Shingles vax is 90 % effective
Nurse treats own MI with DIY
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HIGHLIGHTS
Prostate cancer link unlikely
Large study shows no evidence that vasectomised men have an increased risk of malignancy
VASECTOMY confers no increased risk of developing prostate cancer, a study suggests.
Previous studies have suggested an association but critics say this might be because men who ask about vasectomies are screened for prostate cancer beforehand, or because they are generally better engaged with their health.
To avoid this detection bias, researchers from Australia, the UK and Canada compared almost 10,000 men who had had a vasectomy reversal with almost 700,000 men who had a vasectomy alone. If vasectomies were linked to prostate cancer, patients with a reversal would be expected to develop malignancy at lower rates than the others, the authors said.
The study, believed to be the largest on the issue to date, showed no evidence of a protective effect of vasectomy reversal.
The proposed mechanisms linking vasectomy to malignancy have included seminal fluid composition, hormone levels, production of sperm antibodies, local immune factors and growth factors.
To date, study results have been inconclusive and the authors caution an effect could not be ruled out on their results.
“ Previously published results suggest any effect size( if an effect exists) is likely to be small,” they wrote.
“ However, the most parsimonious explanation for our results is that there is no increased prostate cancer risk in vasectomised men and this accords with evidence from a number of high quality studies and several meta-analyses.”
The results backed current guidelines, which do not require discussion of prostate cancer risk for those seeking a vasectomy. J Urol 2018; online 7 March
Domestic violence in numbers
1 in 6
The number of Australian women experiencing physical or sexual violence by a partner
1 in 16
The number of men experiencing violence by a partner
72,000
The number of women seeking housing in 2016-17 because of family violence
Source: Australian Institute of Health and Welfare
Shingles vax is 90 % effective
A NEW shingles vaccine provides remarkable protection even among vulnerable patients in their 70s and 80s, an Australian researcher says.
Professor Tony Cunningham, from the Westmead Institute for Medical Research, says immunogenicity results from GSK-funded studies show 90 % efficacy, which is comparable to childhood vaccination results.
A GSK spokesperson said Shingrix had been submitted to the TGA for approval.
J Infect Dis 2018; online 26 February
Nurse treats own MI with DIY
A NURSE in the remote coastal community of Coral Bay, WA, has survived ST-segment elevation myocardial infarction by keeping his cool and self-administering tests and drugs.
The 44-year-old man performed and emailed his own electrocardiograms to an emergency physician, then self-cannulated and administered aspirin, clopidogrel, sublingual nitroglycerin, intravenous heparin and opiates.
He was transferred to Perth by the Royal Flying Doctor Service and treated in a tertiary cardiology unit. Coronary angiography showed severe stenosis in the mid-right artery with TIMI grade 3 and mild left ventricular systolic dysfunction.
After insertion of a drug-eluting stent, the man was discharged home after 48 hours.
His doctors said the patient’ s actions“ likely had a substantial beneficial effect on the clinial outcome”. But they added that self-management was not appropriate if any other options are available. N Engl J Med 2018; online
MARCH 2018 MEDICALOBSERVER. COM. AU