Drug and therapeutics bulletin
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Headache is one of the most frequent reasons for medical consultation in both general practice and specialist neurology clinics.1 Prescribed and over-the-counter medications are taken to alleviate headaches, but may be used incorrectly.2 In particular, use of some drugs both frequently and regularly can have a paradoxical effect, causing headaches rather than relieving them, and leading to medication overuse headache (MOH).3 Such overuse is a common cause of frequent headache. Here we review MOH and its management.
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Cardiovascular disease (CVD) is a leading cause of mortality.1 For example, in 2000, it accounted directly for around 2 million deaths in the European Union. Worldwide, many people take aspirin daily in the belief that doing so helps to prevent CVD. ⋯ However, there has been some uncertainty about the place of aspirin for the primary prevention of cardiovascular events.6 In particular, there have been doubts about whether any benefits of aspirin in people with no history of CVD outweigh the risks (e.g. the fact that long-term low-dose aspirin therapy almost doubles the likelihood of gastrointestinal haemorrhage). Here we consider the place of low-dose aspirin in primary prevention of CVD.
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Estimates suggest that, at any one time, 12-33% of the population have back pain. About 5% of a GP's workload involves consultations for the condition, and around 32% of patients who first present with back pain consult again within 3 months. ⋯ Indeed, patients who have been off work with chronic back pain for 1-2 years are unlikely to return to any form of work in the foreseeable future, whatever treatment they receive. Here we discuss the place of non-drug management for patients with the condition.
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Widespread use of oseltamivir (Tamiflu) has been a key strategy in tackling the H1N1 'swine flu' pandemic in the UK. Is the increasing disquiet about this policy justified?
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Estimates suggest that around 1 in 10 people develop carpal tunnel syndrome at some point. The condition comprises potentially disabling sensory and/or motor symptoms in the hand, caused by compression of the median nerve, and carries considerable implications for employment and healthcare costs. Current standard treatment options are splinting, local corticosteroid injections and surgery, and there are a range of other suggested treatments. Here we review how best to manage patients with carpal tunnel syndrome.