{"id":20,"date":"2006-10-26T14:48:39","date_gmt":"2006-10-26T13:48:39","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2006\/10\/26\/nejm-19-oct-2006\/"},"modified":"2006-10-26T14:48:39","modified_gmt":"2006-10-26T13:48:39","slug":"nejm-19-oct-2006","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2006\/10\/26\/nejm-19-oct-2006\/","title":{"rendered":"NEJM 19 Oct 2006"},"content":{"rendered":"<p>I first became aware of <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1647\"> dehydroepiandrosterone<\/a><strong> <\/strong>some years ago when a patient with Addison\u2019s  disease asked if I could prescribe it to help her general well-being and libido.  Not wishing to deny her these benefits, I read up about it and discovered that  it is the most abundant hormone produced by the adrenal cortex but nobody is  sure what it is for. And no, it is not prescribable in the UK, though you can  buy it from innumerable websites (5 million Google hits) selling the stuff as <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1647\"> the elixir of youth<\/a>. <!--more-->In this <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1647\"> trial<\/a> old people were randomised to DHEA or placebo for two years; some of  the men were also randomised to <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1647\"> testosterone<\/a>. Did they leap and rut like young deer? Not a bit of it. DHEA  stands for Dreadfully Hyped and Entirely Actionless.<\/p>\n<p>You\u2019ll remember that a trial  called SPACE a couple of weeks ago showed that <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1660\"> carotid stenting<\/a><strong> <\/strong>was probably inferior to <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1660\"> endarterectomy<\/a><strong> <\/strong>in patients with moderate to severe <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1660\"> carotid stenosis<\/a>. In this French <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1660\"> trial<\/a> (EVA-3S) the stented group had nearly double the rate of death or  further stroke compared with the endarterectomy group. So although the previous  editorial was probably right in saying that SPACE is not the final frontier (in  the carotid stenting debate), EVA-3S probably is.<\/p>\n<p>Slowly, oh how slowly, we are  piecing together what actually makes children wheeze (or \u201ccauses <a href=\"http:\/\/content.nejm.org\/cgi\/content\/full\/355\/16\/1682\"> childhood asthma<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I first became aware of dehydroepiandrosterone some years ago when a patient with Addison\u2019s disease asked if I could prescribe it to help her general well-being and libido. Not wishing [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2006\/10\/26\/nejm-19-oct-2006\/\">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-20","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>NEJM 19 Oct 2006 - 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\/2006\/10\/26\/nejm-19-oct-2006\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"NEJM 19 Oct 2006 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I first became aware of dehydroepiandrosterone some years ago when a patient with Addison\u2019s disease asked if I could prescribe it to help her general well-being and libido. 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