MPox background The MPXV designation remains for the virus; the illness is now called MPox. Clustered outbreaks precipitate concern, and reviews are regularly re-packaged with minor incremental improvements in understanding. Essentially a pox virus that infected a number of tropical… Read More »A pox upon it – MPox overview
Fat soluble vitamins A recent overview published in National Geographic1 pointed to some of the dangers with excessive consumption of fat soluble vitamins, particularly D and E, as these are stored (and accumulate) in the liver and in fat. The… Read More »Can prescribing vitamins cause harm?
Older studies in monkeys suggesting the brain could survive about 6 hours of hypoglycaemia created a false sense of security, particularly in the face of clinical experience showing that most patients presenting unconscious to emergency units do wake up. Not… Read More »A teaspoon of sugar… Or perhaps four. Management of hypoglycaemia
Patients with cortical atrophy are prone to develop chronic subdural haematomas. These can present with stroke-like (hemiplegic) syndromes or more subtly with change in affect, drowsiness or fits. Management is straightforward when there is clearly dangerous neurological harm – reduced… Read More »Medical management of chronic subdural haematoma
Ever since the publication of ALLHAT1 which used chlorthalidone as the preferred diuretic, there has been concern that other thiazides may be either less effective or not as safe as this agent. The LEGEND observational study of 730 000 individuals2… Read More »Diuretic choice in hypertension
Perspective – medication in acute coronary syndromes. Many of the study endpoints in ischaemic heart disease studies are so-called composite endpoints, meaning that the statisticians analyse a number derived from a combination of adverse events – e.g. myocardial infarction,… Read More »Ischaemic heart disease treatment perspectives
Inter-observer variation in reading JVPs. A frequently quoted study1 found a kappa statistic (a measure of the agreement beyond chance) of 0.42 when comparing the ability of interns and registrars to read JVPs when assessed against a gold standard of… Read More »Looking deeper – venous pressure
Comparing different treatments is complicated by trials having different lengths of intervention and follow-up, non-standardization of endpoints, and diverse study populations. The figure reflects effects sizes for interventions from representative individual trials, and gives a feel for the relatively modest mortality benefits… Read More »How well do treatments work in cardiomyopathy?
