This week in the BMJ
Volume 333, Number 7562, Issue of 5 Aug 2006Antibiotics for acute purulent rhinitis-wait and watch
Antibiotics for acute purulent rhinitis-wait and watch
Antibiotics should not be used as first line treatment for acute purulent rhinitis because of their gastrointestinal toxicity, even though they are probably effective. Arroll and Kenealy (p 279) conducted a meta-analysis of seven randomised controlled trials in adults and children. The relative risks for benefits and harms with the antibiotics were 1.18 and 1.46 respectively. Antibiotics may be used when the symptoms continue long enough to concern patients, the authors add.
|
![[To top]](/icons/back.gif){kind=icon}
Radiotherapy patients can trigger airport radiation alarms
Patients who undergo diagnostic and therapeutic procedures involving radioisotopes must be informed that they might trigger radiation alarms during security checks. Gangopadhyay and colleagues (p 293) describe the case of a 46 year old man who received radioiodine treatment for recurrent thyrotoxicosis. The nuclear medicine department did not tell the patient that he might set off radiation detectors. Six weeks later, the patient was detained at Orlando airport in the US after he triggered a radiation alarm. He was released after a long period of investigation and much embarrassment. The half life of the isotope and the increasing sensitivity of the detectors in airports must be considered when such warnings are given, the authors add.
Spread of MRSA increases in hospitals
Hospital acquired Staphylococcus aureus infections, and mortality after the bacteraemia, have increased with the spread of methicillin resistant S aureus (MRSA). In an anonymised record linkage study Wyllie and colleagues (p 281) used data from more than 216 000 patients to identify 461 inpatients admitted to hospitals in Oxfordshire with S aureus bacteraemia. The rates of methicillin sensitive S aureus infections seem to have remained constant. The overall mortality after S aureus bacteraemia was 30%. The mortality was at least as high after methicillin sensitive infections as after MRSA bacteraemia.
|
Both screened and screeners misinterpret test results
Different groups of people draw incorrect inferences when the results of screening are presented to them as probabilities. Bramwell and colleagues (p 284) recruited four groups of participants that were roughly equal in numbers—pregnant women, their companions, midwives, and obstetricians. Participants were presented with the results of a screening test for Down's syndrome, either as percentages or as frequencies, and were asked to interpret the results. Although obstetricians performed considerably better than the rest, almost 86% of the responses were incorrect. Many professionals were confident about their incorrect responses.
|
Manage varicose veins with conventional surgery
Conventional surgery with saphenofemoral ligation is the optimal treatment for varicose veins, and it's cost effective. In his review (p 287), Campbell reiterates the importance of reassuring patients because most people with varicose veins are not harmed by them. Laser and radiofrequency treatments are alternatives for one part of the conventional operation only, and most patients require additional phlebectomies or sclerotherapy.
|
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
