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Student Reviews

Minerva: August 2001

BMJ 2001; 323 doi: (Published 01 August 2001) Cite this as: BMJ 2001;323:0108304
  1. P Mohammed, specialist registrar1,
  2. N McLean, consultant1,
  3. R Charnley, consultant surgeon2,
  4. A J Thompson, senior registrar3,
  5. H J Steen, consultant3,
  6. A J M Reid, locum consultant3
  1. 1department of plastic surgery, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
  2. 2Freeman Hospital, Newcastle upon Tyne NE7 7DN
  3. 3department of child health, Queen's University of Belfast, Institute of Clinical Science, Belfast BT12 6BJ

Treating sleep apnoea may save lives. More than 200 adults with sleep apnoea were treated with nasal continuous positive airways pressure for at least three years. Their motor vehicle collision records three years before and after treatment were compared with those of a similar number of control drivers. Untreated patients had had more recorded collisions than the controls, but after the treatment the rate in both groups became equal (Thorax 2001;56:508–12). One commentator estimates that treating 500 patients for three years could prevent 180 serious crashes.

Dyspepsia guidelines commonly used in clinical practice say that referrals for endoscopy should be limited to patients over the age of 45 and those who present with “alarm” symptoms such as weight loss, recurrent vomiting, or dysphagia. But an American multivariate analysis of over 20 000 patients reports that such rules are not effective predictors of endoscopic findings: major disease was found at endoscopy in only 21% of cases (sensitivity 87%, specificity 26%). The authors recommend that more effective strategies are needed …

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