NEJM 12 May 2016 Vol 374 Smoake is dangerous to ye Lungs 1811 A new study of smokers with preserved pulmonary function finds that a lot of them have lung symptoms. And even if they don’t fulfil the criteria for chronic obstructive pulmonary disease (COPD), they still experience the familiar pattern of exacerbations and limitation […]
NEJM 5 May 2016 Vol 374 Cholera: still not defeated 1723 Endemic cholera is one of those diseases that remind us how unequal the world still is. Cholera from the Indian subcontinent swept Europe in the 1820s and 30s but had virtually disappeared a few decades later, due to improvements in our water supply. Yet […]
NEJM 28 April 2016 Vol 374 Colon cheer 1605 As we get more affluent, we drink more alcohol, grill more meat, grab bacon or salami sandwiches for lunch. Up in heaven, a wrathful god looks on and smites us with bowel cancer. Oh wait, no, he seems to be easing off: for all our sins, […]
NEJM 21 April 2016 Vol 374 Aliskiren in Cardioland 1521 What does the R in the RAA pathway stand for? I used to pose this question in lectures several times a year, believing all that I had been told about the importance of the renin-angiotensin-aldosterone pathway in heart failure. I’d explain that we had drugs […]
NEJM 14 April 2016 Vol 374 Fixing spinal stenosis 1413 Magnetic resonance imaging was like magic when it first appeared. Suddenly structures in the back that could only be guessed at on x-rays or even CT scans could be seen in lavish detail. It became clear that there was no such thing as a normal […]
NEJM 7 April 2016 Vol 374 Prebirth steroids and baby lungs 1311 Most of you will be familiar with the logo of the Cochrane Collaboration, consisting of a blue circle with a vertical line crossed by some bars with a diamond shape at the bottom. This is the forest plot of Iain Chalmers et al’s […]
NEJM 31 Mar 2016 Vol 374 Going Dutch with Lyme 1209 When you open a journal with New England in its name and read about Lyme disease, you somehow don’t expect the study to have been carried out in the Netherlands. But never mind: it’s a good study and the investigators managed to collect enough […]
NEJM 24 Mar 2016 Vol 374 Flinty problem, leaden response 1101 John Snow, the arch-hero of epidemiology, died in 1858 a disappointed man. It was only after he had died that there was a proper inquiry into the cholera outbreaks that he had mapped, and during the interval the water company denied all possibility of contamination. […]
NEJM 17 Mar 2016 Vol 374 Unnecessary pessary 1044 “This randomized trial showed that placement of a pessary in girls and women who were pregnant with singletons and who had a short cervix at 20 to 24 weeks of gestation did not result in a lower rate of preterm delivery before 34 weeks of gestation […]
NEJM 10 Mar 2016 Vol 374 Treating malaria in pregnancy 913 Here’s a tonic for those of us who lie abed with thoughts about the stupidity of the world and the pointlessness of medical research. The PREGACT trial was supported by the European and Developing Countries Clinical Trials Partnership and it tells doctors in Africa exactly […]