Written by Dr Tom Nolan for Doctify
Urine for a treat
How do you decide whether to take antibiotics for a urine infection? You might want to know if it’s likely to clear up without antibiotics, how long it will take to get better and what’s the danger of waiting. This new study in the BMJ offers some help, albeit in a different population (Germany) using different antibiotics to those used in the UK. Nearly 500 women with symptoms of a urinary tract infection (UTI) were given either an antibiotic or ibuprofen. Of those given ibuprofen about two thirds got better without needing to go back to their doctor for antibiotics. However they were also slightly more likely to go on and develop a kidney infection than those given antibiotics straight away. Women given ibuprofen got better about 5 days after they saw their doctor, one day longer than those given antibiotics straight away.
Stool transplants: defrost thoroughly before use
Warning! If you’re having breakfast you might want to leave this one for later – perhaps your next toilet break: I want to tell you about stool transplants. Yes, transplanting healthy faeces from one person to another. Clostridium difficile is a bacteria that can cause severe inflammation in the gut, particularly in frail people who have recently had strong antibiotics. It can spread easily in hospitals and nursing homes. The best cure is to put healthy faeces directly into the gut through the back passage as an enema. In other words, give a stool transplant. As well as having a slight branding problem, supply can be an issue too: until now fresh stool has been mainly used. A new Canadian study, published in JAMA found that freshly frozen then thawed faeces works just as well as fresh stool. Both had around an 85% cure rate. This should make stool transplants more widely available to treat this horrible infection.
IVF: a market in hope
How successful is IVF? Many of those involved have voiced concerns that media hype about test tube babies creates unrealistic expectations about success rates. Lisa Jardine, the former chair of the Human Fertilisation and Embryology Authority, once said
“The world of IVF is a market, a market in hope. Those who enter it deserve to be fully informed of its potential to deliver grief and a sense of failure, as well as success.” A new study in the American journal JAMA provides new data about success rates. Researchers followed over 150,000 women undergoing IVF in the UK. The average success rate of the first cycle of IVF was 29.5%, and after 6 cycles was 65.3%. Success rates, however, are strongly affected by age: women under 40 had a success rate of 32% after the first cycle of IVF, falling to 12% for women aged 40-42, and just 4% for women over 42.
Blood pressure: how low should you go?
High blood pressure can put you at risk of a heart attack or stroke, but how low should your blood pressure be? The answer Dr Tim Chico usually gives is “lower than it is right now”. Why? Because as a new analysis in the Lancet shows, lower blood pressure lowers your chances of having a heart attack or stroke no matter what your blood pressure is. The review of over 100 studies involving over 600,000 participants found that lowering blood pressure by 10mmHg (10 points on your blood pressure readings) lowers heart attack and stroke risk by 20%. Dr Chico, a cardiologist at the University if Sheffield, explains the findings:
“If you are already at a low risk, reducing this by 20% isn’t all that important, and probably isn’t either cost-effective or desirable. However, if you are at high risk (such as if you already have cardiovascular disease, diabetes, or smoke) then a 20% reduction in risk makes a big difference and saves a lot of lives.”