Noninvasive ventilation during an epidemic
Health authorities advised against the use of noninvasive ventilation six years ago during the outbreak of severe acute respiratory syndrome (SARS). McCracken says that this advice needs to be reviewed. He argues that withholding the procedure under current guidelines has the potential for considerable harm. See Commentary, page 663
Modelling pandemic influenza
Vaccination against pandemic influenza can have a disproportionately large impact on reducing the attack rate in a “fall wave.” This is the finding of a simulation model of transmission and mitigation of pandemic influenza in a small population carried out by Zivkovic Gojovic and colleagues. Delays in the availability of vaccine of 30 days or more may erode the effectiveness of vaccination in reducing the attack rate of influenza. See Research, page 673
Following up on fatigue
Only a minority of patients who presented with a new episode of fatigue received a diagnosis of a serious pathology within one year after presentation. This is the finding of an observational cohort study by Nijrolder and colleagues that included 571 patients who experienced new-onset fatigue. The majority of diagnoses reflected symptoms or signs only, the most common being musculoskeletal (19.4%) and psychological problems (16.5%). Clear somatic pathology was diagnosed in 8.2%. See Research, page 683
Destroyed tobacco documents
Information from copies of 60 destroyed documents, which were reviewed and summarized by Hammond and colleagues, shows that British American Tobacco had collected evidence that cigarette smoke was carcinogenic and addictive. See Special report, page 691
Management of asthma in adults
Low-dose inhaled corticosteroids are preferred as the initial controller medication in the treatment of asthma. This is one of the key messages in the second article in our series on asthma. See Review, page E210
Benign childhood myositis
A 6-year-old boy recovering from a fever and runny nose could not bear weight on his legs, which he said were sore. A week later, the pain and weakness had resolved completely. See Practice, page 711
Pheochromocytoma
A 54-year-old man presented with episodic palpitations, chest pain and headache. During cardiac monitoring, his blood pressure rose to peak at 262/172 mm Hg, and he had palpitations due to supraventricular tachycardia. Investigations showed a pheochromocytoma. See Clinical image, page 714