Intended for healthcare professionals



BMJ 1997; 314 doi: (Published 07 June 1997) Cite this as: BMJ 1997;314:1702

In Britain women found to be infected with HIV either before or during pregnancy seem increasingly willing to accept advice on reducing the risk of transmission of the infection to their babies. Between 1994 and 1996 the use of zidovudine by pregnant women rose from 14% to 75% of those offered the treatment (AIDS 1997;11:F53-8). The authors of the report conclude that if all women infected with HIV attending for antenatal care in London consented to testing and accepted treatment the number of babies infected would fall from around 41 to 13 a year. The problem is getting consent to the HIV test.

Surgeons do far fewer radical operations for cancer nowadays: one example is carcinoma of the rectum. Small, low rectal cancers are now being treated by local excision (sometimes with adjuvant chemotherapy) instead of by abdominoperineal resection (Diseases of the Colon and Rectum 1997;40:388-92). Follow up for 40 months of 48 patients having local excisions found that only four had had local or distant recurrences. Clearly this type of surgery will be suitable for only selected patients, but it dramatically reduces postoperative morbidity and mortality.

How should a paediatrician try to decide whether a child has had a simple head injury from a fall or has been hurt by parental abuse? A review in Archives of Disease in Childhood (1997;76:393-7) concludes that the …

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