Practice Short cuts

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BMJ 2006; 333 doi: (Published 26 October 2006) Cite this as: BMJ 2006;333:904
  1. Alison Tonks, associate editor (

    DHEA does not prevent ageing

    Dehydroepiandrosterone (DHEA) is one of our body's most abundant sex steroids. The abundance declines slowly with age, however, and replacing it has become a fashionable way of maintaining eternal youth. It doesn't work, but that doesn't stop DHEA being peddled as an antiageing panacea by manufacturers happy to exploit a regulatory loophole that defines it as a food supplement rather than a drug. This loophole should be closed, writes one commentator. His Google search for DHEA returned five million hits, many from online vendors making exaggerated and unsubstantiated claims.

    Credit: N ENGL J MED

    There is no evidence that replacing DHEA has any effect on the processes of ageing, he writes. A handful of trials have already been published, and the latest simply confirms their negative findings—physiological doses of the hormone taken for two years had no meaningful effect on body composition, physical performance, insulin sensitivity, or quality of life in elderly men or women. Its effect on bone mass was minimal and inconsistent. Physiological doses of testosterone were equally disappointing for the men.

    Credit: JAMA

    No one should be taking either DHEA or testosterone to regain lost youth, the commentator concludes. They don't work and may not be safe. DHEA should be reclassified as a drug and properly regulated “or quackery will prevail.”

    Most children with acute otitis media don't need immediate antibiotics

    More than half of children with acute otitis media could be safely treated with watchful waiting, according to a meta-analysis of randomised trials. Antibiotics should be reserved largely for those with otorrhoea (21% of children, relative risk 0.52 (95% CI 0.37 to 0.73)) and those under the age of 2 years with bilateral infections (20% of children, 0.64 (0.62 to 0.8)), the two subgroups most likely to benefit. In these subgroups, children given antibiotics were significantly less likely to have pain, fever, or both between three …

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