JAMA 3 Nov 2010 Vol 304 There is no suggestion in any of the numerous works of PG Wodehouse that Jeeves might have suffered from Alzheimer’s disease, and we may attribute this to the fact, attested by Bertie Wooster, that he wore a size 14 hat and ate tons of fish. But whereas there is […]
JAMA 27 Oct 2010 Vol 304 Perhaps the greatest prize in preventive medicine this century will be the discovery of an effective non-surgical intervention to cure obesity. This study doesn’t quite achieve that, but at least it shows that there is still something to be gained from those two old mainstays, diet and exercise. The […]
JAMA 20 Oct 2010 Vol 304 What do fish oils and Mozart have in common? Answer: both have been proposed as ways to enhance neurocognitive development in utero. But I am afraid the claim is untrue in both cases, and had Mozart lived he would not have gone on to write The Magic Herring. Or […]
JAMA 13 Oct 2010 Vol 304 Cardiac surgery was once considered too bloody even to contemplate: now it is commonplace. But there is still no agreement in practice about how much blood should be transfused following heart surgery – rates of transfusion vary between 8% and 93% in similar units across the USA (p.1586). The […]
JAMA 6 Oct 2010 Vol 304 1447 “In 2005, because our evaluation of out-of-hospital cardiac arrest in Arizona revealed dismal outcomes, we established a statewide program aimed at improving survival.” I like the way the chief investigator uses the word dismal: I like his name, which is Bentley Bobrow: and I like his study too, […]
NEJM 30 Sep 2010 Vol 363 1303 Spleen tyrosine kinase is an important inflammatory mediator, which for some reason has the abbreviation Syk rather than Stk. The editorial for this paper about fostamatinib therefore bears the title “Healing the Syk through Kinase Inhibitors” – bad enough to be one of mine. […]
JAMA 22-29 Sep 2010 Vol 304 1331 Heart failure management is supposedly a showcase for evidence-based medicine, with lots of interventional trials to guide the deployment of ACE inhibitors, angiotensin receptor blockers, beta-adrenergic blockers and so on: but in fact it is just a mess. These drugs can certainly improve prognosis in some patients but […]
JAMA 15 Sep 2010 Vol 304 1173 Medical students dominate this week’s JAMA. These are American medical students, who all have degrees in something else before they start medicine, so they should be well rounded, relaxed human beings in the prime of youth, enjoying a new and interesting course of study which will result in their […]
JAMA 8 Sep 2010 Vol 304 1073 “Adenocarcinoma of the pancreas is arguably the most challenging of human malignancies”, as the commentary on this study of adjuvant chemotherapy points out. And in fact the ESPAC-3 study doesn’t get us any further, except to rule out any benefit from adding gemcitabine to a regimen of fluouracil […]
JAMA 1 Sep 2010 Vol 304 967 A couple of weeks ago, the BMJ published a rather strange piece about the terrible psychological effects of chemical castration in men with prostate cancer. But although I’ll no doubt be sorry to part with that aspect of myself if I ever have to, this pales into insignificance […]