Minerva

Chronic obstructive airways disease responds moderately well to inhaled steroids, according to a meta-analysis of three clinical trials (Thorax 1999;54:7-14). Subjects given 1500μg of beclomethasone or 1600μg of budesonide daily for two years did better than controls given placebo. Their lung function improved, but steroids did not help them avoid acute exacerbations. There are surprisingly few controlled data on this topic; the investigators could find only 183patients with well defined chronic obstructive airways disease who had been included in long term clinical trials against placebo.

Most readers will remember a favourite medical teacher, but what distinguishes these favourites from other, run of the mill, teachers? Experience and a flair for the psychosocial aspects of medicine, finds one case-control study (New England Journal of Medicine 1998;339:1986-93). House staff in four American hospitals identified 165doctors as role models. Researchers then compared the nominated doctors with control doctors not named by house staff. Role models enjoyed teaching more than controls did, and they spent longer at it. They also had a more holistic approach to patients and gave more feedback to students. All doctors could be excellent teachers with a little training, conclude the authors.

Children with cystic fibrosis who are identified by antenatal screening end up …