Oxygen for moderate COPD This week saw the official launch of the UK Academy of Medical Royal Colleges “Choosing Wisely” campaign, which was so successful that its website crashed. It is proving a bumper week for debunking long-accepted practices. The latest is long-term oxygen for chronic obstructive pulmonary disease with moderate desaturation. This common strategy […]
NEJM 20 Oct 2016 Vol 375 Fainting and pulmonary emboli O Padua, sidus praeclarum, O Padua, brilliant star, hocce nisa fulgido luminous model virtutum regula morum of virtues and manners, serto refulgens florido, resting on this radiant wreath of flowers, te laudat juris sanctio, you receive praise from jurisprudence, philosophiae veritas from philosophical truth, […]
NEJM 13 Oct 2016 Vol 375 Outcomes and choices This week’s print NEJM contains mostly papers I’ve already commented on—notably, Gilbert Welch’s important study of mammography and breast cancer outcomes and the landmark British trial comparing surgery, radiotherapy, and watchful waiting for PSA detected prostate cancer (ProtecT). However, I hadn’t commented on the patient reported […]
NEJM 6 Oct 2016 Vol 375 MI: better care counts in long term Forty years ago, it was generally safer to stay at home with a myocardial infarction. Archie Cochrane demonstrated this in a talk where he deliberately switched his slides round. The cardiologists present declared that the figures mandated the immediate adoption of coronary care […]
NEJM 29 Sep 2016 Vol 375 Creating a Zika vaccine In the 15th century, sailors from Cadiz set sail under a captain from Genoa to find the western route from Europe to China. They landed in a New World, and proceeded to infect it with the rich mix of communicable diseases that Spanish sailors of the […]
NEJM 22 Sep 2016 Vol 375 Learning to love data parasites Back in January, the chief editor of the NEJM joined many other leading journal editors in signing a radical proposal for data sharing tabled by the International Committee of Medical Journal Editors. But at the same time he co-authored an editorial saying that the […]
NEJM 15 Sep 2016 Vol 375 Preherpetic vaccines in the old For most people who get shingles, the rash and discomfort last for a couple of weeks and then gradually remit. The point of a shingles vaccine is to prevent post-herpetic neuralgia, an uncommon, unremitting condition which can blight people’s lives. Age increases both your […]
NEJM 8 Sep 2016 Vol 375 CPAP & CV events I adore CPAP and bless the night when she arrived in my life. I embrace her—or rather she embraces me—for seven or eight hours of sleepy bliss. I will not hear a word said against her. Does she reduce my risk of cardiovascular events? Probably […]
NEJM 1 Sep 2016 Vol 375 Adding LABAs to steroid inhalers This week’s print NEJM contains two trials of adding inhaled long acting beta-adrenergic agents to inhaled corticosteroids. The first recruited 6208 children with asthma from the ages of 4 to 11, and compared fluticasone alone with fluticasone plus salmeterol. We know that salmeterol alone should […]
After a month’s break, I’m catching up with articles of interest in the main non-BMJ journals throughout August. Normal service will be resumed next week. NEJM Aug 2016 Vol 375 No parasites for five years 405 Following its famous “data parasites” editorial last January, the NEJM has struggled to find a comfortable position on the […]