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BMJ 1995; 311 doi: (Published 05 August 1995) Cite this as: BMJ 1995;311:400

The national media showed a lot of interest in a controlled trial in Bristol of oral prednisolone against placebo in patients with active rheumatoid arthritis of less than two years' duration (New England Journal of Medicine 1995;333:142-6). The patients taking steroids showed far less radiological evidence of progression of their arthritis —a finding in line with other research suggesting that aggressive treatment is likely to be most effective early in the course of the disease. Selecting the patients most likely to benefit from such treatment will, however, require further research.

One in every 20 deaths in the United States is due to intestinal ischaemia; more patients die of this than of cancer of the colon, says a review in “Digestive Diseases” (1995;13:3-24). Most patients with ischaemia of the bowel are already gravely ill with heart failure or shock, but nevertheless their only hope of survival lies in early diagnosis, prompt assessment, and possibly surgery.

Adult T cell leukaemia is due to infection with the human immunodeficiency virus type I (HIV-1). Its prognosis has been poor, but a report in the New England Journal of Medicine (1995;332:1749-51) describes five patients treated in France with a combination of zidovudine and interferon alfa. All responded, and three were still alive …

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