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People who can laugh off awkward situations are among those who benefit from having a good sense of humour, the conference of the American Heart Association in New Orleans, USA, was told.

And watching a funny video may one day become as much part of public health as eating well and not smoking, according to Dr Michael Miller, of the University of Maryland, USA.

Researchers found that people with heart disease were 40 per cent less likely to respond to situations with laughter than healthy people.

According to Dr Miller, being unable to laugh may be a sign of underlying anxiety and depression which can contribute to heart disease.

However the researchers will have to answer the charge that people who know they have heart disease may have reason to be gloomier than healthy people of the same age.

The findings come from a study of 300 people, half of whom had a major heart condition.

The volunteers were asked about how they would respond to situations such as a waiter in a restaurant spilling a drink on them.

They found that people with heart disease had difficulty recognising humour or using it to get out of awkward situations. They often displayed greater levels of anger and hostility than others.

Dr Miller said: "We could perhaps read something humorous or watch a funny video and try to find ways to take ourselves less seriously.

"The recommendation for a healthy heart may one day be - exercise, eat right and laugh a few times a day."

Culture of decline at Oxford
A "culture of complacency and secrecy" contributed to a decline in quality in the cardiac unit of the Oxford Radcliffe Hospitals NHS Trust, a report said yesterday.

There was lack of leadership, surgeons worked autonomously and nurses were reluctant to work in the centre, the report, commissioned by the NHS Executive South East, said.

The report said that over a four year period the number of open-heart operations fell from 1,400 to 800 a year with growing numbers of cancellations.

There was a "lack of action" despite withdrawal of training recognition and complaints by chest physicians and nurses, the report said yesterday.

Among 35 recommendations, the report calls for the five surgeons in the unit to function as a team. All patients should be seen by a consultant surgeon before operations and consultants should have job plans, it says.

The report concludes: "The cardiothoracic surgeons must put aside their personal animosities and genuinely try to work together as a team, otherwise the future for this specialty in Oxford is bleak."

Consultant rapped for passivity
The consultant in charge of a ward where elderly patients were abused told investigators that he was made to feel like "a visitor".

The consultant had a "lack of awareness" and "a passive acceptance" of the situation, according to the Commission for Health Improvement report into the North Lakeland NHS Trust, Cumbria, and its management of Garlands Hospital.

The report was one of two published by CHI yesterday. The second was into Carmarthenshire NHS Trust, Wales.

The CHI report says it found limited evidence of improvements in the corporate environment in the North Lakeland trust which would ensure senior staff took responsibility for the care of patients.

The report highlights conflicts between nurses and management with nurses believing that they were being constantly down-graded.

The problems were first highlighted by five student nurses who complained in 1996 that patients were being tied to commodes. Their allegations were investigated but little was done.

According to CHI, a culture developed within the Trust of "unprofessional, counter-therapeutic and degrading - even cruel - practices".

CHI says the Trust should now acknowledge the courage of nurses who sought to blow the whistle in 1996 and in 1998.

The Camarthenshire report was ordered after a patient had the wrong kidney removed at the Prince Phillip Hospital, Llanelli. The report contains a series of recommendations for tightening up action plans instituted after an inquiry by the Royal College of Surgeons.

Hep C GP struck off
A GP has been struck off by the GMC - for the second time - after it heard that poor hygiene in an alternative therapy clinic sparked an outbreak of hepatitis C among patients.

But Dr Madhusudhan Shivadikar, of Finchley, London, may still be able to practise as an acupuncturist, doctors' leaders warned.

The GP admitted a number of charges including failing to take appropriate measures to prevent himself, staff, patients and others from being exposed to the risk of serious communicable diseases.

Dr Ian Bogle, Chairman of the BMA said: "The public and the medical profession will be heartily relieved that this doctor has been struck off.

"His bizarre methods and appalling lack of hygiene control are disgraceful. This man is clearly a public health menace.

"It is essential that he is not allowed to slip through the net by continuing to work as an acupuncturist. Unlike medicine, acupuncture is not regulated by statute."

Dr Shivadikar, aged 70, and his daughter Miriam - who worked in the clinic with him - are among those infected with the virus.

Among the 30 victims of the outbreak were a 17-year-old girl who travelled from Newcastle to be treated for chronic knee pain.

The GMC heard that the doctor used an "unproven" procedure called autohaemotherapy - in which blood is reinjected into the body at particular pressure points.

First Parkinson's diagnostic tool developed by Australian
November 15 - The world's first blood test to diagnose Parkinson's disease has been developed by an Australian researcher.

Doctor Kay Double of the Prince of Wales Medical Research Institute in Sydney developed a test that detects a certain protein that is produced in response to brain cells dying.

Tests conducted so far have shown an 80 per cent detection accuracy.

Dr Double said she hoped the blood test would enable doctors to detect the disease before the symptoms become apparent.

She also hoped to identify substances that can slow down the death of cells to the point where sufferers never show any symptoms.

Symptoms of Parkinson's disease include movement problems, speech impediments and muscle tremors.

Dr Double is now seeking 1500 volunteers over the age of 60 to conduct a large-scale test of the diagnostic tool.

Measles, rubella cases cause alarm
November 15 - An alarming increase in rubella and measles cases in New South Wales has prompted a government warning to women and young adults to ensure they are immunised.

NSW Health Minister Craig Knowles said there had been 30 cases of mumps reported since July, 100 cases of rubella and 14 cases of measles, and many others were likely to have gone unreported.

One cluster of measles, in the North Sydney area, was contracted by someone on an overseas trip. It quickly spread to at least nine unimmunised young adults

Most of the cases have been in young adults between 18 and 30 years old.

Mr Knowles said measles, mumps and rubella were preventable diseases but many young adults were not immunised.

"These diseases are serious. They can cause serious complications. Young adults should who haven't been immunised should visit their doctor for an MMR vaccination which will reduce the transmission of these diseases within the community," he said.

"Rubella infection can cause birth defects. Women planning pregnancy should have their immunity checked by a doctor well before conception."

A free measles-mumps-rubella vaccination is being offered until June 2001.

Anxiety sensitivity clue to alcohol abuse
November 16 - People with high anxiety sensitivity may be drawn to alcohol abuse because of the soothing effects of drink on their mental state, according to new findings.

Canadian researchers studied the effects of alcohol on volunteers with a range of responses to anxiety to reach their conclusions.

Volunteer students were assessed according to their sensitivity to anxiety. Students undertook a hyperventilation test to induce anxiety-like symptoms and were then given alcohol.

The research showed that students with high anxiety sensitivity found alcohol more calming than did others - and that its soothing effects multiplied the more they drank.

Researcher Professor Robert Pihl, of McGill University, Montreal, Canada, said: "Anxiety sensitive individuals are people who have a fear of anxiety, basically.

"It's kind of an anticipatory type response. This study helps us understand why these individuals are highly likely to become alcohol abusers.

"Furthermore, the literature tells us that the abuse is not just about alcohol, it can involve anything that reduces that anticipatory anxiety."

Alcoholism: Clinical & Experimental Research November 2000

Public defibrillators save air travel lives
November 16 - Two major airports have cut death rates from heart attacks by installing dozens of wall-hanging automated defibrillators, a conference was told yesterday.

A total of 49 automated external devices were placed on walls in the airports in Chicago, USA, last June. Two more were placed in car parks.

In the first ten months 14 visitors suffered sudden heart attacks. 12 of these were in ventricular fibrillation, the conference of the American Heart Association in New Orleans, USA, was told.

Nine victims were revived with the aid of the devices without suffering brain damage, the conference was told. Without rapid response, the survival rate from ventricular fibrillation is four per cent, researchers said.

Researcher Paula Willoughby, emergency medical services advisor for the Chicago Fire Department, said: "Easy access and high visibility may be ingredients for success. The real issue right now for these devices is where to put them."

Report Copyright: Englemed Health News at http://www.internationalmedicalnews.com

Alcohol links obesity to liver disease
Obese people with fatty liver disease may be the victims of an internal "distillery" which creates the same problems as drinking of excessive alcohol, researchers have reported.

Tests on laboratory mice have shown that obesity leads to the production of excess quantities of alcohol, according to the researchers at John Hopkins University, Maryland, Baltimore, USA.

According to researcher Professor Anna Mae Diehl, it may be possible to protect obese people from fatty liver disease by prescribing yogurt or antibiotics to patients to reduce the quantities of intestinal bacteria.

Reporting in Gastroenterology, the researchers told how they carried out breath tests on obese and lean mice after feeding them an alcohol free diet for 24 weeks. They found that obese mice produced roughly five times more ethanol than lean animals.

Professor Diehl said: "Our study suggests that obese mice with fatty liver disease make too much of their own alcohol, mimicking what we see in fatty liver disease produced in humans who drink alcohol to excess.

"Whenever the bowel fails to move normally, the partially digested food material becomes a food source for the intestinal bacteria. These bacteria overgrow, ferment the food and produce alcohol.

"If what we see in mice turns out to be true in people, treatment and prevention of obesity-related FLD could be relatively easy using yogurt or oral antibiotics to constrain intestinal bacterial overgrowth."