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Inhaled steroids for all children with asthma? Some children with mild well‐controlled asthma may not need a daily inhaled steroid, a Scandinavian study suggests ( Arch Dis Child 2008;93:654‐9). A total of 176 children aged 5‐10 years were randomised to treatment with cromoglicate (Intal) or budesonide. Initially high doses of budesonide (400μg twice daily) were reduced after one month to 200μg twice daily for four months; subsequent treatment for a further year was 100μg twice daily as required for exacerbations or 100μg twice daily regularly. Budesonide was associated with greater improvement in lung function and fewer exacerbations compared with cromoglicate, but after 18 months lung function improvements did not differ. Regular budesonide was associated with fewer exacerbations than as‐required administration (0.97 vs 1.69 per patient in months 7‐18) but no difference in asthma‐free days or use of rescue medication. Growth suppression was slightly greater with continuous budesonide. Interventions to reduce atypicals weight gain A systematic review has found that techniques such as cognitive behaviour therapy and nutritional counselling can reduce weight gain associated with atypical antipsychotics ( Br J Psychiatry 2008;193:101‐7). Analysis of 10 randomised trials lasting eight weeks to six months found that nonpharmacological intervention increased mean weight loss by about 2.5kg compared with usual care. Check flu vaccine delivery Production of flu vaccine is proceeding according to plan, the Director of Immunisation has told GPs. Practices should now contact their suppliers to confirm a delivery schedule so that clinics can be arranged. New BNF for Children The fourth BNF for Children has been published, containing new sections on HPV vaccination, contraception, treatment of pelvic inflammatory disease and the use of continuous iv infusions in neonates. BNFC 2008 is available online at bnfc.org/bnfc . MMR catch‐up ‘urgent’ The DoH has called for urgent action to reduce the risk of a measles epidemic. Following years of relatively low uptake of MMR vaccine, the pool of unprotected children is now large enough to raise the prospect of 30 000‐100 000 measles cases in England. A catch‐up campaign will now target children and young people who have never been vaccinated, followed by those who have not completed their course of immunisation. Resource materials are available at www.immunisation.nhs.uk . • A new brand of MMR vaccine is now available. Sanofi Pasteur MSD has replaced MMRII with a new formulation and presentation, MMRvaxPro. The new vaccine is equivalent to its predecessor and interchangeable with Priorix. Early primary prevention with low‐dose aspirin? GPs should consider prescribing low‐dose aspirin for primary prevention for men aged 48 and women aged 57, say UK researchers ( Heart 2008; published online 15 August 2008. doi:10.1136/hrt.2008.150698). Using data from the THIN network of electronic patient records, they modelled the age at which 10‐year coronary risk changed from <10 per cent to >10 per cent in men and women without diabetes, not taking lipid‐lowering therapy and with no history of cardiovascular disease. Does COPD therapy slow progression? Treatment with an inhaled steroid and long‐acting beta‐agonist may slow progression of COPD, according to a new analysis of the TORCH study ( Am J Respir Crit Care Med 2008;178:332‐8). TORCH was designed to determine the effects of COPD treatment on mortality; the primary analysis found no significant difference between fluticasone/salmeterol (Seretide) and placebo ( N Engl J Med 2007;356:775‐89). This analysis found that the rate of decline in FEV 1 (a marker of disease progression) was significantly greater with placebo (55ml per year) than with salmeterol or fluticasone monotherapy (both 42ml per year) or their combination (39ml per year). Faster decline in FEV 1 was associated with current smoking, lower BMI and more frequent exacerbations. Copyright © 2008 Wiley Interface Ltd