NEJM 3 July 2014 Vol 371 11 I don’t envy anyone with central lumbar spinal stenosis. The odds of benefit from surgery are slight. The pain can be there all the time and always gets worse on walking, which can limit activity severely. No wonder epidural steroid injections have proved popular. In this study, they […]
What do America, France, the UK, and most of the richest countries in the world all have that they should not have? The answer I’m looking for is not nuclear weapons, national debts, or billionaire bankers. It’s a large (and growing) number of people who are unable to access essential healthcare—many of them extremely vulnerable. At […]
Recently the big four titans of technology (Apple, Microsoft, Samsung, and Google) have, almost simultaneously, thrown their hats into the wearable sensor ring. Apparently, consumers now want to wear devices to record personal physiological data, which can then be synchronized with their smartphones. Through cloud computing, this can then be shared with their doctors and […]
NEJM 26 Jun 2014 Vol 370 2478 Cryptogenic is a good word. It’s up there with “idiopathic” and “pleiotropic” and “diathesis” for covering gross ignorance with a smattering of Greek. “Cryptogenic” sounds as if it was first used to describe the odd symptoms that Superman experienced when exposed to kryptonite. However, its first use was recorded […]
The BMJ has published some recent statistics that are more than a bit disconcerting. The first set regard corruption. Surely hard to measure, but “best estimates are that between 10% and 25% of global spend on public procurement of health is lost through corruption,” Anita Jain, Samiran Nundy, and Kamran Abbasi write in an Editorial. In […]
I stopped adding sugar to my tea when I was a teenager. Up until then (which was sometime in the mid 1970s), I had been wont to fill the cup with several heaped spoonfuls. I regularly covered my morning Weetabix with a glacier of granulated. And I drank a can of Coca-Cola or Pepsi (not […]
California is in the grip of a whooping cough epidemic, with 800 cases reported in the first two weeks of June alone. Outbreaks like these are not uncommon in the US. It’s nothing short of “insane,” fumes political blogger Ezra Klein, founder of news site Vox: “These sentences should only exist in musty newspapers from […]
According to the Commonwealth Fund, in the UK we’re getting it (mostly) right—or, at least, we’re getting it more right than our international counterparts. In their comparative study of health system performance in 11 countries, the UK ranks first across a range of measures covering quality, access, and efficiency of care, while the United States […]
At the end of May, US President Barack Obama unveiled new power plant standards, which are designed to cut pollution and curb greenhouse gas emissions. He should be applauded for this bold step in the right direction, and even more so for recognising and presenting it to the public as a public health policy, which […]
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. […]