This week in the BMJ
Volume 329, Number 7461, Issue of 7 Aug 2004Twins born after assisted conception are not at higher risk of neurological damage
Twins born after assisted conception are not at higher risk of neurological damage
Twins born after assisted conception have a risk of developing neurological problems similar to that of naturally conceived twins. Pinborg and colleagues (p 311), who followed up more than 18 000 children born in Denmark, also found that children born after intracytoplasmic sperm injection (ICSI) had the same risk of neurological sequelae as those born after conventional in vitro fertilisation.
|
![[To top]](/icons/back.gif){kind=icon}
Overseas visitors should have access to free NHS care
An ethical debate by Pollard and Savulescu argues that far from restricting care we should provide access to free NHS care for overseas visitors and people of uncertain residential status (p346). To highlight the ethical dilemma they use the example of an African woman who is found to be HIV positive on antenatal screening and is denied access to a consultant because she cannot produce a passport. An editorial on page 303 about identity cards for UK citizens raises similar questions.
|
Access to medical care does not explain social gradients in heart disease
Differences in medical care are unlikely to contribute to social or ethnic differences in the epidemiology of coronary artery disease. Britton and colleagues (p 318), who followed up more than 10 000 participants in the Whitehall II study for over 15 years, found that South Asians and poorer people—who are more likely to have coronary artery disease—had the same access to cardiac procedures and medication as other social groups. The higher mortality from cardiac disease in poorer people and South Asians would have to be explained by other biological, behavioural, and psychosocial explanations, conclude the authors.
|
Topical NSAIDs relieve osteoarthritis pain for only two weeks
Non-steroidal anti-inflammatory drugs (NSAIDs) are not effective in the long term treatment of people with osteoarthritis, as their effect wears off after two weeks. Analysing 13 randomised trials including 1983 patients with osteoarthritis, Lin and colleagues (p 324) also found that even during the first two weeks of treatment topical NSAIDs were not as effective as oral NSAIDs, and caused more side effects such as rashes, itching, and burning.
|
Clopidogrel may be associated with acquired haemophilia A
Two women who developed excessive bruising and soft tissue bleeding two to three months after starting clopidogrel were found to have haemophilia (p 323). To induce a remission both were treated with steroids and one needed azathioprine also.
|
Treating acute COPD at home is as good and cheaper
Hospital at home schemes are safe, effective, and cheaper than inpatient care in hospitals for treating many patients with acute exacerbation of chronic obstructive pulmonary disease (COPD), and free up hospital beds. A systematic review by Ram and colleagues (p 315) identified seven randomised controlled trials (with 754 patients) comparing hospital at home schemes with inpatient treatment. Mortality and hospital readmission were similar in the two groups of patients. Two studies that compared costs showed that hospital at home care was substantially cheaper than inpatient care.
|
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
