https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126293/

BMJ. 2003 Jun 21; 326(7403): 1406.PMCID: PMC1126293Copyright and License informationDisclaimer

Persistent doubts about the wisdom of babies lying on their backs (despite the reduction in cot deaths) has led to the rates of prone sleeping in the United States remaining higher than 10%. A prospective cohort study rather reassuringly found that babies who did not sleep prone did not have more symptoms or illness during the first six months of life (Archives of Pediatrics and Adolescent Medicine 2003;157: 469-74 [PubMed] [Google Scholar]).​).Open in a separate windowFigure 1

A 72 year old woman with bilateral knee osteoarthritis was admitted to hospital for a total knee replacement. Postoperatively we saw her on the ward with the outer leaf of a cabbage taped to her non-operated knee. She said that this was the only measure that provided relief from the symptoms of her osteoarthritis and that the outer cabbage leaves fitted well with the shape of her knee.

M R Utting, specialist registrar, V Currall, senior house officer, department of trauma and orthopaedics, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB

Repairing varicoceles is often done to improve male infertility or unexplained infertility because the dilated veins are thought to result in poor sperm quality and quantity. But when data from seven previously published trials were reanalysed, varicocele treatment seemed to have little effect on fertility. Surgery increased the pregnancy rate by only 1% (Lancet 2003;361: 1849-52 [PubMed] [Google Scholar]).

A child who presented with folliculitis caused by Pseudomonas aeruginosa passed it onto 35 others by playing on an inflatable obstacle course in a public swimming pool. Microbiological sampling and a survey of 10 other inflatables used in local pools confirmed the same strain of Pseudomonas in all cases and also showed that nine of the other inflatables were colonised by the same bug (Epidemiology and Infection 2003;130: 187-92 [PMC free article] [PubMed] [Google Scholar]). The authors say we need appropriate guidelines for decontaminating inflatables as well as pools.

GPs faced with an ugly case of suppurating impetigo sometimes resort to oral antibiotics. A systematic review and metaanalysis of 16 appropriate studies of available treatments clearly shows that a topical antibiotic used for seven days should be sufficient to treat a well patient with limited disease (British Journal of General Practice 2003;53: 480-7 [PMC free article] [PubMed] [Google Scholar]).

Albert Camus wrote in the middle of the last century that in times of plague there was no shortage of advice offered about how to prevent the problem spreading. A writer in the American Journal of Public Health (2003;93: 861-2) [PMC free article] [PubMed] [Google Scholar] says that the same thing is happening with HIV. But in the United States HIV among men who have sex with men is on the march again, raising questions about the efficacy of the measures that are in place for prevention and treatment.

An artist who developed progressive aphasia associated with frontotemporal dementia produced freer and more original works as her condition wore on. Her language loss was coupled with artistic development, suggesting that language is not required (and may actually inhibit) some types of visual creativity (Neurology 2003;60: 1707-10 [PubMed] [Google Scholar]).

Human clinical trials that lack randomisation or blinding tend to overestimate the size of treatment effects. But what about animal research? A review of abstracts of animal research presented at meetings in the United States identified a similar bias. Studies that didn’t use randomisation or blinding were more likely than those that did to report differences between control and treatment groups. And actually, only a minority of studies used such methods (Academic Emergency Medicine 2003;10: 684-7 [PubMed] [Google Scholar]).

To counter all those studies that show the benefits of cognitive behavioural therapy, Minerva has found one that doesn’t. A three month randomised controlled trial of tapering off long term benzodiazepine use found that adding group cognitive behavioural therapy made little difference (British Journal of Psychiatry 2003;182: 498-504 [PubMed] [Google Scholar]). Many people will find this fortunate because tapering off of benzodiazepines can be supervised in general practice, whereas group therapy is a lot more difficult to access.

The effects of the traumas experienced by Holocaust survivors persist more than 50 years later. A study of attachment and stress in 98 grandmothers who survived the Holocaust when they were girls found that they show more signs of traumatic stress and lack of resolution of trauma than other people, although their adaptation to life was generally good. But concerns about the next generation proved unfounded. The daughters were protected from their mothers’ war experiences (American Journal of Psychiatry 2003;160: 1086-92 [PubMed] [Google Scholar]).

When playing the ultimatum game, be aware that there’s a neural basis to economic decision making. When there’s a pot of money to share between two people, if the one who makes the offer to share it suggests an unfair split, the emotional energy generated by this provokes more active brain activity in brain areas related to reasoning than does a fair proposal. The more brain activity there is, the more likely it is that the proposal will be rejected in favour of taking no money at all in order to punish the opponent (Science 2003;300: 1755-8 [PubMed] [Google Scholar]).

A group of neurologists want to recruit a large number of medical staff to participate in ACCESS—the acute cerebral CT evaluation stroke study—which aims to improve computed tomography investigations in acute stroke. They want to recruit neurologists, stroke physicians, neurological and general radiologists, geriatricians, and emergency doctors (at trainee, academic, and consultant level) to read sample scans and to fill in their responses over the web. The study is due to be completed later this year. For more information, go to www.neuroimage.co.uk

We may have become a risk averse society, with more attention on injury prevention than ever before, but childhood injuries in a study from California came up with an annual injury rate of 371/100 000 for 0-3 year olds. The rate rapidly increases to a peak at 16 months of age. Falls, poisoning, transportation, foreign bodies, and burns were the most frequent causes of injury (Pediatrics 2003;111: e683-92 [PubMed] [Google Scholar]).