.

The authors concluded that this "gives good reasons for recommending a high level of CME activities among doctors."

Source:"Doctors’ learning habits: CME activities among Norwegian physicians over the last decade" BMC Medical Education 2007, 7:10 ( free full text)

Hawthorn extract for treating chronic heart failure

Hawthorn has been used for centuries as a treatment for heart problems. A new Cochrane review shows that a few months of treatment with the Hawthorn extract, along with the patient's conventional treatments for chronic heart failure, is beneficial, and that the side effects are generally tolerable.

Researchers found 14 double-blind, placebo controlled randomised clinical trials (RCTs) including about a thousand patients. Those trials that could be included in a meta-analysis showed improvements in heart failure symptoms and in the function of the heart.

Source: "Hawthorn extract for treating chronic heart failure" Cochrane Database of Systematic Reviews 2008 Issue 1

Vitamin supplements or no supplements?

The Telegraph reported on 15 Feb that a scientist who spoke at the annual conference of the American Association for the Advancement claimed that taking multivitamin could reduce cancer risk.

However, on 26 Feb, it reported that the World Cancer Research Fund (WCRF) warned that vitamin supplements may do more harm than good and urged people to eat healthy diet raher than rely on supplements. This is contradicts the findings of a new report from the Copenhagen University Hospital that found betacarotene, vitamin A, and vitamin E may increase mortality. The results were based on 47 trials involving more than 180,000 people. They found that antioxidant supplements increased mortality by 5 per cent.

The news has attracted a lot of interesting comments from the public.

Depressed junior doctors six times more likely to make mistakes

A Harvard team of researchers studied 123 paediatric residents at three children's hospitals in the USA to establish the prevalence of depression and burnout and whether medication errors are associated with these conditions.


They found that 20% of the participants were depressed and 74% were burned out, 45 medication errors were made. Depressed doctors in training made six times more medication errors than their non-deperessed peers, but burnout did not seem to link with a higher rate of medical errors.


In an accompanying editorial, the commentator cautioned against interpreting the findings and large studies are needed to study how individual factors correlate with medical errors.


Source: "Rates of medication errors among depressed and burnt out residents: prospective cohort study" BMJ 2008;0(2008):bmj.39469.763218.BEv1 (7 February)

Acupuncture increased chance of pregnancy

The Daily Mail reported an interesting review of seven published trials involving 1,366 women undergoing IVF in four different western countries who had acupuncture within one day of embryo transfer.


Researchers found a 65 % increased chance of pregnancy with acupuncture compared with sham acupuncture or no treatment while undergoing IVF. The benefit was smaller in trials where the baseline pregnancy rates were already high. However researchers said acupuncture may be cost-effective therapy in IVF compared with repeated fertility treatments.


Critics said the acupuncture benefit could be due to a placebo response but the authors said shame acupuncture did not increase the pregnancy rate among those women.


Source: "Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis" BMJ, February 7, 2008 BMJ, doi:10.1136/bmj.39471.430451.BE (published 7 February 2008) ( Full text via Athens)

Vacuum out blood clots helps heart patients

A Dutch trial enrolled more than 1000 patients with major heart attack and needed emergency angioplasty and assigned them to either conventional PCI ( percutaneous coronary intervention) or thrombus aspiration ( suctioning out the clot ). They found that suctioning out blood clots in blocked arteries could improve blood flow and clinical outcomes in heart attack patients.

An expert said the findings showed what other trials have shown and there were weaknesses in the study. The trial was published in the New England J of Medicine(NEJM).

Source: "Thrombus Aspiration during Primary Percutaneous Coronary Intervention" NEJM 358(6):557-567 ( free full text)

Mother's stress in early pregnancy may increase baby's risk of schizophrenia

The Telegraph reported a study that found pregnant women who suffered severe stress in early pregnancy had children with a 67 % increased risk of schizophrenia. The study was based on the data from 1.38 million Danish births occurring between 1973 and 1995.


The researchers said this study shows that stress in early pregnancy increases the risk of a baby developing mental health problems. The study is published in the Archives of General Psychiatry.

Women who opt for caesarean are just scared

Multiple news sources reported that Swedish scientists studied the attitudes of 496 pregnant women toward childbirth and followed them until three months after they gave birth. The study is published in the British Journal of Obstetrics and Gynaecology.


The women were divided into three groups: those who had opted for a C-section for medical reasons; those who had elected C-secetion for other reasons and those who planned to have a normal delivery. The scientists found almost half of those having elective C-section had a "clinically significant" fear of childbirth while those having a natural birth or a caesarean for medical reasons had more negative experiences of childbirth.

The authors said "healthy women are sometimes criticised for choosing a C-section over a normal delivery", but this study reveals that a psychological reason may be behind it.


Source: "Expectation and experiences of childbirth in primiparae with caesarean section" BJOG: An International Journal of Obstetrics and Gynaecology 115 (3), 324–331. (full text via Athens)

Study said no link between MMR and autism

The Daily Mail and other news source reported a large research, partly funded by the Department of Health and published in the Archives of Disease in Childhood, studying the blood samples of about 250 children aged 10 to 12 to see if the MMR vaccination had caused an abnormal immune response that could have triggered autism.

The sample included three groups of children : those with autism, those without and those with special educational needs. The researchers said that they found no difference in meales virus or antibody levels between the two comparison groups and no evidence of bowel symptoms among the autistic children.

The authors concluded there is no evidence for a link between MMR vaccination and autism. But critics said the study had selected the wrong children.

Source :"Measles vaccination and antibody response in autism spectrum disorders". Arch Dis Child. Published Online First: 5 February 2008 doi:10.1136/adc.2007.122937 (full text via Athens)

Fizzy drink linked to gout risk in men

A number of news sources reported a study published in the BMJ that warned too much soft drinks and fruit juices can substantially increase the risk of gout in men. More than 46,000 men who did not have gout were followed by researchers over 12 years and monitored their dietary habits, in particular intake of soft drinks, fruit and fruit juices. The men provided updated information about their food and drink consumption every four years.

The analysis found that men who drank two or more cans of soft drinks a day had increased risk of gout by 85 % compared with those who drank less than one soft drink a month. The data also suggest that fructose- rich fruits and fruit juices may also increase the risk, but diet soft drinks were not associated with the risk of gout.

Source: "Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study" BMJ published online 31 January 2008 ( full text via Athens)

Moderate drinking and exercise lower heart disease risk

Multiple news sources reported a study that found those who drank moderate amounts of alcohol and exercised regularly had reduced risk of ischaemic heart disease (IHD).

In this prospective cohort study of 12,000 Danish people who had no pre-existing IHD, the researchers investigated the combined effects of exercise and weekly alcohol consumption on death from heart disease and deaths from any cause, followed up for 20 years.

The authors said this is one of the first to have looked at the combined effects of both alcohol and exercise on the heart. Conclusion: "Leisure-time physical activity and a moderate weekly alcohol intake are both important to lower the risk of fatal IHD and all-cause mortality."

Source: "The combined influence of leisure-time physical activity and weekly alcohol intake on fatal ischaemic heart disease and all-cause mortality" European Heart Journal 2008 29(2):204-212

Blood clot prevention lacking in hospitals

A study published in The Lancet based on the data from more than 68,000 patients worldwide found that about 52% of those patients were at risk of venous thromboembolism (VTE) - the most common preventable cause of in-hospital death because they did not get preventive treatment despite internationally accepted guidelines for prevention of VTE in hospitals.

In an accompanying commentary in the journal, the author said preventive medications can reduce the risk of pulmonary embolism by 75 % in general surgical patients and by 57 % in medical patients.

Source: "Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study" The Lancet 2008; 371(9610):387-394 ( full text via Athens)