New Eng J Med Vol 354/355
2552 Wouldn't it be nice to have a marker to tell us which patients were at highest risk of developing type 2 diabetes, and how successful we were at preventing it? Serum retinol-binding protein 4 may be just the thing we need to guide our treatment.
2645 As you'd expect, men who wear condoms spread less human papilloma virus.
2764 Higher levels of homocysteine (HCy) are a risk factor for dementia, so successfully lowering HCy using three B vitamins over 5 years should have prevented dementia. But it didn't.
2794 Learn to recognise early Lyme disease: as time ticks by, you may see a case.
21 Sooty lungs in children work less well than clean lungs: a study of lung function in relation to carbon in sputum macrophages.
31 Influenza is also bad for little lungs, and most of it could be prevented by universal childhood vaccination.
Lancet Vol 367/368
1990 Aberdonian laboratory doctors decided that instead of moaning about the way that GPs used tests, they would give them feedback. It worked, though I don't agree with some of their advice.
2061 Good old fashioned ECG changes can still have a prognostic role in acute myocardial infarction: Q waves on arrival in hospital predict a bad outcome.
29 A rather crude trawl through a big Canadian database shows that if ‘diabetes’ appears on your medical record before old age, expect 15 fewer years of life.
83 David Grimes speculates that statins might be analogues of vitamin D, bringing a bit of sunshine into people's lives.
119 Newly released prisoners are at high risk of suicide. Am I alone in thinking that society is getting crueller and less interested in rehabilitating offenders?
139 A study from London clinics shows that there are gay strains of gonorrhea and straight strains, and rarely the twain do meet.
JAMA Vol 295/296
2605 Anorexia nervosa continues to elude our efforts to understand and treat it. Merely giving fluoxetine does not prevent relapse.
2752 Statins continue to star: perhaps they prevent cataracts?
2851 Cognitive behavioural therapy (CBT) is a much better treatment than zopiclone for insomnia in Norway. British insomniacs can simply lie awake thinking about CBT, or take zopiclone and dream about it.
47 The pleasure of smoking is mimicked by a new nicotine receptor partial agonist, varenicline, which in a double-blind trial seems twice as effective for smoking cessation as bupropion.
87 Puzzled by some mildly abnormal liver function tests? Ask about paracetamol, which can elevate aminotransferases even at normal therapeutic doses.
Arch Intern Med Vol 166
1190 Coffee prevents alcoholic cirrhosis. This big cohort study provides as much prospective evidence we're ever likely to get, and it shows a marked dose-related benefit. And there's more evidence that coffee prevents type 2 diabetes too on page 1311.
1196 Sssh! Here's a study that seems to show that there is a group of people for whom smoking confers no cardiovascular risk – black American men.
1301 A British study shows no association between routine vaccinations and Guillain–Barré syndrome.
Ann Intern Med Vol 144/145
877 Strange indeed are the ways of atopy. In Israeli army recruits, pre-existing asthma seems to lower the risk of inflammatory bowel disease and rheumatoid arthritis, especially in women.
1 The Mediterranean diet is a good thing. Even in the first 3 months, it cuts your cardiovascular risk factors, rather like transcendental meditation (see Arch Intern Med page 1218).
12 We need more sham acupuncturists. In every trial, sticking the needles in at random is as good as acupuncture, and both are better than physio for knee arthritis.
Guest Journal of the Month: Br J Gen Pract Vol 56
All GPs should seek the pleasure of interacting with their national journal. At least write a letter; maybe an editorial; a nice opinion piece for the Back Pages; or do some research. There were good examples of all these in the July issue. My favourite was the paper showing that nurse practitioners are poorer value than salaried GPs for most purposes (page 530).
Plant of the Month: Fagus sylvatica var heterophylla ‘Aspleniifolia’
August is a month to seek shade. Posterity will bless you for planting themost beautiful of shade trees, the cut-leaved beech.
- © British Journal of General Practice, 2006.
