BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7020.1650 (Published 16 December 1995) Cite this as: BMJ 1995;311:1650

Inflammation of joints in rheumatoid arthritis is at its peak in the early stage of the disease; patients may lose a fifth of their bone mass from the hip in the first three years (Annals of the Rheumatic Diseases 1995;54:944-7). Trials of aggressive early treatment with intraarticular steroids, cyclosporin, and methotrexate are now under way. Careful monitoring of progress should soon show whether this radical approach is justified.

Virological studies of lung tissue from patients with cryptogenic fibrosing alveolitis found evidence of replication of the Epstein-Barr virus in pulmonary epithelial cells. The report in “Thorax” (1995;50:1234-9) says that these results are only preliminary, but they hold out the possibility that antiviral treatment might be useful in this sinister disease.

Early surgical treatment is recommended for patients with subarachnoid haemorrhage to prevent rebleeding, but craniotomy is contraindicated in some cases (Journal of Neurology, Neurosurgery and Psychiatry 1995;59:616-20). Results in 75 such patients whose aneurysms were catheterised and then occluded by electrolytic detachment of platinum coils were encouraging. Formal trials are now needed to compare the efficacy and safety of this new endovascular technique with those of …

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