You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Aser Garcia Rada: The resurgence of HIV/ AIDS in Europe—let’s focus on priorities

23 Jul, 14 | by BMJ

Aser García Rada_BMJI was recently invited to a meeting on HIV/AIDS that was hosted in Athens by the European Commission. Although the grass is greener on the EU side, the epidemic still poses relevant challenges. Contrary to the overall global decline in new HIV infections, 29 381 people were newly diagnosed across the EU in 2012, 1% more than in 2011. Late presenters represent 49% of new diagnoses. In the WHO European region—which includes Central Asia—131 202 new cases were reported (8% higher than in 2011). On the whole, 2.2m people live with HIV in the European region, with around half of those people unaware that they are infected. 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…

Bijal Chheda-Varma: Bariatric surgery is unsustainable

22 Jul, 14 | by BMJ

Bijal Chheda-Varma2Obesity is widely recognised as one of the greatest health threats of the 21st century across the developed world, with about a third of the global population now obese or overweight.

While the evidence of the problem is undisputed, there is little agreement as to how to solve it. Many solutions are being brandished about in terms of both prevention and cure; in the UK, for example, a sugar tax has been suggested, and NICE has issued its headline grabbing draft recommendations that patients with a BMI of 30 or more should be given bariatric surgery. From my experience of treating overweight and obese patients, it seems clear that, as standalone solutions, these are not sustainable as they do not address the root causes of obesity. more…

Sarah Woznick: A nurse’s account of working in Gaza

21 Jul, 14 | by BMJ

msf_gazaSarah Woznick is a specialist intensive care nurse working with Médecins Sans Frontières (MSF/ Doctors Without Borders). She arrived in Gaza six months ago from Denver, Colorado. She was due to leave the mission the day after operation “Protective Edge” began, but decided to stay on to help provide medical care.

Image: Sarah in the intensive care unit of Nasser hospital, Gaza. Credit: MSF. 

I was scheduled to leave Gaza the day after the military operation “Protective Edge” started. That first day there were lots of air strikes in our area. It’s a strange feeling when you realise that one is falling not far from you. Now I am a little more accustomed, but it still makes me jump from time to time. All of us think about our Palestinian colleagues. The MSF compound is a safe place, but their homes might not be, and we worry about them and their families. more…

Vijaya Nath: Medical engagement—change or die

21 Jul, 14 | by BMJ

vijaya_nathMore than a year since Robert Francis’s recommendations, and after reports by Don BerwickSir Bruce Keogh, and the new Care Quality Commission inspection regime, we are still being challenged to demonstrate that healthcare is first and foremost focused on the needs of the patient.

At the same time, there has been a call for the most expensive assets in healthcare—the doctors—to step up and engage in management and leadership. We use the right words when writing about medical engagement, but how do we move from rhetoric to reality and, more importantly, why should doctors embrace this responsibility? more…

Richard Lehman’s journal review—21 July 2014

21 Jul, 14 | by BMJ

richard_lehmanNEJM 17 July 2014 Vol 371
203  Niacin is an abundant natural B vitamin, which lowers bad cholesterol and raises good cholesterol. What’s not to like? Well, niacin, unfortunately. In doses that make any difference to lipid levels, it is very likely to make you feel sick, get flushes and/or rashes, and/or feel muscle pains. So Merck decided to market it in combination with laropripant, a prostaglandin antagonist that is meant to combat its unpleasant effects. Even so, a third of people who were recruited to the present trial could not continue past the run-in phase with the active combination. And now that the full results are out, we have confirmation that this dual agent definitely does not offer any cardioprotection despite its “favourable” effect on lipids. Worse still it causes bleeding, raises blood sugar, and shows a tendency to increase mortality in those who can tolerate taking it for three years. The Clinical Trials Support Unit (CTSU) at Oxford did a great job of running this trial with funding from Merck, following its usual rules of independence. In doing so, it provides a great illustration of the fact that lipid fractions are very unreliable surrogates for cardiovascular outcomes. But we knew that already, and it seems a great pity to me that many superb researchers were tied down for so long on a project that has made such a small contribution to clinical knowledge, whatever it may have contributed to the funds of CTSU. 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…

Readers’ editor: A website needing more soft fruit

20 Jul, 14 | by BMJ Group

davidpayneWe like it when readers take the time and trouble to give us feedback. We’ve been particularly appreciative in the last two weeks as The BMJ’s new website beds down following its launch on 30 June. Some readers responded to the editorial published to mark the new website and the journal’s new name and logo.  Eighty readers replied to an email we sent out about the new site. Others used our customer service feedback form, and contacted us directly via email. Last week we did our first technical release since the new site went live, and we used it to tweak the design (based on your feedback), implement some changes we couldn’t squeeze in before launch, and fix some bugs. more…

Richard Smith: Misunderstanding conflict of interest

18 Jul, 14 | by BMJ

richard_smith2In Britain we have had a row over whether a judge, Elizabeth Butler Sloss, should chair an inquiry into child abuse. Everybody agrees that she has the necessary skills and unquestionable integrity, but she has a conflict of interest: her long dead brother was in the government and may have been involved in covering up child abuse. The case has exposed deep misunderstanding on the nature of conflict of interest.

The country is in the grip of a moral panic over historical cases of child sexual abuse, with well known entertainers going to prison for abuses they committed 50 years ago. Every day we hear rumours of which “national treasure” (a British cliché) will be next. So the government had to react quickly to the possibility that politicians themselves had covered up abuses. In the rush to appoint a chair to the inquiry, the government probably overlooked Butler Sloss’s conflict of interest, and so she was appointed. more…

Tessa Richards: Go with the flow

18 Jul, 14 | by BMJ

Tessa_richardsLegend has it that the Anglo-Saxon king Canute believed his command could hold back the tide. Last week, Financial Times columnist Robert Shrimsley conjured up Canute’s image, as he describes how he went to his GP for a problem and the latter pleaded with him not to go to the internet for information. Of course, the first thing Shrimsley did after leaving the surgery was to search the web, and he says that “‘Don’t google this’ is surely the most forlorn demand since ‘Don’t eat the apple’.”

It’s a great piece. He says cross examination of a doctor was “almost akin to arguing with a priest,” and, tongue in cheek, states it must be “jolly tiresome” for doctors to deal with informed patients; and even more so with “slightly informed ones.” But he urges them to put themselves on “the right side of modernity” and deal with a potentially empowered public. more…

BMJ blogs homepage

The BMJ

Helping doctors make better decisions. Visit site



Creative Comms logo

Latest from The BMJ

Latest from The BMJ

Latest from BMJ podcasts

Latest from BMJ podcasts

Blogs linking here

Blogs linking here