High-volume steroid injections for Achilles tendinopathy did no better than sham at a year

The edition in brief

The BMJ Inject trial randomised 192 adults with midportion Achilles tendinopathy to sham, high-volume injection, or high-volume injection with hydrocortisone, all alongside exercise. At 12 months neither injection beat sham on VISA-A; the steroid injection helped at six weeks but did worse than the steroid-free injection at 26 weeks. Exercise remains the treatment. In the NEJM CONNECT trial, continuous glucose monitoring in 283 primary care adults with type 2 diabetes not on insulin lowered HbA1c by 0.9 points more than routine care over 26 weeks; the trial was industry-funded and short. The NEJM FIIX trial in 737 couples with unexplained infertility found one complete IVF cycle gave a 55% live-birth rate against 31% with up to four IUI cycles at seven months, but by 20 months cumulative rates were 70% and 71%. An Annals cohort of over 4 million US pregnancies found no increase in major malformations after first-trimester benzodiazepine exposure (pooled RR 0.99). A BMJ description of Ontario's 2,377-case measles outbreak, 89% unvaccinated, shows how quickly elimination can be lost. The pearl covers measles post-exposure prophylaxis.