NEJM 15 Oct 2015 Vol 373 NEUROSIS about tiny babies 1497 The first paper in the NEJM this week has me flummoxed. Its acronym is NEUROSIS—who thought that was a good idea for a trial of inhaled budesonide in very premature infants? The European Union funded the trial which took place in 40 centres around […]
NEJM 8 October 2015 Vol 373 1397 Famous as a pioneer of hypertension studies, Sir George Pickering (1904-1980) was a man of forceful opinions, and used to command the attention of his hearers by gripping their arms tightly for the duration of the encounter. As I was a medical student and he was Master of […]
NEJM 1 Oct 2015 Vol 373 1307 What will happen to all the overweight children and young adults we see around us? The honest answer is that nobody knows. There has never been such a generation before in human history, and it is entirely possible that during the next decade or two they will all […]
NEJM 24 Sep 2015 Vol 373 1220 I suspect that good randomized trials of common procedures are difficult to do. Each French doctor probably has a favourite way of gaining central venous access, probably dependent on how they were first taught. But in this trial they were commanded to use the femoral, jugular, or subclavian […]
NEJM 17 Sep 2015 Vol 373 1095 Well, here’s a paper that nearly caused me to stop breathing. It was certainly followed by a sharp intake of breath. Cheyne-Stokes breathing is common in advanced heart failure, and so is central sleep apnoea, which causes frequent periods of nocturnal hypoxia in these patients. Thus continuous positive […]
NEJM 10 Sep 2015 Vol 373 997 Are any readers looking for a nice short term research project in evidence based medicine? Here you have it. On 1 September, the MATRIX triallists reported the results of a trial which randomised 7213 participants with an acute coronary syndrome to receive either bivalirudin or unfractionated heparin prior […]
NEJM 3 Sep 2015 Vol 373 895 The cool new look is beige and fat. Understanding beige fat may be the beginning of the end of obesity in humans. Or it may disappear and be forgotten as soon as the next panacea offers itself on the pharma catwalk. The NEJM clearly thinks it is important, […]
NEJM 20-27 Aug 2015 Vol 373 726 We start with a basket trial. Say you are in a supermarket and put lots of brown things in your basket—bread, a joint of lamb, a tin of brown beans, some kiwi fruit, and a shirt. Now, out of scientific curiosity, you decide to dip the contents of […]
NEJM 6-13 Aug 2015 Vol 373 503 Outcomes in early breast cancer surgery just keep on getting better. But between 20-40% of patients who have a partial mastectomy need to undergo further surgery soon afterwards because the excision margin shows possible tumour involvement. A team at Yale decided to see if this could be averted […]
NEJM 30 July 2015 Vol 373 405 This week’s first paper has an interesting title: Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function. It’s the first time I’ve seen the word “therapeutic” used to describe something done to a person who is already dead. The hypothermia they refer to here occurs in a newly […]