{"id":119,"date":"2007-02-19T13:08:32","date_gmt":"2007-02-19T12:08:32","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/02\/19\/arch-intern-med-12-feb-2007\/"},"modified":"2007-02-19T13:08:32","modified_gmt":"2007-02-19T12:08:32","slug":"arch-intern-med-12-feb-2007","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2007\/02\/19\/arch-intern-med-12-feb-2007\/","title":{"rendered":"Arch Intern Med 12 Feb 2007"},"content":{"rendered":"

<\/strong>Is <\/strong>pot smoking<\/a> <\/strong>good for the lungs? Why no, it isn\u2019t, not least because in order to smoke cannabis <\/a>you also inhale the smoke of burning tobacco and Rizla paper. Here is a systematic review<\/a> of what is known about the short- and long-term effects of marijuana on the lung. In the short term, it\u2019s actually a bronchodilator: in the long term, it makes you cough and wheeze.<\/p>\n

<\/strong>I\u2019m generally impressed with the patience displayed by patients who take warfarin: <\/a>every morning my computer brings up a whole list of INR results which are in the target range. Perhaps the credit should go to our local anticoagulation nurse, because the American IN-RANGE study <\/a>found that the majority of patients were forgetting lots of doses. And this does affect outcomes, as you\u2019d expect \u2013 the next paper<\/a> reports on the international SPORTIF III\/IV trials and shows that INR control in patients taking warfarin for atrial fibrillation<\/a> <\/strong>is directly associated with death, MI and stroke.<\/p>\n

<\/strong>We know that urine <\/a>is meant to be sterile, but what if it grows E coli <\/em><\/a>in an asymptomatic woman<\/a>? Had we better get rid of the bug to prevent long-term kidney damage? This long-term population study <\/a>from the Netherlands (actually two studies, fully analysed forwards and backwards) is very reassuring: there is no evidence of a link between asymptomatic bacteriuria in women and long-term renal failure.<\/p>\n

<\/strong>Whisper it softly, but we tend to bypass clinical prediction rules in general practice. For something like gastrointestinal bleeding<\/a>, we tend to pass the patient straight on and let someone else do the worrying. That usually means endoscopy <\/a>of course, but here is a paper which validates a risk score<\/a> <\/strong>that identifies a group of low-risk patients whom it is safe not to endoscope immediately. The bad news is that they are only 10% of the group.<\/p>\n

<\/strong>We have entered the age of biochemical cardiology, but we don\u2019t quite know what to do about it. I have said my piece on BNP and \u201cheart failure<\/p>\n","protected":false},"excerpt":{"rendered":"

Is pot smoking good for the lungs? Why no, it isn\u2019t, not least because in order to smoke cannabis you also inhale the smoke of burning tobacco and Rizla paper. […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[111],"tags":[],"class_list":["post-119","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"jetpack_featured_media_url":"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2017\/02\/richard-lehman.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/119","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=119"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/119\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/38363"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=119"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=119"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}