JAMA 19 Oct 2011 Vol 306 There are definite green shoots of recovery in this week’s JAMA. Howard Bauchner hasn’t yet made the sweeping changes he’s promised, but there’s a nice mix of papers and the poetry remains as thrillingly bad as ever. 1659 A few weeks ago, The Lancet ran a couple of papers […]
JAMA 12 Oct 2011 Vol 306 1549 It has been a bad week for vitamin supplements. Worst hit, as usual, has been vitamin E. The SELECT trial began collecting 35 000+ healthy men with normal feeling prostates back in 2001 and randomised them to get a selenium supplement, a vitamin E supplement, both, or placebo. […]
JAMA 5 Oct 2011 Vol 306 1461 American medicine is a mass of quirks and contradictions: like medicine anywhere else, but magnified by huge financial forces pulling in different directions. There is a big financial incentive for cardiologists to do percutaneous interventions in elderly patients with stable coronary disease, for example, though the evidence suggests […]
JAMA 28 Sep 2011 Vol 306 1329 Intra-aortic balloon counterpulsation reduces left ventricular load and improves outcomes in animal models of myocardial infarction. But in previous small human studies of MI without shock, it hasn’t been shown to do anything much, and this trial confirms that it does not reduce infarct size significantly. But such […]
JAMA 21 Sep 2011 Vol 306 1205 I don’t know why spammers have me down as so interested in imitation Rolex watches and erectile function: neither is particularly true. But I guess that if I had a diagnosis of localised prostate cancer, I might want to know the chances of each treatment option causing me […]
JAMA 14 Sep 2011 Vol 306 1089 In medicine, always expect the counterintuitive. For some time it has been known that removing more lymph nodes at the time of bowel cancer surgery is associated with better outcomes. This is nicely confirmed in this large cohort study – 86 394 patients, showing a one third reduction […]
JAMA 7 Sep 2011 Vol 306 952 This is a themed issue on Medical Education, a domain where giant forces compete for the minds of highly selected young people, and science can tell us little about what really matters. I gave my first talk on the subject in 1973, to a largely female student audience […]
NEJM 1 Sep 2011 Vol 365 787 Studies of out-of-hospital cardiac arrest require heroic feats of organization and generally provide survival-to-discharge rates around 7%. In this randomized trial, the research question was whether in a person found pulseless out of hospital, it’s best to start CPR immediately or to analyze the heart rhythm immediately. In […]
JAMA 24-31 Aug 2011 Vol 306 840 Every GP knows that some patients who are admitted to hospital come out without their usual medication and take this as an indication that they don’t need it any more. This happens particularly after admission to ICU. The team doing this cohort study in Ontario makes an attempt […]
JAMA 17 Aug 2011 Vol 306 711 Randomized controlled trials of new interventions have become something of a rarity in JAMA of late, so I was interested to see this account of two industry-funded trials of pegloticase, a genetically engineered uricase designed to lower uric acid in people with treatment-resistant gout. This drug already has […]