BMJ 21 Apr 2007 Vol 334

I’m constantly surprised how slowly epidemiological information about fetal outcomes continues to trickle out, despite the existence of huge databases covering several decades. This analysis shows that the risk of perinatal mortality in babies born to South Asian women is more closely linked to birth weight (below 2kg) whereas for the babies of white women, placental abruption is the greatest risk.

In an American study of a cohort of assisted-conception pregnancies, there is no significant difference between the outcome in fetuses who grew at varying rates in the first twelve weeks, except for a very few who showed a deficit of more than four days between the observed and expected size. By generalising this finding into an overall correlation, the authors seek to emphasise the significance of fetal growth in the first three months.

NHS walk-in centres are a typical Blair product. They were supposed to do all sorts of popular, headline-grabbing things, including reducing waiting times to see GPs. But of course they didn’t, for numerous entirely predictable reasons well summarised in the editorial from Warwick.

Delirium in ill elderly people can be very distressing and, if a recent experience of mine is anything to go by, inadequately managed in some NHS hospitals. My father-in-law at 81 was a man of strong clear intellect and you wouldn’t mess with him in an argument. But each time he was ill and admitted to hospital he became agitated and confused. On the last occasion he was heavily sedated, got pneumonia, and died. Here is an excellent review calling for better recognition, better prevention, and better guidelines for management.

During thirty years in general practice, various sorts of dubious dogma about asthma have come into fashion and then gone away. This is a condition which is seen and managed in primary care, and what may apply to other populations can be misleading when applied to the majority of our patients, who get intermittent symptoms and don’t want to be bothered with lengthy work-up. This eminently sensible little “Masterclass