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All you need to read in the other general journals

BMJ 2008; 337 doi: (Published 23 September 2008) Cite this as: BMJ 2008;337:a1760

Vaccinating pregnant women protects infants against influenza

Influenza is a serious infection for small babies. Since vaccines aren’t licensed for this age group, could they be protected by vaccinating mothers during pregnancy instead? Maternal vaccination worked reasonably well for both mothers and babies in a randomised trial in Bangladesh. A trivalent inactivated vaccine reduced the incidence of confirmed influenza by 63% (95% CI 5% to 85%) among babies up to 6 months old, compared with a control pneumococcal vaccine. Babies of mothers given the influenza vaccine had 29% (7% to 46%) fewer febrile respiratory illnesses than control babies. Their mothers had 36% (4% to 57%) fewer febrile respiratory illnesses than control mothers.

Overall, 340 women took part in the trial. All were vaccinated in the third trimester of pregnancy. Their babies were further randomised to test the immunogenicity and safety of the pneumococcal vaccine. The influenza results were analysed independently and seemed unaffected by this parallel trial.

The World Health Organization has recommended vaccinating pregnant women against influenza since 2005, but so far few have received it. This new evidence should help, say the researchers. They estimate that fewer than 16 women would need to be vaccinated to prevent one case of influenza in an infant.

CT colonography is a sensitive screening tool for larger colorectal lesions

Computed tomography (CT) of the colon is a non invasive tool for screening asymptomatic individuals for colorectal cancers and adenomas. Compared with colonoscopy, CT had a sensitivity of 0.9 (95% CI 0.84 to 0.96) in the most recent and largest prospective study to compare the two. In other words, the less invasive option correctly identified 90% of the larger adenomas and cancers (≥10 mm in diameter) detected by colonoscopy. Sensitivity for smaller adenomas (≥6 mm) was 0.78 (0.71 to 0.85).

So CT is good at finding the bigger and most clinically important lesions, but there is a downside, says an …

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