Preventing falls

BMJ 2008;336:130-133 (19 January), by S Gates et al.
Evidence that multifactorial fall prevention programmes in primary care, community, or emergency care settings are effective in reducing the number of fallers or fall related injuries is limited. Data were insufficient to assess fall and injury rates.

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Predictor of long term survival in stroke patients

Karsten Bruins Slot and colleagues – BMJ 29 January 2008
What this study adds:

Functional status of patients six months after onset of an ischaemic stroke has a significant and substantial effect on their long term survival

Less than half those alive with severe disability at six months will survive five years; a survival statistic comparable with that [...]

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Aspirin resistance in cardiovascular disease

BMJ 2008;336:166-167 (26 January).Editorials by Giuseppe Biondi-Zoccai, assistant professor in cardiology et al.
Aspirin resistance in cardiovascular disease carries a worse prognosis, but may be indicative of pre-existing higher risk.
Aspirin has clear benefits in cardiovascular disease. It reduces total mortality, cardiovascular mortality, and cardiovascular morbidity in people with cardiovascular disease or those at high risk of [...]

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Improve dementia services, says Public Accounts Committee

News by Zosia Kmietowicz – BMJ, 25 January 2008
Services for people with dementia should be accorded the same priority as services for cancer and coronary heart disease, the public health spending watchdog for England has said.

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Osteoarthritis of the knee in primary care

Editorials: BMJ 2008;336:105-106 (19 January), by Paul Dieppe.
Many older people have pain in one or both knees from time to time, and the most likely cause is osteoarthritis. And Topical NSAIDS are as effective as oral NSAIDs, and patients prefer them.

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MPs criticise influence of pharmaceutical industry on GP prescribing

Zosia Kmietowicz – BMJ News, 18 January 2008
Too many GPs are influenced by the pharmaceutical industry, says a report from the Public Accounts Committee.
And the NHS spends at least £200m more than it should on medicines because GPs do not heed official guidelines and continue to prescribe branded medicines rather than generics, says the report. [...]

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Calcium supplements may increase heart attacks in older women

Mark J Bolland and colleagues, Department of Medicine, Auckland, New Zealand,  - BMJ, 15 January 2008
In 1400 healthy postmenopausal women, daily calcium supplementation was associated with a higher risk of myocardial infarction over five years. This effect could outweigh any benefits on bone from calcium supplements.

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Call for shake-up in how NICE reviews drug cost effectiveness

News: Andrew Cole – BMJ, 11 January 2008
The House of Commons health select committee has called for a major shake-up in the way the National Institute for Health and Clinical Excellence (NICE) assesses new treatments.

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Survival times in people with dementia

Jing Xie and colleagues – 10 January 2008 BMJ
In a large population based sample from England and Wales, survival after the estimated onset of dementia was 4.6 years for women and 4.1 years for men.
In caring for people with dementia, the focus should be on what can be done rather than on the [...]

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Clinical review of (Viral) Meningitis

BMJ 2008;336:36-40 (5 January). Clinical review
by: Sarah A E Logan, specialist registrar, Eithne MacMahon, consultant Infection and Immunology:

Bacterial and viral meningitis cannot reliably be differentiated clinically, and all suspected cases should be referred to hospital
Viral meningitis is most common in young children; the incidence decreases with age
Enteroviruses are the most common cause at all ages
Although [...]

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