Mike Richards’s independent review of adult screening programmes in England is out and can be summarised as “nothing is too much.”1 Calling for financial incentives, increased uptake, reorganisation,…
Just listen!
Welcome to the Australasian College of Sport and Exercise Physicians edition of the BJSM. In the first minute of a consultation, if you stay quiet, your patients will tell you where they hurt, how it started and be quite happy
Phase I trials: not all are made equal
Nature Reviews Clinical Oncology, Published online: 30 October 2019; doi:10.1038/s41571-019-0296-z Phase I trials form the foundations of evidence-based oncology. Here, we explore the ethical controversies surrounding how participation in such trials should be presented to patients.
[Editorial] Global elimination of cervical cancer is achievable—with commitment
On Sept 6, 2019, WHO called on countries in the South-East Asia region to accelerate their efforts towards cervical cancer elimination. Cervical cancer is a substantial burden in South-East Asia, with an estimated 158 000 new cases and 95 766 deaths reported
Fecal Microbiota Transplantation for Dysbiosis — Predictable Risks
The term “dysbiosis” usually refers to a change in the human microbiome from a healthy pattern toward a pattern associated with disease. Although the term is increasingly being used, the definition, not surprisingly, is vague. Yet dysbiosis has become an
Fecal Microbiota Transplantation for Dysbiosis — Predictable Risks
The term “dysbiosis” usually refers to a change in the human microbiome from a healthy pattern toward a pattern associated with disease. Although the term is increasingly being used, the definition, not surprisingly, is vague. Yet dysbiosis has become an
Where Were the Women? Gender Parity in Clinical Trials
In 2017, a total of 19% of all new HIV infections in the United States and nearly half of infections globally were in cisgender (nontransgender) women. Women of childbearing potential shoulder a disproportionate burden, which raises further concerns about perinatal
Allergan pays $750m to settle claims that it blocked generics by “product hopping”
Allergan has agreed to pay $750m (£580m ;€680m) to settle claims from a group of US direct purchasers that it used anti-competitive practices to block them from buying cheaper generic alternatives…
Heartbeat: guidelines versus reality for patients with severe aortic stenosis
The increasing prevalence of aortic stenosis (AS) in our ageing population and clinical trials demonstrating the benefits of transcatheter valve implantation for severe symptomatic AS have focused attention on this disease in recent years. Yet, despite clear recommendations from professional
Predictors of cardiovascular health in teenagers (aged 13-14 years): a cross-sectional study linked with routine data
Objective To examine the predictors of cardiovascular health in teenagers (aged 13–14 years). Methods Measures of arterial stiffness (augmentation index (AIx)), blood pressure and cardiovascular fitness were taken from 234 teenage children (n=152 boys) and subsequently linked to routine data
Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer
The BRAF V600E mutation occurs in approximately 10% of patients with metastatic colorectal cancer, with recent estimates ranging from as low as 5% to as high as 21%. This mutation identifies a distinct subtype of colorectal cancer that has a
[Editorial] New PrEP formulation approved…but only for some
On Oct 3, the US Food and Drug Administration (FDA) approved Gilead’s Descovy (tenofovir alafenamide plus emtricitabine) for use as HIV pre-exposure prophylaxis (PrEP). Till then, tenofovir disoproxil fumarate plus emtricitabine, either as Gilead’s Truvada (which comes off patent in
Science and creativity: the root of knowledge
bmj;367/oct29_22/l6268/FAF1faRichard H SmithHidden away in a quiet part of London SW3, on the edge of the river Thames, is the Chelsea Physic Garden. London’s oldest botanic garden, it was set up in…
Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy
Abstract Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high
HDAC9 is implicated in atherosclerotic aortic calcification and affects vascular smooth muscle cell phenotype
Nature Genetics, Published online: 28 October 2019; doi:10.1038/s41588-019-0514-8 Genome-wide analyses identify variants near HDAC9 associated with abdominal aortic calcification and other cardiovascular phenotypes. Functional work shows that HDAC9 promotes an osteogenic vascular smooth muscle cell phenotype, enhancing calcification and reducing
CRISPR screens come into sight
Nature Reviews Genetics, Published online: 28 October 2019; doi:10.1038/s41576-019-0192-5 A new study in Cell reports a mammalian genetic screening strategy that combines CRISPR libraries with in situ sequencing to read out both complex cellular phenotypes and genetic perturbations using microscopy.
Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Cesarean Section
Presentation of Case. Dr. Rachel Wood (Obstetrics and Gynecology): A 35-year-old pregnant woman was admitted to the labor and delivery unit of this hospital at 36 weeks 4 days of gestation for a planned repeat cesarean section because of placenta
Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction is common and is associated with substantial morbidity and mortality. Several physiological mechanisms have been postulated, including myocardial hypertrophy and fibrosis, impaired diastolic compliance and relaxation, subclinical systolic dysfunction,…
Patient-Customized Oligonucleotide Therapy for a Rare Genetic Disease
Rare diseases in aggregate affect approximately 30 million persons in the United States alone. Although next-generation sequencing is revolutionizing their diagnosis, the sheer number of distinct conditions (more than 7000 [https://globalgenes.org/rare-list]) and the limited number of patients…
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training
Burnout, a syndrome of emotional exhaustion, cynicism, and reduced effectiveness at work, has been linked to poor health, alcoholism, depression, and suicide in physicians. Burnout has adverse effects on patient care and the physician workforce, since burned-out physicians are more
Editörden
Değerli Adli Bilimciler, Adli Tıp Bülteni’nin yeni sayısıyla karşınızdayız. Dergimizin ülkemizde Tübitak Ulakbim TR ve DOAJ (Directory of Open Access Journals) tarafından dizinlenen tek adli bilimler dergisi olması ve adli bilimler alanının bilimsel patformuna dönüşmesi yeni hedefleri de zorunlu kılmaktadır.
Sudan Çıkarılmış Cesetlerde Kolloidal Silika Gradyen Santrifüj Metodu Kullanılarak Vücudun Dış Yüzeylerinden ve İç Organlardan Elde Edilen Diatomların Karşılaştırılması
Amaç: Diatom analizi, suda boğulma olgularında ölüm nedeninin ve boğulma ortamının tespitinde kullanılan çok değerli bir araçtır. Diatom analizinin temel prensibi, boğulma ortamında bulunan diatomların, suyun inhalasyonu yolu ile penetrasyonu ve alveollerden genel kan dolaşımına katılarak karaciğer, beyin, kemik iliği
Sık Hastane Başvurusu Ev içi Şiddetin Habercisi mi?
Amaç:Eş şiddeti toplumun her kesiminde değişik oranlarda görülmektedir ve orta-uzun vadede çok farklı sağlık sorunlarına neden olabilmektedir. Bu çalışmada, Adli Tıp Polikliniğine eşinden/partnerinden şiddet görme nedeniyle başvuran olguların son bir yıl içindeki hastane başvurularını değerlendirerek; şiddet mağdurlarının sağlık sorunlarını ortaya
Profesyonel Araç Sürücülerinde Sürücü Davranışları ve Becerileri ile Alkol, Madde ve İlaç Kullanımının Değerlendirilmesi
Giriş: Sürücü davranışları ve sürücülük becerileri, trafikte kaza riskini oluşturan ana unsurlar arasında yer almaktadır. Alkol ve madde etkisi altında araç kullanma davranışı; ölümlere, maddi hasarlara ve yaralanmalara neden olan önemli bir trafik sorunudur. Bu çalışmada; profesyonel araç sürücülerinde alkol,
Ekstremite Kırığı Olgularında Tedavi Seçeneklerinin ve Meslekte Çalışma Gücü Kaybı ve Engellilik Oranlarının Karşılaştırılması
Amaç: Çalışmamızda; trafik kazası sonucu meydana gelen kemik kırıklarına uygulanan tedavilerin başarıları ile bu tedavi sonucunda kalan sekellere ait meslekte kazanma gücü kaybı ve özürlülük oranlarının hesaplanarak kıyaslanması amaçlanmıştır. Gereç ve Yöntem:01 Şubat 2016 – 01 Şubat 2017 tarihleri arasında
Lack of paediatric experts to testify in cases of suspected child harm is traumatising families, says judge
Justice is being delayed and families traumatised because there are too few paediatric experts willing to give evidence in cases where local authorities accuse parents of harming a child, a family…
Zika Virus Infection — After the Pandemic
Zika virus (ZIKV) was discovered in Africa in 1947 and was first detected in Asia in 1966, yet its potential effect on public health was not recognized until the virus caused outbreaks in the Pacific from 2007 to 2015 and
Calcinosis in Systemic Sclerosis
Figure 1.
Preexisting Conditions
Doc gets these calls more often now, cries for help from family and friends. They call him, he says, because he’s the one doctor they know who answers the phone himself (he’s retired) — none of that “please listen carefully,
Calcinosis in Systemic Sclerosis
Figure 1.
Enhanced Recovery after Surgery (ERAS) at Cesarean to Reduce Postoperative Length of Stay: A Randomized Controlled Trial
Our objective was to determine whether an enhanced recovery after surgery (ERAS) pathway at the time of cesarean birth would permit a reduction in postoperative length of stay and improve postoperative patient satisfaction compared to standard perioperative care (SC).
Metoprolol for the Prevention of Acute Exacerbations of COPD
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of COPD-related morbidity, mortality, and health care costs are driven by exacerbations, particularly those leading to hospitalization. Since many patients have such exacerbations despite maintenance…
Five-Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma
In the past decade, progress in the treatment of advanced melanoma has markedly improved survival outcomes. The availability of new systemic therapies — including ipilimumab, an anti–cytotoxic T-lymphocyte–associated antigen 4 monoclonal antibody; anti–programmed death 1 agents (nivolumab and…
Think First, Cut Last — Lessons from a Clinical Trial of Refractory Heartburn
Conceptualizing gastroesophageal reflux disease (GERD) as a single disease process that will respond to higher and higher doses of acid suppression is a mistake. The underlying mechanisms that can lead to reflux of stomach contents into the esophagus and subsequent
Does Early Chemotherapy Improve Survival in Advanced Endometrial Cancer?
Objectives: In endometrial cancer, the appropriate sequence of adjuvant chemotherapy (aCT) and adjuvant radiation therapy (aRT) is unclear. We aim evaluated whether early chemotherapy is associated with improved overall survival (OS) and cancer-specific survival (CSS). Methods: Endometrial cancer patients that
Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer
The BRAF V600E mutation occurs in approximately 10% of patients with metastatic colorectal cancer, with recent estimates ranging from as low as 5% to as high as 21%. This mutation identifies a distinct subtype of colorectal cancer that has a
Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Cesarean Section
Presentation of Case. Dr. Rachel Wood (Obstetrics and Gynecology): A 35-year-old pregnant woman was admitted to the labor and delivery unit of this hospital at 36 weeks 4 days of gestation for a planned repeat cesarean section because of placenta
Patient-Customized Oligonucleotide Therapy for a Rare Genetic Disease
Rare diseases in aggregate affect approximately 30 million persons in the United States alone. Although next-generation sequencing is revolutionizing their diagnosis, the sheer number of distinct conditions (more than 7000 [https://globalgenes.org/rare-list]) and the limited number of patients…
A prime alternative
Nature Reviews Genetics, Published online: 24 October 2019; doi:10.1038/s41576-019-0191-6 A new genome editing strategy called prime editing uses a catalytically impaired Cas9 fused to an engineered reverse transcriptase to write desired genetic sequence information directly into a target locus.
Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Cesarean Section
Presentation of Case. Dr. Rachel Wood (Obstetrics and Gynecology): A 35-year-old pregnant woman was admitted to the labor and delivery unit of this hospital at 36 weeks 4 days of gestation for a planned repeat cesarean section because of placenta
Calcinosis in Juvenile Dermatomyositis
Figure 1.
Whither religion in medicine?
Few topics in medical ethics stimulate as much heated debate as the question of the proper place of religious beliefs in medical practice. Typically, this debate is orientated towards questions about the religious beliefs held by medical practitioners, and in
Tackling inertia in decision making after fetal monitoring
Findings from the NHS early notification scheme12 might be grim reading, but they will be an effective driving force in reducing avoidable severe brain injury in babies in years to come. The headline…
Imatinib and the long tail of targeted drug development
Nature Reviews Clinical Oncology, Published online: 24 October 2019; doi:10.1038/s41571-019-0287-0 New molecular insights occasionally lead to the rapid development of therapeutic agents that improve the outcomes of patients with cancer; however, these breakthroughs can be followed by extensive, empirically driven
Modeling the Placenta with Stem Cells
Pluripotent stem cells — which have the ability to differentiate into any cell type in the body — have enormous potential for regenerative medicine and for uncovering the developmental biology underlying health and disease. New advances in stem-cell technologies are
Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction is common and is associated with substantial morbidity and mortality. Several physiological mechanisms have been postulated, including myocardial hypertrophy and fibrosis, impaired diastolic compliance and relaxation, subclinical systolic dysfunction,…
Calcinosis in Systemic Sclerosis
Figure 1.
Posterior-Wall Myocardial Infarction
Figure 1.
Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer
The BRAF V600E mutation occurs in approximately 10% of patients with metastatic colorectal cancer, with recent estimates ranging from as low as 5% to as high as 21%. This mutation identifies a distinct subtype of colorectal cancer that has a
Goal-Concordant Care — Searching for the Holy Grail
The notion that the care delivered to seriously ill patients ought to promote those patients’ goals — regarding such matters as aggressiveness of treatment, hoped-for functional outcomes, and ability to participate in future events — is widely supported by patients,
Patient-Customized Oligonucleotide Therapy for a Rare Genetic Disease
Rare diseases in aggregate affect approximately 30 million persons in the United States alone. Although next-generation sequencing is revolutionizing their diagnosis, the sheer number of distinct conditions (more than 7000 [https://globalgenes.org/rare-list]) and the limited number of patients…
Getting Comfortable with Risk
In 2018, knowing that I would become infected, I received a heart transplant from a donor with hepatitis C who’d died from a heroin overdose. Accepting a high-risk organ was a deliberate decision made long before I was offered the
Overview of Systematic Reviews of Aerobic Fitness and Muscle Strength Training after Spinal Cord Injury
Journal of Neurotrauma, Volume 36, Issue 21, Page 2943-2963, November 1, 2019.
Patient-Customized Oligonucleotide Therapy for a Rare Genetic Disease
Rare diseases in aggregate affect approximately 30 million persons in the United States alone. Although next-generation sequencing is revolutionizing their diagnosis, the sheer number of distinct conditions (more than 7000 [https://globalgenes.org/rare-list]) and the limited number of patients…
Patient-Customized Oligonucleotide Therapy for a Rare Genetic Disease
Rare diseases in aggregate affect approximately 30 million persons in the United States alone. Although next-generation sequencing is revolutionizing their diagnosis, the sheer number of distinct conditions (more than 7000 [https://globalgenes.org/rare-list]) and the limited number of patients…
[Editorial] Where next for randomised controlled trials in global health?
The 2019 Nobel Memorial Prize in Economic Sciences was awarded to three economists—Esther Duflo, Abhijit Bannerjee, and Michael Kremer—for their experiment-based research to mitigate global poverty. The award was notable for several reasons. Esther Duflo was only the second woman
Calcinosis in Systemic Sclerosis
Figure 1.
Seven days in medicine: 16-22 Oct 2019
Emergency medicineClosures are “not linked to rise in deaths”The closure of hospital emergency care departments in England is not linked to an increase in deaths from serious conditions that warrant…
Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls
Objective Patients with repaired coarctation (RCoA) remain at higher risk of cardiac dysfunction, initially often only detected during exercise. In this study, haemodynamics of isometric handgrip (HG) and bicycle ergometry (BE) were compared in patients with RCoA and matched controls
Tracing evolution reveals new biomarkers
Nature Reviews Clinical Oncology, Published online: 23 October 2019; doi:10.1038/s41571-019-0295-0 Tracing evolution reveals new biomarkers
Single-cell genomics illuminates human forebrain development
Nature Reviews Genetics, Published online: 22 October 2019; doi:10.1038/s41576-019-0189-0 In a new study published in Nature, Kanton et al. shed light on the unique genetic features of human forebrain development and how they diverged from those in great apes.
Metoprolol for the Prevention of Acute Exacerbations of COPD
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of COPD-related morbidity, mortality, and health care costs are driven by exacerbations, particularly those leading to hospitalization. Since many patients have such exacerbations despite maintenance…
[Editorial] Dracunculiasis—a case study for infection eradication
On Sept 30, Nature reported that WHO had pushed back the guinea worm eradication target by a decade: from 2020 to 2030. No formal announcement had been made by the time The Lancet Infectious Diseases went to press, but the
La CaSSA da Drosophila: A Versatile Expansion of the Tool Box
In this issue of Neuron, Garcia-Marques et al. (2019) describe a new set of elegant tools based on the single strand annealing DNA repair system and CRISPR technology that provide many avenues for genetic and cellular manipulations.
Neurodegenerative Disease Mortality among Former Professional Soccer Players
Concerns have been raised about the risk of several neurodegenerative diseases, such as Alzheimer’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy (CTE), associated with participation in contact sports. Recognition of the pathologic changes of CTE in former players who…
Taking antihypertensives at bedtime nearly halves cardiovascular deaths when compared with morning dosing, study finds
Taking antihypertensive medicine at bedtime is associated with improved blood pressure control and a near halving of cardiovascular deaths and events when compared with morning dosing, a study of…
Coronary wave intensity patterns in stable coronary artery disease: influence of stenosis severity and collateral circulation
Objective Wave intensity analysis is a method that allows separating pulse waves into components generated proximally and in the periphery of arterial trees, as well as characterising them as accelerating or decelerating. The early diastolic suction wave (eaDSW) is one
Highlights from this issue
A universal artificial intelligence platform for collaborative management of cataracts (see page 1553) Universal AI-based multilevel platforms have the potential to make accurate cataract diagnoses and detect referral cases after evaluation of severity. The novel tertiary referral pattern achieved the
Review of the scientific evolution of gene therapy for the treatment of homozygous familial hypercholesterolaemia: past, present and future perspectives
Familial hypercholesterolaemia (FH) is a devastating genetic disease that leads to extremely high cholesterol levels and severe cardiovascular disease, mainly caused by mutations in any of the main genes involved in low-density lipoprotein cholesterol (LDL-C) uptake. Among these genes, mutations
Withdrawal, dependence and adverse events of antidepressants: lessons from patients and data
Tolerability, withdrawal effects and dependence on prescription medication is an important topic of current scientific and clinical debate, as highlighted by the recent report published on September 2019 by Public Health England (https://www.gov.uk/government/publications/prescribed-medicines-review-report).1 This was a mixed methods public health
[Editorial] Changing the face of clinical trials
Judging the value of new drugs and medical devices is becoming an increasingly important issue with the proliferation of alternative treatment options. Beyond key aspects such as clinical efficacy and safety, other considerations such as quality of life and costs
Associations between the vaginal microbiome and Candida colonization in women of reproductive age
The composition of bacteria within the vaginal microbiome has garnered a lot of recent attention and has been associated with reproductive health and disease. Despite the common occurrence of yeast (primarily Candida) within the vaginal microbiome, there is still an
Genetic architecture of subcortical brain structures in 38,851 individuals
Nature Genetics, Published online: 21 October 2019; doi:10.1038/s41588-019-0511-y Genome-wide analysis identifies variants associated with the volume of seven different subcortical brain regions defined by magnetic resonance imaging. Implicated genes are involved in neurodevelopmental and synaptic signaling pathways.
Neurodegenerative Disease Mortality among Former Professional Soccer Players
Concerns have been raised about the risk of several neurodegenerative diseases, such as Alzheimer’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy (CTE), associated with participation in contact sports. Recognition of the pathologic changes of CTE in former players who…
Enabling Healthful Aging for All — The National Academy of Medicine Grand Challenge in Healthy Longevity
During the past century, human life expectancy has nearly doubled globally, increasing by more years than it did in all previous millennia combined. Today, 617 million people are 65 years old or older; by 2050, the number will reach 1.6
Neurodegenerative Disease Mortality among Former Professional Soccer Players
Concerns have been raised about the risk of several neurodegenerative diseases, such as Alzheimer’s disease, amyotrophic lateral sclerosis, and chronic traumatic encephalopathy (CTE), associated with participation in contact sports. Recognition of the pathologic changes of CTE in former players who…
Measles Outpatient Prevention
Outpatient clinics in New York are turning to a range of measles prevention practices to protect patients against the ongoing outbreak in the city—the largest in the United States since 1992, according to a report by the CDC and New
[Editorial] Towards improved delivery of care in the paediatric ICU
Guidance on admission, triage, and discharge within the paediatric intensive care unit (PICU) setting is needed to allow clinicians to make the right decisions about the appropriate level of care for critically ill children, which is key to improving health
Metoprolol for the Prevention of Acute Exacerbations of COPD
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of COPD-related morbidity, mortality, and health care costs are driven by exacerbations, particularly those leading to hospitalization. Since many patients have such exacerbations despite maintenance…
Dislocated jaw is common in patients with Ehlers-Danlos syndromes
Ghali and colleagues give an overview of Ehlers-Danlos syndromes (EDS) and their increasing public awareness owing to the growing number of EDS patient organisations.1Joint hypermobility is the…
Highlights from this issue
Is it OK to close emergency departments? Many emergency physicians would be very concerned by any talk about closing Emergency Departments (EDs). We may have experienced it in our own regions, and we may have our own opinions about its
Clinical practice variation and overtreatment risk in women with abnormal cervical cytology in the Netherlands; two-step versus see-and-treat approach
Only a few small studies compared the two-step method (biopsy followed by treatment) with see-and-treat (immediate treatment) in women with both low-grade or high-grade referral cytology. The clinical practice variation in the Netherlands has not been reviewed before.
Building machines with DNA molecules
Nature Reviews Genetics, Published online: 21 October 2019; doi:10.1038/s41576-019-0175-6 This Review discusses the potential of DNA for creating machines that are both encoded by and built from DNA molecules. Alongside an overview of DNA nanostructure assembly, the authors describe recent
Meta-Analysis in the Mirror of its Quotations: Science, Scepticism, Scorn, and Sarcasm
Meta-analysis is unique among scientific studies in that it has been subject to an eclectic array of quips and wisecracks that are prone to trivialize its use and abuse. However, reflecting both strengths and weaknesses of this ever more common
Beta-Blockers in COPD — A Controversy Resolved?
Cardiovascular disease, which is common in patients with chronic obstructive pulmonary disease (COPD), has a profound effect on morbidity and mortality, yet the condition is often unrecognized and as a result is undertreated. Systematic reviews have recognized the underuse of
Think First, Cut Last — Lessons from a Clinical Trial of Refractory Heartburn
Conceptualizing gastroesophageal reflux disease (GERD) as a single disease process that will respond to higher and higher doses of acid suppression is a mistake. The underlying mechanisms that can lead to reflux of stomach contents into the esophagus and subsequent
Soccer and Mortality — Good News and Bad News
In the general population, moderate exercise, physical activity, and participation in sports have important health benefits, including slowing cognitive decline and preventing dementia. Participation in elite-level sports, not surprisingly, is also associated with reductions in all-cause mortality…
Former footballers are more likely to die from neurodegenerative disease, study finds
Former professional football (soccer) players are more likely to die from neurodegenerative disease than the general population but less likely to die from other common causes such as lung cancer, a…
Challenges of developing sports medicine in the Netherlands … work in progress!
Sports medicine was finally recognised as a full medical specialty in the Netherlands, comparable with the position of orthopaedic surgeons and cardiologists, on 1 July 2014; nearly 50 years after the Dutch Association of Sports Medicine (VSG) was founded by
Beta-Blockers in COPD — A Controversy Resolved?
Cardiovascular disease, which is common in patients with chronic obstructive pulmonary disease (COPD), has a profound effect on morbidity and mortality, yet the condition is often unrecognized and as a result is undertreated. Systematic reviews have recognized the underuse of
Symptomatic pelvic organ prolapse in middle-aged women – a national matched cohort study on the influence of childbirth
The relative impact of age, pregnancy and vaginal delivery on symptomatic pelvic organ prolapse is still an unresolved issue that involves the controversial question about the protective effect of cesarean section.
Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn
In the United States, approximately 20% of adults regularly have symptoms of gastroesophageal reflux disease (GERD), and annual costs for managing GERD exceed $12 billion. Patients with heartburn, the cardinal symptom of GERD, report reduced work productivity and significant impairments
Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes
Despite advances in care, attaining good glycemic outcomes in patients with type 1 diabetes remains challenging; the targets set by the American Diabetes Association are met in only a minority of patients. The use of a closed-loop system (also referred
20-Year Follow-up of Statins in Children with Familial Hypercholesterolemia
Familial hypercholesterolemia is a common autosomal dominant disorder of lipoprotein metabolism. It is caused by mutations in genes encoding key proteins involved in the low-density lipoprotein (LDL) receptor endocytic and recycling pathways that lead to decreased cellular uptake of LDL…
Complex interaction between the atrium and the ventricular filling process: the role of conduit
Think First, Cut Last — Lessons from a Clinical Trial of Refractory Heartburn
Conceptualizing gastroesophageal reflux disease (GERD) as a single disease process that will respond to higher and higher doses of acid suppression is a mistake. The underlying mechanisms that can lead to reflux of stomach contents into the esophagus and subsequent
Case 32-2019: A 70-Year-Old Woman with Rapidly Progressive Ataxia
Presentation of Case. Dr. Kun-Wei Song (Neurology): A 70-year-old woman was admitted to this hospital because of rapidly progressive ataxia. The patient had been in her usual state of good health until 3 months before this admission, when fatigue and
NICE updates antidepressant guidelines to reflect severity and length of withdrawal symptoms
The National Institute for Health and Care Excellence has amended its guidelines1 on depression to recognise the severity and length of antidepressant withdrawal symptoms.The guidance on treating…
Highlights from this issue
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Highlights from this issue
Pulseless electrical activity Deandra Luong and colleagues report a series of infants where ECG monitoring was used to monitor the heart rate during initial stabilisation after birth and there was no clinically detectable cardiac output despite ECG traces showing heart
Mycoplasma genitalium and the means to others ends
The BASHH guideline on the management of Mycoplasma genitalium (2018) contains the following advice: Current asymptomatic partners (including non-regular partners where there is likely to be further sexual contact and risk of reinfection) of individuals with disease caused by M.
Immunotherapy trials in mesothelioma — promising results, but don’t stop here
Nature Reviews Clinical Oncology, Published online: 17 October 2019; doi:10.1038/s41571-019-0291-4 In the past few years, several studies have addressed the possibility of using immunotherapies to treat patients with mesothelioma. Herein, we discuss two recent trials, one testing the immune-checkpoint inhibitor
Five-Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma
In the past decade, progress in the treatment of advanced melanoma has markedly improved survival outcomes. The availability of new systemic therapies — including ipilimumab, an anti–cytotoxic T-lymphocyte–associated antigen 4 monoclonal antibody; anti–programmed death 1 agents (nivolumab and…
In Vitro Fertilization and Risk for Hypertensive Disorders of Pregnancy: Associations with Treatment Parameters
Although in vitro fertilization (IVF) has been associated with an increased risk for hypertensive disorders of pregnancy, the association of risk with IVF treatment parameters is unclear.
More about Factor H Autoantibodies in Membranous Nephropathy
To the Editor: Primary membranous nephropathy, one of the most common causes of nephrotic syndrome in adults, results from the deposition of IgG and complement components in the subepithelial layer of the glomerular basement membrane. In 70 to 80% of
20-Year Follow-up of Statins in Children with Familial Hypercholesterolemia
Familial hypercholesterolemia is a common autosomal dominant disorder of lipoprotein metabolism. It is caused by mutations in genes encoding key proteins involved in the low-density lipoprotein (LDL) receptor endocytic and recycling pathways that lead to decreased cellular uptake of LDL…
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
According to the American Heart Association, approximately 720,000 persons in the United States will have a first episode of an acute coronary syndrome and approximately 335,000 will have a recurrent coronary event in 2019. Dual antiplatelet therapy (an adenosine diphosphate
Five-Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma
In the past decade, progress in the treatment of advanced melanoma has markedly improved survival outcomes. The availability of new systemic therapies — including ipilimumab, an anti–cytotoxic T-lymphocyte–associated antigen 4 monoclonal antibody; anti–programmed death 1 agents (nivolumab and…
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
According to the American Heart Association, approximately 720,000 persons in the United States will have a first episode of an acute coronary syndrome and approximately 335,000 will have a recurrent coronary event in 2019. Dual antiplatelet therapy (an adenosine diphosphate
Preexisting Conditions
Doc gets these calls more often now, cries for help from family and friends. They call him, he says, because he’s the one doctor they know who answers the phone himself (he’s retired) — none of that “please listen carefully,
More about Factor H Autoantibodies in Membranous Nephropathy
To the Editor: Primary membranous nephropathy, one of the most common causes of nephrotic syndrome in adults, results from the deposition of IgG and complement components in the subepithelial layer of the glomerular basement membrane. In 70 to 80% of
Case 32-2019: A 70-Year-Old Woman with Rapidly Progressive Ataxia
Presentation of Case. Dr. Kun-Wei Song (Neurology): A 70-year-old woman was admitted to this hospital because of rapidly progressive ataxia. The patient had been in her usual state of good health until 3 months before this admission, when fatigue and
The Texture of Chromatin
DNA-replication machinery introduces intertwining and supercoiling of DNA strands as it traverses the double helix, which could impede replication and compromise genome stability. A new study in Cell shows that the intrinsic physical properties of chromatin fibers dictate how torsional
[Editorial] Child nutrition: the need for courageous action
Dame Sally Davies has stepped down as Chief Medical Officer for England, using her final report to make strong and ambitious recommendations for the UK to stem childhood obesity. Her proposals include a cap on the calories per serving for
Calcinosis in Juvenile Dermatomyositis
Figure 1.
Preexisting Conditions
Doc gets these calls more often now, cries for help from family and friends. They call him, he says, because he’s the one doctor they know who answers the phone himself (he’s retired) — none of that “please listen carefully,
[Editorial] Of mice and mental health
Single-trial neural dynamics are dominated by richly varied movements; or, put another way, mice adorably fidget when thinking hard. This article and linked news item refer to an unexpected finding by Anne Churchland’s group from Cold Spring Harbor Laboratory, USA.
Calcinosis in Juvenile Dermatomyositis
Figure 1.
The low down on back pain . . . and other stories
Low back painLow back pain is the world’s leading cause of disability. Although there are guidelines for diagnosis and management, they are not always fully implemented in primary care. A cluster…
Molecular pathology of neurodegenerative diseases: principles and practice
Neurodegenerative diseases are characterised by selective dysfunction and progressive loss of synapses and neurons associated with pathologically altered proteins that deposit primarily in the human brain and spinal cord. Recent discoveries have identified a spectrum of distinct immunohistochemically and biochemically
A systems approach to clinical oncology uses deep phenotyping to deliver personalized care
Nature Reviews Clinical Oncology, Published online: 16 October 2019; doi:10.1038/s41571-019-0273-6 A systems biology-based approach incorporating multiscale, longitudinal measurements (from single-cell analyses to whole-body monitoring) would help to decipher the complexity of cancer and would facilitate the development of personalized therapies.
Improving the quality of care for patients with or at risk of atrial fibrillation: an improvement initiative in UK general practices
Objective Atrial fibrillation (AF) is a growing problem internationally and a recognised cause of cardiovascular morbidity and mortality. The London borough of Hounslow has a lower than expected prevalence of AF, suggesting poor detection and associated undertreatment. To improve AF
Will Emergency Holds Reduce Opioid Overdose Deaths?
The opioid overdose crisis has claimed more than 400,000 lives in the United States since 1999. As part of efforts to reduce overdose deaths and increase enrollment in treatment, lawmakers in some states are contemplating enacting or expanding emergency hold
Toward Automated Insulin Delivery
For patients with type 1 diabetes, achieving the glycemic target recommended by the American Diabetes Association remains challenging, despite the use of insulin pumps, sensors for continuous glucose monitoring, the combination of these technologies (sensor-augmented pump), and systems that…
Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes
Despite advances in care, attaining good glycemic outcomes in patients with type 1 diabetes remains challenging; the targets set by the American Diabetes Association are met in only a minority of patients. The use of a closed-loop system (also referred
Will Emergency Holds Reduce Opioid Overdose Deaths?
The opioid overdose crisis has claimed more than 400,000 lives in the United States since 1999. As part of efforts to reduce overdose deaths and increase enrollment in treatment, lawmakers in some states are contemplating enacting or expanding emergency hold
Hostile environment: doctors mustn’t lose sight of core professional values
Salisbury is spot on in her discussion of the NHS’s hostile position towards healthcare provision for overseas visitors, but education is the solution.1 Junior doctors need more training in dealing…
Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer
Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment
Nivolumab effective in oesophageal carcinoma
Nature Reviews Clinical Oncology, Published online: 15 October 2019; doi:10.1038/s41571-019-0289-y Nivolumab effective in oesophageal carcinoma
piRNAs make sense of retroviral invaders
Nature Reviews Genetics, Published online: 15 October 2019; doi:10.1038/s41576-019-0187-2 A new study in Cell reports that sense-strand Piwi-interacting RNAs have an important role in protecting the germline genome from invading retroviruses.
Hidden Caveat of Inducible Cre Recombinase
Conditional gene recombination using Cre-loxP system is a powerful and widely used approach employed to interrogate gene function in mouse models. Although Cre-loxP systems are invaluable gene-targeting tools, there are multiple potential caveats that should be considered, as recently commented
Ligelizumab for Chronic Spontaneous Urticaria
Chronic spontaneous urticaria is a skin disorder that is characterized by the occurrence of itchy wheals (hives), angioedema, or both for 6 weeks or more in the absence of specific external stimuli. Studies have indicated that chronic spontaneous urticaria has
Correction: Heart sounds: a pilot randomized trial to determine the feasibility and acceptability of audio recordings to improve discharge communications for cardiology inpatients protocol
[Editorial] Let’s talk about sex
The symptoms of menopause can be tremendously distressing, yet this life transition is still shrouded in stigma. To raise awareness for the health, personal and social issues women can experience when approaching, during and after the menopause, the International Menopause
Case 31-2019: A 45-Year-Old Woman with Headache and Somnolence
Presentation of Case. Dr. Elinor L. Baron: A 45-year-old woman with multiple sclerosis, seronegative inflammatory polyarthritis, and migraine was admitted to this hospital during the winter because of lethargy and decreased verbal output. The patient had been in her usual
Controlled Trial of Two Incremental Milk-Feeding Rates in Preterm Infants
Infants who are very preterm ( Existing trial data are insufficient to determine whether advancing enteral feeding volumes slowly (typically by Methods. Trial Design and Procedures. The trial was a multicenter, parallel-group, randomized, controlled trial that followed a published protocol
Improving Nutrition to Save Lives
Greater investment in ensuring access to good nutrition could save 3.7 million lives by 2025, according to a World Health Organization (WHO) report.
Correction: Trends in the method and gestational age of abortion in high-income countries
Popinchalk A, Sedgh G. Trends in the method and gestational age of abortion in high-income countries. BMJ Sexual & Reproductive Health 2019;45:95-103. doi: 10.1136/bmjsrh-2018-200149 In this article, the following changes should have been made in the published version. On page
Doctors join Extinction Rebellion demonstrations
bmj;367/oct15_13/l6037/FAF1faDominic Lipinski/PADoctors and other healthcare workers joined demonstrations by the climate change action group Extinction Rebellion in central London last week. They…
Responsibility for health
The question of whether any of us can truly be held responsible for what we do is an issue that occupied the ancient Greeks and continues to entertain our leading thinkers. Whether we can be held responsible for our health,
Clinical evidence guidelines in systemic lupus erythematosus: revaluation
The paper on the First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus (SLE) points to some conclusions that need to be further clarified since the bulk of evidence points to a different direction.1 Belimumab safety
Highlights from this issue
Fireworks Night is an annual British event that marks the occasion of the foiling of the Gunpowder Plot on the 5th November 1605. These nocturnal festivities recount the arrest of Guy Fawkes, whilst he was guarding the explosives secretly placed
Venetoclax in Lymphoid Malignancies: New Insights, More to Learn
In this issue of Cancer Cell, Guièza et al. describe that overexpression of the pro-survival protein MCL1 and cellular energy metabolic reprogramming can contribute to resistance to the BCL2 inhibitor venetoclax in patients with chronic lymphocytic leukemia. This adds a new
Author Correction: Postzygotic inactivating mutations of RHOA cause a mosaic neuroectodermal syndrome
Nature Genetics, Published online: 14 October 2019; doi:10.1038/s41588-019-0527-3 Author Correction: Postzygotic inactivating mutations of RHOA cause a mosaic neuroectodermal syndrome
Evolutionary entanglement of mobile genetic elements and host defence systems: guns for hire
Nature Reviews Genetics, Published online: 14 October 2019; doi:10.1038/s41576-019-0172-9 Incessant encounters of all cellular life forms with mobile genetic elements (MGEs) have driven the evolution of diverse defence mechanisms, including CRISPR–Cas and restriction–modification systems. In this Perspective, Koonin, Makarova, Wolf
A Better IgE Trap to Control Urticaria
Chronic spontaneous urticaria is a benign disease with symptoms that adversely affect quality of life, such as disrupted sleep, distracting pruritus, and unsightly wheals. Spontaneous attacks without identifiable triggers render prevention impossible. As a result, the therapeutic goal is complete…
Endocarditis: the Cinderella of Cardiology is back!
Serine and Lipid Metabolism in Macular Disease and Peripheral Neuropathy
Understanding the pathophysiology of diseases with complex genetic inheritance patterns is challenging. Macular telangiectasia type 2, which has a prevalence of 0.0045% to 0.06%, is a rare macular disease that leads to loss of central vision, with the onset of
Conservative Oxygen Therapy during Mechanical Ventilation in the ICU
The provision of supplemental oxygen to patients in the intensive care unit (ICU) who require invasive mechanical ventilation often exposes them to a high fraction of inspired oxygen (Fio2) and a higher-than-normal partial pressure of arterial oxygen (Pao2). Among adults
US hospital is accused of keeping vegetative patient alive to boost its transplant survival rate
Federal agents are investigating a New Jersey hospital accused of keeping a patient with catastrophic brain damage alive for a year and barely consulting his family, in order to keep its one year…
Into ploughshares: forging effective surveillance for work-related lung disease
This year marks the 30th anniversary of the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) programme, the voluntary scheme for surveillance originally established at the National Heart and Lung Institute in London in January 1989. The SWORD surveillance programme
Ligelizumab for Chronic Spontaneous Urticaria
Chronic spontaneous urticaria is a skin disorder that is characterized by the occurrence of itchy wheals (hives), angioedema, or both for 6 weeks or more in the absence of specific external stimuli. Studies have indicated that chronic spontaneous urticaria has
Case 31-2019: A 45-Year-Old Woman with Headache and Somnolence
Presentation of Case. Dr. Elinor L. Baron: A 45-year-old woman with multiple sclerosis, seronegative inflammatory polyarthritis, and migraine was admitted to this hospital during the winter because of lethargy and decreased verbal output. The patient had been in her usual
Editörden
Değerli Adli Bilimciler, Adli Tıp Bülteni’nin yeni sayısıyla karşınızdayız. Dergimizin ülkemizde Tübitak Ulakbim TR ve DOAJ (Directory of Open Access Journals) tarafından dizinlenen tek adli bilimler dergisi olması ve adli bilimler alanının bilimsel patformuna dönüşmesi yeni hedefleri de zorunlu kılmaktadır.
Sudan Çıkarılmış Cesetlerde Kolloidal Silika Gradyen Santrifüj Metodu Kullanılarak Vücudun Dış Yüzeylerinden ve İç Organlardan Elde Edilen Diatomların Karşılaştırılması
Amaç: Diatom analizi, suda boğulma olgularında ölüm nedeninin ve boğulma ortamının tespitinde kullanılan çok değerli bir araçtır. Diatom analizinin temel prensibi, boğulma ortamında bulunan diatomların, suyun inhalasyonu yolu ile penetrasyonu ve alveollerden genel kan dolaşımına katılarak karaciğer, beyin, kemik iliği
Sık Hastane Başvurusu Ev içi Şiddetin Habercisi mi?
Amaç:Eş şiddeti toplumun her kesiminde değişik oranlarda görülmektedir ve orta-uzun vadede çok farklı sağlık sorunlarına neden olabilmektedir. Bu çalışmada, Adli Tıp Polikliniğine eşinden/partnerinden şiddet görme nedeniyle başvuran olguların son bir yıl içindeki hastane başvurularını değerlendirerek; şiddet mağdurlarının sağlık sorunlarını ortaya
Profesyonel Araç Sürücülerinde Sürücü Davranışları ve Becerileri ile Alkol, Madde ve İlaç Kullanımının Değerlendirilmesi
Giriş: Sürücü davranışları ve sürücülük becerileri, trafikte kaza riskini oluşturan ana unsurlar arasında yer almaktadır. Alkol ve madde etkisi altında araç kullanma davranışı; ölümlere, maddi hasarlara ve yaralanmalara neden olan önemli bir trafik sorunudur. Bu çalışmada; profesyonel araç sürücülerinde alkol,
Ekstremite Kırığı Olgularında Tedavi Seçeneklerinin ve Meslekte Çalışma Gücü Kaybı ve Engellilik Oranlarının Karşılaştırılması
Amaç: Çalışmamızda; trafik kazası sonucu meydana gelen kemik kırıklarına uygulanan tedavilerin başarıları ile bu tedavi sonucunda kalan sekellere ait meslekte kazanma gücü kaybı ve özürlülük oranlarının hesaplanarak kıyaslanması amaçlanmıştır. Gereç ve Yöntem:01 Şubat 2016 – 01 Şubat 2017 tarihleri arasında
CDK4/6 inhibitors prolong OS
Nature Reviews Clinical Oncology, Published online: 11 October 2019; doi:10.1038/s41571-019-0288-z CDK4/6 inhibitors prolong OS
Racial differences in body composition and cardiometabolic risk during the menopause transition: a prospective, observational cohort study
Obesity disproportionately affects more women than men. The loss of ovarian function during the menopause transition coincides with weight gain, increases in abdominal adiposity, and impaired metabolic health. Racial differences in obesity prevalence that results from the menopause transition are
Determinants of enhancer and promoter activities of regulatory elements
Nature Reviews Genetics, Published online: 11 October 2019; doi:10.1038/s41576-019-0173-8 Activating transcriptional regulatory elements have traditionally been categorized into promoters, which define transcription start sites, and enhancers, which act distally to stimulate transcription. In this Review, Andersson and Sandelin discuss the
Complete Revascularization with Multivessel PCI for Myocardial Infarction
Primary percutaneous coronary intervention (PCI) is the preferred method of reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). These patients often have multivessel coronary artery disease, with additional angiographically significant lesions in locations separate…
Phakomatosis Pigmentokeratotica
Figure 1.
Imaging of Vaping-Associated Lung Disease
To the Editor: Lung injury associated with vaping — the use of electronic nicotine delivery systems (ENDS) — has been recognized in the medical literature, and a case series of such injuries is now published in the Journal. If vaping
Live Offspring after Testis Tissue Transplantation
Substantive improvements in the treatment of pediatric diseases such as leukemia and sarcomas have led to greater numbers of survivors, many of whom have reduced fertility. One means of preserving the reproductive potential of male patients who have reached adolescence
Algorithm-Aided Prediction of Patient Preferences — An Ethics Sneak Peek
The use of artificial intelligence (AI) is increasingly common in medicine, as it is in other fields. Just as AI systems using natural language processing answer legal questions, predict court decisions, and prepare contracts, and as self-driving cars gather traffic
Serine and Lipid Metabolism in Macular Disease and Peripheral Neuropathy
Understanding the pathophysiology of diseases with complex genetic inheritance patterns is challenging. Macular telangiectasia type 2, which has a prevalence of 0.0045% to 0.06%, is a rare macular disease that leads to loss of central vision, with the onset of
Trends in Adolescent Vaping, 2017–2019
To the Editor: The rapid increase in adolescents’ use of electronic cigarettes (known as vaping) during the past decade has aroused public health concern, recently heightened by potential links between vaping and acute lung injury. Adolescents who vape use a
Imaging of Vaping-Associated Lung Disease
To the Editor: Lung injury associated with vaping — the use of electronic nicotine delivery systems (ENDS) — has been recognized in the medical literature, and a case series of such injuries is now published in the Journal. If vaping
Psychiatrist plans to leave NHS if his mother is refused permission to stay in UK
An experienced consultant child psychiatrist plans to leave the NHS and move to Australia unless the Home Office grants his widowed mother permission to stay in the UK by Christmas.Nishchint Warikoo,…
BEACON of hope in BRAFV600E CRC
Nature Reviews Clinical Oncology, Published online: 10 October 2019; doi:10.1038/s41571-019-0286-1 BEACON of hope in BRAFV600E CRC
Phakomatosis Pigmentokeratotica
Figure 1.
Zika Virus Infection — After the Pandemic
Zika virus (ZIKV) was discovered in Africa in 1947 and was first detected in Asia in 1966, yet its potential effect on public health was not recognized until the virus caused outbreaks in the Pacific from 2007 to 2015 and
Serine and Lipid Metabolism in Macular Disease and Peripheral Neuropathy
Understanding the pathophysiology of diseases with complex genetic inheritance patterns is challenging. Macular telangiectasia type 2, which has a prevalence of 0.0045% to 0.06%, is a rare macular disease that leads to loss of central vision, with the onset of
A Better IgE Trap to Control Urticaria
Chronic spontaneous urticaria is a benign disease with symptoms that adversely affect quality of life, such as disrupted sleep, distracting pruritus, and unsightly wheals. Spontaneous attacks without identifiable triggers render prevention impossible. As a result, the therapeutic goal is complete…
Mobile phone text-messaging interventions aimed to prevent cardiovascular diseases (Text2PreventCVD): systematic review and individual patient data meta-analysis
Background A variety of small mobile phone text-messaging interventions have indicated improvement in risk factors for cardiovascular disease (CVD). Yet the extent of this improvement and whether it impacts multiple risk factors together is uncertain. We aimed to conduct a
Proposals to Redesign Medicare Part D — Easing the Burden of Rising Drug Prices
Amid concerns about high and rising drug prices, policymakers are considering options for modifying the Medicare Part D prescription-drug benefit to reduce spending by beneficiaries and taxpayers. Medicare beneficiaries without low-income subsidies currently face high and unlimited out-of-pocket…
Case 31-2019: A 45-Year-Old Woman with Headache and Somnolence
Presentation of Case. Dr. Elinor L. Baron: A 45-year-old woman with multiple sclerosis, seronegative inflammatory polyarthritis, and migraine was admitted to this hospital during the winter because of lethargy and decreased verbal output. The patient had been in her usual
[Editorial] E-cigarettes: time to realign our approach?
A multistate, US outbreak of lung injury associated with e-cigarette use has affected at least 1080 people and caused 18 deaths as of Oct 1, according to the US Centers for Disease Control and Prevention (CDC). This number looks set
Case 31-2019: A 45-Year-Old Woman with Headache and Somnolence
Presentation of Case. Dr. Elinor L. Baron: A 45-year-old woman with multiple sclerosis, seronegative inflammatory polyarthritis, and migraine was admitted to this hospital during the winter because of lethargy and decreased verbal output. The patient had been in her usual
Severe obesity in year 6 children in England reaches new high
New data show that 4.4% of year 6 schoolchildren in England are classified as severely obese, the highest rate on record.1 The figures from NHS Digital show that the rate of severe obesity among…
Heartbeat: sex differences in patient-reported outcomes with atrial fibrillation
Patient-reported outcome measures (PROMs) now are recognised as an essential element in clinical cardiovascular research studies. In addition, we are increasing aware of significant sex differences, not only in risk factors, clinical presentation and outcomes, but in the treatments provided
Correction: oral ponesimod in relapsing-remitting multiple sclerosis: a randomised phase II trial
Olsson T, Boster A, Fernández Ó, et al. Oral ponesimod in relapsing–remitting multiple sclerosis: a randomised phase II trial. J Neurol Neurosurg Psychiatry 2014;85:1198–1208. For Figure 3 (A), the 95% CI values provided for the 3 Ponesimod groups below each
Pathology of Vaping-Associated Lung Injury
To the Editor: Despite the accumulating data on the clinical and imaging features of vaping-associated lung injury, its pathology is poorly understood. We reviewed lung biopsies from 17 patients (13 men; median age, 35 years [range, 19–67]), all of whom
A Better IgE Trap to Control Urticaria
Chronic spontaneous urticaria is a benign disease with symptoms that adversely affect quality of life, such as disrupted sleep, distracting pruritus, and unsightly wheals. Spontaneous attacks without identifiable triggers render prevention impossible. As a result, the therapeutic goal is complete…
Drug Regulation in the Era of Individualized Therapies
Kim et al. in a report now published in the Journal, describe the discovery, development, and administration of an antisense oligonucleotide (ASO) therapy specifically designed for a single patient with CLN7 neuronal ceroid lipofuscinosis (a form of Batten’s disease), a
Longer-Term Outcomes of HIV-Positive–to–HIV-Positive Renal Transplantation
To the Editor: The longer-term clinical outcomes of renal transplantation in human immunodeficiency virus (HIV)–positive patients who have received organs from HIV-positive donors, as well as the potential risks associated with donor-derived HIV superinfection among such patients, are unknown. We…
[Editorial] Universal health coverage and the forgotten generation
At the UN General Assembly (UNGA) on Sept 23, a high-level meeting on universal health coverage reaffirmed the value of achieving the highest attainable standard of physical and mental health for every human being. Heads of State and Government recommitted
Drug Regulation in the Era of Individualized Therapies
Kim et al. in a report now published in the Journal, describe the discovery, development, and administration of an antisense oligonucleotide (ASO) therapy specifically designed for a single patient with CLN7 neuronal ceroid lipofuscinosis (a form of Batten’s disease), a
Behavior Matters
Neuroscience needs behavior. This is the powerful title of a seminal review article by Krakauer et al. that Neuron published in 2017. As argued by the authors, identifying the neural basis of behavior requires the understanding of the behavior itself prior
[Editorial] Patient-reported outcomes in the spotlight
The importance of patients’ perspectives on their disease status and quality of life is well recognised as an essential part of research studies and neurological practice. How best to incorporate patient-reported outcomes (PROs) in clinical studies and, eventually, into clinical
Tommy’s campaign uses emotive language around pregnancy loss
Obviously I welcome further research into the causes and prevention of pregnancy loss, but I take issue with the wording used around Tommy’s new Tell Me Why campaign and its media coverage.1Saying…
ACE gene missense mutation in a case with early-onset, rapid progressing dementia
The population of early-onset Alzheimer’s disease (EOAD) accounts for 1%–2% of the total population of Alzheimer’s disease, and genetic mutations are more common in EOAD. The first symptom of the patient in the present case report was the decline in
Oncolysis without viruses — inducing systemic anticancer immune responses with local therapies
Nature Reviews Clinical Oncology, Published online: 08 October 2019; doi:10.1038/s41571-019-0272-7 Oncolytic viruses are beginning to enter clinical use in patients with cancer despite regulatory and practical considerations precluding the widespread use of such therapies. Here, the authors describe the potential
Mumps in Migrant Detention Centers
Nearly 900 confirmed and probable cases of mumps have been identified in US migrant detention centers in the past year, according to a recent CDC investigation.
GSK recalls ranitidine products over potential carcinogen contamination
Pharmacies should stop dispensing four prescription ranitidine products supplied by GlaxoSmithKline (GSK) and should return any stock to the company, says an alert issued by the UK Medicines and…
Adolescent and young adult oncology—past, present, and future
Abstract There are nearly 70,000 new cancer diagnoses made annually in adolescents and young adults (AYAs) in the United States. Historically, AYA patients with cancer, aged 15 to 39 years, have not shown the same improved survival as older or younger
Publisher Correction: Inferring whole-genome histories in large population datasets
Nature Genetics, Published online: 07 October 2019; doi:10.1038/s41588-019-0523-7 Publisher Correction: Inferring whole-genome histories in large population datasets
1000 MitraClip™ proceduresLessons learnt from the largest single-centre experience worldwide
Ligelizumab for Chronic Spontaneous Urticaria
Chronic spontaneous urticaria is a skin disorder that is characterized by the occurrence of itchy wheals (hives), angioedema, or both for 6 weeks or more in the absence of specific external stimuli. Studies have indicated that chronic spontaneous urticaria has
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