{"id":120,"date":"2007-02-19T13:08:41","date_gmt":"2007-02-19T12:08:41","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/02\/19\/lancet-17-feb-2007\/"},"modified":"2007-02-19T13:08:41","modified_gmt":"2007-02-19T12:08:41","slug":"lancet-17-feb-2007","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/19\/lancet-17-feb-2007\/","title":{"rendered":"Lancet  17 Feb 2007"},"content":{"rendered":"<p><strong>559   <\/strong>For several years now, there has been a stream of trials comparing <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602001\/fulltext\">aromatase inhibitors<\/a><strong> <\/strong>with <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602001\/fulltext\">tamoxifen <\/a>at various stages of <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602001\/fulltext\">breast cancer<\/a>,<strong> <\/strong>and the<strong> <\/strong>aromatase inhibitors always win. <!--more-->A couple of years ago, a review in the <em>NEJM <\/em>suggested that exemestane was perhaps the most effective, and in this trial, women who had been taking tamoxifen for 2-3 years after breast cancer treatment and without recurrence were randomised to receive exemestane or carry on with tamoxifen. Once again, the aromatase inhibitor proved better at preventing recurrence and improving survival. <\/p>\n<p><strong>571   <\/strong>The freeways of Southern  California are hellish places and give out hellish quantities of sulphur, particulate carbon and all the rest. Is this good for the developing lung? Why no, it isn\u2019t. This study compared the <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607600373\/fulltext\">lung function<\/a> of Californian <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607600373\/fulltext\">children <\/a>living close to or distant from freeway <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607600373\/fulltext\">motor traffic<\/a>: there are substantial and probably permanent effects on FEV<sub>1<\/sub> and maximum midexpiratory flow rate. <\/p>\n<p><strong>578    <\/strong>The idea that <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602773\/fulltext\">fish <\/a>is good for the <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602773\/fulltext\">brain <\/a>was frequently expounded by Bertie Wooster in his exchanges with Jeeves, and is absolutely correct. This American <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602773\/fulltext\">study <\/a>looked at <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602773\/fulltext\">neurodevelopmental<\/a> outcomes in <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602773\/fulltext\">children <\/a>according to whether their pregnant mothers adhered to a 340g per week limit on fish intake or not. The presumption was that more fish meant more methylmercury contamination and hence more brain damage; but in fact it means more omega-3 fatty acids, and therefore better brain development.<strong \/><\/p>\n<p><strong>587   <\/strong>I have a patient who has a patch of face which looks as it has been bitten off by a wolf and is vaguely red: this is the origin of the term <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602797\/fulltext\">lupus erythematosus<\/a>, and it is rare, unlike lupus vulgaris, which used to be common in the days of rampant tuberculosis. The <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602797\/fulltext\">systemic<\/a><strong> <\/strong>form of <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602797\/fulltext\">lupus erythematosus<\/a> on the other hand is fairly common, nine times more so in women than men, and especially so in people of African origin. Nothing about SLE is straightforward, and there are competing ideas about pathogenesis, diagnosis and treatment \u2013 comprehensively summarised in this <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602797\/fulltext\">review<\/a>, which you need to read, as you are bound to have a patient with this condition. It includes a short and useful section on <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673607602797\/fulltext\">antiphospholipid syndrome<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>559 For several years now, there has been a stream of trials comparing aromatase inhibitors with tamoxifen at various stages of breast cancer, and the aromatase inhibitors always win. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/19\/lancet-17-feb-2007\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-120","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Lancet 17 Feb 2007 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/02\/19\/lancet-17-feb-2007\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lancet 17 Feb 2007 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"559 For several years now, there has been a stream of trials comparing aromatase inhibitors with tamoxifen at various stages of breast cancer, and the aromatase inhibitors always win. 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