In the latest Endgames picture quiz, a 41 year old man presents to the emergency department with a two week history of worsening shortness of breath, productive cough, intermittent fever, night sweats, and non-pleuritic pain in the right side of the chest wall. He was diagnosed with a pulmonary abcess secondary to community acquired pneumonia. […]
Category: US healthcare
The BMJ Today: Paying people to live healthier lives and tackling climate change
This week, the Intergovernmental Panel on Climate Change (IPCC) released its Fifth Assessment Report. The scientists who wrote it warn of the serious impact that climate change—unequivocally influenced by human activity—will have on humans and other species in the planet. The IPCC calls for world leaders and policy makers to promote adaptation strategies to mitigate […]
The BMJ Today: Vitamin D, probiotics, and polio
We have been longing for a final word on whether vitamin D supplements improve health. An umbrella review published today included 107 systematic literature reviews and 74 meta-analyses of observational studies looking at serum levels of vitamin D, as well as 87 meta-analyses of randomised trials testing vitamin D supplements. A total of 137 outcomes […]
Gavin Yamey: Soldiers, academics, and an unusual health initiative
It’s not every day that you find yourself at a work meeting chatting to a soldier who led the Counterinsurgency Advisory and Assistance Team in Afghanistan and the doctor who directed the largest global health initiative in human history. Retired US Army Colonel Joseph Felter is now a Stanford University academic with expertise in studying […]
The BMJ Today: Selective decontamination revisited and healthcare reform in Massachusetts
Richard Price and co-workers published a network meta analysis evaluating the effect on mortality of selective digestive decontamination (SDD), selective oropharyngeal decontamination (SOD), and topical oropharyngeal chlorhexidine in patients in general intensive care units. They found that both SDD and SOD confer a mortality benefit when compared with chlorhexidine. […]
The BMJ Today: Debates about alternative medicine and cancer screening
People love complementary and alternative therapies, and vote with their wallets to spend close to £5 billion a year in the UK alone on treatments such as massage, relaxation, evening primrose oil, and reflexology. Doctors may be more or less comfortable with these therapeutic choices, but we should all be trained to deal with them […]
Richard Lehman’s journal review—31 March 2014
NEJM 27 Mar 2014 Vol 370 1189 I sing the body mitotic: we are a mass of cells dividing, mutating, cannibalizing, spreading. The wonder is not that we ever die of cancer, but that we often don’t. Cells which become aggressive are extraordinarily versatile at remaining aggressive, as shown by the relatively rare ALK-Rearranged Non–Small-Cell […]
The BMJ Today: Einstein’s theory of data, climate change and the “threat to human survival,” and New York facing legal challenge over e-cigs ban
“Information is not knowledge,” was Einstein’s cautionary take on the power (and limitation) of data. In healthcare, the collection of patient feedback and other data is regularly hailed as the panacea for all ills, physical or otherwise. In an analysis published on bmj.com today, Angela Coulter and colleagues argue that in the UK, the NHS […]
The BMJ Today: Farewell to traditional public health services and to our GP columnist
There’s a new vocabulary being used to describe the NHS in England that conjures up images of the American Frontier; of battles over territories, conquests, and survival. GP and former chair of the RCGP Clare Gerada started it when she described the changes brought in by the Health and Social Care Act 2012 as “the wild […]
The BMJ Today: From mental asylums to cognitive behavioural therapy
“The mental asylum belongs to a vanished era,” begins the obituary of psychiatrist Henry Rollin in The BMJ. Despite working in asylums until their closure, there is no implication that Rollin himself belonged to that vanished era. After Enoch Powell’s Hospital Plan of 1962 brought about the closure of mental hospitals and moved care into […]