5 minutes from BMJ Group

July 2008

Dear Colleague,

5 minutes from BMJ Group is our monthly email alerting service providing you with free access to the latest and most relevant articles from our wide range of products.

Pee is for prostate

Nearly a third of men over 60 have benign enlargement of the prostate. Many just live with it, some take prostate-shrinking drugs, and others opt for surgery. They may be offered traditional transurethral resection (TURP) or newer treatments like laser ablation or vaporisation. This review of 45 randomised controlled trials shows that the newer approaches may cause less need for blood transfusions and shorter hospital stays. But the outcomes of newer treatments are similar to TURP, and there’s not much good evidence that laser is better than TURP. So TURP should remain the gold standard for now, the authors say.

Source: BMJ 2008;337:a449



Breathless

This is useful prescribing information for patients with moderate chronic obstructive pulmonary disease (COPD). SFC (salmeterol and fluticasone propionate) and TIO (tiotropium bromide), given together as triple therapy, improved bronchodilation more than TIO or SFC on their own. Patients using the triple therapy said they felt their breathing was better and they didn’t need to use rescue medication as often.

Source: Thorax 2008;63:592-598



Night-night

People with rheumatoid arthritis often have to take courses of steroids because of pain and stiffness, which are worst in the early morning. This review says the steroids are best given at night because inflammatory chemicals follow a circadian rhythm and are released more at night. It may even be possible to reduce the dose if steroids are taken at night, rather than in the morning.

Source: Annals of the Rheumatic Diseases 2008;67:905-908



Restless legs

Restless legs syndrome (RLS) is hard to treat, often chronic, and causes a lot of distress. Dopaminergic drugs are sometimes used, but the effect tends to wear off. In this pilot study a programme based on cognitive behavioural therapy was tested on 25 patients who took part in eight sessions of group therapy. Quality of life related to RLS and mental health both improved and remained good three months later. GPs involved in commissioning may want to consider funding similar groups.

Source: Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:823-825



Wine and chocolates

This editorial will please a lot of doctors! It reminds us that –

  • Alcohol reduces the risk of heart disease and total mortality
  • Moderate drinkers who aren’t overweight, and have a healthy diet, are less likely to have a heart attack than teetotallers
  • Regular alcohol boosts HDL and can reduce the risk of diabetes
  • Red wine reduces the risk of thrombotic stroke (whereas white wine doesn’t) – polyphenols in wine, especially red wine, may be the protective chemicals
  • Dark chocolate and cocoa also contain polyphenols
  • More research is needed on optimum doses of polyphenols

Meanwhile, an evening dose of red wine and chocolate seems sensible!

Source: Heart 2008;94:821-823