NEJM 3 Oct 2013 Vol 369 1295 The human birth canal, it has often been observed, is not particularly well designed for the passage of one baby, let alone two. So in an age of safety first, caesarean section has become almost routine for all twin pregnancies. Gut feeling and a number of cohort studies […]
NEJM 26 Sep 2013 Vol 369 1195 Gosh, I feel vulnerable. The opening paper in this week’s New England Journal is about sources of C difficile infection in “healthcare settings or in the community in Oxfordshire, United Kingdom.” Will I be named and shamed? A few weeks ago I received a message of gentle reproof […]
NEJM 19 Sep 2013 Vol 369 1106 I’m starting with the second paper about colonic cancer screening in this week’s New England Journal of Medicine, because it takes us to one of the places where it first began: the state of Minnesota. Up there, just under Canada and just west of the Great Lakes, 46,551 […]
NEJM 29 Aug-12 Sep 2013 Vol 369 799 When comparing a new fixed-dose anticoagulant with conventional warfarin based anticoagulation, what do you look for? Thrombotic events, death, major bleeding? Yes, certainly. But what makes the comparison meaningful? That depends largely on how well the warfarin group were kept within the target INR range. In the […]
NEJM 22 Aug 2013 Vol 369 699 Vedolizumab. What a name for an important new drug. Just remember the vedo bit and the fact that it’s a monoclonal antibody, and you might be able to recall the full name. Vedo is the new kid on the block for inflammatory bowel disease. “Hi new kid,” say […]
NEJM 15 Aug 2013 Vol 369 603 A publicly funded trial in the USA, simply called the Prostate Cancer Prevention Trial, examined the effect of finasteride on prostate cancer incidence and mortality in men without known prostate cancer at the time of enrolment, and found that finasteride significantly reduced the risk of prostate cancer, but […]
NEJM 8 Aug 2013 Vol 369 507 A phase 1 study of a drug for an arcane cancer gets first place in the NEJM this week, and I think it deserves it, because ibrutinib seems to be a major breakthrough in the treatment of mantle-cell lymphoma. The name for once means something: this drug inhibits […]
NEJM 1 Aug 2013 Vol 369 397 Shared decision making at the end of life is probably the toughest challenge in medicine. It requires good evidence about a wide range of interventions, good communication skills, close teamwork, and above all emphasis on the patient as a whole, and a sensitive capacity to take responsibility and […]
JAMA 24-31 July 2013 Vol 310 It’s possible that you want to read about US physicians’ views on their role in cost containment, and about rates of breast cancer survival in white and black US women (there is little difference) and even about raccoon rabies virus variant transmission through solid organ transplantation, and you may […]
JAMA 17 July 2013 Vol 310 270 There are three papers in this week’s JAMA which would make good teaching material for a course on critical reading. The first is a randomised, double-blind trial of an intervention for in-hospital cardiac arrest, carried out in three large Greek hospitals. The “placebo” was epinephrine (adrenaline) in saline, […]