JAMA 23-30 Mar 2011 Vol 305 1165 In 1941, there was a rumour that the Germans were buying up large quantities of bovine adrenal glands from Argentina so as to produce a substance that boosted the flying powers of Luftwaffe pilots. Intense efforts to isolate this substance followed, but the war was long over by […]
JAMA 16 Mar 2011 Vol 305 1119 “Chronic kidney disease is one of the most rapidly increasing chronic diseases in the United States. More than 20 million US adults have an estimated glomerular filtration rate of less than 60 mL/min/1.73m2, which represents loss of more than half of normal kidney function.” So begins the editorial […]
NEJM 10 Mar 2011 Vol 364 907 “Microalbuminuria is an early predictor of diabetic nephropathy and premature cardiovascular disease.” That’s the opening message of the ROADMAP trial, and it will just about do. What it does not mean is that any agent that reduces the appearance of tiny amounts of albumin in the urine will […]
JAMA 2 Mar 2011 Vol 305 913 A friend recently began a piece on outcomes research with Bishop Joseph Butler’s maxim, “Every thing is what it is, and not some other thing.” If a trial like SOLVD is designed to measure the effect of a particular ACE inhibitor on survival in people with symptomatic left […]
JAMA 23 Feb 2011 Vol 305 783 The highly prevalent custom of poisoning the osteoclasts of old ladies with bisphosphonates for years on end seems surprisingly harmless. This case-control study confirms that there is a tiny increase in the risk of subtrochanteric fracture after five years, heavily outweighed by the protective effects of these drugs […]
JAMA 16 Feb 2011 Vol 305 I like to hold a torch for JAMA, and once even suggested to the BMJ that it should try to become more like this decently old-fashioned American weekly, provoking dismay and perhaps even derision from my progressive friends there. Anyway, the BMJ has gone its own way, and JAMA […]
JAMA 9 Feb 2011 Vol 305 569 If I were a woman, the things I would most fear from breast cancer surgery would be arm lymphoedema and recurrence of the cancer. Does one have to be balanced against the other? Common sense would suggest that the more axillary lymph nodes you dissect, the less likely […]
JAMA 2 Feb 2011 Vol 305 487 Most of us have never come near a vial of bevacizumab, though we’ve read plenty about it, especially over recent years in the context of eye disease involving vascular proliferation. This monoclonal antibody targeting vascular endothelial growth factor A was initially developed as a treatment for solid cancers […]
JAMA 26 Jan 2011 Vol 305 391 Stroke medicine grew up in the 1990s: like heart failure medicine, it shone welcome light on a large and neglected group of patients with organ damage who had been written off as unsalvageable. This was a Very Good Thing in itself, but its proponents then went on to […]
JAMA 19 Jan 2011 Vol 305 261 I’m of an age when the words cognitive decline in the title of a paper make me rush to read it – the exception being a self-assessment study in the BMJ a couple of years ago, which was just too scary. This paper isn’t scary; in fact it […]