JAMA 28 Dec 2011 Vol 306 2684 When I first became a GP in England well over 30 years ago, the early diagnosis of myocardial infarction was a matter of slight importance, since there was no intervention which made any difference to survival. You tried to reach patients in their homes quickly to relieve their […]
JAMA 21 Dec 2011 Vol 306 2567 Amongst all the awful things that can befall human beings, poor sleep seems but a trivial inconvenience. Well, maybe: it merely doubles one’s risk of cardiovascular events and depression, and leads to undesirable effects on everyone around. In this survey of nearly 5,000 US police officers, 40% were […]
JAMA 14 Dec 2011 Vol 306 2459 The topic of stillbirth got a thorough airing in The Lancet last April, when the British press seized on the fact that our figures were as bad as Estonia and therefore a disgrace to the civilized world. In fact they are much better than those in the USA, […]
JAMA 7 Dec 2011 Vol 306 2331 Over the period I have been writing these reviews, rheumatology has moved from being a rather sleepy discipline to being a hotbed of innovation, largely thanks to the arrival of tumour necrosis factor (TNF)-α antagonists. Known rather quaintly as “biologicals,” these drugs inspired fear when first used because […]
Arch Intern Med 28 Nov 2011 Vol 171 1879 Recitative (Dido): Thy hand, Belinda! Darkness shades me – On thy bosom let me rest; More I would, but Death invades me; Death is now a welcome guest. Aria (addressed to Aeneas): When I am laid, am laid in earth, May my wrongs create No trouble, […]
JAMA 23/30 Nov 2011 Vol 306 2221 “There is a fifth dimension, beyond that which is known to man,” intones Rod Serling in accents strange, “…we call it The Twilight Zone.” Fans of the 1950 series will enjoy this week’s episode, where a bewildered reviewer finds himself in a parallel universe where he is doomed […]
JAMA 16 Nov 2011 Vol 306 2099 Steve Nissen became something of a hero of mine when he showed how bad data from pharma-funded studies had been used to mask the fact that rosiglitazone (Avandia) was harming diabetic patients while lowering a surrogate end-point – blood glucose or glycated haemoglobin. But here he is leading […]
JAMA 9 Nov 2011 Vol 306 1983 Replumbing the brain through a hole in the skull is an idea that sounds straight out of the heroic days of kill-or-cure surgery. It’s been known for about 50 years that you can connect the superficial temporal artery branch through the cranium to a middle cerebral artery cortical […]
JAMA 2 Nov 2011 Vol 306 1874 The older you get, the more likely you are to have a haematological malignancy, and the less likely you are to be able to stand up to the rigours of myeloablative therapy followed by allogeneic haematopoietic cell transplantation, which can offer a cure in younger patients. You might […]
JAMA 26 Oct 2011 Vol 306 1775 There is now pretty clear evidence that CT scanning to detect lung cancer in heavy smokers can save lives. This Dutch study shows that the same scans can also detect chronic obstructive pulmonary disease in about 38% of the smokers they recruited. In this population the sensitivity of […]