Adherence to Mediterranean diet and risk of developing diabetes

This prospective cohort study shows that high adherence to a diet rich in olive oil, fruit and vegetables, and little meat, was associated with an 83% relative risk reduction for developing type 2 diabetes.

Prolonged conservative care versus early surgery in patients with sciatica from lumbar disc herniation

Early surgery relieved sciatica more effectively, but only in the first six months, and at two years 20% of all patients reported an unsatisfactory outcome, according to the two year results of a randomised controlled trial. A cost utility analysis of this RCT finds that early surgery provides better quality adjusted life years, and the greater healthcare costs are compensated for by earlier return to work. An accompanying editorial says this trial adds to the body of evidence supporting surgery eight weeks after onset of sciatica if symptoms persist. This research underwent fast track publication.

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women

Women with prothrombotic mutations or a high body mass index should avoid oral oestrogens, but transdermal preparations seem to be safer, says this systematic review and meta-analysis. The accompanying editorial says that observational evidence suggests that transdermal oestrogen may be safer than oral oestrogen, but the side effect profile of transdermal oestrogens is insufficiently well known owing to a lack of trials and incomplete and non-standardised reporting. HRT patches also cost more.

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