Intended for healthcare professionals

Minerva Minerva


BMJ 1999; 318 doi: (Published 10 April 1999) Cite this as: BMJ 1999;318:1018

Every day 23 000 Americans consult a doctor because of ankle sprains. One survey suggests that nearly three quarters of them continue to have symptoms for months, even years, regardless of the type of treatment they receive (Archives of Family Medicine1999;8:143-8). Respondents were people with ankle sprains from Minnesota and Wisconsin, 400 of whom were surveyed 6-18 months after injury. Over 40% reported being unable to walk a mile, and a similar percentage could not jump or pivot because of pain or weakness.

Three months of anticoagulation treatment may not be enough for people with idiopathic deep vein thromboses. Investigators had to stop a randomised controlled trial of short term versus long term warfarin treatment when it became obvious that continuing warfarin for more than 3 months prevented up to 95% of recurrent thromboses (New England Journal of Medicine1999;340:901-7). The trial was terminated after only 10 months so it's still unclear how long treatment should continue to strike the best balance between the risk of bleeding and the risk of further thrombosis.

Adults with cancer do better if they are affluent, and there is some evidence that the same is true for children. An international team of researchers reports, however, that there …

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