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Arch Intern Med 13/27 Aug 2007 Vol 167

18 Aug, 07 | by BMJ Group

Here is a systematic review of RCTs aimed at the prevention of sports injuries. Successful interventions include the use of insoles, external joint supports and multi-interventional training programmes. Personally I have successfully avoided sport since the age of 16 and am free of injury.

In response to a characteristically ignorant reference to aspirin resistance in one of my reviews, Jeff Aronson once kindly took the trouble to explain to me the various different pharmacological mechanisms by which patients and their platelets fail to respond to aspirin. But does it really matter? Yes, is the answer in this useful systematic review of laboratory-defined aspirin resistance. Laboratory resistance means a higher risk of recurrent cardiovascular risk despite compliance with aspirin treatment.

In the early 1990s, 8171 women health professionals were randomised to receive various combinations of placebo and /or vitamins C,E and beta-carotene.  None made the slightest difference to their rates of cardiovascular disease in the next 9.4 years. Antioxidants are so last decade.

For the majority of patients, arriving on the Intensive care unit is a delirious experience, according to this study from the USA. The predictors of delirium are age, dementia, previous benzodiazepine use, acidosis and a high creatinine. Some of these factors are treatable, and as I’ve said before, that can be life-saving.

Which is really the best place to measure bone mineral density by dual-energy X-ray absorptiometry (DEXA)? For predicting all fractures it’s definitely the proximal femur, according to this retrospective study of 16,500 women. Spinal bone density was only useful for predicting spinal fractures.

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