Ginkgo biloba does not slow cognitive decline in older adults

Snitz BE, O'Meara ES, Carlson MC. Arnold AM, Ives DG, Rapp SR, Saxton J, Lopez OJ, Dunn LO. Sink KM. DeKosky ST: Ginkgo Evaluation of Memory Study Investigators. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. Journal of the American Medical Association, 2009; 302(24): 2663-70.

Older adults who used herbal supplement Ginkgo biloba for several years did not have a slower rate of cognitive decline compared to adults who received placebo. G biloba is marketed widely and used in the hope of improving, preventing or delaying cognitive impairment associated with ageing and neurodegenerative disorders such as Alzheimer's disease. However, US researchers who analysed outcomes from the Ginkgo Evaluation of Memory Study found that the use of G biloba (120mg twice daily) did not result in less cognitive decline in older adults with normal cognition or mild cognitive impairment. These findings are consistent with previous smaller studies and the 2009 Cochrane review of G biloba for dementia and cognitive impairment.

Use of kitchen spoons unreliable for measuring liquid medicines

Wansink B, van lttersum K, Spoons systematically bias dosing of liquid medicine. Annals of Internal Medicine. 2010; 152(1): 66-7.

Using kitchen spoons to measure liquid medicine can result in either underdosing or overdosing, say US researchers. To examine the effect of spoon size on dosing of liquid medication, 195 university students were asked to pour a 5ml (teaspoon) dose of nighttime flu medicine into a teaspoon, a medium-sized tablespoon and a larger spoon. Depending upon the size of the spoon, participants poured an average of 8% too little or 12% too much. When asked to judge their dosing accuracy, participants had above average confidence that they had poured the correct amount into the medium and larger spoons. The clinical implications of an 8% to 12% dosing error in a one teaspoon serving of medicine may be minimal, but the dosing error is likely to accumulate among fatigued patients who are medicating themselves every four to eight hours for several days, say the authors. They recommend using a measuring cap or dropper, or a dosing spoon or syringe to measure liquid medicine.

Low serotonin levels in brain associated with SIDS

Duncan J, Paterson D, Hoffman J, Mokier D, Borenstein N. Bellíveau R. Krous H. Haas E. Stanley C, Nattie E, Trachtenberg F. Kinney H. Brainstem serotonergic deficiency in sudden infant death syndrome. Journal of the American Medical Association, 2010: 303(5): 430-437.

Decreased levels in the brainstem of serotonin (5-HT - a chemical that helps to regulate breathing, blood pressure and heart rate in the brain during sleep) and tryptophan hydroxylase (TPH2 - an enzyme involved in the synthesis of serotonin) are associated with an increased risk for sudden infant death syndrome (SIDS), researchers have concluded. SLDS is believed to result from abnormalities in brainstem control of autonomic function and breathing during a critical developmental period. Abnormalities of serotonin in regions of the medulla oblongata involved in this control have been reported in infants who have died from SIDS. To test the hypothesis that SIDS is associated with reductions in tissue levels of 5-HT, TPH2 or both, US researchers conducted a study to analyse levels of 5-HT and TPH2 in 41 infants who died from SLDS (cases), seven infants with acute death from known causes (controls) and five hospitalised infants with chronic hypoxiaischemia. 5-HT levels were 26% lower in regions of the brain of SIDS cases compared with controls, TPH2 levels were 22% lower in the SIDS cases compared with controls, and 5-HT levels were higher in the hospitalised group compared with the SIDS group. The authors conclude that compared with controls, SIDS was associated with lower 5-HT and TPH2 levels, consistent with a disorder of medullary 5-HT deficiency.

Low-carb diet effective at lowering blood pressure

Corder K. van Sluijs E, McMlnn A, Ekelund U, Cassidy A. Griffin S. Perception versus reality: awareness of physical activity levels of British children. Am J Prev Med, 2010; 38(1): 1-8.

In a head-to-head comparison, two popular weight loss methods proved equally effective at helping participants lose weight. A lowcarbohydrate diet proved better at lowering blood pressure than the weight-loss drug orlistat, according to researchers. The two potent weight loss therapies - a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O+LFD) - were compared when 146 overweight or obese outpatients in North Carolina were randomised to either LCKD instruction (initially, less than 2Og of carbohydrate daily) or orlistat therapy ( 120mg orally three times daily) plus low-fat diet instruction over 48 weeks. LCKD led to similar improvements as O+LFD for weight, serum lipid and glycemic parameters, but systolic blood pressure dropped considerably in the LCKD group compared to the O+LFD group. If people have high blood pressure and a weight problem, a low-carbohydrate diet might be a better option than a weight loss medication.

'Poop dermatitis' linked to detergents and fashionable toilet seats

Litvinov I, Sugathan P. Cohen B. Recognizing and treating toilet-seat contact dermatitis in children. Pediatrics, 2010; 125(2) : e419-22.

Paediatric practitioners should consider 'toilet seat dermatitis' for any child who presents with an itchy dermatitis on his or her buttocks and posterior thighs, according to researchers from the Johns Hopkins Children's Centre, US. They say that the condition is re-emerging due to harsh cleaning chemicals and because toilet seats made of exotic woods are making a comeback. Most cases are fairly benign and easy to treat with topical steroids, but because many paediatricians do not suspect the cause and do not treat it properly, the inflammation can persist and spread further, causing painful and itchy skin eruptions.

Clinical papers was compiled by June Thompson