Menopausal women often say they notice memory problems, and evidence from hormonal studies backs this up. Now tests of memory in 16 young women throughout their menstrual cycle have thrown up some surprising findings. Performance on recollection tests was the same throughout the cycle. But at the mid-luteal phase (high hormone levels) they did better at tests that don't rely on recalling specific events or objects than during the early follicular stage, when there are lower levels of hormones (Neuropsychologia 2002;40:518-29).

More hormones and memory. Oestrogen has long been under scrutiny for its possible benefits in delaying or preventing Alzheimer's disease. The latest thinking is that testosterone on its own or in combination with oestrogen may be what's important, rather than oestrogen alone. Testosterone (with or without oestrogen) seems to prevent some of the abnormalities in the tau protein that cause the neurofibrillary tangles found in brains of people with Alzheimer' disease (www.pnas.org/cgi/doi/10.1073/pnas.032646799). Older men might benefit from hormone replacement therapy after all.

Minerva's impression that there are more colds around at the moment than people with flu is confirmed by the Pharmaceutical Journal (2002;268:51). To explain why there are more colds during the winter than the summer the authors suggest that people spend more time indoors during the winter (helping virus spread), levels of virus killing ultraviolet light are lower in winter, and virus replication speeds up in noses cooled by colder air. The stress of Christmas may also suppress the immune system.

The old wives' tale “feed a cold, starve a fever” could have some basis in science. A study reported in Clinical and Diagnostic Laboratory Immunology (2002;9:182) found that differences in cytokine levels that may be linked to responses to infection were influenced by whether a person had just eaten.

Obstetric care by general practitioners is a declining service in Canada. Presuming that experiences during obstetrics training influence doctors' decisions to practise obstetrics, one survey found that at the start of their residency 51% of 411 doctors intended to do so. The figure fell to 17% by the end, and 16% were still delivering babies two years later (Canadian Medical Association Journal 2002;166:179-84). Minerva wonders if some of the waning interest is due to increasing litigation.

Women are said to look for their fathers when seeking mates. In this study, 49 women graded male body odours—produced by men wearing T-shirts—on their degree of “pleasantness.” The most desirable smells were those produced by men with an intermediate level of genetic similarity, rather than those with a large degree of genetic overlap or none at all. The most desirable donor smells were significantly correlated with genes that the women had inherited from their fathers (Nature Genetics 2002;30:175-9).

In 1966, China was virtually free of sexually transmitted diseases. Since 1985, and mostly because of HIV, the number of cases has soared. Experts say that the epidemic needs a massive education and prevention campaign. Although the Ministry of Public Health recognises the problem, China's medical system is undergoing rapid transformation towards more privatisation and curative care, threatening its long tradition of prevention (Journal of Public Health Policy 2002;22:429-40). This pattern is being observed in other countries too.

A survey in Dispensing Doctor (2002;18:6) found that more than 40% of dispensing GPs said their prescribing decisions were influenced by NICE (the National Institute for Clinical Excellence). A slightly higher proportion admitted that their primary care group or trust influenced them. As most primary care groups are developing incentive schemes that penalise overspending, Minerva is not surprised that NICE takes second place. Perhaps one solution would be to increase drug budgets to ensure that NICE guidelines can be followed too.

Exercise induced asthma occurs in up to 80% of children with asthma. A small randomised double blind trial in Archives of Diseases in Childhood (2002;86:38-9) tested the hypothesis that because loratadine (a long acting antihistamine) produces mild bronchodilatation, it might be able to prevent the condition. But a once daily dose of 10 mg of loratadine taken for three days showed that although loratadine reduced exercise induced asthma, it did not prevent it.

Being rushed to hospital by ambulance can be a nauseating business. Having shown that perioperative oxygen reduces postoperative vomiting, a group of anaesthetists wanted to see if the same tactic could reduce motion sickness in elderly patients with minor trauma. Supplemental oxygen during transport by ambulance reduced nausea by 50% and vomiting fourfold. Not surprisingly, those who received oxygen reported greater satisfaction with their care (Mayo Clinic Proceedings 2002;77:25-8).

The Academy of Medical Royal Colleges' Information Group has published a long list of essential requirements for any clinical information system destined to be used in hospitals. Their document is evolving and the group behind it would be grateful for feedback (www.aomrc.org.uk).

Figure.

A 79 year old woman with Parkinson's disease presented with hypothermia after a fall on three separate occasions over a period of five months. On each occasion she regained her usual mobility and was discharged home. She was taking co-careldopa and pramipexol for the Parkinson's disease. During the third admission her temperature was monitored for the 19 hours and plotted against ambient temperature. The temperature chart indicates that the patient was poikilothermic, probably owing to a hypothalamic vascular lesion, since computed tomography of the head showed multiple infarcts.

Poikilothermia may present with instability and recurrent hypothermia. Measures are being taken to maintain her home environmental temperature above 25°.

David Bourne, specialist registrar in geriatric and general internal medicine, Wythenshawe Hospital, Manchester M23 9L