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The BMJ Today: Alcohol pledges, fake antibiotic fixes, and NFL payouts

26 Mar, 15 | by BMJ

Analysis-low alcoholThe UK government’s responsibility deal with the alcohol industry promises to remove a billion units of alcohol (about 2% of consumption) from the market, through reducing the strength of alcoholic drinks such as beer and wine.

The interim report from the government has been published, and claims that the deal has already worked better than promised. However, researchers from the Sheffield Alcohol Research Group at the University of Sheffield have analysed that report and believe that it is so flawed it should be withdrawn. more…

The BMJ Today: History lessons

25 Mar, 15 | by BMJ

ThinkstockPhotos-465117786• In 1938 New Zealand created a national health system, coining the term “from cradle to grave,” and showing the British government what was possible.

More recently, the country repealed its unsuccessful, competition based health legislation.

As it is now hard to find anyone in England who believes that the 2012 Health and Social Care Act was a good idea: Can New Zealand again offer lessons for England? more…

The BMJ Today: An ancient enemy, School-EduSalt, and “low value care”

24 Mar, 15 | by BMJ

india_tuberculosis_patientTB. An ancient enemy getting stronger
• BMJ is supporting the World Health Organization’s End TB strategy by highlighting World TB Day today and offering free access to TB papers and resources.

In an editorial for The BMJ, Zarir F Udwadia et al write that TB is India’s silent epidemic and a death sentence for poor people. In separate personal view pieces, Yogesh Jain et al suggest India should screen all tuberculosis patients for drug resistant disease at diagnosis, and Mike Frick et al urge we end the use of stigmatizing language—disease of poverty, treatment defaulter, TB suspect, non-compliant—in tuberculosis research and practice. more…

The BMJ Today: Regulator will hunt down apps that harm patients

23 Mar, 15 | by BMJ

Action to be taken against apps that harm patients
A UK health regulator has issued a warning to makers of mobile medical apps that may harm patients.

app_medicalSpeaking at a health technologies seminar in London on 18 March, Neil McGuire, clinical director of devices at the Medicines and Healthcare Products Regulatory Agency (MHRA) said, “Be under no illusion—if you have . . . software or an app and patients come to grief, we’re coming looking.” He was speaking after hearing concerns that the growth in medical apps was outpacing the ability of organisations to respond effectively. more…

The BMJ Today: Alcohol, NSAIDS, and improving end of life care

20 Mar, 15 | by BMJ

alcohol_shelvesHealth campaigners have condemned tax breaks on alcohol announced by the UK government. Ian Gilmore, chair of the Alcohol Health Alliance UK, calls this move “thoroughly shameful,” given the burden of alcohol related harm and hospital attendances the NHS handles each year. more…

The BMJ Today: Are you worried about your cardiovascular risk?

19 Mar, 15 | by BMJ

athletes• Sudden cardiac death is the main cause of medical death in athletes. Despite the fact that many cases of sudden cardiac death in athletes aged less than 35 are caused by an underlying genetic heart disorder, our most recent clinical review highlights that in up to half of the cases of sudden cardiac death, no structural heart anomalies are found in the post-mortem examination. more…

The BMJ Today: Statins in pregnancy, sexual health in Pakistan, and mammography screening

18 Mar, 15 | by BMJ

georg_rogglaStatins in pregnancy

Bateman and co-workers report a well designed epidemiological study on statins in early pregnancy. Their analysis did not find a significant teratogenic effect from maternal use of statins in the first trimester. In a related editorial, Françoise Haramburu and co-workers state that the new safety data are reassuring, but suspension of treatment is still advisable. more…

The BMJ Today: Prescribing on sparse evidence, homeopathy, and research methodology

17 Mar, 15 | by BMJ

How to prescribe when the evidence is lacking
LoperamideSeveral observational studies have shown associations between using drugs with anticholinergic side effects—such as loperamide, loratadine, baclofen, amitriptyline, oxybutynin, or chlorphenamine—and cognitive decline. Links have also been shown with earlier death, falls, and admission to hospital with confusion and dementia. “But is this cause, or is it effect,” asks Margaret McCartney. Read her discussion of the little evidence that there is and what doctors should do, in this week’s No Holds Barred column. more…

The BMJ Today: Treatments for inflammatory diseases

16 Mar, 15 | by BMJ

A combination of old drugs is not inferior to biologics for rheumatoid arthritis

rheumatoid_arthritis• Tumor necrosis factor inhibitors are safe and effective therapies for patients with rheumatoid arthritis resistant to methotrexate and other disease modifying drugs, but they are very expensive.

The BMJ Today reports the results of an open label pragmatic trial—the TACIT trial—that compared the impact on disability at 12 months of a TNF based strategy (as recommended by the National Institute for Health and Care Excellence) versus a combined disease modifying drug strategy, which includes methotrexate. In this study, the combination of older drugs was non-inferior to the biologic agents. more…

BMJ Today: Reassurance on varenicline, caring (or not) for NHS staff, and more holiday for emergency doctors

13 Mar, 15 | by BMJ

Good news for quitters

varenicline

A research paper in The BMJ today “is the most comprehensive published review to date of the neuropsychiatric safety of varenicline.” It was necessary, say the authors from Bristol University, because while several studies have found no evidence of an increased risk of neuropsychiatric side effects with varenicline, these studies have been criticised for being observational and sponsored by industry. more…

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