So what do we do about patients with chronic kidney disease who become anaemic? Watchers of QI, put your fingers on your buzzers. “Give them erythropoietin […]
NEJM 16 Nov 2006
Category: Richard Lehman’s weekly review of medical journals
BMJ 18 Nov 2006
This year, British GPs have suddenly been required to keep registers of chronic kidney disease, based on lab returns of estimated GFR from samples we have sent opportunistically. We have devoted at least three full practice meetings to the subject, while various partners have nobly gone off to hear renal physicians present their (vigorously dissenting) […]
Orphic Mysteries
In her Editor’s choice, Fiona Godlee reports receiving an e-mail from her distinguished predecessor Stephen Lock, asking for readers to come up with medical excuses to celebrate the four hundredth anniversary of the first performance of Monteverdi’s Orfeo on 23rd February 2007. No problem there, surely. […]
Lancet 18 Nov 2006
Two years ago, we were all rather shocked when the COX-2 specific drug rofecoxib was accused of increasing cardiovascular risk. There has been a flurry of reviews and meta-analyses since then, to which this study (MEDAL) comes as an afterword, confirming what we already know. […]
Arch Intern Med 13 Nov 2006
This paper consists of subgroup analyses from ALLHAT, trying to work out how it is that some blood pressure lowering agents—notably the thiazide diuretics—increase blood sugar but still appear to protect against cardiovascular events. The conclusion is worth pondering on: “Fasting glucose levels increase in older adults with hypertension regardless of treatment type. For those […]
JAMA 8 November 2006
As many people get older, they become fatter and their blood pressure rises. Some become diabetic. To maintain cardiac output, heart myocytes hypertrophy and stay hypertrophied over long periods, causing some of them to die early (apoptosis), and giving rise in the long term to a stiff left ventricle. […]
NEJM 9 Nov 2006
Is it time that we had another go at eliminating malaria from the world? According to Nicholas White, prof at Bangkok, we already have the necessary tools and do not need to wait for a vaccine. “We can do it now, and it won’t cost that much. […]
BMJ 11 Nov 2006
Most of us are willing to concede, with varying degrees of regret, that civilised nations need standing armies, and that for these to be effective, soldiers need to be trained to kill and to withstand the brutality of battle. We have come a long way from the attitudes towards mental collapse in battle crudely depicted […]
Blake for the week
from Auguries of Innocence A truth that’s told with bad intent Beats all the lies you can invent. […]
Lancet 11 Nov 2006
What is the equation used to calculate the cardiovascular mortality burden in populations due to higher-than-optimum blood glucose? Pencils at the ready: you have thirty minutes. Or you may prefer to read this paper, which estimates that cardiovascular deaths associated with mildly elevated blood sugar are about twice those associated with diabetes. […]