Public health in England in 2016—the health of the public and the public health system: a review
This article describes the current state of the health of the public in England and the state of the public health professional service and systems.<div class="boxTitle">Sources of data</div>Data sources are wide ranging including the Global Burden of Disease, the Commonwealth Fund and Public Health England reports.<div class="boxTitle">Areas of agreement</div>There is a high burden of preventable disease and unacceptable inequalities in England. There is considerable expectation that there are gains to be made in preventing ill health and disability and so relieving demand on healthcare.<div cla...
Source: British Medical Bulletin - January 8, 2017 Category: Journals (General) Source Type: research
Ocular oncology: advances in retinoblastoma, uveal melanoma and conjunctival melanoma
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Retinoblastoma, uveal and conjunctival melanomas are important malignancies within the remit of ocular oncology. Outlined are the diagnostic features and management principles, as well as advancements in the field and current challenges.<div class="boxTitle">Sources of data</div>Original papers, reviews and guidelines.<div class="boxTitle">Areas of agreement</div>Most eyes with retinoblastoma (International Intraocular Retinoblastoma Classification (IIRC) Group A–D...
Source: British Medical Bulletin - January 8, 2017 Category: Journals (General) Source Type: research
The cancer risk related to meat and meat products
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Meat has been classified by International Agency for Research on Cancer (IARC) as carcinogenic to humans. The evidence and the implications for health are reviewed.<div class="boxTitle">Sources of data</div>Evidence was obtained from published reports and systematic reviews published before and since the IARC decision.<div class="boxTitle">Areas of agreement</div>Epidemiology indicates that processed meat products are associated with increased risk of colorectal ca...
Source: British Medical Bulletin - December 17, 2016 Category: Journals (General) Source Type: research
Functional assessment of thoracic aortic aneurysms – the future of risk prediction?
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Treatment guidelines for the thoracic aorta concentrate on size, yet acute aortic dissection or rupture can occur when aortic size is below intervention criteria. Functional imaging and computational techniques are a means of assessing haemodynamic parameters involved in aortic pathology.<div class="boxTitle">Sources of data</div>Original articles, reviews, international guidelines.<div class="boxTitle">Areas of agreement</div>Computational fluid dynamics and 4D fl...
Source: British Medical Bulletin - December 17, 2016 Category: Journals (General) Source Type: research
In this issue Volume 120
(Source: British Medical Bulletin)
Source: British Medical Bulletin - December 9, 2016 Category: Journals (General) Source Type: research
Microbiome, antibiotics and irritable bowel syndrome
<span class="paragraphSection"><div class="boxTitle">Introduction</div>Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal (GI) disorder. Increasing evidence implicates the GI microbiota in IBS pathogenesis and its modulation represents an emerging therapeutic strategy.<div class="boxTitle">Sources of data</div>Original and review articles were identified through selective searches performed on PubMed and Google Scholar.<div class="boxTitle">Areas of agreement</div>The role of gut microbiota in IBS is supported by evidence from animal and human studies....
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Genetic predisposition to prostate cancer
<span class="paragraphSection"><div class="boxTitle">Introduction</div>Prostate cancer (PrCa) is the commonest non-cutaneous cancer in men in the UK. Epidemiological evidence as well as twin studies points towards a genetic component contributing to aetiology.<div class="boxTitle">Sources of data</div>Key recently published literature.<div class="boxTitle">Areas of agreement</div>A family history of PrCa doubles the risk of disease development in first-degree relatives. Linkage and genetic sequencing studies identified rare moderate–high-risk gene loci, which predispose to PrCa d...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
F-18 FDG PET/CT imaging of cardiac and vascular inflammation and infection
<span class="paragraphSection"><div class="boxTitle">Introduction</div>Inflammation forms an important core of the aetiopathogenic process involved in many diseases affecting the heart and the blood vessels. These diseases include infections as well as inflammatory non-infectious cardiovascular conditions. The common feature of this is invasion of the heart or blood vessel by inflammatory cells. F-18 2-fluoro 2-deoxy-D glucose (FDG) is an analogue of glucose and like glucose it is taken up by activated inflammatory cells that accumulate at the site of infection. This has formed the basis of the use of F-1...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
The miracle of face transplantation after 10 years
<span class="paragraphSection"><div class="boxTitle">Introduction</div>At the 10th year anniversary of the first face transplantation, there are currently 36 patients worldwide, who are the recipients of faces coming from human donors.<div class="boxTitle">Areas of agreement</div>Despite the initial debates and ethical concerns, face transplantation became a clinical reality with satisfactory functional outcomes.<div class="boxTitle">Areas of controversy</div>The areas of controversy still include the impact of lifelong immunosuppression on otherwise healthy patients as well as the...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Sugar and Type 2 diabetes
<span class="paragraphSection"><div class="boxTitle">Background</div>Consumption of sugar, specifically sugar-sweetened beverages, has been widely held responsible by the media for the global rise in Type 2 diabetes (T2DM).<div class="boxTitle">Sources of data</div>Systematic reviews and dietary guidelines relating dietary sugars to T2DM.<div class="boxTitle">Areas of agreement</div>Weight gain and T2DM incidence are associated with diet and lifestyle patterns characterized by high consumptions of any sweetened beverages. High sugar intakes impair risk factors for macrovascular com...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Targeted response? An exploration of why ambulance services find government targets particularly challenging
This article explores some areas of this multifaceted problem.<div class="boxTitle">Sources of data</div>Research articles, government publications and published audit data.<div class="boxTitle">Areas of agreement</div>Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success.<div class="boxTitle">Areas of controversy</div&...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Globalizing and crowdsourcing biomedical research
<span class="paragraphSection"><div class="boxTitle">Introduction or background</div>Crowdfunding and crowdsourcing of medical research has emerged as a novel paradigm for many biomedical disciplines to rapidly collect, process and interpret data from high-throughput and high-dimensional experiments. The novelty and promise of these approaches have led to fundamental discoveries about RNA mechanisms, microbiome dynamics and even patient interpretation of test results. However, these methods require robust training protocols, uniform sampling methods and experimental rigor in order to be useful for subsequ...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
China: the tipping point in tobacco control
<span class="paragraphSection"><div class="boxTitle">Background</div>Tobacco control in China, the world's largest producer and consumer of tobacco, began in the 1980s with the first national prevalence survey and a conference on tobacco held in Tianjin. Since then, there have been dozens of research papers, partial restrictions on smoking and tobacco advertising, public education campaigns, and the ratification of the World Health Organization Framework Convention on Tobacco Control, but progress has been slow. The state-owned tobacco industry remains a major obstacle to tobacco control.<div class="bo...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Apophyseal injuries in children's and youth sports
<span class="paragraphSection"><div class="boxTitle">Introduction</div>The authors reviewed the current English literature regarding apophyseal injuries affecting young athletes, to highlight the frequency and characteristics of these injuries, to clarify risk factors and specific prevention measures, and to identify future research objectives.<div class="boxTitle">Sources of data</div>The authors performed a comprehensive search of the medical literature, using the Medline database, including all English articles. Various combinations of the Keywords ‘injury’, ‘sports’, ‘athletic in...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
Advances in the recognition and management of hereditary cancer
<span class="paragraphSection"><div class="boxTitle">Introduction</div>Constitutional mutations in genes controlling DNA repair, cell-cycle regulation and cell apoptosis can determine an individual's tendency to develop cancer. Hereditary cancer predisposition syndromes present with multiple cancers at a young age and underlie a significant burden of morbidity and mortality. Recent advances in the recognition and management of hereditary cancer will be illustrated with specific examples of developments in diagnosis and treatment.<div class="boxTitle">Sources of data</div>Key recent published l...
Source: British Medical Bulletin - December 8, 2016 Category: Journals (General) Source Type: research
