Published: 03/02/2005, Volume II4, No. 5941 Page 31

Isolation policies may not prevent spread of MRSA

Isolation of intensivecare patients infected with MRSA (methicillin resistant Staphylococcus aureus) does not reduce cross-infection, a study has suggested.

Single room or group isolation of patients infected or colonised with MRSA is commonly used to reduce spread.

But the one-year study in two London teaching hospitals showed no increase in transmission or infection rates when MRSA-positive patients were not isolated.

In the middle six months of the study, the hospitals halted the practice of moving MRSApositive patients to a single room or treating them as an infected group of patients unless they were at risk of spreading other serious infections.

There were no differences in transmission or infection between management phases. However, the authors warn that their findings need further confirmation from larger studies.

The Lancet. Online publication 7 Jan 2005.

www. thelancet. com

Stroke twice as likely in migraine sufferers

Migraine sufferers are twice as likely to suffer a stroke, according to researchers.

In the first systematic review of its kind, Canadian and US researchers looked at 14 studies investigating a link between stroke and migraine. They found the risk of stroke for migraine sufferers was 2.16 times that for non-sufferers.

Three of the studies showed that women migraine sufferers taking the contraceptive pill were up to eight times more likely to suffer a stroke than those not taking the pill, although these results were at odds with other studies.

Migraine is the most common form of headache in young adults, with as many as a quarter of women in their mid to late thirties suffering the condition.

The increased risk of stroke is probably due to reduced blood flow to the brain, say the researchers. Further research is needed, particularly into risk factors for migraine sufferers taking the pill.

BMJ 2005; 330:63.

www. bmj. com

Motive for self-harm good measure of suicide risk

Measuring suicidal intent in the assessment of selfharm patients is useful in evaluating future suicide risk, according to a new study from Oxford.

The study examined clinical and demographic data on 4,415 patients attending hospital following self-harm between 1993 and 2000.

Suicidal intent was measured using a suicide intent scale questionnaire to assess severity of intent. Followup information on repetition of self-harm and suicide was investigated for 2,489 of these patients attending hospital again between 1993 and 1997.

Suicidal intent at the time of self-harm was associated with risk of subsequent suicide.

Use of the eight questions regarding patients' circumstances in the SIS, along with a question about the patient's wish to die, may be sufficient in clinical practice to evaluate future suicide risk, say the authors.

Br J Psychiatry 2005 186: 60-66.

www. rcpsych. ac. uk