NEJM 5 Mar 2015 Vol 372 893 “A Precious Jewel—The Role of General Practice in the English NHS” is an essay by Martin Marshall from University College, London. It is open access, and the best summary I have read of the plight of general practice after the maulings of the last few years. Without being […]
NEJM 26 February 2015 Vol 372 803 It’s hard to imagine a world without chocolate, potatoes, tomatoes, avocados, sweet peppers, and chilli peppers. Since the 16th century, one or more of these excellent South American foods has become a characteristic ingredient of almost every national cuisine from Northern Europe to Thailand. The peanut or tlalcacahuatl was […]
NEJM 19 Feb 2015 Vol 372 703 In our syphilis lecture at medical school we were told that immigrants coming to the United States of America in bygone days were quarantined on Staten Island and had to undergo testing for Treponema pallidum using the Wassermann Reaction. An unlucky few would test positive not because they […]
NEJM 12 Feb 2015 Vol 372 601 A couple of months ago I went all Edgar Allen Poe about clones in the bone marrow—clones, bones and groans in fact. Watching the processes that lead up to myeloproliferative disaster is like watching evolution on fast-wind, a point well made in an editorial about this first study […]
NEJM 5 Feb 2015 Vol 372 519 Refractory angina seems to be common in cardiac clinics but not in primary care. When all the drugs have failed, and revascularization is not an option, device makers like to get inventive. The latest gizmo is an hour-glass shaped expandable metal object which sits at the portal of […]
NEJM 29 January 2015 Vol 372 407 A Canadian trial tells us a bit more about how to treat raised blood pressure in pregnancy. If women already have elevated BP or acquire it before 34 weeks of gestation without proteinuria, treating to a target diastolic of 100 mm Hg produces the same result as treating […]
NEJM 22 Jan 2015 Vol 372 331 “Approximately one in four extremely premature infants born at 22 to 28 weeks of gestation does not survive the birth hospitalization; mortality rates decrease with each additional week of completed gestation.” I am not your best guide to this topic, but for those who want to know more, […]
NEJM 15 Jan 2015 Vol 372 201 “The main challenge is to ensure better systems [of sharing data] for the future. Because ‘the optimal systematic review would have complete information about every trial—the full protocol, final study report, raw dataset, and any journal publications and regulatory submissions, ‘a prospective system of research governance should insist […]
NEJM 8 Jan 2015 Vol 372 113 A vaccine that works really well is the best kind of medical intervention. But a vaccine that gives partial protection is a headache. Sanofi Pasteur has developed a tetravalent vaccine which is 60.8% protective against symptomatic dengue in children in Latin American countries where dengue is endemic. It […]
JAMA 24-31 December 2014 Vol 312 2659 The effects of extreme heat on older adults: what a great topic for this cold gloomy time of the year. “Heat wave periods (are) defined as two or more consecutive days with temperatures exceeding the 99th percentile of county-specific daily temperatures,” and in this US study they were […]