Most of the patients in our practice who have been given radioiodine for hyperthyroidism have had at least one course of antithyroid drugs previously. This meta-analysis shows that such treatment has a weak blocking action on the radioiodine if given in the week before or after. I’m not sure what the clinical significance of this might be, and I’m not convinced by the authors’ suggestion that it warrants a large randomised trial.
We all want a good death and the present structure of the NHS is well adapted to thwart our wishes – as illustrated by the horror story on p.536, about dying from heart failure. Nobody has done more to find out what dying patients and their carers go through than Marilyn Kendall, the main author of this paper about the difficulties researchers encounter when they enter this territory. I’ve dabbled a little in this field myself, and now my “star patient
BMJ 10 Mar 2007 Vol 334
