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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…

Dawn Richards: A Canadian arthritis patient charter

9 Sep, 14 | by BMJ

Dawn-Richards_newIn 2014 the Canadian Arthritis Patient Alliance (CAPA) undertook the creation of an Arthritis Patient Charter. The arthritis community in Canada has a history of collaboration, to which this project was no exception. In 2001 the creation of an Arthritis Patient Bill of Rights (English and French versions) was led by the Arthritis Society with input from all stakeholders and which was more advocacy-based document (it came out at the time when patients were lobbying for access to biologic treatments). In the nearly decade and a half since that bill was produced, we felt that it was time to provide new life to this document.

more…

Billy Boland: A lesson in perseverance

9 Sep, 14 | by BMJ

billy_bolandIt did not feel like the end when I submitted my portfolio for the NHS Leadership Academy, and sure enough it was not. I’ve been asked to make amendments, and there is also the submission of my closing statement to do, the final piece of written work on the journey. Any celebratory talk had been premature. more…

The BMJ Today: Read this, but no emailing please

9 Sep, 14 | by BMJ

Arterial and venous thromboses are common serious postoperative complications (about 8% of surgical procedures are followed by a thrombosis). The fact that they are still so common despite years of research suggests we haven’t yet cracked what causes them and how to prevent them. Although some risk factors like malignancy and previous thromboembolism are well established, others are less clear. more…

Roy K Philip: New “Kerala model” on alcohol policy: Great public health initiative or an “alco-pops” repeat?

8 Sep, 14 | by BMJ

Roy_K_Philip
The Indian state of Kerala has the highest alcohol consumption per head in India (8.3 litres against the national average of 4 litres,[1] while also being credited with the highest literacy rate (including female literacy),[2] best social indicators, and best infant mortality.[3] Kerala has the historical mix of influences from the spice trade, its early introduction to Christianity and the English language, tea and rubber plantations, the first elected Communist government of the world, and, during the past three decades or so, the economic affluence resulting from the millions of Keralites choosing to work abroad—particularly in the wealthy Gulf region. more…

Richard Lehman’s journal review—8 September 2014

8 Sep, 14 | by BMJ

richard_lehmanNEJM  4 Sep 2014  Vol 371
892    A terrific piece by Rita Redberg discusses sham controls in medical device trials. Whenever sham procedures are used in the control arms of such trials (or in surgical trials generally) they reveal a huge placebo effect. For example, renal denervation therapy produced huge sustained falls in recorded blood pressure in unblinded, uncontrolled trials in people with “resistant hypertension”. But when it was tested in a properly blinded trial using a sham control, it failed to detect enough difference to satisfy its primary end-point. She goes on to point out that percutaneous coronary intervention has never been tested against sham PCI. I’ve just learnt to my amazement that Darrel Francis at Imperial College is planning a trial to do just this in people with angina and single-vessel disease, and it’s still open to extra UK investigators on http://clinicaltrials.gov/ct2/show/NCT02062593.    more…

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