This week in the BMJ
Volume 332, Number 7549, Issue of 6 May 2006Academics may be losing control of clinical research
Academics may be losing control of clinical research
Academic affiliations remain prominent among authors of the most frequently cited medical research. However, such research is increasingly funded by industry, often exclusively so. Patsopoulos and colleagues (p 1061) identified the authors' affiliations and funding sources of the 289 most frequently cited articles of the Web of Knowledge database. Sixty per cent of the articles published during 1994-2003 and cited by the end of 2004 were funded by government or public funding, but the proportion of articles funded by industry alone increased over time; 18 of the 32 most cited trials published after 1999 were funded by industry alone.
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Consider rectal quinine for moderately severe malaria
Rectal quinine has an acceptable safety profile in the early management of moderately severe malaria in children who cannot take oral treatment. In a randomised controlled trial by Barennes and colleagues (p 1055), almost 900 children with moderately severe Plasmodium falciparum malaria received either rectal or intramuscular quinine every 12 hours until they could take oral treatment. Although primary safety and efficacy was slightly lower in the rectal group, rectal quinine could be used in the field when injectable disposables were not available, thus guaranteeing immediate treatment.
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Tobacco exposure is associated with glucose intolerance
Active and passive smoking may have a role in the development of glucose intolerance in young adulthood. Houston and colleagues (p 1064) followed over 4600 black and white men and women aged 18-30 with no glucose intolerance at baseline, including current smokers, previous smokers, and "never" smokers with and without exposure to secondhand smoke. After 15 years the incidence of glucose intolerance was highest among smokers (22%), followed by never smokers with passive smoke exposure (17%), and lowest for never smokers without exposure (11%).
Goth subculture is strongly linked with self harm and attempted suicide
Identification with the Goth youth subculture is strongly associated with self harm and attempted suicide. A longitudinal cohort study by Young and colleagues (p 1058) of 1258 people aged 19 who had been followed up since they were 11, found that the prevalence of self harm and attempted suicide were 53% and 47% respectively among the participants who identified mostly strongly with the Goth subculture. Prevalences of self harm and attempted suicide in the whole sample were 7% and 6%.
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Skin sutures can get wet safely after minor excisions
Uncovering sutures and allowing them to get wet in the first 48 hours after minor skin excisions may not increase infection rates. Heal and colleagues (p 1053) randomised over 800 patients to two groups: the "dry" group had to keep their wounds dry and covered for the first 48 hours, and the "wet" group had to remove the dressings within 12 hours and bathe as normal. By the time the sutures were removed, the incidence of infection was 8-9% in both groups. The study was conducted in a tropical area (Queensland, Australia), however, and the authors say their results may not be generalisable to temperate climates: sweat induced by tropical conditions may dampen dressings and reduce their effectiveness as a barrier against bacteria.
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