Rabbit sperm will always swim towards the heat in a laboratory

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					Rabbit sperm will always swim towards the heat in a laboratory mock up of a fallopian tube. The Israeli scientists who discovered this think that human sperm might do the same, guided to their target like small, heat seeking missiles (Nature Medicine 2003;9:149-50). Thermotaxis, they say, has the potential to guide sperm over longer distances than chemotaxis, which probably only works for the last few millimetres.

Two Spanish doctors think there may be a link between playing wind instruments and an increased risk of lung cancer, following an unexpected finding in their small case-control study (Occupational and Environmental Medicine 2003;60:143). Two of the cases, men with lung cancer, were amateur musicians and had been playing trombone or clarinet for more than 30 years. None of the controls without cancer played any instrument. Both were ex-smokers.

The next stage of reproduction— implantation of an embryo in the uterine wall—has always been something of a mystery. Laboratory research on human endometrium now suggests that embryos stick to endometrium in the same way as leukocytes sometimes stick to vascular endothelium, by covering themselves in proteins called selectins. When receptive, endometrial cells express oligosaccharide receptors that interlock with selectins, capturing the embryo as it floats by (Science 2003;299:405-8).

If you like the idea of cycling to work, but don’t want to work up a sweat, try sharing the journey with a friend. Tandem cycling is faster and, if you sit on the back, easier than solo cycling. A study in the British Journal of Sports Medicine (2003;37:50-3) shows that captains (the front half) have to pedal just as hard as they do going solo. Stokers (the back half) can relax because they don’t have to pedal against the wind.

A 64 year old woman presented to the orthopaedic fracture clinic. The previous day her mild dorsally angulated distal radial fracture had been manipulated under a Bier block in the emergency department. She had no bleeding disorder but was taking aspirin. The procedure was uncomplicated and the cuff was subsequently tested and found to be correctly calibrated. She said, “The treatment is worse than the accident. ”
J Mountney orthopaedic specialist registrar, Southampton General Hospital, Southampton SO16 6YD Submissions for this page should include signed consent to publication from the patient

A survey of primary school children in England and Sweden confirms what many parents already know—that school toilets are dirty, smelly, and dangerous. A quarter of the boys and half the girls surveyed say they don’t go to the toilet at school because, among other things, they are afraid of bullies kicking the door in or pushing their heads down the toilet (Child: Care, Health and Development 2003;29:47-51). Swedish children call this “baptism.”

When police in Vancouver seized 100 kg of heroin in September 2002, they must have celebrated a major upset in Canada’s heroin trade. Unfortunately the seizure had little impact on the streets, according to a study of injecting drug users that was in progress at the time (Canadian Medical Association Journal 2003;168:165-9). None of the users reported any interruption in or changes to their supply. The street price of heroin actually went down, suggesting that other shipments quickly compensate for drugs seizures, even record breaking ones.

honey, Jane, Jean, Jeanette, hen, ma’am, my love, my pet, and sweetheart.

It’s becoming increasingly clear from observational research that people with heart failure often have anaemia as well. In one recent study, 17% of a community based cohort of people with heart failure were also anaemic. They had a higher mortality than the rest (Circulation 2003;107:223-5). Would correcting their anaemia help them live longer? The authors don’t know, but randomised controlled trials are planned.

When Minerva eats out in America, she usually takes most of the meal home with her in a “doggy bag.” Portion sizes in fast food restaurants are getting bigger and bigger, along with customers’ waistlines. A study in Journal of the American Dietetic Association (2003;103:41-7) finds that soft drinks are a particular problem. An extra 2 fluid ounces (60 ml) a day of any soft drink will increase your weight by around 3 lb (1.4 kg) each year.

The latest report from the Whitehall II study, a long running cohort study of over 10 000 UK civil servants, says that a demanding job coupled with little job control increases your risk of coronary heart disease (Journal of Epidemiology and Community Health 2003;57:147-53). This finding is not new, and the authors think it’s time to test it properly, in a randomised trial of interventions to redesign jobs and minimise job strain. Any volunteers?

Other researchers, also reporting in Circulation (2003;107:226-9), go further and say that anaemia should be corrected in all patients with heart failure. In their small study, two thirds of patients with severe heart failure were anaemic—but only half of them were truly anaemic; the others had fluid overload.

Potassium permanganate solution can be useful for treating infected eczema in children. It comes in handy tablets that dissolve in the bath. Undissolved tablets, however, can give toddlers a nasty caustic burn if they are unlucky enough to sit down on one (Archives of Disease in Childhood 200:388:96). The doctors who report such a case say parents should be warned of the risk.

A study reporting the risk factors for peptic ulcer disease in a cohort of over 3600 Danish adults contains few surprises. Infection with Helicobacter pylori and smoking cigarettes were the main risks: both had odds ratios around 4 (Gut 2003;52:186-93). Being moderately active during leisure time protected against peptic ulcer disease in this cohort, but the researchers don’t say what kind of activities are moderate.

Paediatricians may welcome the preliminary data showing that montelukast can reduce symptoms in children with bronchiolitis due to respiratory syncitial virus (American Journal of Respiratory and Critical Care Medicine 2003;167:379-83). But an editorial (290-1) urges them to be cautious. The drug takes two weeks to work, and there’s no evidence yet that it can prevent or modify the asthma that often follows this unpleasant infection.

Things have moved on since patients were labelled by their physical signs, but some hospital staff still struggle with names. A woman named Joan reported that during her short stay in the Edinburgh Royal Infirmary, Scotland, she was called darling, dear,

You can catch Minerva every week on bmj.com


APRIL 2003


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