Treating patients with acute optic neuritis with high doses of intravenous methylprednisolone for three days and oral prednisone for 11 days reduces their risk of developing multiple sclerosis in the next two years(New England Journal of Medicine 1993;329:1764-9). A trial on 389 patients of this treatment against oral prednisone alone or placebo showed a clear advantage for the group given the intravenous steroids. Nevertheless, the journal warns, this work needs confirmation in further trials before it becomes accepted practice

Controversy continues in the United States about the safety of silicone breast implants. A recent report in “JAMA” (1993;270:2602-6) from the American Medical Association's council on scientific affair's recommended that women should be able to choose to have implants fitted so long as they had been fully informed of the risks and benefits. In the same issue the Food and Drug Administration repeated its view that the use of implants should be restricted to clinical research trials. As “JAMA” says, “the brouhaha should be interesting.”

The immoral behaviour of the Prince of Wales may have contributed to …