Thursday, 24 January 2013

BMI = 1.3*kg/m**2.5

"millions of short people think they are thinner than they are, and millions of tall people think they are fatter"

Just blogged about a suggestion for a revised Body Mass Index formula on the BMJ Diabetes Blog.

Tuesday, 15 January 2013

Breast Cancer prevention - age, history, genetics

The National Institute for Health and Clinical Excellence (NICE) have issued a consultation on the updated draft of its guidance on familial breast cancer due for publication in June 2013.

Widely reported in the news today is the proposed recommendation for tamoxifen or raloxifine at high risk of breast cancer. The news, as far as I can see doesn't highlight that this recommendation is for post-menopausal women. The BBC (Breast cancer drug tamoxifen recommended for 'high risk' women) seem to simplify the whole thing by only talking about tamoxifen and not mentioning the age issue except to say "Most cases occur by chance and with increasing age."

The full draft guidance says:
"Offer tamoxifen or raloxifene for 5 years to post-menopausal women at high risk of breast cancer unless they have a past history of thromboembolic disease or endometrial cancer."
The debate about genetic testing is discussed in the evidence review. There are three genes known to cause susceptibility BRCA1 BRCA2 and TP53 but they cause a minority of cases (5% or so). NICE favour family history over widespread genetic testing but I just wonder what the future will bring? If better genetic risks are identified then the complex computer algorithms and detailed family history checking to quantify risk might give away to more objective test.

Thursday, 3 January 2013

Go paperless in 2013

If you haven't already then perhaps 2013 is the year to go paperless using tools like Google Drive and Expensify.

“It’s finally fast and simple to complete paperwork and expense reports, to manage accounting, pay bills and invoice others. The paperless office is here — we just need to use it.”

Just think of all that paper you'll save and you'll never be a mug again buying a cheap printer with expensive ink.

Tuesday, 1 January 2013

Hillary Clinton's 'blood clot'

Just blogged about Hillary Clinton's transverse sinus venous thrombosis on BMJ Case Reports Blog.

It was interesting following the story and the speculation over where the clot was - which was probably only of interest to physicians. Why was she kept in hospital? What sort of routine scan did she have that prompted all this? What would it be like to be that prominent in politics and get unwelcome news from your doctors?