Clindamycin versus Trimethoprim-Sulfamethoxazole (TMP-SMX) for Uncomplicated Skin Infections This report concerns a multi-centre randomised trial in the USA. Patients with uncomplicated skin infections were randomised to 10 days of treatment with either clindamycin or TMP-SMX. 524 patients, including 155 children, were involved in the study. 280 patients had cellulitis. 160 had an abscess and 82 had a mixed infection. All of the abscesses were incised and drained. S. aureus was isolated in 217 patients and in 77% of these, the organism was identified as being a methicillin resistant S. aureus. The conclusions reached were that there was no significant difference between clindamycin and TMP-SMX, with respect to either efficacy or side-effect profile, for the treatment of uncomplicated skin infections, including both cellulitis and abscesses. N Engl J Med 2015;372:1093-103 Exercises to improve function of the rheumatoid hand Disease-modifying biological agents and other drug regimens have substantially improved control of disease activity and joint damage in people with rheumatoid arthritis of the hand. However, commensurate changes in function and quality of life are not always noted. This study concerns a randomised trial to evaluate whether tailored hand exercises might provide additional improvements. 490 patients were randomly assigned to usual care or tailored exercises involving strengthening and stretching hand exercises. Using a standard outcome questionnaire at 12 month follow-up, the researchers report a very significant difference in overall hand function favouring the exercise group. Lancet 2015; 385:421-29 Hypomagnesaemia linked to depression? Magnesium is a coenzyme for more than 300 intracellular reactions and it has been proposed that hypomagnesaemia might be associated with significant adverse impacts on the central nervous system, leading to depression. Several studies have looked at this possibility, but the results have been conflicting. Hence this meta-analysis. Six relevant observational studies involving 19,137 patients have been reviewed. The pooled relative risk of depression in patients with hypomagnesaemia was 1.34. However, the researchers conclude that their meta-analysis, at best, demonstrates an association but not a causal relationship. Internal Medicine Journal 2015; 45:436-440

Clindamycin versus Trimethoprim-Sulfamethoxazole (TMP-SMX) for Uncomplicated Skin Infections This report concerns a multi-centre randomised trial in the USA. Patients with uncomplicated skin infections were randomised to 10 days of treatment with either clindamycin or TMP-SMX. 524 patients, including 155 children, were involved in the study. 280 patients had cellulitis. 160 had an abscess and 82 had a mixed infection. All of the abscesses were incised and drained. S. aureus was isolated in 217 patients and in 77% of these, the organism was identified as being a methicillin resistant S. aureus. The conclusions reached were that there was no significant difference between clindamycin and TMP-SMX, with respect to either efficacy or side-effect profile, for the treatment of uncomplicated skin infections, including both cellulitis and abscesses. N Engl J Med 2015;372:1093-103 Exercises to improve function of the rheumatoid hand Disease-modifying biological agents and other drug regimens have substantially improved control of disease activity and joint damage in people with rheumatoid arthritis of the hand. However, commensurate changes in function and quality of life are not always noted. This study concerns a randomised trial to evaluate whether tailored hand exercises might provide additional improvements. 490 patients were randomly assigned to usual care or tailored exercises involving strengthening and stretching hand exercises. Using a standard outcome questionnaire at 12 month follow-up, the researchers report a very significant difference in overall hand function favouring the exercise group. Lancet 2015; 385:421-29 Hypomagnesaemia linked to depression? Magnesium is a coenzyme for more than 300 intracellular reactions and it has been proposed that hypomagnesaemia might be associated with significant adverse impacts on the central nervous system, leading to depression. Several studies have looked at this possibility, but the results have been conflicting. Hence this meta-analysis. Six relevant observational studies involving 19,137 patients have been reviewed. The pooled relative risk of depression in patients with hypomagnesaemia was 1.34. However, the researchers conclude that their meta-analysis, at best, demonstrates an association but not a causal relationship. Internal Medicine Journal 2015; 45:436-440