Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change servers in April

BMJ No 7126 Volume 316 17 January 1998 This Week in BMJ | Editor's Choice | Press releases Receive this page by email each week Editorials 161 Neonatal vitamin K prophylaxis: the Gordian knot still awaits untying Rüdiger von Kries 162 The management of H pylori infection E A J Rauws, R W M van der Hulst 164 Health action zones Bobbie Jacobson, Laurann Yen 165 Distinction awards and racial discrimination Peter Rubin 166 Is measles infection associated with Crohn's disease? Jane Metcalf News 167 US scientist plans human cloning clinic Genetic test for breast cancer approved in US Warning about contraceptive device given Urine beats milk in "biopharming" BMJ to act on media abuse UK acts to deter prescription fraud Addict died after opiate detoxification UK health departments to lead on food safety Scottish cooperatives to be investigated Scandal over blood donation from prisoners India bans payment to blood donors US call for mandatory skiing helmets Medicare to be extended Papers 173 Case-control study of childhood leukaemia and cancer in Scotland: findings for neonatal intramuscular vitamin K Patricia A McKinney, Edmund Juszczak, Elizabeth Findlay, Katrina Smith 178 Case-control studies of relation between childhood cancer and neonatal vitamin K administration S Jane Passmore, Gerald Draper, Pat Brownbill, Mary Kroll 184 Ecological studies of relation between hospital policies on neonatal vitamin K administration and subsequent occurrence of childhood cancer S Jane Passmore, Gerald Draper, Pat Brownbill, Mary Kroll 189 Neonatal vitamin K administration and childhood cancer in the north of England: retrospective case-control study L Parker, M Cole, A W Craft, E N Hey 193 Racial discrimination in the allocation of distinction awards? Analysis of list of award holders by type of award, specialty and region Aneez Esmail, Sam Everington, Helen Doyle 195 Association between use of a quilt and sudden infant death syndrome: case-control study Anne-Louise Ponsonby, Terence Dwyer, David Couper, Jennifer Cochrane 196 Exposure to measles in utero and Crohn's disease: Danish register study Lise Lotte W Nielsen, Nete Munk Nielsen, Mads Melbye, Morten Sodermann, Marianne Jacobsen, Peter Aaby 195 Correction: Comparison of blood or urine testing by patients with newly diagnosed non-insulin dependent diabetes: patient survey after randomised crossover trial Pat Miles et al General practice 198 Relation between sexual abuse in childhood and adult depression: case-control study Marese Cheasty, Anthony W Clare, Claire Collins 201 Understanding controlled trials: Why are randomised controlled trials important? Bonnie Sibbald, Martin Roland Clinical review 202 Fortnightly review: Aggressive behaviour in childhood Stephen Scott 206 Lesson of the week: Emergence of classic enteropathy after longstanding gluten sensitive oral ulceration Usha Srinivasan, Donald G Weir, Conleth Feighery, Cliona O'Farrelly 208 ABC of palliative care: The carers Amanda Ramirez, Julia Addington-Hall, Michael Richards 207 Correction: General management of end stage renal disease Robert Walker Education and debate 212 The New NHS: commentaries on the white paper: From command economy to demand management 212 Financing the NHS Chris Ham 213 A third way? England - yes; Scotland - maybe Greg Parston, Laurie McMahon 214 How will primary care groups work? Tom Butler, Martin Roland 215 The new health authorites: moving forward, moving back? Jonathan Boyce, Tara Lamont 215 NHS Direct: managing demand David Pencheon 217 Is NHS purchasing serious? An American perspective Donald W Light 221 Meta-analysis: Unresolved issues and future developments George Davey Smith, Matthias Egger 225 Correction: Papers that report diagnostic or screening tests Trisha Greenhalgh Letters 226 Regulating the pharmaceutical industry J Furniss and others; P Read; A Towse; P Rowlatt; P R Clear and M Grobler; S P Lance; A Maynard and K Bloor 228 Too soon to market S Senn; W Clark and others; D H Sochart; H C Williams; F Wolff 230 Preventing late bleeding in infants with vitamin K deficiency W Tin and others 230 Water fluoridation and tooth decay in 5 year olds T Vemmer; S L M Gibson and R G Gibson; C Jones and others 231 Litigation over organophosphates J M Williams and D Brennan; A Watterson; C Dyer 232 Severe persistent visual field constriction associated with vigabatrin G F A Harding; R Mackenzie and A Klistorner 233 ECT should be treatment option in all cases of refractory depression N Gormley 233 Steroids in facial palsy due to herpes zoster C P Fielder and S A Raza; J J Homer and others 234 Effect of calcium supplementation during pregnancy on blood pressure of offspring I F D Stephens; J Villar and J Bélizán 234 Correction: Factors influencing relative weights of placenta and newborn infant P Steer 234 Correction: Epidural anaesthesia does not cause long term backache F Reynolds and R Russell Obituaries 235 J Chouler, E R Frizelle, B McKinney, J Schiller, J Shackleton. Correction: G L Mackay Medicopolitical digest 236 Public health and the UK presidency Liberal Democrats criticise NHS staff shortages Juniors' concern at new training proposals Views & reviews Soundings 237 Looking back on 1997 George Dunea Personal view 237 Lassa fever: 10 years on David Cummins Medicine and books 239 Therapeutic Uses of Cannabis British Medical Association Marijuana Myths and Marijuana Facts: A Review of the Scientific Evidence Lynn Zimmer, John P Morgan Michael Farrell When Doctors Join Unions Grace Budrys Norman Ellis Minerva 240 S2 Career Focus Classified supplement What hospital work is really like Joe West Editor's choice Beware individual issues of journals A journal is an ever flowing stream and to appreciate it you must immerse yourself. You may be deceived if you look at just one issue of a journal. This issue contains a confluence of streams that have been flowing through the BMJfor years. The result is not calm water but turbulence. Since 1992 the BMJhas been publishing studies on the question of whether giving vitamin K to newborn infants increases their risk of developing childhood cancer. The first study suggested that it did. But subsequent studies mostly found no association. Today we publish four more studies, two of which are reassuring (p 173 and p 184) and two of which are less so (p 189 and p 178). Professor Rüdiger von Kries picks his way through the papers in an editorial and hopes that pooling records from European studies may sort out the confusion (p 161). Sometimes streams flow in from other journals. Two studies published in the Lancetsuggested that intrauterine exposure to measles might cause Crohn's disease. One showed that three of four babies - from a cohort of 25,000 - whose mothers had measles developed Crohn's disease. A paper we publish today reports that none of the offspring of 25 women who had had measles in pregnancy developed Crohn's disease (p 196). This study joins three other negative studies, and Jane Metcalf declares the hypothesis dead (p 166). Another hypothesis started in the BMJis that the antiepileptic drug vigabatrin may cause visual field defects. The manufacturers had had almost 100 cases reported to them by June 1997, but the risk-benefit ratio of the drug remains unclear. A meeting reported by Professor G F A Harding (and sponsored by the manufacturer) concluded that the drug might be particularly useful in treating infantile spasms (p 132), but two Australians report two new cases of visual field defects in asymptomaticpatients (p 133). This stream is still flowing. Some controversies become very heated, and this seems to be true of whether organophosphates cause long term neurological damage. Three court cases - in Britain, Australia, and Hong Kong - have judged that they do, but several correspondents have objected to the fact that Clare Dyer, our legal correspondent, emphasised in her story that the judge was critical of the expert evidence. They have their say on p 231, but those criticised have felt strongly enough to make a formal complaint, stir up a story in the Sunday Telegraph,and encourage a countess to write to me. Sometimes a riposte in the letters columns is not enough. Finally, anybody who has ever despaired about the conduct of their children may be comforted by Winston Churchill's school report (p 203). "Very bad," wrote the headmaster, "is a constant trouble to everybody and is always in some scrape or another." Home | Current contents | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline