This week in the BMJ
Volume 333, Number 7577, Issue of 18 Nov 2006Physical activity does not alter children's BMI
This week in the BMJ
Physical activity does not alter children's BMI
A physical activity intervention designed to prevent obesity in children did not alter body mass index or sedentary behaviour, according to Reilley and colleagues (doi: 10.1136/bmj.38979.623773.55). The authors randomised 545 preschool children either to follow an exercise programme at nursery and at home or to no extra activity. Follow-up at six and 12 months showed that the exercise programme improved children's motor skills, which may affect future participation in sport, but had little effect on obesity in the short term.
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This week in the BMJ
Is screening for chronic kidney disease cost effective?
Screening for chronic renal disease would be an effective case detection strategy in people over 55 and those with diabetes or hypertension (number needed to screen 8.7, 95% confidence interval 8.5 to 9.0) say Hallen and colleagues (doi: 10.1136/bmj.39001.657755.BE). In their eight year follow-up of a Norwegian national cross sectional health survey, relatively few people developed end stage renal disease after kidney disease was detected, and substantially more died from cardiovascular disease. Further research is needed to establish whether such screening is cost effective.
This week in the BMJ
Baseline serum albumin concentrations do not affect resuscitation outcomes
Fluid resuscitation with saline or albumin produces similar outcomes regardless of patients' baseline serum albumin concentrations say the SAFE study investigators in their randomised controlled trial of 6045 patients across 16 intensive care units (doi: 10.1136/bmj.38985.398704.7C). They randomised 2451 patients with baseline albumin concentrations of 25 g/l or less and 3594 with values greater than 25 g/l to receive either saline or albumin during resuscitation. Rates of admission to intensive care and renal replacement therapy, and length of mechanical ventilation and hospital stay did not differ between groups.
This week in the BMJ
Prenatal genetic testing for parents who won't terminate
Parents who intend to continue with the pregnancy but nevertheless request antenatal genetic testing raise difficult issues for clinicians. In an ethical debate (doi: 10.1136/bmj.38950.645799.55) two authors take opposing stances on prenatal testing for Huntington's disease—an untreatable condition with adult onset—if parents have decided against a termination. One author argues for testing to spare parents and child from uncertainty, whereas the other argues against testing so that parents are spared the responsibility of deciding when to tell the child.
This week in the BMJ
Religion provides insight into how doctors interpret evidence
Individual interpretations of evidence based medicine can be traced to the reader's "world view" says Links (10.1136/bmj.38966.487350.68). The author draws a comparison between evidence based medicine and religious faith, and describes a spectrum of world views from fundamentalist to conservative and liberal. Where religious belief requires tolerance, debates on evidence must allow for differing world views and recognise limitations of evidence based medicine, specifically when considering evidence not derived from randomised controlled trials.
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