NEJM 19 Jun 2014 Vol 370 2387 If you have a patient who is taking an opioid for chronic, non-cancer pain and gets constipated as a result, what do you do? Prescribe a laxative. Well done. And advise them that for most people with chronic pain, opioid analgesics don’t work and are best weaned off. […]
Overdiagnosis and over-treatment of malaria is a major problem in South and central Asia, where malaria is a minority cause of febrile illness, and primary health centres often rely on clinical symptoms for a diagnosis. Researchers from London and Afghanistan conducted a patient randomised study in a primary care setting in two areas where malaria […]
Two years ago, GP Michael Frank Harris discovered a right inguinal swelling while looking in his bathroom mirror. He writes about what happened next in the return of our Patient’s Journey series. Harris surprised his haematologist with an alternative diagnosis and together they took a leap of faith—deciding on treatment for stage I follicular lymphoma, […]
NEJM 12 June 2014 Vol 370 2265 Obstructive sleep apnoea is often a result of weight gain, and unfortunately, once it is established, losing weight does not reduce it. But losing weight has benefits of its own (he sighs wistfully), as this trial of weight reduction, continuous positive airways pressure, or both for OSA demonstrates. I […]
Is evidence based medicine broken? That’s the question that Greenhalgh et al are asking in this Analysis article. From inside The BMJ, with our attempts to shed light on unpublished data, it’s easy to become jaded about the whole medical-industrial complex, and say that yes, it is. But recently, while editing some videos collected as […]
While it’s been challenging to make neglected tropical diseases (NTDs) a priority on the global health agenda, until recently, the struggle to raise the conversation beyond niche circles has been even harder. The illnesses are prevalent in places that many would struggle to find on a map, let alone pronounce (echinococcosis and onchocerciasis, for example). Factors […]
Can partnership with patients be improved to the benefit of healthcare? We think so, and today we launch a strategy to help make it happen. It’s a delivery on a promise made last year, developed with the help of our international panel. We’ll be including more on, and from, patients throughout the journal—in Research, Analysis […]
NEJM 5 Jun 2014 Vol 370 2169 There is a story that when new antibiotics were arriving every few weeks in the late 1950s, drug companies had a hard time thinking up new names for them, all ending in mycin. So they started using a word generating machine, but stopped when it came up with […]
A few years ago, I was at a rural hospital in Eastern Province, Zambia. Doctors were trying frantically, and in the end unsuccessfully, to save the life of a five year old boy. He died from acute respiratory tract infection. But what really killed him, as one of the doctors told me afterwards, was poverty: […]
On 30 April 2014, I wrote my first reflection on the topic of non-communicable diseases to whet your appetite, and promised seven more. My first reflection, if you recall, was: “Keep the growth of NCDs in perspective by acknowledging the incredible positive changes in life expectancy and economic wellbeing the world over—thanks to development and mechanization.” […]