Category Archives: Impact

Topics that have positively impacted my patient care

Cluster headache

Cluster headaches are one of a group of trigeminal autonomic cephalalgias, also including SUNCT and paroxysmal hemicrania.  Diagnostic criteria are: At least 5 attacks Attacks of severe unilateral orbital, supraorbital, or temporal pain, lasting between 15 minutes and 3 hours … Continue reading

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Anterior uveitis vs. conjunctivitis

Features of conjunctivitis: Purulent discharge (as opposed to just excessive watering, which may be present in uveitis) May be other contacts affected Enlarged preauricular lymph nodes. Features of acute anterior uveitis: Pain worse on accommodation (eg reading) Opaque spots on … Continue reading

Posted in Credits 2012, Eyes, Impact | Leave a comment

BMJ 2011: 342: 933 – 984 (30th April)

Another analysis showing increased MI risk in patients taking calcium supplements.  In this re-analysis of the WHI data, calcium supplements, whether with or without Vitamin D, increased the risk of both CVA or MI by about a fifth each.  As … Continue reading

Posted in BMJ, Contraception, Gynaecology, Impact, Liver | Leave a comment

BMJ 2011: 342: 717 – 772 (2nd April)

The main topic in this BMJ is investigation of weight loss in elderly people. What counts as significant weight loss? Generally, anything over 5% of body weight over 6 – 12 months, although smaller losses may be important in frail … Continue reading

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BMJ 2010: 342:1 – 58 (1st January)

An absolute stack of useful points to start the year off.  The one that I found most important was that, in our rush to restrict prescription of NSAIDs, we may unknowingly have done more harm than good.  A study in … Continue reading

Posted in BMJ, ENT, Impact, Medication, NSAIDs, Rheumatoid arthritis, Rheumatology | Leave a comment

BMJ 2010: 314: 1171 – 1226 (4th December)

Not much for me in the research studies this week. About the only possibly useful point was that the people who think measuring BMI in children isn’t helpful may be wrong, at least in 9 – 12-year-olds, in whom it … Continue reading

Posted in BMJ, BMJ 2010, BMJ 341, Diabetes, Gastroenterology, Gout, Impact, Medication, Obesity, Pregnancy and Childbirth, Rheumatology | 1 Comment

BMJ 2010: 341: 1111 – 1170 (27th November)

The most interesting article this week was on causes and investigation of peripheral neuropathy. My usual approach for patients with peripheral neuropathy is to send them off for random glucose, B12, and folate, and if all those are normal to … Continue reading

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BMJ 2010; 341: 259 – 308 (7th August)

First off, calcium supplements (article on page 289, editorial pp 260 – 261). You remember how we’ve all been advised to start everyone on calcium supplements when we start them on bisphosphonates? Because all the studies on bisphosphonates were actually … Continue reading

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