Bits and bobs from the BMJ of 9th September:

A systematic review in PLoS Medicine found gabapentin and pregabalin to be not particularly helpful with chronic low back pain; any benefits from them were outweighed by the risk of side-effects (dizziness, fatigue, visual disturbances). (Minerva)

The pendulum has, kind of, swung back on the issue of prescribing prophylactic antibiotics for high-risk patients undergoing dental procedures; now we’re meant to offer it and discuss risks and benefits. ‘High-risk’, here, includes patients with prosthetic heart valves; patients with a past history of infective endocarditis; and patients with some types of congenital heart disease. Note that, although prophylaxis is known to reduce the incidence of bacteraemia, we do not currently have good evidence as to whether it actually reduces the risk of endocarditis. (Uncertainties)

And a sacred cow appears to have been slain. PURE, an enormous observational study of diet and cardiovascular mortality (five continents and almost 150 000 people, over a median of 7.4 years), found that consumption of fat – even saturated fat – was actually associated with lower cardiovascular disease rates, and saturated fat was also associated with lower stroke risk. Carbohydrate appeared to be the actual problem; high intake was associated with higher total mortality risk. More expectedly, higher fruit, vegetable, and legume intake was associated with lower mortality risk; maximum benefit appeared to occur at 3 – 4 servings (375 – 500g)/day. (Richard Lehman)


About Dr Sarah

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