NEJM 17 Dec 2015 Vol 373 Chilling brain trauma 2403 Traumatic brain injury is the commonest cause of permanent disability in Europeans under the age of 40, and its incidence is rising. After the trauma, many people show an increase in intracranial pressure above 20mm Hg. One way to reduce it is to cool the […]
NEJM 10 Dec 2015 Vol 373 Pacific treatments for scabies 2305 Wow. Here is the ultimate cluster randomised trial: an island randomised trial. First find your islands in the vastness of the Pacific Ocean. Make sure they are big enough for your power calculation, and that they have a similar prevalence of your target condition: […]
NEJM 3 Dec 2015 Vol 373 CPR with or without breaks 2203 Cardiopulmonary resuscitation for cardiac arrest outside hospital carries a mortality risk of more than 90%. It is usually assumed that the death rate would otherwise be 100%, but trials of CPR don’t ever include a non-intervention arm, so we don’t really know. In […]
NEJM 26 Nov 2015 Vol 373 “Artificial cell” for diabetes 2129 “Home use of an artificial beta cell in type 1 diabetes” conjures up a vision of some huge cellular blob taken home in a glass tank and connected up with the circulation, probably by Peter Cushing in a white coat and half-moon spectacles. In […]
NEJM 19 Nov 2015 Vol 373 Spooky RSV trial 2048 There’s a hint of Porton Down about this phase 1 study of an oral treatment for respiratory syncytial virus (RSV). The 62 volunteers trooped in and the steel doors shut behind them. Two days later, masked personnel in white coats proceeded to inoculate them intranasally […]
NEJM 12 Nov 2015 Vol 373 SPRINTing to conclusions OL There’s no denying that the research event of the week has been the online publication of the SPRINT hypertension trial. So here I am departing from the usual pattern of these reviews, because it would seem odd not to begin with it. I’m going to […]
NEJM 5 Nov 2015 Vol 373 Now for the good news 1824 In the middle of the joy and uncertainty of pregnancy, you are told you have cancer. It happens to a few women every week across Europe. Thanks to a collaboration between national referral centres in Belgium, the Netherlands, Italy, and the Czech Republic […]
NEJM 29 Oct 2015 Vol 373 Noddy meets oncology 1679 PARP stands for poly(adenosine diphosphate [ADP]–ribose) polymerase. For every child who grew up in England since the 1950s, it is also the noise that Noddy’s car makes. Now there is a PARP inhibitor called olaparib which costs about £900 a week for treating metastatic cancers […]
NEJM 22 October 2015 Vol 373 Neatest knee trial 1597 “Whatever next. A patient centred, surgical RCT on a common operation with a thoughtful, patient centred editorial in the NEJM,” wrote a friend on the day this paper appeared. Like minded messages and tweets poured in from both sides of the Atlantic. This randomised trial […]
The liveliest e-mail streams I have ever encountered are the ones which are currently coming out of the Overdiagnosis Group, set up by Margaret McCartney last year. The group is now a standing body within the Royal College of General Practitioners and most of its members are working GPs. But there are participants from all […]