Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E114

This article originally appeared in BMJ USA

The challenge for coronary imaging is to develop techniques that will identify which plaques are stable and which unstable. A review in (Heart 2002;87:195–197) claims that big advances have been made in the past decade but adds that the non-invasive techniques—magnetic resonance coronary angiography, electron beam computed tomography, and multisliced computed tomography—lack sufficient and consistent image quality to replace conventional coronary angiography. Several years' more research seem to be needed.

A comparison in Sweden of laparoscopic and open surgery for the treatment of esophageal reflux found that treatment failure and patient dissatisfaction were twice as common in the patients who had had the laparoscopic procedure (British Journal of Surgery 2002;89:225–230). The study was based on questionnaires sent to patients four years after operation. The authors strongly recommend that someone should carry out a randomized clinical trial.

Echinacea is an increasingly popular complementary medicine and is widely available over the counter. In Australia there is growing evidence for allergic type reactions to echinacea in atopic individuals. Some sources now suggest that there may be a cross reactivity between echinacea and other environmental allergens in people who have not previously taken it (Annals of Allergy, …

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