This week's journal reviews on Doctors.net.uk
Journal Watch is a service provided to summarise some of the most popular medical journals.
Doctors.net.uk has a panel of specialist advisers responsible for reviewing a range of journals of general medical interest and some more specialised publications.
General Journal Watch is written by Dr Druin Burch, Consultant in Internal Medicine
This week's journals include....
The Lancet:
Emerging options in myeloma
The treatment of multiple myeloma is becoming a happy and increasingly fruitful mess. Thalidomide, steroids, melphalan, lenolidamide, vincristine, doxorubicin, bortezomib and stem-cell transplantation: you don't have to be quick at estimating permutations to spot that these agents can combine in a large number of ways even before you start varying doses and chronological regimens.
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BMJ:
The Christmas BMJ
is its usual traditional self, stuffed full of articles intended to be funny or off-beat. This year it's a success. Ikea pencils for osteotomies, the urine output of intensive care doctors and the parking speeds of consultants correlated to their specialities are a pleasurable read, and all worth an idle few moments.
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NEJM:
Biventricular pacing in heart failure
I fail completely to understand this study. It started with the perfectly reasonable observation that those with systolic heart failure and widened QRS complexes are known to benefit from re-synchronisation via biventricular pacemakers. It then recruited a large number of these patients, gave them all implantable ICDs, and looked to see if adding biventricular pacemakers to some resulted in an improvement in outcomes which, of course, it did. The mysteries are how they got ethical approval, and why they thought it reasonable to randomise a group of patients to not getting a treatment already proven to be of prognostic benefit.
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