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Richard Smith: Treating cardiovascular disease as well as we treat TB and HIV

22 Dec, 14 | by BMJ

richard_smith_2014Globally, about 70% of people diagnosed with tuberculosis and about 40% of those with HIV are treated, but less than 20% of those who have had heart attacks or strokes receive the treatments known to reduce further events substantially, said Anthony Rodgers at the Global Cardiovascular Clinical Trials Forum in Washington earlier this month.

Even in high income countries, less than 40% of cardiovascular patients receive recommended drugs long term. There is, said Rodgers, “enormous undertreatment.” more…

David Kerr: Rise of the medical selfie

22 Dec, 14 | by BMJ

david_kerrAccording to Twitter, 2014 was the year of the selfie. The Oxford English dictionary defines a selfie as “a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media.” Selfies began only a few years ago, but have reached epidemic and global proportions—and a new industry has developed with the creation of selfie sticks to support the phenomenon. more…

Richard Lehman’s journal review—22 December 2014

22 Dec, 14 | by BMJ

richard_lehmanNEJM 18 December 2014 Vol 371
2353 Try to make winter bearable by thinking of the joys of late spring, such as seeing laburnum trees in full blossom. But you need to have plenty of garden space for the brief show they provide, and you also need to warn children against their poisonous seeds. This poison binds to the nicotinic acetylcholine receptors, which, as their name implies, are also the receptors that nicotine binds to. That is why laburnum extract has been sold as an aid to stopping smoking ever since the 1920s, under the name cytisine. Apparently, it is still available in some eastern European countries, but elsewhere we prescribe its vastly more expensive derivative, varenicline. I applaud the NEJM for publishing this open label New Zealand trial in which cytisine was compared with standard nicotine replacement therapy for smoking cessation. It was better. With vaping and cytisine becoming widely available, I really cannot see why combustible tobacco products should remain on the market. more…

The BMJ Today: All I want for Christmas is . . . brussel sprouts

22 Dec, 14 | by BMJ

kate_adlington_pic‘Twas the Monday before Christmas and all through BMA house,
Not an editor was typing, nor clicking a mouse.
The Christmas issue already hung on the website with care,
In hopes festive doctors soon would look there.
And a feast of Yuletide delights awaits you. So . . .

Banish all thoughts of diets until January and instead spare a thought for the doctors working hard this Christmas. While the rest of us are tucking into our third helping of Christmas pudding and mulled wine, they might be facing the prospect of a Brussel sprout-free festive shift. more…

Christmas Appeal: Gibson Chijaka—I cannot hold back my joy

19 Dec, 14 | by BMJ

Gibson_Chijaka_grandmotherMy name is Gibson Chijaka, and for the last two years I have endured dozens of nauseating tablets every day. Today, I am so happy and cannot hold back my joy; I am cured of multidrug-resistant tuberculosis (MDR-TB).

Me with my grandmother, Margaret Kadzere, October 2014. © Stambuli Kim/MSF more…

Khaled E Emam: What are the privacy concerns when sharing clinical trial data?

19 Dec, 14 | by BMJ

khaled_e_emamThe principles developed by industry and the European Medicines Agency (EMA) have made it clear that protecting the privacy of individuals is a necessary part of any policy to share participant data from clinical trials. But I often get asked: what are we protecting these participants from? In this short piece I will answer this question in a pragmatic manner, and also make clear that ensuring privacy through anonymization protects the sponsors as well as the participants. more…

Chris Baker: Bollywood stars should not endorse food of low nutritional quality—but a ban is not the solution

19 Dec, 14 | by BMJ

chris_bakerIn India, the prevalence of overweight and obesity in children aged 5-19 stands at 22%. Tackling this substantial and growing epidemic requires a population level shift away from poor diets and sedentary activity. Such a shift will be more effective if individual lifestyle change is accompanied by upstream modifications that create healthy environments.

Sadly, aspirational advertising is omnipresent in India, and succeeds in creating an appetite for junk food. Household names from Bollywood and the cricket field are frequently employed to attach a sheen of glamour and success to cheap foodstuffs high in fat, sugar, or salt, and low in minerals and vitamins. more…

The BMJ Today: Hidden holiday horrors

19 Dec, 14 | by BMJ

peter_doshiAre you ready to switch off the email and settle into some quiet time with family? Switch on the old classic cartoons for the kids and permit them an extra hour of late night Nintendo? The holidays—a time of extra kindness and compassion, a time of safety and comfort, a time when doing good just seems so much easier to do. Or maybe not.

According to new research published in The BMJ, children’s animated films are—in the words of the authors—“rife with on-screen death and murder.” Measuring “time to first on-screen death,” epidemiologist Ian Colman and colleagues compared a sample of 45 children’s films with 90 dramas for adults. more…

Shreelata Rao Seshadri: Tracking India’s battle with malnutrition

18 Dec, 14 | by BMJ

For several years now, India has been sharply criticized for being one of the most undernourished nations on earth despite consistently high rates of economic growth. So the First Global Nutrition Report released recently by the International Food Policy and Research Institute (IFPRI) provides a welcome update on the nation’s progress on key nutrition indicators. Using the Indian government’s rapid survey on children (2013-14), the authors of the Global Nutrition Report estimate that under-five stunting in India has reduced on average from 47.9% in 2005-06 to 38.8% in 2013-14. This nine percentage point reduction translates into almost 14.5 million fewer stunted children. Perhaps the World Health Assembly target of reducing under-five stunting worldwide from 162 million children in 2012 to ~100 million in 2025 is feasible after all. more…

Samir Dawlatly: Would I make it through medical school these days?

18 Dec, 14 | by BMJ

I specialised at being a university student. I didn’t graduate from medical school until I was 30, for a variety of reasons, despite the fact that I first set foot in the hallowed halls at the age of 19. Only one of those years was spent recovering from illness. Aside from giving me the chance to grow up, meet my future wife, and learn how to be a junior doctor, it also gave me the opportunity to make lots of mistakes. more…

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