BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6935.1050 (Published 16 April 1994) Cite this as: BMJ 1994;308:1050

Patients who give a typical history of cardiac pain but have non-diagnostic electrocardiograms may often have had spontaneous thrombolysis before they reach hospital (British Heart Journal 1994;71:309-10). In these circumstances even should they have abnormal cardiac enzymes they should still not be given thrombolytic drugs, since their coronary arteries are patent and all the drugs will do is expose the patients to the risk of haemorrhagic side effects.

A long review of the management of patients with meningitis in the “Journal of Neurology, Neurosurgery, and Psychiatry” (1994;57:405-15) includes the recommendation that all children who have recovered from the illness should have an auditory assessment 4-6 weeks after leaving hospital. Early recognition of sensorineural loss is important so that rehabilitation can begin promptly.

A case-control study of environmental factors in meningococcal disease in children is reported in Epidemiology and Infection (1994;112:315-28). Passive smoking in the home (more than 30 cigarettes a day) was associated with an odds ratio of 7.5, while other important risk factors were overcrowding and stress - marital arguments and legal disputes.

Women in their 40s who are worried about their risk of developing breast cancer are told that none of the screening methods - mammography, …

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