The National Epirubicin Adjuvant Trial (NEAT) was conducted in the Nation of England, while a very similar trial, BR9601, was conducted in Scotland. Both show that this agent reduces rates of death or recurrence when given for early breast cancer before the standard cocktail of cyclophosphamide, methotrexate and fluouracil. […]
JAMA 1 Nov 2006
How do you get someone to use their disabled arm after a stroke? Why, put the other one out of action. Not all the time of course, but for periods of repetitive exercise. It’s a pretty basic idea, but successful enough to justify the trial eponym – EXCITE. It’s a lot more exciting than yet […]
JAMA 25 Oct 2006
Those interested in the hospital volume/quality debate may like to take a look at this study from the USA which shows that admission to the highest-volume centres there is strongly influenced by social class, race and insurance status. Once upon a time, our National Health Service would have been the ideal place to carry out […]
NEJM 26 Oct 2006
This is a classic example of a certain kind of screening study—the sort that tells you how marvellous it is that we can now spot (in this case) lung cancerat a stage early enough to cure it by surgery in 80% of cases. […]
BMJ 28 Oct 2006
This study randomised primary care patients with osteoarthritis to six sessions of self-management instruction plus a booklet or just the booklet. At one year, there was no difference in scores of pain, physical functioning or contact with primary care. A third of the patients randomised to the training sessions dropped out. Maybe they reasoned that […]
Lancet 28 Oct 2006
Here is an important case-control study which goes a long way towards proving that conjugate pneumococcal vaccine could save a great many children’s lives, especially in the developing world (see editorial, p.1469). The investigators looked at the serotypes of pneumococcus involved in 782 cases and 2512 controls. […]
Ann Intern Med 17 Oct 2006
A new treatment for irritable bowel syndromewhich improves symptoms for 10 weeks after a 10-day course—let’s all start prescribing rifamixin, a non-absorbed antibiotic! But hang on. Read the editorial first. With meticulous politeness it points out all the defects of this drug-company sponsored trial, not least the fact that only one symptom—bloating—showed any significant improvement. […]
JAMA 18 Oct 2006
Coronary artery bypass grafting has become the commonest major surgical procedure in the developed world. But since it tends to be needed most in people who are old, have smoked, got fat, and/or become diabetic, there is a sizeable risk of post-operative pulmonary complications. A team from Utrecht sensibly wondered if these might be reduced […]
NEJM 19 Oct 2006
I first became aware of dehydroepiandrosterone some years ago when a patient with Addison’s disease asked if I could prescribe it to help her general well-being and libido. Not wishing to deny her these benefits, I read up about it and discovered that it is the most abundant hormone produced by the adrenal cortex but […]
BMJ 21 Oct 2006
This week’s BMJ is devoted to “Health in the Middle East […]