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:
Physical and mental health
An editorial that misses the point. It notes the awful physical side effects of antipsychotics, and the fact they appear to reduce life expectancy massively, "people with severe mental illness have lives 16-25 years shorter than does the general population, and that coronary heart disease, not suicide, is the major cause of death". But it doesn't make the obvious argument that we don't know the long-term benefits of antipsychotics. We have never had a trial looking at what they do to psychosis over the long term. So we're left knowing that they kill people, but unable to say if they do enough good to make them worthwhile all the same. A shocking lack, and one The Lancet should stir itself to notice.
Read more...
BMJ:
Irradiate that fetus?
A case-control study of radiology scans in utero and cancer that tells us nothing of any use. Ultrasound appears entirely safe, while X-rays look like they've got some danger to them, but usually too small to show up if you're only looking (as these authors are) at cancers that crop up in childhood. The conclusion? "Caution is needed in the use of diagnostic radiation imaging procedures to the abdomen/ pelvis of the mother during pregnancy and in children at very young ages". And I'm quoting, believe it or not, from the BMJ's "What this study adds" section. God knows what they thought we've been doing till now.
Read more...
NEJM:
Bavacizumab for retinopathy of prematurity
Vascular endothelial growth factor receptors are important and widespread, and their involvement in angiogenesis has been making them a target for recent advances in anti-cancer treatments. Here, they're shown to have promise in the setting of retinopathy of prematurity, although the results from this trial weren't as positive as might have been hoped.
Read more..
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