A near point-of-care TB test is sensitive but misses smear-negative disease; UTI prophylaxis in general practice often goes unreviewed

The edition in brief

A Cochrane review of five studies (3,291 participants) assessed one near point-of-care nucleic acid amplification test for pulmonary tuberculosis on sputum: summary sensitivity against culture was 85.4% and specificity 97.6%, but sensitivity fell to 79.2% in people with HIV and 66.7% in smear-negative, culture-positive disease; against a laboratory-based automated molecular test it was 7.5 percentage points less sensitive with similar specificity. A retrospective audit of 256 adults prescribed antibiotic prophylaxis for recurrent UTI across 18 English general practices found guideline-concordant regimens in 73.6%, review within 6 months in 58.1%, and therapy modified after a resistant isolate in only 22.9%. An American Family Physician review on stopping buprenorphine for opioid use disorder advises maintenance beyond 12 months where possible, slow individualised tapers of 2 mg a month or less, naloxone and shared decision-making. A cross-sectional study of 837 older adults in Berlin found continuity with a general practitioner was only weakly associated with self-rated health. A pearl on how to reassure after a normal test closes the edition.