BMJ 2011: 342: 341 – 90 (12th February)

A hotch-potch of interesting snippets:

Next time anyone tries to persuade me to prescribe oxygen for a patient whose breathlessness is due to CCF rather than COPD, I will have good back-up for my refusal.  Several studies show that SBOT therapy is no better than room air for relieving intractable breathlessness, and nobody has proved it’s harmless (indeed, there is some tentative evidence from small, short-term studies that it may impair cardiac function).  We don’t know one way or the other about LTOT as it hasn’t been researched, but buggered if I’m going to prescribe LTOT with no evidence.  The one possible benefit would be of overnight therapy, which shows some small benefits in terms of exercise capacity in small, short-term studies – whether this is likely to be clinically significant is not made clear.

The reason why oxygen is so little use in CCF, incidentally, is because CCF patients aren’t actually hypoxaemic.  The reverse, if anything – they have slightly higher mean arterial pressures of oxygen than people who don’t have CCF.

Self-testing BP machines for the surgery waiting room could be a wise investment – they virtually eliminate the white coat response.  I wonder if the reduction on prescription bills would eventually be enough for them to pay for themselves?

Looks as though the old claim about diet affecting ADHD may actually be true, at least in one small study in the Lancet reported in Short Cuts.  However, the results relied on parental self-report and obviously a blinded trial wasn’t possible, so treat with caution.

And exercise may have mental as well as physical benefits – walking for 40 minutes three times weekly slightly increased brain volume and spatial memory in healthy older adults, according to a Proceedings of the National Academy of Sciences study reported in Minerva.


About Dr Sarah

I'm a GP with a husband and two young children.
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