Serious infections cause about a third of global neonatal deaths (within 28 days of birth) each year, and up to half of neonatal deaths where death rates are high.

One "key entry point" for germs is the freshly-cut umbilical cord stump, say Professor Abdullah Baqui of Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, and colleagues.

In the Lancet, they publish their study of two cord-cleansing methods based in Bangladesh. Both used the antiseptic chlorhexidine, either once at birth, or daily for a week. The study included 29,760 newborn babies.

The results were unclear, they say. Compared with standard care, death rates were 20 per cent lower in the single-cleansing group. Multiple-cleansing did not seem to reduce deaths - but this group did have significantly fewer severe cord infections.

The researchers say: "Chlorhexidine cleansing of a neonate's umbilical cord can save lives, but further studies are needed to establish the best frequency."

In a second study, Professor Zulfiqar Bhutta of the Aga Khan University in Pakistan, and colleagues looked at the effect of umbilical cord cleansing with chlorhexidine, with or without hand-washing with antiseptic soap.

A total of 9,741 newborn babies in Pakistan received either standard care, chlorhexidine application to the cord at birth and for up to two weeks plus educational messages promoting hand-washing. A further group had chlorhexidine only, and the fourth group had hand-washing only.

Overall, cord cleansing reduced the risk of infection by 42 per cent and mortality by 38 per cent. Hand-washing alone had no beneficial effect.

"The results of these trials done in community settings lend support to the policy of application of chlorhexidine on newborn umbilical cord," say the authors.

The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial. Arifeen, S. E. et al. The Lancet, February 8 2012 doi:10.1016/S0140-6736(11)61848-5

Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, cluster-randomised trial. Soofi, S. et al. The Lancet February 8 2012 doi:10.1016/S0140-6736(11)61877-1

Around 40 per cent of patients are 65 years or older at diagnosis. Dr Willemien van de Water of the Leiden University Medical Centre in the Netherlands, and colleagues, looked at whether age is a stand-alone risk factor.

They investigated the possible link among 9,766 postmenopausal patients with hormone receptor-positive breast cancer. Over about five years, 1,043 of the women died.

Compared with patients younger than 65 years risk of death due to the cancer increased with age, from 5.7 per cent in patients younger than 65, to 8.3 per cent in patients 75 or older. Risk of relapse also increased with age.

Writing in the Journal of the American Medical Association, the authors conclude that increasing age was associated with increased death rates from the disease.

They add that: "Because breast cancer incidence increases with increasing age, changing demographics and continuously increasing life expectancy will further enlarge the number of older women confronted with breast cancer."

However, the experts point out that the older women in the study may have been undertreated, missing out on vital chemotherapy or radiotherapy.

"In conclusion, regardless of a higher risk of other-cause mortality and independent of tumour and treatment characteristics, disease-specific mortality increases with age," they write.

They call for more age-specific breast cancer studies in order to improve outcomes in patients of all ages. Further studies may also uncover the reasons for this higher disease-specific mortality with increasing age, they add.

Association Between Age at Diagnosis and Disease-Specific Mortality Among Postmenopausal Women With Hormone Receptor-Positive Breast Cancer. van de Water, W. et al. The Journal of the American Medical Association February 8 2012 Volume 307 Number 6 pp. 590-97.

Weaning with solid finger food makes a child more likely to be happy to eat health food, according to a study in Nottingham, UK.

And it also means a child is less likely to be overweight.

The findings come from a survey of some 150 parents with young children, reported in BMJ Open. Psychologists asked them to recall how they weaned their child.

About 40 per cent used spoon-feeding with smooth purees and 60 per cent used solid finger food after the age of six months.

The researchers found that neither technique reduced the chances of a child being a "picky" eater - but that those which were spoon-fed were more likely to have a taste for sweet food.

Children who were given solid finger food were happier to eat carbohydrates, such as bread.

Researcher Dr Ellen Townsend, of Nottingham University, said: "Although numerous studies have focused on when to introduce solid foods into an infant's diet there is a dearth of evidence concerning the impact of different weaning methods on food preferences and health prospects.

"We believe our report is the first piece of research to examine whether weaning method can influence food preferences and the future health of the child."

Baby knows best - The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled study NMJ Open February 7 2012; doi 10.1136/bmjopen-2011-000298

Drug addiction is a particular hazard from having an unsettled childhood, the Scottish researchers say.

Although frequent moving was strongly linked to single parent households and those with remarriages, the researchers say drug addiction is a risk independently of these situations.

The findings come from a 20 year study of some 850 people in the west of Scotland, reported in the Journal of Epidemiology and Community Health.

The researchers found no link between frequent moving and physical health.

But it was linked to psychological distress, heaving drinking and smoking starting in the teenage years.

Some of this may be explained by the effect of moving school, according to Professor Alistair Leyland, of the Medical Research Council's public health unit in Glasgow, Scotland.

He writes: "Illicit drug use during adolescence and adulthood was independently associated with the frequency of house moves during childhood, even after taking account of parental background and levels of affluence and the number of school moves."

The Journal of Epidemiology and Community Health February 7 2012

The latest study in the NUTRIMENTHE project, a 5.9 million Euro research programme funded by the European Commission’s 7th Framework Programme, found that children born to mothers who ate more fish during pregnancy score higher in verbal intelligence and fine motor skill tests.

They are also more likely to display increased levels of social behaviour, which suggests empathy and a desire to help others for no personal gain.

Professor Cristina Campoy Folgoso, of the University of Granada, Spain, who co-ordinated the study, analysed concentrations of long-chain fatty acids of the series omega-3 and omega-6 from blood samples from 2,000 women at 20 weeks’ pregnancy and from the umbilical cord of the infant at birth.

They examined the genotype of 18 polymorphisms in the fatty acid desaturase (FADS) gene cluster to try and assess the effects of maternal fish intake on foetal development, and to determine how the different genotypes affect long-chain fatty acid concentrations in the foetus.

Dr Pauline Emmett, from the University of Bristol, Dr Eva Lattka of Helmholtz Zentrum München, the German Research Centre for Environmental Health, with their colleagues found that fatty acid concentrations in umbilical cord blood depend on maternal and offspring genotypes.

Maternal genotypes are mainly related with omega-6 fatty acid precursors, and offspring genotypes are related with the more highly elongated fatty acids of the omega-6 series.

Researchers also found that concentrations of docosahexaenoic acid (DHA) of the Omega-3 series, which is the main component of brain cell membranes, depend on maternal and offspring genotypes.

“Foetal contribution of long-chain polyunsaturated fatty acids of the omega-6 series is more relevant than expected; foetal DHA concentrations depend on maternal and foetal metabolism,” says Dr Lattka.

The amount of DHA transmitted to the foetus through the placenta might be crucial for foetal development, but it is not yet known if maternal DHA concentrations are directly correlated with the offspring’s IQ.

The research has been submitted to the American Journal of Clinical Nutrition.

The genetic variation affects as many as ten per cent of people and increases the risk of a blockage of the main arteries to the brain, according to a report in Nature Genetics.

The gene, HDAC9, is known to play a role in muscle and heart development and drugs already exist which could control it.

Researcher Professor Hugh Markus, from St George's, University of London, said: "This discovery identifies a completely new mechanism for causing stroke.

"The next step is to determine in more detail the relationship between HDAC9 and stroke and see whether we can develop new treatments that reduce the risk of stroke."

He added: "It is important that we understand the mechanism involved before trialling the effects of these drugs on stroke."

The findings, which also involved Oxford University and the Wellcome Trust, come from comparing some 10,000 stroke patients with 40,000 healthy people.

Fellow researcher Professor Peter Donnelly, from Oxford, said the research indicated potentially different genetic causes for different kinds of stroke.

He said: "This is really fascinating, and if it holds up more generally, will move us closer to personalised medicine, where treatments and preventions can be tailored more precisely to individual patients."

Dr Peter Coleman, of the Stroke Association, said: "Further study is needed, but this research could potentially lead to new methods of screening and prevention for large vessel stroke, and ultimately, new methods of treatment."

Genome-wide association study identifies a variant in HDAC9 associated with large vessel ischemic stroke. Nature Genetics February 5 2012

But interventions to tackle the killer disease have been increased over the past decade, which is helping to drive down mortality rates.

The findings, by Professor Christopher Murray, director of the Institute for Health Metrics and Evaluation (IMHE), University of Washington, Seattle, USA, and colleagues, were published in The Lancet.

The researchers collected all available data for malaria mortality from 1980 to 2010 and found that global malaria deaths rose from one million in 1980 to a peak of 1.8 million in 2004. By 2010, the figure fell to 1.2 million.

Between 1980 and 2004, deaths from the disease in children aged under five years in sub-Saharan Africa almost tripled from 377,000 to just over one million, while in 2010, there were 700,000 deaths – about 56 per cent of total global malaria deaths. Death rates were highest in western, eastern, and, in particular, central sub-Saharan Africa.

IHME found that more than 78,000 children aged 5 to 14, and more than 445,000 people ages 15 and older died from malaria in 2010, meaning that 42 per cent of all malaria deaths were in people aged five and older.

The increase in insecticide-treated bed nets and artemisinin-combination treatments (ACTs) have been the biggest drivers in reducing deaths, they said. In September 2011, IHME reported that homes with at least one bed net were associated with a 23 per cent reduction in child mortality.

“You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults,” said Prof Murray, IHME director and the study's lead author.

“What we have found in hospital records, death records, surveys and other sources shows that just is not the case.”

Global malaria mortality between 1980 and 2010: a systematic analysis. Murrey C et al. The Lancet. February 4 2012. 379: 413–31.

A study led by Professor David Brown, School of Pharmacy and Biomedical Sciences, University of Portsmouth, England, warned that websites offering statins for sale “contain little information on the safety of these drugs, which are intended as prescription only medicines”.

Researchers simulated a customer search and evaluation of 184 retrieved sites using evaluation tools that focused on quality and safe medicine use.

Results, published in the journal Pharmacoepidemiology & Drug Safety, showed general contraindications were missing in 92.4 per cent of sites and contraindicated medicines were absent in 47.3 per cent.

Key warnings on the appearance of symptoms associated with myopathy, liver disease, hypersensitivity and pancreatitis were absent in 37, 48.4, 91.3, and 96.2 per cent of sites respectively.

Prof Brown said that most websites presented a “chaotic and incomplete list of known side effects”, while just 13 (7.1 per cent) provided a list that was compatible with current prescribing information. Only two thirds described any side effects in lay language.

“There is an inherent danger in patients seeking to self-medicate in this way without consulting a healthcare professional and being appraised of ways to use the medicine safely,” writes Prof Brown.

Direct to consumer Internet advertising of statins: an assessment of safety. Brown D, Williams B. Pharmacoepidemiology & Drug Safety. Vol 211. February 1 2012. DOI: 10.1002/pds.3208

The finding, made by researchers at the University of Southampton, University of Oxford and Retroscreen Virology Ltd, hope such a vaccine would offer people immunity against all strains of the disease, including seasonal, avian, and swine flu.

The team recruited healthy volunteers who were infected with the influenza virus and then closely monitored in a sterile isolation unit.

Blood samples were taken at regular intervals to establish how their immune systems responded to the viral infection.

The immune systems produced various types of T-cells, which are part of the immune system that kills both viral particles, and cells infected with viral particles. The T-cells responded to peptides associated with the internal structures of the influenza viruses.

External structures of influenza virus mutate very rapidly and create a new strain of virus, but the internal structures, which are found in all strains of flu virus, change very slowly over a long period of time.

It means a vaccine that targets the peptides may provide immunity against all strains of influenza, says Dr Tom Wilkinson, senior lecturer in Respiratory Medicine at the University of Southampton, who led the study.

“Most influenza vaccines only protect us against known influenza strains by creating antibodies in the blood but the influenza virus has the ability to rapidly change itself and new strains can emerge which rapidly spread across the globe by escaping this immunity,” he says.

“We have found that there is an important role for T-cells that recognise the flu virus, which if harnessed could protect against most or even all strains of seasonal and pandemic flu.

“Through this discovery we hope to improve vaccines for future strains of influenza; and potentially protect against the next pandemic. However there is more to do to translate these findings into new approaches to treatment.”

Professor Sir Andrew McMichael, director of the Medical Research Council Weatherall Institute of Molecular Medicine at Oxford University said vaccines that stimulate a T-cell response might be an option, but more research was needed.

The study is published in Nature Medicine.

Preexisting influenza-specific CD4+ T cells correlate with disease protection against influenza challenge in humans. Wilkinson T et al. Nature Medicine. January 29 2012. doi:10.1038/nm.2612

Levels of multi-drug resistant TB have now reached a record high, according to the Bulletin of the World Health Organisation.

In some cases it now affects 65 per cent of patients who succumb to TB after previous treatment, according to experts.

The problem is especially rife in eastern Europe and central Asia in countries such as Estonia, Belarus, Russia and Tajikistan.

But experts said they still do not know the full extent of the problem in countries such as India and Africa.

Dr Matteo Zignol, of the WHO, said: "Surveillance of resistance to drugs is the cornerstone of TB control.

"Following 15 years of intensive effort, we now have high quality data for two-thirds of countries in the world.

"At the same time, we don't know the full extent of the problem because we lack data from many countries, in particular India and most of Africa where the TB burden is high."

Bulletin of the World Health Organisation February 2012