Increasing antituberculosis drug resistance in the UK

A significant rise in the prevalence of isoniazid resistance from 5% to 7% probably reflects the rise in drug resistant cases in people from sub-Saharan Africa and the Indian subcontinent and inadequate control of transmission in London. The accompanying editorial says that control depends on a global perspective, not solely on local strategies.

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Nortriptyline plus nicotine replacement versus placebo plus nicotine replacement for smoking cessation: pragmatic randomised controlled trial

In 901 people at NHS stop smoking service clinics adding nortriptyline to nicotine replacement therapy made no significant difference to quit rates, withdrawal symptoms, or urge to smoke but did reduce anxiety and depression initially. An accompanying editorial agrees that current evidence does not support routine use of combination therapy with nortriptyline.

Self monitoring of blood glucose in patients with type 2 diabetes

Self monitoring - whether intensive or not - is unlikely to be cost effective if added to standardised usual care, and initially reduces quality of life. Self monitoring also had no effect over one year on HbA1c, body mass index, use of oral hypoglycaemic drugs, or reported hypoglycaemia but was associated with a 6% higher score for depression. An accompanying editorial agrees that self monitoring of blood glucose in type 2 diabetes may not be clinically beneficial or cost effective, and may reduce quality of life.

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