In 2004 a small study was reported in which nine of 12 women who had had a pregnancy complicated by neural tube defect and two of 20 controls were found to have antibodies against folate receptors. It was hypothesised that this might be why folate prophylaxis prevents neural tube defects. Now (New England Journal of Medicine 2009;361:152–60) a study in Ireland has not corroborated the findings. In the first part of the study stored blood from 1993–94 was analysed and in the second, fresh blood. In all there were 140 case mothers (previous neural tube defect pregnancies), 125 control mothers, 68 women who had never been pregnant, and 45 men. There were no significant differences between the groups as regards the presence or titres of either blocking or binding folate-receptor autoantibodies. The causes and importance of folate-receptor autoantibodies are poorly understood.

Another reason to restrict the use of antibiotics for children with acute otitis media has emerged from a Dutch general practice study (BMJ 2009;338: b2525 doi: 10.1136/bmj. b2525). A questionnaire was sent to the parents of 168 children who had been randomised to amoxicillin or placebo for acute otitis media at the age of 6 months …