Minerva

# Minerva

BMJ 1998; 316 (Published 07 February 1998) Cite this as: BMJ 1998;316:486

The rapid increase in malignant melanoma in recent years has led to a search for all potential avoidable factors. One possibility investigated in Sweden was phototherapy for neonatal jaundice (Archives of Pediatrics and Adolescent Medicine 1997;151:1185-8). The results showed that none of 30 children who had developed malignant melanomas had had phototherapy, whereas 11 of the controls had done so.

Until quite recently the diagnosis of acute appendicitis was made on clinical grounds. Then came laparoscopy; and now the most accurate diagnostic test seems to be helical computed tomography after the introduction of a contrast medium into the colon. The costs and benefits of this procedure were assessed in 100 patients with suspected appendicitis in Boston (New England Journal of Medicine 1998;338:141-6). The scans gave an accurate verdict in 98 cases, and these results led to changes in treatment in 59 patients. The average cost of scanning was $228 (£143) per patient, and overall the savings made on preventing unnecessary admissions averaged$447 (£279) per patient.

Necropsies in patients with Alzheimer's disease are said to confirm the clinical diagnosis in over 90% of cases. In reality, says a paper in the Journal of Neurology Neurosurgery and Psychiatry (1998;64:18-24), correcting for dual pathology and verification …

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