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The BMJ Today: Improving vaccination rates

30 Jul, 14 | by BMJ

peter_doshiIn the United States, the Centers for Disease Control and Prevention (CDC) held a press conference to discuss a recent survey, which found that rates of HPV vaccine coverage did not reach the 80% target. This in itself is not a surprise given the vaccination levels of previous years.

But at the press conference, The BMJ reports, officials delivered a message for doctors: forego a conversation with parents about whether or not to get the HPV vaccine, and instead just recommend it outright. US assistant surgeon general Anne Schuchat said “she thought that doctors were recommending the vaccine, just not forcefully enough.” more…

The BMJ Today: Bleeding anticoagulants and guerrilla warfare

29 Jul, 14 | by BMJ

rich_hurleyCan we better quantify the risk of upper gastrointestinal and intracranial bleeding among patients who are taking long term oral anticoagulants for venous thromboembolism, systemic embolism, or stroke prevention? This information would help inform treatment, further investigation, or monitoring.

A research paper published yesterday on thebmj.com describes the newly devised “QBleed algorithms.” The researchers, from the University of Nottingham, found that these calculations “provided valid measures of absolute risk . . . in patients with and without anticoagulation.” more…

The BMJ Today: Dabigatran—the impact of The BMJ’s investigation

28 Jul, 14 | by BMJ

TJackson_09“The results of this investigation are somewhat shocking to me, but, reviewing the information, not entirely surprising.” That was the verdict of David Haines, section head of the Heart Rhythm Center at Beaumont Health System in the United States, on The BMJ’s investigation into dabigatran, the first of the new oral anticoagulants licensed to prevent stroke in patients with non-valvular atrial fibrillation. One of the main findings of The BMJ’s investigation—by investigations editor Deborah Cohen—was that Boehringer Ingelheim, the manufacturer of dabigatran, withheld important analyses from the regulators, which showed that monitoring blood levels and dose adjustment could improve the drug’s safety. more…

The BMJ Today: Feet and fudge

25 Jul, 14 | by BMJ Group

davidpayneA calcaneal fracture can mean a two year recovery, with a stiff, painful, deformed foot that will not fit into a normal shoe.

How does operative and non-operative treatment for intra-articular fractures compare?

A research team led by Damian Griffin, professor of trauma and orthopaedic surgery at Warwick University Medical School, conclude in their randomised controlled trial that operative treatment by open reduction and internal fixation is not recommended. more…

The BMJ Today: More on transparency

24 Jul, 14 | by BMJ

BirteIn recent years, The BMJ has campaigned on transparency—the focus of our Open Data campaign, and an issue of vital importance if modern medicine is to retain the trust of doctors and the public, writes Trevor Jackson in this week’s Editor’s Choice.

Dabigatran was the first of the new oral anticoagulants licensed to prevent stroke in patients with non-valvular atrial fibrillation. It was approved by the US Food and Drug Administration in 2010 and by the European Medicines Agency for this use a year later. The drug’s unique selling point, said its manufacturer, Boehringer Ingelheim, was that it would need no monitoring, unlike warfarin. more…

The BMJ Today: Time to rethink your assumptions about sepsis, Minerva

23 Jul, 14 | by BMJ

When I first arrived at the University of Bath, to study history and philosophy of science, our first lecture was about Sulis-Minerva: the combination of Minerva, Roman goddess of wisdom, and Sulis, the Celtic goddess who lived in the hot springs that gave the city its name.Sulis_Minerva_head_Bath

Sulis-Minerva became the goddess of health in Roman Britain, so it it seemed appropriate when working at The BMJ to ritually read her summary of the big journals each week. The latest edition is called “The progression of rheumatoid arthritis and other stories . . . ” but it’s the note about Chickenpox that makes this worth a read. The virus used to kill 100 US residents of all ages every year, but that number’s dropped after concerted vaccination programmes. And, the fear that this may push the virus into older populations, where shingles is much more severe, hasn’t manifested. more…

The BMJ Today: A good idea gone wrong?

22 Jul, 14 | by BMJ

At the 2008 World Economic Forum in Davos, Bill Gates highlighted a new US Food and Drug Administration (FDA) law that rewarded sponsors of drugs for tropical diseases with a voucher that entitles the bearer to a “priority review” of another new drug application. It was intended to encourage for-profit companies to invest in treating diseases that affect the poor. Seven years on, the FDA has awarded just three vouchers, and two of the three drugs were developed and registered outside the US well before the voucher system was established. Peter Doshi looks at the controversy surrounding the voucher scheme, and asks if it is a good idea gone wrong. more…

The BMJ Today: Talking shit again

21 Jul, 14 | by BMJ Group

By the end of next month rural India could have an extra 5.2m toilets as part of a pre-election pledge by Narendra Modi, now prime minister, to build “toilets first and temples later.”

Readers of The BMJ will no doubt be heartened by the Indian government’s announcement, coming seven years after sanitation topped a reader poll as the greatest “medical milestone” in the past 166 years  more…

The BMJ Today: Society and healthcare

18 Jul, 14 | by BMJ

jose_merinoRecently, The BMJ published two articles that address important areas of contact between medicine and society. One deals with the best way to deter scientific fraud, the other with potential changes to the healthcare system in Scotland if this nation becomes independent.

On 18 September, Scottish voters will decide whether Scotland will become an independent country. Everyone understands that independence would change many aspects of Scottish life, including how the healthcare system is organized and financed, the medical profession is regulated, drugs are approved, scientific research is supported, and medical education is structured. more…

The BMJ Today: Helping GPs make better decisions

17 Jul, 14 | by BMJ

tiago_villanuevaAfter being one year out of clinical practice, and working full time in medical editing at The BMJ, I decided to take some time off from work and return this week to the trenches of the healthcare system as a locum GP in my native Portugal, where I remain licensed to practice. I personally feel that it is very important for clinicians who are also professional editors to stay in active clinical practice, even if it’s only to a small extent. I think one job ends up enhancing the other. As editors, we get to easily stay up to date and at the cutting edge of knowledge, but as clinicians, contact with the often complex problems of real patients helps us to more easily identify the learning needs of doctors. more…

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