{"id":198,"date":"2007-04-23T14:13:36","date_gmt":"2007-04-23T13:13:36","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/04\/23\/ann-intern-med-17-apr-2007-vol-146\/"},"modified":"2007-04-23T14:13:36","modified_gmt":"2007-04-23T13:13:36","slug":"ann-intern-med-17-apr-2007-vol-146","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/23\/ann-intern-med-17-apr-2007-vol-146\/","title":{"rendered":"Ann Intern Med  17 Apr 2007 Vol 146"},"content":{"rendered":"<p>A big group of Canadians make a valiant attempt to determine <a href=\"http:\/\/www.annals.org\/cgi\/content\/abstract\/146\/8\/545\">which inhalers really benefit patients with chronic obstructive airways disease.<\/a> The idea was to start with tiotropium and randomise to salmeterol or salmeterol-fluticasone or placebo.<!--more--> But this was the messy world of real-life, breathless, elderly people with smoking-related lung damage: 40% of the patients crossed groups or were given unblinded extra treatment. So although it\u2019s probable that salmeterol alone is useless, it\u2019s not entirely certain that salmeterol with a steroid really has a useful effect on exacerbations either, though it might have. There was no difference on the exacerbation rate itself in this group, but the patients tended to feel better and ended up in hospital less.<\/p>\n<p>Eradication of Helicobacter pylori using a standard three-drug combination is becoming less effective as time goes on, so an Italian team decided to do a<a href=\"http:\/\/www.annals.org\/cgi\/content\/abstract\/146\/8\/556\"> double-blinded trial of sequential treatment<\/a> instead. This consisted of high-dose amoxicillin and pantoprazole for five days, followed by pantoprazole, clarithromycin and tinidazole for 5 days. I guess the potential combinations are endless, but this one produced an eradication rate of 89%, compared to 77% with a ten-day regime of pantoprazole, clarithromycin and amoxicillin.<br \/>\nThe clinical discussion treatments for knee osteoarthritis in <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/297\/15\/1697\">this week\u2019s JAMA <\/a>doesn\u2019t rate chondroitin highly, and that\u2019s the message of <a href=\"http:\/\/www.annals.org\/cgi\/content\/abstract\/146\/8\/580\">this systematic review<\/a>. There is no evidence that it works, and much to suggest it doesn\u2019t.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A big group of Canadians make a valiant attempt to determine which inhalers really benefit patients with chronic obstructive airways disease. The idea was to start with tiotropium and randomise [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/04\/23\/ann-intern-med-17-apr-2007-vol-146\/\">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-198","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 v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ann Intern Med 17 Apr 2007 Vol 146 - 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\/04\/23\/ann-intern-med-17-apr-2007-vol-146\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ann Intern Med 17 Apr 2007 Vol 146 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"A big group of Canadians make a valiant attempt to determine which inhalers really benefit patients with chronic obstructive airways disease. 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