An intensive approach started in the hospital can help improve quitting rates among smokers admitted after a myocardial infarction (MI) and those who had coronary artery bypass surgery. The approach consisted of a one hour counselling session with a nurse while in hospital and then seven phone calls over a two-month period after discharge. Using this approach with 137 smokers admitted to the cardiac units at a large urban hospital in western Canada resulted in a one-year self-reported abstinence rate of 62%. This compares to a one-year quit rate of 46% for the patients who received minimal advice on quitting smoking while in the hospital. The study was conducted by a pair of researchers from the Northern Ontario School of Medicine and the University of Calgary, Alta. Dr. Nancy Rigotti, a tobacco research expert from Boston, who commented on the findings said routine hospital-based smoking counselling for patients with MI is “well overdue.” However, she also noted the intensive approach used in the study did not stop almost half of the patients from resuming smoking within a year. As such, Dr. Rigotti said, other strategies, such as adding smoking cessation medications, are needed to make the approach more effective.

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Lyme disease — a condition spread by ticks on deer and other wildlife that can have devastating consequences if untreated — is spreading in Canada. An analysis of the situation by a team of public health officials shows the range of the ticks carrying the infection is expanding across eastern and central provinces. This is attributed to warmer temperatures and the spread of the ticks on wildlife. As of this year, it is now mandatory for doctors to report confirmed and suspected cases of Lyme disease. Lyme disease is potentially preventable if people wear appropriate clothing and use DEET repellents. Removing infected ticks within 24 hours can prevent infection, and early Lyme disease is usually easily treated with antibiotics. However, if not promptly treated, Lyme disease can cause seriously debilitating disorders, which may be more difficult to treat. The researchers urge more surveillance to inform people about local risk levels and the need for regimens appropriate for prevention and early diagnosis.

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Weight loss by over­weight or obese individuals can be maintained for an extended period using a relatively low-cost approach. This finding comes from a New Zealand study that evaluated 174 obese or overweight women who were enrolled in one of two support programs and received one of two dietary supplements intended to support long-term weight mainten­ance. All subjects in the study lost 5% or more of their weight in an intensive support program. Over a two-year period, the study showed that women receiving minimal nurse support (involving weigh-ins and brief support sessions) maintained the same degree of weight loss (about 8% of their initial weight) as those who received intensive support involving a number of individualized one-on-one sessions with a nutritionist and exercise trainer. Weight loss was also compar­able among those who received a relatively high-monoun­saturated fat diet and those receiving a high-carbohydrate diet. From these findings, the researchers concluded that “women who are sufficiently motivated to join a two-year study can maintain their weight and, in many instances, further reduce their weight ... with a simple, inexpensive nurse support program.”

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A review of 13 published studies looking at the use of multiple micronutrient supplements during pregnancy suggests that this approach can reduce the risk of babies being born with low birth weights. If proven safe and effective, this approach could significantly improve pregnancy outcomes in the developing world, where a significant proportion of women of childbearing age are seriously undernourished. In countries such as Canada, micronutrient deficiency in pregnancy has been associated with poverty and poor dietary habits. The analysis, conducted by researchers from Mount Sinai Hospital and the University of Toronto, showed a significant reduction in the risk of low birth weight among infants born to women who received multimicronutrients during pregnancy compared with women taking no supplements or those just taking iron and folic acid supplements.

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Concern about the spread of microorganisms that are resistant to antimicrobial drugs has led to more attention being paid to preventing the transmission of these microorganisms in health care settings and in the home. Winnipeg infectious disease experts report that many of the suggestions made for controlling the spread of infection in health care facilities are impractical and unrealistic in the home. For the home, they note, keeping hands clean is the most important step to take to prevent infection. Hand hygiene can involve either using soap and water or an alcohol-based hand rub. They urge the use of regular household soap rather than antimicrobial hand soaps because use of the latter remains controversial and may not have additional benefit. In addition, the review states that household surfaces should be cleaned with standard household cleaning solutions rather than special antibacterial products. The authors said it is not realistic or practical to keep infected individuals in isolation or have family members wear personal protective equipment. However, they urge that those providing care to people infected with antimicrobial-resistant microorganisms follow basic infection control principles.

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