Expect the unexpected: screening for secondary findings in clinical genomics research
AbstractBackgroundDue to decreasing cost, and increasing speed and precision, genomic sequencing in research is resulting in the generation of vast amounts of genetic data. The question of how to manage that information has been an area of significant debate. In particular, there has been much discussion around the issue of ‘secondary findings’ (SF)—findings unrelated to the research that have diagnostic significance.Sources of dataThe following includes ethical commentaries, guidelines and policies in respect to large-scale clinical genomics studies.Areas of agreementResearch participant autonomy and their informed ...
Source: British Medical Bulletin - April 7, 2017 Category: General Medicine Source Type: research
Apoptosis and rotator cuff tears: scientific evidence from basic science to clinical findings
AbstractIntroductionExcessive apoptosis has been hypothesized as possible cause of tendinopathy and tear in the tendons of the rotator cuff (RC). Different mechanisms and molecules play a key role in cell regulation. Biological interventions can affect the process of apoptosis to control the tendinopathy process, and may be useful to design new treatments.Source of dataWe identified basic science,in vitro andin vivo preclinical and clinical studies listed in the Pubmed Google Scholar, CINAHL, Cochrane Central and Embase Biomedical databases in English, Spanish, Italian and French concerning the effects of apoptosis on RC t...
Source: British Medical Bulletin - March 24, 2017 Category: General Medicine Source Type: research
Colour vision requirements in visually demanding occupations
AbstractNormal trichromatic colour vision (CV) is often required as a condition for employment in visually demanding occupations. If this requirement could be enforced using current, colour assessment tests, a significant percentage of subjects with anomalous, congenital trichromacy who can perform the suprathreshold, colour-related tasks encountered in many occupations with the same accuracy as normal trichromats would fail. These applicants would therefore be discriminated against unfairly. One solution to this problem is to produce minimum, justifiable CV requirements that are specific to each occupation. This has been ...
Source: British Medical Bulletin - March 18, 2017 Category: General Medicine Source Type: research
Utilization of health care services by migrants in Europe and The ethics of reporting all the results of clinical trials
(Source: British Medical Bulletin)
Source: British Medical Bulletin - March 13, 2017 Category: Journals (General) Source Type: research
Effect of vitamin D deficiency in developed countries
AbstractIntroductionVitamin D deficiency is common worldwide with adverse effects on skeletal health. In recent years, there has been great interest in non-classical actions of vitamin D. Basic research has uncovered actions in a range of non-skeletal tissues, and observational studies have identified inverse relationships with risk of a number of disease states including sarcopenia, obesity, the metabolic syndrome, cardiovascular disease, cancer and autoimmune diseases.Sources of dataPubMed, Medline and Cochrane Systematic Reviews.Areas of agreementCurrent evidence supports the use of vitamin D supplementation in deficien...
Source: British Medical Bulletin - March 9, 2017 Category: General Medicine Source Type: research
The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review
AbstractIntroductionOsteoarthritis (OA) often leads to symptoms such as pain, stiffness and decreased function. OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise.Sources of dataSearches of the electronic databases, PubMed, ISI web of science, PEDro and SPORTDiscus, were conducted for all Level 1 –4 studies published from inception through to December 2016.Areas of agreementTen studies were evaluated and results show significant improvement in scores for pain, function and range of motion, both ...
Source: British Medical Bulletin - March 4, 2017 Category: General Medicine Source Type: research
Surgical versus conservative management of Type III acromioclavicular dislocation: a systematic review
AbstractIntroductionThe management of Type III acromioclavicular (AC) dislocations is still controversial. We wished to compare the rate of recurrence and outcome scores of operative versus non-operative treatment of patients with Type III AC dislocations.Source of dataA systematic review of the literature was performed by applying the PRISMA guidelines according to the PRISMA checklist and algorithm. A search in Medline, PubMed, Cochrane and CINAHL was performed using combinations of the following keywords: ‘dislocation’, ‘Rockwood’, ‘type three’, ‘treatment’, ‘acromioclavicular’ and ‘joint’.Areas ...
Source: British Medical Bulletin - February 27, 2017 Category: General Medicine Source Type: research
Ethical issues of CRISPR technology and gene editing through the lens of solidarity
AbstractBackgroundThe avalanche of commentaries on CRISPR –Cas9 technology, a bacterial immune system modified to recognize any short DNA sequence, cut it out, and insert a new one, has rekindled hopes for gene therapy and other applications and raised criticisms of engineering genes in future generations.Sources of dataThis discussion draws on articles that emphasize ethics, identified partly through PubMed and Google, 2014 –2016.Areas of agreementCRISPR –Cas9 has taken the pace and prospects for genetic discovery and applications to a high level, stoking anticipation for somatic gene engineering to help patients. W...
Source: British Medical Bulletin - February 23, 2017 Category: General Medicine Source Type: research
Measuring maternal mortality: a systematic review of methods used to obtain estimates of the maternal mortality ratio (MMR) in low- and middle-income countries
(Source: British Medical Bulletin)
Source: British Medical Bulletin - February 17, 2017 Category: General Medicine Source Type: research
Stem cell therapy for ischemic heart diseases
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Ischemic heart diseases, especially the myocardial infarction, is a major hazard problem to human health. Despite substantial advances in control of risk factors and therapies with drugs and interventions including bypass surgery and stent placement, the ischemic heart diseases usually result in heart failure (HF), which could aggravate social burden and increase the mortality rate. The current therapeutic methods to treat HF stay at delaying the disease progression without repair and reg...
Source: British Medical Bulletin - February 5, 2017 Category: Journals (General) Source Type: research
Utilization of health care services by migrants in Europe—a systematic literature review
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries.<div class="boxTitle">Sources of data</div>A systematic literature review was performed, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39.<div class="boxTitl...
Source: British Medical Bulletin - January 19, 2017 Category: Journals (General) Source Type: research
The ethics of reporting all the results of clinical trials
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction or background</div>The terms ‘publication bias’ and ‘reporting bias’ describe aspects of a phenomenon by which data from trials are not publicized, and so remain inaccessible. This may generate a false impression about the world; but those facts may have important implications for clinical decisions. Thus, the bias may leave patients worse off than they might be.<div class="boxTitle">Sources of data</div>Published journal articles.<div class="boxTitle">Areas of agreem...
Source: British Medical Bulletin - January 18, 2017 Category: Journals (General) Source Type: research
Measuring maternal mortality: a systematic review of methods used to obtain estimates of the maternal mortality ratio (MMR) in low- and middle-income countries
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>The new global target for maternal mortality ratio (MMR) is a ratio below 70 maternal deaths per 100 000 live births by 2030. We undertook a systematic review of methods used to measure MMR in low- and middle-income countries.<div class="boxTitle">Sources of data</div>Systematic review of the literature; 59 studies included.<div class="boxTitle">Areas of agreement</div>Civil registration (5 studies), census (5) and surveys (16), Reproductive Age Mortality Studies (RA...
Source: British Medical Bulletin - January 18, 2017 Category: Journals (General) Source Type: research
Implementing electronic records in NHS secondary care organizations in England: policy and progress since 1998
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>A number of different policies have aimed to introduce electronic records into National Health Service (NHS) secondary care organizations in England over recent years. There has been little formal attempt to explore the overall impact of these policies (as opposed to evaluations of individual initiatives) and how they have developed and progressed over time.<div class="boxTitle">Sources of data</div>National NHS IT policy documents and evaluations of national NHS IT policy betwe...
Source: British Medical Bulletin - January 8, 2017 Category: Journals (General) Source Type: research
The effect of economic development on population health: a review of the empirical evidence
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Economic growth is considered an important determinant of population health.<div class="boxTitle">Sources of data</div>Relevant studies investigating the effect of economic growth on health outcomes were identified from Google Scholar and PubMed searches in economics and medical journals.<div class="boxTitle">Areas of agreement</div>Additional resources generated through economic growth are potentially useful for improving population health.<div class="boxTitle"&g...
Source: British Medical Bulletin - January 8, 2017 Category: Journals (General) Source Type: research
