I’m sure that individual susceptibility to the effect of drugs has been known from before the dawn of civilisation: in oral epics, most chieftains hold their drink better than underlings. As soon as there was Mendelian genetics, there was phamacogenetics – the linking of particular genes to particular drug responses. Now we have pharmacogenomics […]
You are unlikely to find the story-book red spotted caps of this fungus so late in the season, but I nominate it for illustrating that primitive tribes – in this case from Siberia – can show a sophisticated understanding of pharmacology. Groups of Siberian tribesmen would get their women to chew the fungus […]
Working in a urology unit thirty years ago, I was struck by the discrepancy between male patients’ symptoms of urgency, frequency and nocturia and the size of their prostates, which in those days we were very keen to remove. We tended to ignore the bladder, though that is where the problem often lies. […]
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 […]
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) […]
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. […]
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. […]
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 […]
“If history has taught us anything, it’s that Internet business models are like buses: If you miss one, all you have to do is wait a little while another one will come along.” Steve Krug, Don’t Make Me Think On the basis of recent mega-deals (Rupert Murdoch’s $580m for MySpace, Google’s $1.65bn for YouTube) it […]
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. […]