[smartdoctor] [Fwd: 5 Minutes of International Medicine]
- From: htiljak@xxxxxx
- To: smartdoctor@xxxxxxxxxxxxx
- Date: Wed, 20 Apr 2011 00:30:15 +0200 (CEST)
--------------------------- Originalna poruka ---------------------------- Naslov: 5 Minutes of International Medicine Šalje: "BMJ Group" <email@xxxxxxxxxxxxxxxxxxx> Datum: Uto, travanj 19, 2011 10:33 am Prima: htiljak@xxxxxx -------------------------------------------------------------------------- *************************************************************************************************************** The Clinical Leadership Programme: 3 courses for the price of 2 for a limited period* Want to expand your expertise in leadership, service improvement and innovation? The Clinical Leadership Programme has a range 5 key short courses that are relevant to GPs in your region. All courses are accredited by the Open University Business School and developed in collaboration with BMJ Learning, so you can be assured of the quality and clinical relevance of our flexible, online courses. http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLxxHPcStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFKw **************************************************************************************************************** 5 Minutes of International Medicine from BMJ Group - April 2011 Dear Colleague, 5 Minutes of International Medicine from BMJ Group is our monthly email alerting service providing you with free access to the latest and most relevant articles from our wide range of products. Big headed babies Many family doctors still check child development, and may see lots of babies with a head circumference above the 99th centile. Do these babies need to be referred? This study compared head circumference according to the new UK-WHO standard with the UK 1990 reference. The UK-WHO standard identified many more infants with heads above the 98th centile, and infants with rapid head growth (defined as crossing upwards through two major centile bands) than the UK 1990 reference. Referral in these cases wouldn't be necessary. http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLyQpvcStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFEr Source: Archives of Disease in Childhood 2011;96:386-388 Should non insulin dependent diabetics self monitor their glucose? Anyone who uses insulin should be encouraged to use self monitoring of blood glucose (SMBG). But is it useful in diabetic patients who don't need insulin? The short answer from a systematic review is "not proven." A commentary on the review says that there is no clinically relevant benefit and that SMBG can worsen a patient's quality of life. However, there may be subgroups of patients who would benefit from SMBG; a meta-analysis is under way. http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLyQp_cStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFEo Source: Evidence Based Medicine 2011; 16:42-43 What to add to metformin? Metformin is the first line drug for type 2 diabetes. Most patients will need additional therapy in time. Which is best? This meta-analysis shows they are similarly effective at lowering blood glucose when added to metformin. The newer therapies cause less hypoglycaemia and keep weight stable or reduce it. However, their long term effects are less well known. The options are: * Sulphonylureas/glinides - have a risk of hypoglycaemia, but their long term effects are well documented * Thiazolidinediones (AGI, DPP4 inhibitors and GLP-1 analogues) - newer drugs with less well known long term effects but have a lower risk of hypoglycaemia compared to sulphonylureas and the glinides. * DPP4 inhibitors and the AGI - have a neutral effect on weight * GLP-1 analogues - associated with highly significant weight loss http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLyQpPcStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFEp Source: Evidence Based Medicine 2011; 16:39-40 Abdominal angina Chronic gastrointestinal ischaemia (CGI) or abdominal angina, is more common than previously thought. Classic symptoms are â�˘ postprandial pain â�˘ weight loss due to fear of pain after eating â�˘ abdominal bruit on examination. These studies showed symptoms may be more varied than this triad. CT angiography and assessment of mucosal perfusion can help to make the diagnosis. Endovascular or surgical revascularisation can be highly successful. Source: Gut 2011;60:722-737 doi:10.1136 http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLyQQvcStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFFH Compiled by Dr Ann Robinson ----------------------------------------------------------- If this email is not relevant to you please help us send you the information you need: Update your details and email preferences here http://emails.bmjgroup.com/HS?a=ENX7CqkHKmjD8SA9MKJOsgznGHxKLLxxHfcStGb5lw8W0bBhOG5mpqVsje_Hhe-mDFKx Please let us know how we can make this service more useful to you - mailto:response.gp5mins@xxxxxxxxxxxx The BMJ Group is one of the world's most trusted providers of medical information for doctors, researchers, health care workers and patients www.bmjgroup.bmj.com. The recipient should check this email and attachments for viruses because the BMJ Group accepts no liability for any damage caused by viruses. 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