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Press releases Saturday 14 August 2004

Please remember to credit the BMJ as source when publicising an article and to tell your readers that they can read its full text on the journal's web site (http://bmj.com).

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(1) INEXPENSIVE DRUG COULD BE BEST HOPE FOR EARLY PARKINSON'S

(2) PELVIC FLOOR MUSCLE TRAINING AIDS LABOUR

(3) HOSPITALS SHOULD BE ENCOURAGED TO IMPROVE ERROR REPORTING

Online First
(1) INEXPENSIVE DRUG COULD BE BEST HOPE FOR EARLY PARKINSON'S

(Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients)
http://bmj.bmjjournals.com/cgi/reprint/bmj.38184.606169.AE

An inexpensive but rarely used drug could be one of the most effective treatments for early Parkinson's disease, according to new research available on bmj.com today.

Selegiline is from a group of drugs called monoamine oxidase type B inhibitors (MAOBIs) used to slow the progression of Parkinson's disease. But uncertainty about selegiline arose in 1995, when one trial linked it to high death rates. Since then, its use in the United Kingdom has dropped substantially.

Now a team of researchers say that this was probably a chance finding and that selegiline could be one of the most effective and cost effective treatments available for early Parkinson's disease.

They analysed 17 trials comparing MAOBIs with placebo or a drug called levodopa and found that MAOBIs reduced disability, the need for levodopa, and problems with movement, without substantial side effects or increased risk of death.

This study provides the most reliable available summary of the current evidence from clinical trials of MAOBIs, say the authors. However, they suggest that further large, long term trials comparing selegiline with other available drugs, and assessing patient rated quality of life measures, are needed.

Contact:

Keith Wheatley, Professor of Medical Statistics, Birmingham Clinical Trials Unit, University of Birmingham, UK
Email: k.wheatley@bham.ac.uk

(2) PELVIC FLOOR MUSCLE TRAINING AIDS LABOUR

(Randomised controlled trial of pelvic floor muscle training during pregnancy)
http://bmj.com/cgi/content/full/329/7462/378

Pelvic floor muscle training during pregnancy seems to facilitate labour, say researchers from Norway in this week's BMJ.

Their study challenges a myth that prevails among birth attendants that strong pelvic floor muscles (for example, as a result of horse riding) may obstruct labour.

They identified 301 healthy pregnant women who had not given birth before. Half the women took part in an intensive pelvic floor muscle training programme between the 20th and 36th week of pregnancy. The other half acted as a control group.

Duration of the second stage of labour (active pushing time) and number of prolonged deliveries (more than 60 minutes of active pushing) were recorded.

Women in the training group had a lower rate of prolonged second stage labour than women in the control group, with 24% undelivered after 60 minutes of active pushing compared to 38% in the control group.

However, there was no significant difference in the duration of the second stage of labour between groups (40 minutes versus 45 minutes).

Despite the borderline significance of the results, intensive training of the pelvic floor muscles during pregnancy results in improved muscle control and strong flexible muscles, and seems to facilitate rather than obstruct labour, conclude the authors.

Contact:

Kjell Salvesen, Professor in Obstetrics and Gynaecology, Trondheim University Hospital, Norway
Email: pepes@medisin.ntnu.no

(3) HOSPITALS SHOULD BE ENCOURAGED TO IMPROVE ERROR REPORTING

(Dr Foster's case notes: How often are adverse events reported in English hospital statistics?)
http://bmj.com/cgi/content/full/329/7462/369

Hospitals should be encouraged to improve the recording of medical errors on their systems, say researchers at Dr Foster in this week's BMJ.

About 850,000 medical errors occur in NHS hospitals every year, resulting in 40,000 deaths.

Researchers looked at four years of English hospital statistics to examine patterns in the recording of adverse events and ask whether this routinely collected source of data could be of use in monitoring this problem.

They found, on average, 2.2% of all episodes (about 27,500 per year) included a code for an adverse event. Misadventures were mentioned in 0.03% of episodes (nearly 4,000 per year). Events were more likely to occur in men, in elderly people, and in emergency admissions.

Although adverse events using routine data may be under-recorded, this analysis has shown that adverse events are recorded within hospital episode statistics, say the authors. For these statistics to accurately monitor adverse events, hospitals should be encouraged to improve the recording of events on their systems, they conclude.

Contact:

Roger Taylor, Dr Foster Ltd, London, UK

*Dr Foster is an independent organisation that analyses the availability and quality of health care in the United Kingdom and worldwide (www.drfoster.com)

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