The practice of medicine is merely a collection of fashionable interventions based on the knowledge/belief sets of the day.
Remember, that in its day, thiolidamide was heavily promoted as a safe sedative indicated for pregnancy.
Things will change, and I remember that on my first day in medical school, the dean told us that 50% of what we were taught would be wrong by the time we graduated (i.e. only go to 50% of lectures).
Do you remember the Woody Allen film 'Sleepers' . He wakes up to find that smoking has become almost a health treatment.
We can expect other fundamentals to change, and the only thing we can do is to act like reasonable doctors, and implement conventional wisdom,
Dr Martin Goldman
Senior Medical Advisor, Forest Laboratories, Europe.
www.forestlabs.com
tel 01322 429355
fax 01322 555469
-----Original Message-----
From: Paul Galloway (K84076) Marston Medical Centre OX3 0LY
[mailto:[log in to unmask]]
Sent: Tuesday, February 17, 2004 11:08 AM
To: [log in to unmask]
Subject: Re: Wot now for HRT?
Similarly distressed. If the large RCT's with long follow up and several
thousand in the cohort can get this so wrong what do we really know?
Looking forward to the "high fibre diets give you bowel cancer" studies
being published.! :-(
> -----Original Message-----
> From: Paul Caldwell [mailto:[log in to unmask]]
> Sent: 17 February 2004 10:32
> To: [log in to unmask]
> Subject: Wot now for HRT?
>
>
> V occasionally a BMJ editorial changes my clinical practice.
> This weeks one on HRT will do so. Wot now for HRT? It seems
> relegated to short-term treatment of incapacitating
> menopausal symps in those women willing to take the risk of
> an MI/PE in the first year of treatment. + wot about
> osteoporosis prevention? Now must it be raloxifene or
> bisphosphonate? and have these been subject to longterm
> follow-up? and r they as good as HRT (not seems to be the
> conscensus)? Most women who get osteoporosis by age 65 r not
> in the known risk groups either. Anyone still got shares in
> HRT drug companies or bought shares in alendronate?! I'm
> confused let alone the pts.. 10 years ago HRT clinicians were
> arguing, rightly, that the post-menopause state was unnatural
> (cats, dogs or chimps who go thru it die quickly) and that
> HRT was manna from heaven.
>
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