Archive for the ‘chronic disease’ Category

BMJ 2008;336:2-3 (5 January).
Proton pump inhibitors have been a tremendous therapeutic advance and have transformed the lives of patients with previously intractable symptoms, say editorialists Ian Forgacs and Aathavan Loganayagam. But the drugs are being overused, and side effects – although rare – should not be overlooked.

Rapid Response by Dr Raymond C Seidler, GP, NSW, Australia:

  • “Perhaps it would be salutary to consider how rare it is now to see patients with perforated ulcers or even serious gastric or duodenal ulceration.
  • These were commonplace in my early days of general practice 25 years ago. The proton pump inhibitors as a class are effective.”

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BMJ  2007;335:786 (20 October).

Two papers have recently been published on bmj.com on the treatment of osteoarthritis of the knee.

Acupuncture has no additional benefit in people taking a course of exercise.

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Research, BMJ, doi:10.1136/bmj.39367.495995.AE (published 6 November 2007)

What is already known on this topic

  • Increased body mass index is known to increase the risk of adenocarcinoma of the oesophagus, endometrial cancer, kidney cancer, and postmenopausal breast cancer in women
  • Body mass index has also been associated with the risk of other, rarer, cancers, but the findings are not yet conclusive

What this study adds

  • High body mass index in women may increase the risk of multiple myeloma, leukaemia, pancreatic cancer, non-Hodgkin’s lymphoma, and ovarian cancer
  • Menopausal status seems to affect the relation between body mass index and risk of breast cancer, endometrial cancer, and colorectal cancer
  • Among postmenopausal women in the UK, 5% of all cancers (about 6000 annually) are attributable to women being overweight or obese
  • Around half of all cases of endometrial cancer and adenocarcinoma of the oesophagus in postmenopausal UK women are attributable to women being overweight or obese

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Editorials, BMJ  2007;335:897 (3 November).

The possible influence of diet on the risk of cancer is constantly topical. The subject is important because people can change their diets, and even a moderate effect on risk could prevent several thousand cancers each year in a country the size of the United Kingdom. However, apart from the confirmed adverse effects of alcohol and obesity on the risk for some types of cancer, progress in understanding has been slow and the evidence remains confusing.

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There is little evidence that fall prevention programmes used throughout the NHS are effective in cutting the number of fallers or fall related injuries.

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BMJ  2007;335:765-768 (13 October), by:

Patrick Petignat, consultant gynaecological oncologist, Michel Roy, professor and gynaecological oncologist.

  • Cervical cancer is the second most common cancer in women worldwide.
  • Cervical cancer is an important cause of early loss of life as it affects relatively young women. 
  • Cervical biopsy is the most important investigation in diagnosing cervical cancer

Surgery or chemoradiotherapy can cure 80-95% of women with early stage disease (stages I and II) and 60% with stage III disease.

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Rapid response to Professor Gareth William’s editorial on the use of weight loss aid, orlistat, correctly concludes that it is no substitute for a healthy lifestyle;

by: Howard Marsh MRCP MRCGP
Medical Director
GlaxoSmithKline Consumer Healthcare, 1500 Littleton Rd, Parsipanny, New Jersey 07054, USA

GSK launched a non-prescription version of orlistat (brand name alli) in the US in June this year, the first FDA-approved weight loss medicine to be available over-the-counter (OTC).

The weight loss that can be achieved with OTC orlistat requires commitment to adopt a low-fat, reduced calorie diet.

Indeed all our communication, including television advertising, websites, in-store communications as well as materials provided to pharmacists stresses this requirement. These materials specifically state that “alli is not a magic pill” and provide candid information about the consequences of eating too much fat.

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