BMJ 2011: 342: 449 – 506 (26th February)

At what age should diabetics start statins?  50 in men and 60 in women, advise two cardiologists in the editorials.  Also, they advise considering their use in men over 55 and women over 65 with multiple risk factors.  Broadening the general topic of CV disease prevention, think ABCDE – Assessment of need for aspirin and/or statins, Blood pressure control, Cholesterol management + Cessation of Cigarettes, Dietary improvement, and Exercise.

A little of what you fancy may do you good – people averaging 1 – 2 drinks per day had a lower MI risk than people averaging none.  On the other hand, the people at the lowest risk of stroke were those who had less than one drink per day.

The ‘just relax!’ myth for infertile women has finally been set to rest.  A meta-analysis shows that the success of assisted conception attempts is not related to the distress levels women feel at the time.

And the review article is about mastitis.  Bacterial mastitis should be treated for at least 10 days (with flucloxacillin, co-amoxiclav, or a macrolide).  There is little evidence for fungal infection as a cause of mastitis, and this also applies to intertrigo, which is more likely to be due to Staph aureus.  Raynaud’s disease of the nipple can cause breast pain during feeding and should be treated with nifedipine.  Abscesses should be referred for drainage.  Risk factors for infection in non-lactating breasts include smoking, diabetes, and the occasional case of carcinoma in situ (so women over 35 with no obvious cause for their peripheral breast infection should be referred for mammography when it has resolved).

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About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in Cardiovascular, Clean Living, Uncategorized. Bookmark the permalink.

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