Tom Nolan reviews the latest research
Each year, respiratory syncytial virus (RSV) quietly sweeps through the world killing over 100 000 children. Somehow, it barely gets a mention in the news cycle, although that may soon change if countries launch RSV vaccination programmes. A meta-analysis sought to estimate the global burden of RSV disease and risk factors for both getting the infection and severe outcomes.
A key finding was that preterm infants born <32 weeks’ gestation have a higher risk of RSV and hospital admission from RSV that persists into their second year of life. Late preterm infants (born between 32 weeks and 37 weeks’ gestation) also had an increased risk of hospital admission, but only until they were 6 months old. Other risk factors for severe outcomes include congenital heart disease, tracheostomy, bronchopulmonary …
Tom Nolan reviews the latest research
When the infamous adverts suggesting that e-cigarettes are “95% less harmful than cigarettes” appeared in 2015, it seemed to knock the stuffing out of smoking cessation services: why should soon to be bankrupt councils pay GPs and pharmacists to help people stop smoking when they could just buy a vape instead? Since then vapes have become a permanent presence in corner shops and school classrooms. But, despite their success as consumer products, vapes are still not licensed as smoking cessation aids. A clinical trial in China randomised people motivated to quit smoking to receive electronic cigarettes, varenicline, or nicotine chewing gum for 12 weeks with minimal behavioural support. E-cigarettes came out as non-inferior to varenicline around 15% remaining abstinent from smoking after six months in these groups, compared with only 8.8% in the gum chewers.
JAMA Intern Med doi:10.1001/jamainternmed.2023.7846 …
Breast cancer survival has improved hugely since 1975. But what is it that has made the difference? Is it screening, the treatment of early stage cancer, or the management of metastatic cancer? And as treatment improves, does screening still have a place?
This study used four simulation CISNET models to estimate the relative impact of interventions at each stage. Overall, improvements in mammographic screening and treatment of breast cancer in the US between 1975 and 2019 were associated with a 58% reduction in breast cancer mortality (from an estimated 64 deaths without intervention to 27 per 100 000 women after adjustment for age). Of this reduction in mortality, about 29% was associated with treating metastatic breast cancer, 25% with screening, and 47% with treating stage I to III breast cancer. Median survival improved more for oestrogen receptor-positive breast cancer than receptor-negative cancers (2.5 v 0.5 years.)
As treatment for stages I to III cancer improves, screening