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Daniel Maughan: What has climate change got to do with mental health?

15 Sep, 14 | by BMJ

CSH_and_MFETG_logos
This blog is part of a series on sustainable healthcare, which looks at health, sustainability, and the interplay between the two. The blog is coordinated by the Centre for Sustainable Healthcare and shares ideas from experts across the healthcare field.

The World Health Organization and the Lancet Commission have both stated that climate change is the largest threat to human health in the 21st Century. Does this threat extend to mental health? Weather systems are likely to become more unstable as global temperatures rise, but could unstable weather have an effect on the development of mental disorders? more…

Richard Lehman’s journal review—15 September 2014

15 Sep, 14 | by BMJ

richard_lehmanNEJM 11 September 2014 Vol 371
1016  Ticagrelor has had mixed fortunes since it was introduced as a new thienopyridine platelet aggregation inhibitor a few years ago. The PLATO trial left lingering doubts whether it is better than the much cheaper clopidogrel when used in acute coronary syndromes. Rather than attempting to resolve these, the latest trial (ATLANTIC) compares prehospital administration of ticagrelor with in-hospital administration in patients undergoing immediate percutaneous coronary intervention for ST-elevation myocardial infarction. There is no difference. The name ticagrelor keeps reminding me of Excelsior, in Henry Wadsworth Longfellow’s poem of that name:

THE SHADES of night were falling fast,
As through an Alpine village passed
A youth, who bore, ‘mid snow and ice,
A banner with the strange device,
Excelsior! more…

The BMJ Today: You don’t always get what you pay for

15 Sep, 14 | by BMJ

On thebmj.com today, researchers have found that a much cheaper treatment for wet age related macular degeneration causes no more side effects than the far more expensive licensed treatment.

Zosia Kmietowicz reports that the authors of the Cochrane review have found that ranibizumab (Lucentis), which is most commonly used in the UK and costs about £700 an injection, is no more effective than bevacizumab (marketed as Avastin), which costs about £60 an injection. Researchers have previously estimated that using bevacizumab, rather than ranibizumab, could save the NHS £84m a year. more…

Ian Bushfield: Respond to EMA and FDA consultations

12 Sep, 14 | by BMJ

On Monday 15 September, two important consultations (one by the EMA and one by the FDA) will close, ending the public’s opportunity to respond to these consultations and help defend the independent analyses of medical data. The AllTrials campaign has been urging interested parties to respond and have their say on these two consultations, which are outlined below.

Tell the EMA not to censor independent analyses

In Europe, the medicines regulator wants the right to censor analyses of side effects data that it disagrees with. The European Medicines Agency (EMA) is consulting on updates to its EudraVigilance access policy. EudraVigilance is the database where reports of side effects from approved drugs in Europe are recorded. The proposal would give researchers access to more detailed and systematic records from the database, but it also contains a condition that would give the EMA the ability to block publication of analyses it disagreed with. more…

Richard Smith: Simon Stevens, chief executive of NHS England, live

12 Sep, 14 | by BMJ

richard_smith_2014When Simon Stevens, chief executive of NHS England, was buying his Sunday papers a few weeks ago he encountered an elderly woman complaining that her newspaper didn’t contain the television section. It did, as the newsagent pointed out to her before asking her, “Would you like me to walk you home?” Stevens was struck that this was a “dementia friendly community” in action. He followed the story by emphasising that the traditional “factory model of health and social care” will not solve society’s problems, including the rise in dementia. Without a redesign of health and social care services, the NHS will not be sustainable. “We don’t exclusively own the problem or the solution,” he said. more…

The BMJ Today: Watch out for the quiet ones

12 Sep, 14 | by BMJ

sally_carterI’m always pleased to see that people keep an eye on changes that are announced quietly by big organisations. Jim Murray alerts us to a discreet switch made by the European Commission. He explains in his blog: “In the UK, the Department of Health is the ‘parent,’ or sponsoring department, for the Medicines and Healthcare Products Regulatory Agency (MHRA). That seems reasonable. It would be surprising if the Department for Business, Innovation and Skills (BIS) were given the job, yet something like this has just happened in the new European Commission announced today.” more…

David Kerr: An Apple a day keeps the doctor away?

11 Sep, 14 | by BMJ

david_kerrIt might be cool, but will it make a difference to health? This is still the unanswered question after the launch of the latest must-have device from Apple, 30 years after the launch of the original Mackintosh computer in the same building in California. Due to be released next year at a starting price of $349, the Apple Watch (not iWatch) already has the tentative approval of big names in fashion and apparently is causing nervousness among high-end Swiss watch makers. The other potentially significant item previewed by Apple was the company’s plans to “do way with wallets”—it will soon be possible to pay for goods at the supermarket checkout simply by using the Apple Watch device—but only if you also own an iPhone. more…

Jim Murray: What have medicines to do with health in the EU?

11 Sep, 14 | by BMJ

jim_murray

In the UK, the Department of Health is the “parent,” or sponsoring department, for the Medicines and Healthcare Products Regulatory Agency (MHRA). That seems reasonable. It would be surprising if the Department for Business, Innovation and Skills (BIS) were given the job, and yet something like this has just happened in the new European Commission announced today.

Historically, the European Medicines Agency came under the aegis of the Commission’s directorate general for enterprise, which was also responsible for promoting industry, including the pharmaceutical industry. Five years ago, in a reform that was widely welcomed, the Commission transferred the units dealing with medicines and medical devices from DG Enterprise to DG Sanco, the health directorate. Today, Mr Juncker, the president-designate of the new Commission, announced that these units would be transferred back to DG Enterprise. more…

The BMJ Today: The perils of not keeping your mouth shut

11 Sep, 14 | by BMJ

tiago_villanueva A few weeks ago, I had to take parenteral antibiotics for a condition that was not improving with oral antibiotics. Moreover, in my native Portugal it is still common, for example, to prescribe parenteral penicillin for bacterial tonsillitis since for some reason oral penicillin is not available there. more…

The BMJ Today: Medical device regulation – still out of joint

10 Sep, 14 | by BMJ

The introduction of new orthopaedic implants has for some time been a major focus of attention within scientific and policy circles since concerns about certain devices used in total hip replacements were brought into the spotlight. One of the conclusions of a BMJ feature by Deb Cohen in 2012 was that “After a series of failures, device regulation is in need of radical change.” more…

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