Minerva

Minerva

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7144.1618 (Published 23 May 1998) Cite this as: BMJ 1998;316:1618

Medical termination of pregnancy using the antiprogestin mifepristone and a prostaglandin has been confirmed as a safe and effective alternative to surgery in a large multicentre trial from the US (New England Journal of Medicine 1998;228:1241-7). The success rate was shown to fall as the duration of the pregnancy went up: the best results were achieved in women who were less than 7 weeks pregnant. Unexpectedly, the medical regimen was less likely to work in women who had had previous elective abortions—more than half the 2121 women in this study.

With the advent of clot busting drugs for stroke, the pressure is on to get patients to hospital for treatment as fast as possible. Fast response depends initially on the patients recognising their symptoms and calling for help. A telephone survey in JAMA (1998;279:1288-92) reports, however, that people at risk are ignorant of the signs of impending stroke. Just over half of the 1880 people surveyed were able to list one of the five established warning signs. More mentioned “chest pain” as a warning sign than mentioned one sided weakness. Less than a third made any reference at all to weakness or numbness. Predictably, those at highest risk were the most ignorant.

The well established sociocultural divide between the United States and the United Kingdom extends even into the …

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