This week in the BMJ
Volume 332, Number 7536, Issue of 4 Feb 2006Didgeridoo playing could improve sleep apnoea
Didgeridoo playing could improve sleep apnoea
Regularly playing a didgeridoo reduces daytime sleepiness and snoring in people with moderate obstructive sleep apnoea syndrome. In a randomised controlled trial, Puhan and colleagues (p 266) allocated 25 adults with self reported snoring and an apnoea-hypoponea index of 15-30 (episodes per hour) either to didgeridoo lessons and regular practice at home or to a waiting list. After four months the intervention group had less daytime sleepiness and significant improvement in the index score. The collapsibility of the upper airways must have decreased through the "training," say the authors.
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Collaborative care improves late life depression
Tailored collaborative care management benefits depressed older patients in primary care not just in the short term but also in the longer term. Hunkeler and colleagues (p 259) randomised 1801 primary care patients aged over 60 who had major depression to a programme that included a depression care manager, a primary care doctor, and a psychiatrist or to usual care for depression. They found that collaborative care actively engaged these patients in their treatment and delivered benefits—like less depression and better physical functioning—and that these benefits persist at least a year after the intervention has ended.
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New mothers in UK do use child records booklet
Although use of the personal child health records booklet is lower among mothers living in disadvantaged circumstances, overall the booklet is retained and used by a high proportion of mothers across the UK during their child's first year of life. Walton and colleagues (p 269) analysed interviews with mothers of more than 18 000 children in the millennium cohort study between 2000 and 2002 and found that 89% of mothers from "disadvantaged" areas, and 95% from "advantaged" areas had been able to show the interviewer the booklet. The booklet has benefits that may extend beyond the direct care of individual children, say the authors.
Scoring prognosis in stable angina
In stable angina, six clinical factors are independently most predictive of adverse outcome: comorbidity, diabetes, shorter symptom duration, increasing symptom severity, ventricular dysfunction, and resting electrocardiography changes. Daly and colleagues (p 262) carried out a cohort study of more than 3000 patients from 156 European outpatient cardiology clinics who had a new clinical diagnosis of stable angina. Using those six simple, readily available factors, they constructed a score to estimate the probability of death or myocardial infarction within one year after a patient presents with stable angina.
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What's new in diverticulitis?
Recent advances in diagnosis and treatment of diverticular disease have enabled successful medical management of patients who would previously have had surgery, say Janes and colleagues on page 271. In a clinical review on management of diverticular disease, the authors revisit pathophysiology, terminology, and diagnostic imaging of this increasingly common disorder and discuss the evidence on the use of dietary fibre and drugs in uncomplicated disease. They document how emergency surgery has evolved from a three stage to a one stage procedure and examine whether elective surgery prevents future complications.
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