Research
Migraine with aura and risk of cardiovascular and all cause mortality in men and women
Individuals who suffer from migraines with aura are at a higher risk of dying from heart disease or stroke, according to research by Larus Gudmundsson and colleagues. In a linked editorial, Klaus Berger and Stefan Evers question whether doctors should inform patients about the risks associated with migraine with aura. They argue that "for many people the information will cause an unwarranted amount of anxiety, although others may use the opportunity to modify their lifestyle and risk factors accordingly." The researchers stress, however, that the individual risk for a migraine sufferer remains low. A second paper, finds that female sufferers of migraines with aura are also at a higher risk of haemorrhagic stroke.
Comment
Consent for blood transfusion
Millions of people receive blood transfusions each year, but many will not be fully aware of the risks. Anne-Maree Farrell and Margaret Brazier argue for a formalised consent procedure. But in an accompanying commentary, Ravi Gill questions whether the risks of transfusion are high enough to warrant specific informed consent.
More comment published on 24 August:
Research
Nurse led interventions to improve control of blood pressure in people with hypertension
Nurse led interventions for hypertension require an algorithm to structure care, say the authors of this systematic review and meta-analysis. Evidence was found of improved outcomes with nurse prescribers from non-UK healthcare settings. Good quality evidence from UK primary health care is insufficient to support widespread employment of nurses in the management of hypertension within such healthcare systems, they conclude.
News
GPs should not profit personally from NHS reforms, say doctors' leaders
GPs should not gain any personal profit from commissioning budgets under the proposed reforms to the NHS, say doctors' leaders. The BMA's General Practitioners Committee has published what it says should be the fundamental principles underlying the development of GP commissioning.
More news published on 24 August:
Comment
US moves to improve health decisions
A new US institute for comparative effectiveness research will help patients, clinicians, and policy makers make more informed choices. Sean Tunis and Steven Pearson explain why it has been controversial and assess its prospects for success. In an accompanying commentary, Nicholas Mays concludes that, "measurement and research are not sufficient to achieve high quality, more cost effective care. They have to be linked with other features of the system such as financing, regulation, market structure, and governance."
Education
Evaluating the child who presents with an acute limp
Orthopaedic surgeons Daniel C Perry and Colin Bruce review the epidemiology of acute limp and outline the pitfalls in diagnosis. They provide a framework for early assessment and management of the child who presents with a limp.
More education articles:
Research
Education and self management for people with newly diagnosed type 2 diabetes
This cost effectiveness analysis of a 12 month, multicentre, cluster randomised controlled trial previously reported on bmj.com (read more) shows that the diabetes education and self management for ongoing and newly diagnosed (DESMOND) intervention is likely to be cost effective compared with usual care, especially with respect to the real world cost of the intervention to primary care trusts, with reductions in weight and smoking being the main benefits delivered.
Other recently published research articles:
- Fruit and vegetable intake and incidence of type 2 diabetes mellitus
- Maintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis
- Determinants of disparities between perceived and physiological risk of falling among elderly people
- Making decisions for people with dementia who lack capacity
- Definition, reporting, and interpretation of composite outcomes in clinical trials
Community
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BMJ Group's clinical community for doctors worldwide now has more than 30 000 members. Meet them by logging in or registering to read and join in the latest discussions, including clinical topics posted in forums that can only be accessed by verified doctors. doc2doc clinical editor Sabreena Malik's favourite posts today include:
- It is not Pakistan, it is Perishanistan
- Can dementia be prevented?
- Should we pay transfer fees for poaching healthcare professionals?
- Investigating mildly abnormal serum aminotransferase levels
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