GORD is common in Italy, but the prevalence of Barrett's oesophagus in the community is lower than has been reported in selected populations. Both frequent and infrequent reflux symptoms are associated with an increased risk of oesophagitis. Individuals with oesophagitis and Barrett's oesophagus often have no reflux symptoms.

Background: Venous thromboembolism (VTE) manifesting as deep vein thrombosis (DVT) and pulmonary embolism (PE) remains a common vascular disease with high mortality and morbidity. Our aim was to study the clinical spectrum of VTE, assess its incidence in the general population, and evaluate potential risk factors.Methods: Prospective cohort study with nested casecontrol analysis using the General Practice Research Database (1994Database ( -2000. Venous thromboembolism was newly diagnosed in 6550 patients. Cases were compared with a random sample of 10 000 controls and frequencymatched by age, sex, and year. Results:The incidence rate of VTE was 74.5 per 100 000 person-years. Overweight, varicose veins, inflammatory bowel disease, cancer, and oral corticosteroid use were associated with a greater risk of VTE. Ischemic heart disease, heart failure, and cerebrovascular diseases were associated with an increased risk of PE but not with DVT. Venous thromboembolism was strongly associated with fractures (odds ratio [OR], 21.3; 95% confidence interval [CI], 15.7-28.9) and surgery (OR, 25.0; 95% CI, 14.4-43.5). In women, the risk of VTE was 1.9 (95% CI, 1.5-2.3) among those receiving opposed hormone therapy (in which the woman takes estrogen throughout the month and progesterone for 10-14 days later in the month) and 1.9 (95% CI, 1.4-2.5) among those taking oral contraceptives. Cancer and cerebrovascular diseases presented a greater relative risk of fatal PE compared with nonfatal PE.Conclusions: Overweight, varicose veins, cancer, inflammatory bowel disease, fractures, surgery, and use of oral corticosteroids, oral contraceptives, and opposed hormone therapy were independent risk factors for both DVT and PE. The magnitude of the association with some risk factors varied between DVT and PE, as well as between fatal and nonfatal PE.

Summary Background : Cross‐sectional studies indicate that gastro‐oesophageal reflux disease symptoms have a prevalence of 10–20% in Western countries and are associated with obesity, smoking, oesophagitis, chest pain and respiratory disease. Aim : To determine the natural history of gastro‐oesophageal reflux disease presenting in primary care in the UK. Methods : Patients with a first diagnosis of gastro‐oesophageal reflux disease during 1996 were identified in the UK General Practice Research Database and compared with age‐ and sex‐matched controls. We investigated the incidence of gastro‐oesophageal reflux disease, potential risk factors and comorbidities, and relative risk for subsequent oesophageal complications and mortality. Results : The incidence of a gastro‐oesophageal reflux disease diagnosis was 4.5 per 1000 person‐years (95% confidence interval: 4.4–4.7). Prior use of non‐steroidal anti‐inflammatory drugs, smoking, excess body weight and gastrointestinal and cardiac conditions were associated with an increased risk of gastro‐oesophageal reflux disease diagnosis. Subjects with gastro‐oesophageal reflux disease had an increased risk of respiratory problems, chest pain and angina in the year after diagnosis, and had a relative risk of 11.5 (95% confidence interval: 5.9–22.3) of being diagnosed with an oesophageal complication. There was an increase in mortality in the gastro‐oesophageal reflux disease cohort only in the year following the diagnosis. Conclusions : Gastro‐oesophageal reflux disease is a disease associated with a range of potentially serious oesophageal complications and extra‐oesophageal diseases.

This study shows an extensive multiple drug use among elderly people living at home. Whether this multiple drug use per se is harmful to the patients or not could not be evaluated in this study. Further focused investigations are needed to assess the effect of multiple drug use in an elderly population.

The prevalence and incidence of type 2 diabetes have increased in the UK over the past decade. This might be primarily explained by the changes in obesity prevalence. Also, there was a change in drug treatment pattern from sulphonylureas to metformin.

SUMMARY BackgroundThe association between psychiatric disorders and gastro-oesophageal reflux symptoms is uncertain, and few population-based studies are available.

Some causes of chest pain are underdiagnosed in primary care. This is of particular consequence for the minority of chest pain patients with cardiac disease.

No clear association was apparent between the use of antihypertensive drugs and prostate cancer. However, specific focus on users of captopril showed a lower risk of subsequent prostate cancer. Further research is needed to explore this association.