Speciality
Spotlight

 




 


Family Practice


 

 







Clinical
Issues



    

  • Cancer and Aspirin 

    Sturmer T, Glynn RJ, Lee I-M, et al (Harvard Med School, Boston)

    Aspirin Use and Colorectal Cancer: Post-Trial Follow-up Data From the Physicians’ Health Study 

    Ann Intern Med 128: 713-720, 1998

           


    Follow-up period in this study was 12 years (mean). 375 mg of aspirin on alternate days while reducing cardiovascular disease had no effect on colorectal malignancy.

         


    The authors advise caution in the use of aspirin and nonsteroidal anti-inflammatory drugs in prevention of colorectal cancer. 

          

  • Cancer 

    Sankila R, for the Association of the Nordic Cancer Registries and the Nordic Society of Paediatric Haematology and Oncology (Finnish Cancer Registry, Helsinki; Danish Cancer Society, Copenhagen; Univ Hosp, Lund, Sweden; et al) 

    Risk of Cancer Among Offspring of Childhood-Cancer Survivors

    N Engl J Med 338: 1339-1344, 1998

          


    Growing number of childhood cancer survivors have begun to become adults. Except for a retinoblastoma their children’s chances of developing cancers is the subject of this paper. 

          


    The authors conclude that such a chance is limited even in those who had cancer below 10 years of age. They should not be discouraged from having children. Hereditary cancers are not included in this statement. 

           

  • Cough and Lung Cancer 

    Liedekerken BMJ, Hoogendam A, Buntinx F, et al (Univ of Maastricht, The Netherlands; Univ of Leuven, Belgium)

    Prolonged Cough and Lung Cancer: The Need for More General Practice Research to Inform Clinical Decision-making 

    Br J Gen Pract 47: 505, 1997

           


    The authors have collected data from the MEDLINE from 1966 to 1995, on the value of cough of more than 6 weeks duration on the diagnosis of lung cancer.

           


    This large study shows that cough is not an indicator of lung cancer. General practice teaching needs to be more research oriented is suggested.

           

  • Doukas DJ, Fetters M, Ruffin MT IV, et al (Univ of Michigan, Ann Arbor; Baylor Medical College, Houston)

    Ethical Considerations in the Provision of Controversial Screening Tests

    Arch Fam Med 6: 486-490, 1997

        

    Tests of doubtful value are often asked for by patients. This knowledge is often gleamed from the media and others.

         

    The ethical problem thus posed is attended by patients education. The authors suggest that a greater trust be created in the patient.

          

  • Johnston SC, and the End-of-Life Study Group (Univ of Kansas, Wichita)

    Patient and Physician Roles in End-of-Life Decision Making

    J Gen Intern Med 13: 43-45, 1998

          

    This questionnaire based study brings out what patients expect in end-of-life decisions. Physicians feel that it is the patient who should be one to decide and patients on the other hand feel that the physician should share the responsibility.

          

    The authors feel that physicians should be aware of this difference in viewpoint.

         

  • Meier DE, Emmons C-A, Wallenstein S, et al (Mount Sinai School of Medicine, NY; Univ of Chicago; Univ of Rochester, NY)

    A National Survey of Physician-assisted Suicide and Euthanasia in the United States

    N Engl J Med 338: 1193-1201, 1998

          

    Considerable controversy arises because of legal restrictions. In this questionnaire based study 11 percent of physicians felt that they should help the patient by prescribing legally allowable injections.

          

    The authors conclude that 6 per cent of specialists have complied with this request.

           

  • Alternative and Complementary Medicine

    Astin JA (Stanford Univ, Palo Alto, Calif)

    Why Patients Use Alternative Medicine: Results of a National Study 

    JAMA 279: 1548-1553, 1998

            

    Use of an unconventional form of medicine due to personal opinion or a philosophy or lack of satisfaction with medication is reported in this paper to be prevalent in 34 per cent in the United States. 4.4 per cent use only alternative forms of medication.

             

  • Drug Reactions

    Lazarou J. Pomeranz BH, Corey PN (Univ of Toronto) 

    Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies

    JAMA 279: 1200-1205, 1998

           

    This study emphasizes the need for pharmaceutical companies to give adequate information on adverse reactions to drugs.

           

    Thirty-nine studies over a period of 32 years were covered in this report.

          

    The authors report an incidence of 6.7% serious adverse drug reactions (ADR). Of these 0.32 per cent are fatal. ADRs are fourth to sixth in ranking as causes of death after lung and heart disease, accidents stroke and malignancy.

           




 

 

Speciality Spotlight

 

 

Clinical Issues
    

  • Cancer and Aspirin 
    Sturmer T, Glynn RJ, Lee I-M, et al (Harvard Med School, Boston)
    Aspirin Use and Colorectal Cancer: Post-Trial Follow-up Data From the Physicians’ Health Study 
    Ann Intern Med 128: 713-720, 1998
           
    Follow-up period in this study was 12 years (mean). 375 mg of aspirin on alternate days while reducing cardiovascular disease had no effect on colorectal malignancy.
         
    The authors advise caution in the use of aspirin and nonsteroidal anti-inflammatory drugs in prevention of colorectal cancer. 
          

  • Cancer 
    Sankila R, for the Association of the Nordic Cancer Registries and the Nordic Society of Paediatric Haematology and Oncology (Finnish Cancer Registry, Helsinki; Danish Cancer Society, Copenhagen; Univ Hosp, Lund, Sweden; et al) 
    Risk of Cancer Among Offspring of Childhood-Cancer Survivors
    N Engl J Med 338: 1339-1344, 1998
          
    Growing number of childhood cancer survivors have begun to become adults. Except for a retinoblastoma their children’s chances of developing cancers is the subject of this paper. 
          
    The authors conclude that such a chance is limited even in those who had cancer below 10 years of age. They should not be discouraged from having children. Hereditary cancers are not included in this statement. 
           

  • Cough and Lung Cancer 
    Liedekerken BMJ, Hoogendam A, Buntinx F, et al (Univ of Maastricht, The Netherlands; Univ of Leuven, Belgium)
    Prolonged Cough and Lung Cancer: The Need for More General Practice Research to Inform Clinical Decision-making 
    Br J Gen Pract 47: 505, 1997
           
    The authors have collected data from the MEDLINE from 1966 to 1995, on the value of cough of more than 6 weeks duration on the diagnosis of lung cancer.
           
    This large study shows that cough is not an indicator of lung cancer. General practice teaching needs to be more research oriented is suggested.
           

  • Doukas DJ, Fetters M, Ruffin MT IV, et al (Univ of Michigan, Ann Arbor; Baylor Medical College, Houston)
    Ethical Considerations in the Provision of Controversial Screening Tests
    Arch Fam Med 6: 486-490, 1997
        
    Tests of doubtful value are often asked for by patients. This knowledge is often gleamed from the media and others.
         
    The ethical problem thus posed is attended by patients education. The authors suggest that a greater trust be created in the patient.
          

  • Johnston SC, and the End-of-Life Study Group (Univ of Kansas, Wichita)
    Patient and Physician Roles in End-of-Life Decision Making
    J Gen Intern Med 13: 43-45, 1998
          
    This questionnaire based study brings out what patients expect in end-of-life decisions. Physicians feel that it is the patient who should be one to decide and patients on the other hand feel that the physician should share the responsibility.
          
    The authors feel that physicians should be aware of this difference in viewpoint.
         

  • Meier DE, Emmons C-A, Wallenstein S, et al (Mount Sinai School of Medicine, NY; Univ of Chicago; Univ of Rochester, NY)
    A National Survey of Physician-assisted Suicide and Euthanasia in the United States
    N Engl J Med 338: 1193-1201, 1998
          
    Considerable controversy arises because of legal restrictions. In this questionnaire based study 11 percent of physicians felt that they should help the patient by prescribing legally allowable injections.
          
    The authors conclude that 6 per cent of specialists have complied with this request.
           

  • Alternative and Complementary Medicine
    Astin JA (Stanford Univ, Palo Alto, Calif)
    Why Patients Use Alternative Medicine: Results of a National Study 
    JAMA 279: 1548-1553, 1998
            
    Use of an unconventional form of medicine due to personal opinion or a philosophy or lack of satisfaction with medication is reported in this paper to be prevalent in 34 per cent in the United States. 4.4 per cent use only alternative forms of medication.
             

  • Drug Reactions
    Lazarou J. Pomeranz BH, Corey PN (Univ of Toronto) 
    Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies
    JAMA 279: 1200-1205, 1998
           
    This study emphasizes the need for pharmaceutical companies to give adequate information on adverse reactions to drugs.
           
    Thirty-nine studies over a period of 32 years were covered in this report.
          
    The authors report an incidence of 6.7% serious adverse drug reactions (ADR). Of these 0.32 per cent are fatal. ADRs are fourth to sixth in ranking as causes of death after lung and heart disease, accidents stroke and malignancy.
           

 

By |2022-07-20T16:43:22+00:00July 20, 2022|Uncategorized|Comments Off on Clinical Issues

About the Author: