Consider The Evidence: Med/Peds Journal Roundup

April 17, 2006

Call me on my (benign) Cell

Filed under: BMJ, cancer, Uncategorized — medblog @ 12:34 pm

BMJ 4/15 – Hepworth et al. weigh in on the cell phone / brain tumor controversy with a case- control study. Some (poorly interpreted) studies have shown some correlation, so I'm sure this won't end the controversy. Frankly, I'm amazed that they found enough non-cell phone users to do the study. The study compared about a thousand glioma patients with seventeen hundred controls. The cases were matched by age, sex, and geography. All patients were interviewed about the frequency and duration of cell phone use. They conclude "There is generally a lack of convincing and consistent evidence of any effect of exposure to radiofrequency field on risk of cancer…" The group also commented on the fact that their study also found a increased risk in relation to side of use despite an unchanged overall risk – "this finding is probably explained by recall bias, with patients with glioma systematically over-reporting use on the same side as their tumour and consequently under-reporting use on the opposite side." Ambidexterity finally has a downside…

March 25, 2006

Omega-3 fatty acids: Just a fish tale?

Filed under: BMJ, cardiovascular — medblog @ 10:10 pm

BMJ – A meta-analysis published online first on BMJ.com casts doubt on the purported health benefits of omega-3 fatty acid supplementation. The new study contradicts a 2002 meta-analysis by Bucher et al. which found that intake these fatty acids were protective against fatal coronary events. The inclusion of data from a large European study by Burr in 2003 was the main influence for the new conclusion. From the figure of the source data, it appears that the largest RCTs such as GISSI-P actually favored less Omega-3. Some have even suggested that omega-3 FA's can be pro-arrythmogenic. The cohort trials appear to be clustered around the line of no benefit.

Clearly the trials included are highly variable on the type of intake (dietary vs supplemental) as well as the pre-intervention risk (from healthy to post-MI) – so although there may be a specific subgroup who would yield benefit, it appears that this analysis does not support a general reccomendation for increasing omega-3 fatty acid intake. Is something fishy going on? Hopefully futher research will find out…

March 5, 2006

High-pitched Wine taken down a peg?

Filed under: BMJ, health — medblog @ 9:34 pm

BMJ 3/4 – A study by Johansen et al. finds that wine drinkers buy healthier foods than beer drinkers. Analyzing 3.5 million transactions at two large supermarket chains revealed that people who buy wine are also more likely to buy healthier lower-fat foods. Does this blow a hole in the wine-a-day effect on reducing mortality? (more…)

February 22, 2006

Melatonin meta-analysis: Back to counting sheep?

Filed under: BMJ, melatonin, sleep — medblog @ 3:46 pm

BMJ 2/10 – Although Melatonin continues to be one of the most widely used supplements for sleep, its popularity seems to be driven by anecdotal evidence than RCTs. A meta-analysis in the BMJ looks at more than 30 trials with melatonin, and concludes that it is pretty much useless for anything related to sleep. Travelers, shiftworkers, and insomniacs are just going to have to keep getting refills on their Ambien until the next natural sleep-aid fad comes around.

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February 12, 2006

BMJ update

Filed under: BMJ — medblog @ 11:14 pm

BMJ 2/12 – Nothing too exciting this week in the BMJ. Apparently Fondaparinux is effective for thromboprophylaxis in medical patients. And the News section makes mention of the approval of inhaled insulin for use in the US and UK.

February 4, 2006

Risk score for stable angina – Euro heart study

Filed under: BMJ, Cardiology — medblog @ 3:47 pm

BMJ 2/4 – Isnt the Framingham score all we need in predicting cardiovascular outcomes? Apparently not according to this study by Daly et al. in this weeks BMJ.

The framingham risk score was designed for adults who do not have existing cardiac disease. As one can imagine, predicting risk of mortality in a patient with stable angina is a very different animal. (more…)

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