Richard Lehman’s journal review – 23 January 2012

JAMA  18 Jan 2012  Vol 307 265     Cangrelor is one of a number of reversible thienopyridine platelet inhibitors competing to replace clopidogrel. This could be an enormous market, but the BRIDGE study, funded by The Medicines Company, begins with a small niche: patients who discontinue antiplatelet treatment before elective coronary artery bypass grafting. The problem […]

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Richard Lehman’s journal review – 3 January 2012

JAMA  28 Dec 2011  Vol 306 2684    When I first became a GP in England well over 30 years ago, the early diagnosis of myocardial infarction was a matter of slight importance, since there was no intervention which made any difference to survival. You tried to reach patients in their homes quickly to relieve their […]

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Richard Lehman’s journal review – 28 December 2011

JAMA  21 Dec 2011  Vol 306 2567   Amongst all the awful things that can befall human beings, poor sleep seems but a trivial inconvenience. Well, maybe: it merely doubles one’s risk of cardiovascular events and depression, and leads to undesirable effects on everyone around. In this survey of nearly 5,000 US police officers, 40% were […]

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Richard Lehman’s journal review – 12 December 2011

JAMA  7 Dec 2011  Vol 306 2331   Over the period I have been writing these reviews, rheumatology has moved from being a rather sleepy discipline to being a hotbed of innovation, largely thanks to the arrival of tumour necrosis factor (TNF)-α antagonists. Known rather quaintly as “biologicals,” these drugs inspired fear when first used because […]

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Richard Lehman’s journal review – 5 December 2011

Arch Intern Med  28 Nov 2011  Vol 171 1879         Recitative (Dido): Thy hand, Belinda! Darkness shades me – On thy bosom let me rest; More I would, but Death invades me; Death is now a welcome guest. Aria (addressed to Aeneas): When I am laid, am laid in earth, May my wrongs create No trouble, […]

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Richard Lehman’s journal review – 28 November 2011

JAMA  23/30 Nov 2011  Vol 306 2221   “There is a fifth dimension, beyond that which is known to man,” intones Rod Serling in accents strange, “…we call it The Twilight Zone.” Fans of the 1950 series will enjoy this week’s episode, where a bewildered reviewer finds himself in a parallel universe where he is doomed […]

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Richard Lehman’s journal review – 21 November 2011

JAMA  16 Nov 2011  Vol 306 2099    Steve Nissen became something of a hero of mine when he showed how bad data from pharma-funded studies had been used to mask the fact that rosiglitazone (Avandia) was harming diabetic patients while lowering a surrogate end-point – blood glucose or glycated haemoglobin. But here he is leading […]

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