This week in the BMJ
Volume 333, Number 7581, Issue of 16 Dec 2006Antibiotic prevents complications of measles
This week in the BMJ
Antibiotic prevents complications of measles
Prophylactic co-trimoxazole given to children with measles reduces the incidence of pneumonia (odds ratio 0.08, 95% confidence interval 0 to 0.56) and conjunctivitis, and positively affects weight gain in the month after infection (P=0.04), say Garly and colleagues (doi: 10.1136/bmj.38989.684178.AE). They randomised 84 patients in Guinea-Bissau with measles to either receive the antibiotic or a placebo for seven days after diagnosis. They saw a non-significant trend towards less diarrhoea, severe fever, oral thrush, and stomatitis in the group treated with antibiotic, but no difference in rates of otitis media between groups.
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This week in the BMJ
Flu vaccine for staff protects care home residents
Vaccinating care home staff against influenza in times of moderate influenza activity can reduce deaths, health service use, and hospital admissions in residents, say Hayward and colleagues (10.1136/bmj.39010.581354.55). The authors randomised 44 care homes in the United Kingdom to offering their staff influenza vaccine or not for two consecutive winters. In the first winter, when influenza activity was high, vaccination had a significant positive impact on residents' health; but this was not seen the next winter when influenza rates were lower than usual.
This week in the BMJ
Journals omit absolute risks
Absolute risks should be routinely included in abstracts, adjacent to any reported risk ratio, to allow readers to discern the meaning of ratio measures. In a structured review of the accessibility of absolute risk data in six leading journals, including the BMJ, Schwartz and colleagues (10.1136/bmj.38985.564317.7C) examined 222 articles with study designs that allow absolute risks to be calculated. They found 68% of articles failed to report absolute risks in the abstract, and half of these did not report them anywhere in the article.
This week in the BMJ
How to manage osteoporosis
Considerable advances have been made in identifying people at risk of fractures because of osteoporosis and in treatments designed to reduce fractures, say Poole and Compston (10.1136/bmj.39050.597350.47) in their clinical review of the management of osteoporosis. They discuss the genetic, nutritional, hormonal, and physical factors that influence peak bone mass, which is attained in the third decade and determines bone mineral density in later life. Avoidable clinical risk factors for fragility fractures include smoking, high alcohol consumption, low body mass index, and falls.
This week in the BMJ
Lab tests for diabetic dyslipidaemia
Hypertriglyceridaemia is commonly associated with poorly controlled diabetes and does not usually respond well to lipid lowering agents before hyperglycaemia is tackled, says Smellie (10.1136/bmj.39043.398738.DE). In this Practice article the author examines two cases in which patients' serum biochemistry showed hypertriglyceridaemia that was difficult to treat in primary care because of diabetes. High triglyceride concentrations are associated with a risk of complications such as pancreatitis and fatty deposits in the liver. Management of such patients needs to incorporate lifestyle advice as well as drug therapy and ongoing monitoring.
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