This week's journal reviews on Doctors.net.uk
Journal Watch is a service provided to summarise some of the most popular medical journals.
Doctors.net.uk has a panel of specialist advisers responsible for reviewing a range of journals of general medical interest and some more specialised publications.
General Journal Watch is written by Dr Druin Burch, Consultant in Internal Medicine
This week's journals include....
Evidence-based antibiotic duration
Much of antibiotic prescribing is a dark act of expert opinion, perhaps the least trustworthy of all the tools by which we decide what's best for patients. This sensible study looks at whether 5 days of ceftriaxone is as good as 10 days for children with bacterial meningitis in poorer countries. It was, and this is a useful thing to know.
Dietary calcium and fractures
Despite all that those selling food supplements or idiotic health advice would have you believe, more is not necessarily better. That's true of a whole host of dietary components, and appears to be true here in this observational study of ageing Swedes. Those who had diets very poor in calcium were at highest risk of osteoporotic fracture, but anyone eating even a reasonable quantity of the stuff wasn't - there was no linear relationship between dietary calcium intake and fracture risk.
Bacterial meningitis in the USA
In JAMA they'd use this sort of a title for a sentimental poem; in the NEJM it's an account of the shifts in epidemiology from 1998 to 2007 and much more readable. The news is basically good - pneumococcal and H. Influenzae type b vaccines are to credit - and overall incidence and mortality have gone down. Case fatality rates are static - acute therapies haven't really gotten any better - and since children have received the bulk of the benefits from vaccinations, a greater proportion of cases are now in adults and the elderly.
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