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Practice Short cuts

What's new in the other general journals

BMJ 2006; 332 doi: (Published 30 March 2006) Cite this as: BMJ 2006;332:781
  1. Alison Tonks, associate editor (

    Pain is different for men and women

    It's been clear for a long time that men and women experience pain differently. Women get painful conditions such as fibromyalgia more often than men and are much more likely consult a doctor when they do, for example. Until recently, doctors tended to undertreat or even dismiss women's pain, putting women's complaining down to a lack of moral fibre or to emotion.

    But a recent review of pain research finds mounting evidence that women feel pain differently from men because they have different neurophysiology (moderated by different receptors) and different neurochemicals. Scientists have already found one gene that modulates pain in women but not men—the melanocortin-1 receptor gene, which is linked to red hair and fair skin.

    Credit: JAMA

    Experiments in functional brain imaging are also emerging, showing that pain activates different areas of the brain in men and women. This has knock-on effects on the system generating endogenous opioids.

    Credit: N ENGL J MED

    These issues are not simply academic. One fifth of medical consultations are about pain, and a tenth of all sales of prescription drugs are for pain relief. The review argues that if scientists could unravel sex differences in pain processing, then the path would be clear for drug companies to develop analgesics specifically for men or women, improving pain relief.

    Telithromycin implicated in life threatening liver failure

    Doctors should think carefully before prescribing telithromycin, say authors from North Carolina who report three cases of massive hepatic necrosis in fit people taking the drug. Only one patient recovered spontaneously. A 26 year old man died of liver failure, and the remaining patient, a 51 year old woman, survived after a liver transplant operation.

    Telithromycin is the first in a new class of antibiotic. It was developed to overcome macrolide resistance and is licensed in the US for common primary care infections such as …

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