Oxymetazoline with a steroid spray helped chronic nasal obstruction without rebound over four weeks

The edition in brief

In a single-centre double-blind trial of 60 adults with chronic nasal obstruction who had failed topical steroids, twice-daily oxymetazoline plus budesonide for four weeks produced responders in 83% against 36% with budesonide alone, a 47-point difference, with no rebound congestion during treatment and all patients weaning without difficulty over three weeks; longer-term safety is unknown. A secondary analysis of the HEARS trial found a community health worker hearing programme with low-cost over-the-counter devices improved hearing handicap scores by 12 to 14 points whether or not older adults used smartphones or the internet. A meta-analysis of 28 studies found pepsin in middle ear effusions of about 72.5% of children with chronic or recurrent otitis media, though diagnostic methods varied widely. In 5,753 children with obstructive sleep apnoea, those from the most socially vulnerable neighbourhoods had more asthma and underwent adenotonsillectomy more often, with similar time to surgery.