Monthly Archives: July 2011

BMJ 2011: 343: 215 – 266 (30th July)

Depression in someone with Alzheimer’s may be better treated with support than with medication.  In a large study in the Lancet, both sertraline and mirtazapine were found to work no better than placebo for depression in Alzheimer’s, but (less surprisingly) … Continue reading

Posted in BMJ, Elderly Medicine, Medication, Psychiatry | Leave a comment

Antiplatelet therapy

Latest NICE guidelines, according to MeReC, are that antiplatelet treatment after CVA or for PAD is now long-term clopidogrel on its own.  After TIA, it’s still aspirin + dipyridamole, but indefinitely rather than for just two years.  After MI, guidance … Continue reading

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BMJ 2011: 343: 103 – 62 (16th July)

Otitis media with effusion (glue ear) Red flag features are: Atypical otoscopy with persistent foul-smelling discharge suggestive of cholesteatoma Excessive hearing loss/examination findings that indicate additional sensorineural hearing deficit. Both of these need urgent ENT referral, ‘urgent’ meaning within 2 … Continue reading

Posted in ENT, Gastroenterology, Infectious Diseases | Leave a comment


I already knew that meat, seafood, and alcohol were bad for gout while skimmed milk and weight loss were good for it.  To the ‘bad for’ column I can now apparently add fructose and sugar-sweetened soft drinks, and to the … Continue reading

Posted in Arthritis UK handouts, Gout, Medication, Prescriber | Leave a comment

NSAIDs and CV risk

A meta-analysis published in January showed etoricoxib and diclofenac to carry the highest risk of MI of the NSAIDs currently on the market (rofecoxib, unsurprisingly, took the absolute top slot).  Ibuprofen was the riskiest for CVA, with diclofenac coming in … Continue reading

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JFPRHC 2011: 37(3) (July)

An article about legal aspects of management of contraceptive decisions in the learning disabled.  Important points: The key piece of legislation is the Mental Capacity Act 2005, which formalised existing case law and added new requirements. Presume competence unless demonstrated … Continue reading

Posted in Contraception, Medicolegal | Leave a comment

BMJ 2011: 343: 1 – 50 (2nd July)

Chronic chilblains 1. Check they actually are chilblains.  Raynaud’s syndrome is often misreported as chilblains, so take a history.  The diabetic foot, or PVD, can also be misreported/misdiagnosed as chilblains.  Check peripheral pulses. 2. This is, apparently, and with all … Continue reading

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