BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b3700 (Published 15 September 2009) Cite this as: BMJ 2009;339:b3700

The real life experience of patients who undergo percutaneous coronary interventions after ST elevation myocardial infarction compares favourably with that of patients under study conditions. Patients who underwent routine interventions in the community had similar outcomes (including rates of death, re-infarction, and stroke) to those included in a landmark randomised trial published in 2003. Long term prognosis was the same whether procedures were done during or after hours, and whether or not patients had to be first transported to another centre (Circulation: Cardiovascular Interventions 2009; published online 18 Aug, doi:10.1161/circinterventions.108.845636).

Children diagnosed with acute lymphoblastic leukaemia and treated with dexamethasone do better than those treated with prednisolone, presumably in part because dexamethasone penetrates the central nervous system more effectively. But little is known about whether treatment with the steroid impairs the nervous system in the long term. Fortunately, a study of cognitive function in children almost 10 years after being randomised to receive either dexamethasone or prednisolone for childhood …

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