Diet like a celebrity
As the Atkins phenomenon sweeps the Western world, the diet has been billed as a delicious and permanent “nutritional approach”, promising weight loss, spawning an entire industry, and endorsed by stars such as Jennifer Aniston and Renée Zellweger. Aside from the hype, does it really work and how safe is it? Riley and Coveney cover what you need to know in advising patients about this “controlled carbohydrate” diet (→ Weight loss occurs in the short term, but not enough is known to recommend long term use).
Talking about a revolution
The recent PBS listing of the anti-tumour necrosis factor infliximab for ankylosing spondylitis is good news for sufferers and for doctors, who previously have had very little to offer patients with severe disease. In fact, Schachna says the drug is likely to revolutionise the way we think about this painful condition (→ The anti-TNF revolution in ankylosing spondylitis).
A ubiquitous guideline
The National Health and Medical Research Council has just released guidelines on a topic that affects everyone at some time or another — acute musculoskeletal pain. For some background, a user’s guide and a summary of the key messages, see de Jager and Ahern (→ Guidelines from the National Health and Medical Research Council are now available).
Insulin-sensitising agents (pioglitazone and rosiglitazone) have been found to improve type 2 diabetes control in trials and are now in clinical use. How do they perform in real life? Hussein et al audited 18 months of experience at Royal Melbourne Hospital to find out (→ Effectiveness and side effects of thiazolidinediones for type 2 diabetes: real-life experience from a tertiary hospital).
A major concern for patients with psychosis is that drug-induced weight gain will trigger type 2 diabetes. Recognising the need to manage this well, an expert group of psychiatrists, pharmacists, endocrinologists, general practitioners, nurses and consumers have produced “Diabetes, psychotic disorders and antipsychotic therapy: a consensus statement”.
A cox up
In recent weeks, most doctors have had some explaining to do about the worldwide withdrawal of rofecoxib. To help answer all your patients’ questions, read Langton et al (→ Cardiovascular safety of rofecoxib (Vioxx): lessons learned and unanswered questions).
Distress down south
The Journal has published many studies showing poorer health among rural Australians than in city dwellers; however, Eckert et al have found that, at least in South Australia, mental health may be another story (→ How does mental health status relate to accessibility and remoteness?).
An early start
Another recent recipient of federal funding is the new MBS Item for a preventive health check for Aboriginals and Torres Strait Islanders. However, according to Mayers and Couzos, we have much work to do in implementing the Item — including learning to recognise and acknowledge eligible patients (→ Towards health equity through an adult health check for Aboriginal and Torres Strait Islander people).
Visitors to Sydney might be forgiven for believing that we sentence all foreigners to a period of enforced taxi-driving. In the UK, however, you’re more likely to hear exotic accents in the hospital than on the rank. And, despite appearances, the process is highly selective, say Jamrozik et al in another colourful Postcard from the UK (→ The energy of slaves).
With the warmer weather you might be tempted to guzzle down an ice-cold carbonated drink. Before you do, though, consider the case presented by Loh et al — perforated oesophagus. “As a matter of fact, I’ve got it now...” (→ Partial oesophageal perforation associated with cold carbonated beverage ingestion).
More Floreys please
If you were running a pharmaceutical company, would you spend much time and money on developing new antibiotics? In ’ The dearth of new antibiotic development: why we should be worried and what we can do about it”, Charles and Grayson discuss the current dearth of antibiotic research, and why we should be concerned about the lack of new agents in the pipeline. Rather than “bashing” the big drug companies, though, they suggest ways in which government, academia and the private sector might collaborate.
Diarrhoea and dehydration
A young child presents with acute diarrhoea. She doesn’t seem too “dry” but you know that can change quite quickly. Where do you go from here? In the second article in the MJA Practice Essentials — Paediatrics series, Elliott and Dalby-Payne bring us up to date on current best practice for this common problem (→ 2. Acute infectious diarrhoea and dehydration in children).
Waving red flags
If conversation at your next drug-sponsored dinner runs out of steam, we suggest serving up topics from our correspondence columns for guaranteed controversy: exercising when you have chronic fatigue syndrome, racism in Australian healthcare, complementary medicine, and colonic irrigation.
Another time ... another place
If human beings consume meat or other food that is rich in fats, or if they eat foods containing too much blood, they will incur infirmity rather than health.
Hildegard of Bingen, 12th century AD
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