“Enfield Aitchess?” I called to the waiting room. A 65 year old man shuffled towards me and shook my hand. He seemed slightly out of breath. “My name is Dr Dawlatly, please come in and take a seat, Mr Aitchess,” I said as we entered my room. As he sat down he mumbled, “Most people just […]
The BMJ Today: Thinking about common and not so common conditions
• Pityriasis versicolor is a superficial fungal infection of the skin that is commonly seen in general practice. The latest practice pointer looks at its diagnosis, differential diagnosis, management, and prevention. One particular aspect about its management is that first line treatment comprises shampoo containing either ketoconazole, selenium sulphide, or zinc pyrithione. • Iron deficiency […]
Richard Lehman’s journal review—7 April 2015
NEJM 2 April 2015 Vol 372 372 In English nursery rhyme, it is traditional for a Duke to have 10 000 men. Here is a trial from Duke University that recruited 10 000 men and women, and allowed in a further three for extra measure. These 10 003 recruits were those “whose physicians believed that […]
The BMJ Today: Lucentis vs Avastin, teenagers with back pain, and a maternal blood test for Down’s syndrome
• The BMJ‘s investigation looking at why UK doctors have had difficulty prescribing the drug Avastin to treat wet age related macular degeneration rather than the more expensive Lucentis has provoked some interesting responses, including ones from Niall Dickson, chief executive of the General Medical Council, and Stephen JW Evans, professor of pharmacoepidemiology at the […]
Jeffrey Aronson: When I use a word . . . Phonemes shmonemes
I referred my patient Pat for a specialist opinion. The consultation was not a success. “That specialist registrar you referred me to was totally useless,” said Pat. “What an insolent shmuck! Doc, don’t ever become a registrar.” I don’t know which surprised me more, the insult or the advice. I certainly don’t expect to hear […]
Caroline Fryar: Risky business
A UK Supreme Court ruling has implications for the way doctors obtain consent from patients, particularly the way they tell patients about the risks of any treatment. The details of the judgment in Montgomery -v- Lanarkshire Health Board have been previously reported in The BMJ but doctors may be left wondering what practical implications this has […]
The BMJ Today: Lucentis vs Avastin, fracking, and delusional infestation
Good morning. Here’s what is new on thebmj.com today. The BMJ Investigation: Lucentis vs Avastin • Why have UK doctors had difficulty prescribing a cheap, safe, and effective drug (Avastin) and instead turned to a far more expensive one (Lucentis) for the treatment of wet age related macular degeneration? An investigation by The BMJ’s investigations editor Deborah […]
Neville Goodman: From metaphor to cliché
While on metaphor watch, certain phrases and ideas will recur. Metaphor is one of the broadest figures of speech. I use the Concise Oxford Dictionary (COD), which defines it as a word or phrase applied to something to which it is not literally applicable. That is a wide definition, and other authorities give tighter ones: […]
The BMJ Today: Promises, promises—the general election, the NHS, and political sensitivity over major incident reporting
• In the week of the formal launch of the UK general election campaign, with NHS policies set to take centre stage, The BMJ publishes an analysis article looking at politicians’ pledges on access to primary care. Thomas E Cowling and colleagues go behind the rhetoric and look at the evidence on getting a GP […]
Conor Farrington: Lords reform—bad news for expert scrutiny in Westminster?
As the general election draws near, a wide range of medical issues will be examined through political lenses in The BMJ and elsewhere. However, few (if any) pre-election medical debates will focus on the constitutional status of the House of Lords. In many ways, this is an unsurprising omission. Parliamentary politics in general is distant […]