Minerva has had her knuckles gently rapped, once again. Commenting on her recent reporting of a study that found that the inexperience of junior doctors had little impact on patients' outcomes in intensive care, a reader says, “Surely she is aware that junior staff have minimal or non-existent influence in intensive care, at least in the UK. One could assume that over the pond, the US would also rely on more senior staff in ITU to make decisions, and hence be little influenced by changes in junior staff.” He says that the authors were probably looking in the wrong place.
Anal sphincter damage after childbirth is much more common than we think. A meta-analysis of 717 vaginal deliveries showed that 26.9% of primiparous women had anal sphincter defects and 8.5% of multiparous women had new sphincter defects. Fortunately, at least two thirds of defects caused no symptoms, although it's been