JAMA 1 June 2011 Vol 305 2184 Diabetes is a state of increased risk for many things, including fractures. The most striking thing I learnt from this study is that a man on insulin treatment has double the fracture risk for any given level of bone mineral density. The additional risk is less dramatic in […]
JAMA 25 May 2011 Vol 305 2071 Idiopathic sudden sensorineural hearing loss: now that’s the kind of medical label I can do business with – the kind that tells you what is happening and that we don’t know why. The “sudden” bit may be literally true or refer to a period of up to three […]
JAMA 18 May 2011 Vol 305 1969 “Gastroesophageal reflux disease (GERD) is a chronic, relapsing disease with symptoms that have negative effects on daily life.” Actually it only became a “disease” about ten years ago: before that it was classed as a nuisance, treated with antacids by many, proton pump inhibitors by some, and surgery […]
JAMA 11 May 2011 Vol 305 1863 It’s hard to think of any physiological rationale for trying out a bolus dose of epoetin alfa following successful percutaneous intervention for myocardial infarction, but apparently it reduced infarct size in animal models, so this trial gave it to humans. It did not work; in fact it may […]
JAMA 4 May 2011 Vol 305 1769 When I first started writing comments on the medical journals in 1998, coronary artery bypass surgery had become the commonest major operation in the developed world. The alternative was balloon angioplasty, though increasingly this was being augmented with the insertion of bare metal stents. And then, as most […]
JAMA 27 Apr 2011 Vol 305 1625 Obedience is no longer a fashionable concept, though it was once prized as the most essential virtue in religion and society (see Psalm 119 vv1-176, Dante’s De Monarchia, Hobbes’ Leviathan; look up the meaning of the Arabic word islam). Nowadays we go to endless lengths to persuade ourselves […]
JAMA 20 Apr 2011 Vol 305 1545 Chronic kidney disease, pre-diabetes, subclinical hypothyroidism, vitamin D insufficiency, attention deficit disorder, asymptomatic systolic dysfunction, borderline personality disorder, early chronic obstructive pulmonary disease, pre-hypertension, Barrett’s oesophagus: you may think you’re healthy, but how do you know you haven’t got any or all of these? Wake up! Have the […]
JAMA 13 Apr 2011 Vol 305 1441 The old JAMAs were comfortable: they looked good and I looked forward to getting into them – there was a nice feeling, like fluffy cotton against the skin. But sadly the old garment is getting threadbare: I report on this week’s issue more out of a sense of […]
JAMA 6 Apr 2011 Vol 305 1305 Postmenopausal oestrogen protects against breast cancer. Now there’s a headline I never thought I would write; and yet it’s the clear conclusion of this follow-up study of the women in the Women’s Health Initiative Estrogen-Alone Trial. In this unique double-blinded RCT, over 10,000 women aged between 50 and […]
NEJM 31 Mar 2011 Vol 364 1195 A great deal of what I report to you every week is discouragingly futile, but the conquest of serious viral disease still has about it the excitement of the great era of microbial therapeutics (c.1942-1962). Mind you, the eradication of a slow-burning virus like hepatitis C is more […]