The presence of osteoarthritis (OA) in any finger joint significantly predicted cardiovascular deaths in Finnish men. A total of 7127 Finns aged 30 and over participated in a general health examination, of which 3595 gave hand radiographs. Follow up mortality was calculated in 1994, 17 years after the study began, during which time 897 people died, including 497 from cardiovascular diseases. The results confirmed a high prevalence of finger joint OA in the population, and that obesity and physical workload retained a close association with the risk of developing the disease. No other significant association was found between finger joint OA and cause specific mortality. (

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Growth, or lack of it, has long been a concern for paediatricians treating children with diabetes; reduced final height and blunted growth spurts have not been uncommon in the past. The results of a recent study should allay fears however, as they clearly show that children with diabetes who were diagnosed after 1990 achieved better linear growth than those diagnosed before 1991. Current therapeutic techniques are responsible, according to the authors, who reassuringly did not observe any increase in the obesity rate in their cohort. (

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The dearth of stroke incidence and survival information for very old people prompted researchers from the Netherlands to perform a large prospective study into the condition, which remains a leading cause of death in Western countries. They found that stroke incidence and fatality increases with age, even in the very old and, while the incidence rate is higher in men than in women, the lifetime risks were similar for both sexes. Of the stroke subtypes, cerebral haemorrhage proved more fatal than cerebral infarction. (

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The impact of musculoskeletal disorders will grow as life expectancy increases, yet epidemiological data on the frequency of total hip replacement (THR), already a common orthopaedic procedure in the elderly population, are scarce.

In an attempt to address this, researchers from Germany collected all available country specific hip replacement data for countries in the Organisation for Economic Cooperation and Development (OECD), using data sources of national authorities, estimates of leading hip replacement manufacturers, and the available literature. Their results show major variations in hip replacement rates between developed countries.

The reported crude primary THR rate varied between 50 (Canada) and 125 (Sweden) procedures/100 000 inhabitants and the crude overall hip implantation rate—covering THR, partial hip replacement, and hip revision procedures—ranged from 60 to 200 procedures/inhabitants. The authors suggest several possible causes for the reported variations, including differences in population age structure, coding systems, and indication criteria for THR. (

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The high prevalence of smoking in South Korea damages the country not only through the negative public health impact, but also by imposing a large economic burden on society. The authors used two different approaches to estimate the cost; disease specific, and all causes. The disease specific approach returned an estimate of between $2269.42 million and $2956.75 million, while the all causes approach yielded a minimum cost of $3154.75 million and a maximum of $4580.25 million—equivalent to 1.19% of the country’s GDP. Considering that the government, in a highly duplicitous arrangement, is the main producer of cigarettes in South Korea, the authors may sadly be waiting a long time for the effective national tobacco policy that they hope this evidence helps precipitate. (

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Concerned by the comparatively high incidence of gonorrhoea in black Caribbean men, researchers from Birmingham, UK, decided to evaluate the risk factors for disease contraction in that population. Using a questionnaire based case-control study (196 cases, 189 controls), they found the risk factors to be a lesser degree of acculturation, greater number of partners, not being married, lack of condom use, attending a single sex school, and not holding the belief that sex before marriage is wrong. Religious belief or country of birth were not shown to have any association. The authors suggest further research to explore the potential effectiveness of specific health education programmes in black Caribbean men. (

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Despite providing social services in one English urban authority with detailed information on the immunisation status of each child in their care (with advice on what immunisation was needed to bring them up to date), not one single child received the necessary immunisations. The Department of Health, acting on growing evidence of poor physical and mental health outcomes of children looked after by social services, recommended the key to improving this is to identify such children’s health needs so that they can be addressed. This study clearly shows that such an approach is insufficient, and the authors suggest that national policy is needed to clarify exactly where responsibility lies for the provision of health care to children looked after by local authorities. (

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The frequency of congenital syphilis in the Russian Federation is high and its consequences severe, resulting in death for over a quarter of infants born to infected mothers. After the break up of the Soviet Union the number of cases increased 26-fold, mirroring a similar increase in woman aged 18 and over between 1991 and 1999. In a disease with so many risk factors, the authors found that at least two were independent and modifiable in their study population: a lack of prenatal care, and having the first syphilis test at, or after, 28 weeks gestation. The authors highlight that the prime strategies for preventing congenital syphilis are similar to those for preventing HIV transmission between mother and child: timely testing, diagnosis, and treatment of infected mothers. (

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