Lösningar till fråga 1 ELF

Våren 2008



Hardly a week goes by without reports of aspirin expanding its repertoire. You could easily think it was the latest wonder drug, but it is available from garages, newsagents and supermarkets. Research already shows it can reduce the likelihood of strokes, heart attacks and the risk of cancers. Nature magazine recently reported that it could treat turban tumours, a rare, inherited form of skin cancer. So should we all take a pill a day? That’s what Professor Nick Wald from the University of London has suggested in the British Medical Journal (BMJ). He argues that if the over-55s took aspirin as part of a “polypill” with other drugs (such as those to low er blood pressure), it would have a major health impact on the West. However, aspirin is a powerful drug. And, like any medicine, it has risks as well as benefits. Soon after the Nature report, the BMJ published research showing that aspirin increased the risk of miscarriage when taken by pregnant women. The risk was highest when aspirin was taken at the time of conception. In the study, 1,055 women in San Francisco who had positive pregnancy tests were asked about their use of nonsteroidal anti-inflammatory drugs, types of painkillers that include aspirin. Women who had taken these drugs had almost double the risk of miscarriage compared with those who had not taken them. The study shows only that aspirin is associated with miscarriage, not that it definitely causes it. But Dr Li DeKun, an epidemiologist at the Kaiser Foundation Research Institute and one of the authors of the study, believes that women should discuss the results with their doctors. Professor John Cleland, cardiologist at the University of Hull, believes that we may have embraced aspirin as a wonder drug too uncritically. “The idea that aspirin is cheap and harmless is beginning to evaporate,” he says. “If you take aspirin, there is a risk of kidney failure and it is one of the commonest causes of major bleeding from the gut.” Aspirin is recommended for people who have already had a stroke or heart attack to prevent them having further attacks and is also used to treat heart failure. “Doctors should be really conservative about what they recommend in clinical practice,” says Cleland. In people with heart failure, he is concerned that aspirin may counteract the proven and beneficial effects of drugs called ace inhibitors that major clinical trials show reduce the risk of death and hospitalisation. Joe Collier, professor of medicines policy at St George’s Hospital, London, believes that whatever doubts there are about aspirin, it has been an enormous life-saver. “I am sure that low-dose aspirin has saved millions of lives by stopping second heart attacks and strokes,” he says. What interests him most about the aspirin story is how it has taken the medical profession 100 years to begin to use aspirin to its full potential. “It is quite contrary to drug companies pushing through a drug and then replacing it, because the patent runs out – you never get to know the product fully. We are gradually learning about drugs such as aspirin, and morphine and water tablets.” At Cancer Research UK, they are feeling increasingly friendly towards aspirin. “My personal theory is that aspirin will be most useful in preventing cancers coming back, and aspirin is less toxic than many long-term chemotherapy drugs,” says Dr Richard Sullivan. But he warns against people thinking that by taking aspirin they will ward off cancer. “For the average person to prevent cancer, if you smoke or if you are obese, then these are the risk factors to worry about,” he says. Sullivan doesn’t take aspirin himself. “Anything you swallow has side effects and you should swallow as few things as possible to give yourself a healthy life,” he says. “I don’t think you should throw aspirin out to the general public at large. You should direct it to people who really need it, where the evidence shows it reduces risk.” Luisa Dillner, The Guardian Weekly

**What is implied about aspirin in the first two paragraphs?**

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