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....
What causes breast cancer?
The first group of women noted to have a higher incidence of breast cancer shared a common employment, they were nuns. That observation was made three centuries ago, and age at menarche, parity, age at first birth and breast feeding history (all of which accounted for it) are still useful risk factors. That's despite the advance of much genetic research aiming to uncover our risks at a subcellular level. This trial explored what can be added to ten established risk factors (those mentioned already, plus menopause, HRT, BMI, height and alcohol) by 12 genetic polymorphisms. The answer was nothing at all. Using genetic knowledge in a clinically useful way is often fabulously difficult.
Reducing smoking might be good for your heart
The impact of smoking on health is unmatched, cancelling out the combined good effects of all medical innovations since World War II. We've absolutely superb evidence for this, so quite what the point of this paper is escapes me entirely. It suggests you might be able to show smoke-free legislation leads to a reduction in heart attacks. The public health time involved in researching and producing this paper would have been much better spent giving out smoking cessation advice.
Reducing maternal transmission of HIV
Over 2,000 mother and children pairs were recruited from Malawi, with all women having HIV and low CD4 counts. All Mums got nevirapine as a single perinatal dose and then a week of zidovudine and lamivudine after. The intervention groups got either nevirapine for the infants, triple therapy for Mums or nothing extra whatsoever. All but the latter were effective.
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