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US
editor�s choice
January 28
Andrew Blann and
Gregory Lip review the
diagnosis and treatment of venous thromboembolism. Their article includes a
helpful diagnostic algorithm that facilitates calculating the likelihood of
a DVT and emphasizes non-invasive testing. It makes a nice companion piece
to the pulmonary embolism review
in the January 21st issue.
In the setting of an upcoming Parliamentary debate on banning smoking in
British workplaces, American researcher Nadine Leavell and colleagues
comment on recent actions by
the British American Tobacco Company to promote the effectiveness of air
filtration systems. Research says such systems do not protect nonsmokers
from adverse health consequences of tobacco smoke, but that doesn�t stop BAT
from advocating for them.
In a Personal View, Hasan Tahir
and Zafar Iqbal ask whether well-meaning but poorly prepared and
disorganized doctors are helping or hurting victims of natural disasters in
Sri Lanka and Pakistan. They appeal for better training and more affiliation
with ongoing programs that can provide both acute care and necessary
follow-up
An anonymous London prostitute
reacts to recent UK proposals to decriminalize prostitutes� work while
maintaining laws against men who pay for sex. She argues that accepting
money for sex is not inherently degrading and does not inevitably lead to
coercion, illegal drug use, and child abuse.
January 21
Demosthenes Bouros and
colleagues discuss in an editorial
whether to use fibrolytics in the treatment of infection-related pleural
effusions. Conventional wisdom that installation of fibrolytics helps speed
recovery has been tempered by a recent randomized trial that found no
benefit from the use of intrapleural streptokinase. The authors point out
the weaknesses of that study but still urge caution in the use of these
agents.
In a very useful review of the
treatment of rheumatoid arthritis, Paul Emery states that a revolution in RA
treatment is occurring, one that may lead to thoughts of cure. Treatment
with biologic agents that block tumor necrosis factor a is now being used
with promising results in relatively early-stage disease and needs to be
considered in the care of all newly diagnosed RA patients.
The diagnosis and management of pulmonary embolism is
reviewed by Grace Robinson. She
emphasizes the importance of pre-test probability in making an often
difficult diagnosis. Studies have now shown that subcutaneous low molecular
weight heparin is as effective as intravenous heparin in the acute setting,
is more convenient, and it may be safer.
January 14
In a useful
editorial,
Mark Schiffman and Phillip Castle discuss the
promise of human papilloma virus testing in screening, detection, and
monitoring of cervical cancer. Like all screening tests, it has
strengths and weaknesses, but their overall conclusion is cautious optimism.
Rachel Huxley and colleagues
performed a meta-analysis of the risk of fatal coronary heart disease in
patients with diabetes.
They find that diabetes poses a 50% greater risk of death in women than men,
which may be due partly to differential effects of the disease but also to
less aggressive heart disease treatment of women.
The
diagnosis and management of gastro-esophageal reflux disease, called GERD in
the US but GORD in the UK, is reviewed by Mark Fox and Ian Forgacs.
With the advent of safe and effective proton pump inhibitors, the authors
advocate a month�s drug treatment before endoscopy or other diagnostic
interventions are ordered.
January 7
BMJ�s
first issue of 2006 opens appropriately with
a baby story: a
case-control study from California that finds that babies using pacifiers
(called �dummies� in the UK) were at significantly less risk for sudden
infant death syndrome than those who did not. Use of a pacifier seemed to
mitigate other SIDS risk factors, such as sleeping in a prone position, use
of soft bedding, and having a mother who smoked.
Practical tips from this issue
include a reminder from Gerald Liew and colleagues that
fundoscopy is
twice as accurate when the patient�s pupils are dilated, and that the
commonly cited risk of precipitating acute angle closure glaucoma is
actually extremely small. Also, Leonard Finegold and Bruce Flamm summarize
the evidence for the (increasingly popular)
use of magnets to treat pain in
various joints: poor.
Peter Goadsby summarizes
recent advances in the diagnosis and treatment of migraine headache, the
most common disabling headache. We now know that migraine is a brain
disorder involving abnormal sensory processing. It can usually be managed
well with a combination of acute and preventive treatment.
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January 28
Venous thromboembolism
Andrew D Blann, Gregory Y H Lip
Blowing smoke: British American
Tobacco's air filtration scheme
Nadine Rae Leavell, Monique E Muggli, Richard D Hurt, James Repace
Do doctors who volunteer their
services in disasters overseas do more harm than good?
Hasan Tahir, Zafar Iqbal
Prostitution shake-up
one sex worker's view
January 21
Intrapleural streptokinase for pleural infection
Demosthenes Bouros, Katerina M Antoniou, Richard W Light
Treatment of rheumatoid arthritis
Paul Emery
Pulmonary embolism in hospital
practice
Grace V Robinson
January 14
When to test women for human papillomavirus
Mark Schiffman, Philip E Castle
Excess risk of fatal coronary heart disease associated with diabetes in men
and women: meta-analysis of 37 prospective cohort studies
Rachel Huxley, Federica Barzi, Mark Woodward
Gastro-oesophageal reflux disease
Mark Fox, Ian Forgacs
January 7
Fundoscopy: to dilate or not to dilate?
Gerald Liew, Paul Mitchell, Jie Jin Wang, Tien Yin Wong
Magnet therapy
Leonard Finegold, Bruce L Flamm
Use
of a dummy (pacifier) during sleep and risk of sudden infant death syndrome
(SIDS): population based case-control study
De-Kun Li, Marian Willinger, Diana B Petitti, Roxana Odouli, Liyan Liu,
Howard J Hoffman
Recent advances in the diagnosis and management of migraine
Peter J Goadsby
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