Coronary heart disease and household air pollution from use of solid fuel: a systematic review
Background
Evidence is emerging that indoor air pollution (IAP) from use of solid fuels for cooking and heating may be an important risk factor for coronary heart disease (CHD).
Sources of data
We searched the Ovid Medline, Embase Classic, Embase and Web of Science databases from inception through to June 12, 2015, to identify reports of primary epidemiological research concerning the relationship of CHD to IAP from solid fuel, the likely magnitude of any increase in risk, and potential pathogenic mechanisms.
Areas of agreement
The current balance of epidemiological evidence points to an increased risk of CHD from IAP as...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Fatmi, Z., Coggon, D. Tags: Invited review Source Type: research
Arthroscopic treatment of tibial eminence fracture: a systematic review of different fixation methods
Introduction
Arthroscopy procedures are the gold standard for the management of tibial spine avulsion. This review evaluates and compares different arthroscopic treatment options for tibial spine fractures.
Source of data
PubMed, Medline, Ovid, Google Scholar and Embase databases were systematically searched with no limit regarding the year of publication.
Areas of agreement
An arthroscopic approach compared with arthrotomy reduces complications such as soft-tissue lesions, post-operative pain and length of hospitalization.
Areas of controversy
The use of suture techniques, compared to cannulated screw technique, avoids...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Osti, L., Buda, M., Soldati, F., Del Buono, A., Osti, R., Maffulli, N. Tags: Invited review Source Type: research
The use of adjustable gastric bands for management of severe and complex obesity
Background
Obesity levels in the UK have reached a sustained high and ~4% of the population would be candidates for bariatric surgery based upon current UK NICE guidelines, which has important implications for Clinical Commissioning Groups.
Sources of data
Summary data from Cochrane systematic reviews, randomized controlled trials (RCTs) and cohort studies.
Areas of agreement
Currently, the only treatment that offers significant and durable weight loss for those with severe and complex obesity is surgery. Three operations account for 95% of all bariatric surgery in the UK, but the NHS offers surgery to only a small fract...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Hopkins, J. C. A., Blazeby, J. M., Rogers, C. A., Welbourn, R. Tags: Invited review Source Type: research
Chronic granulomatous disease
Introduction
Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent, life-threatening bacterial and fungal infections of the skin, the airways, the lymph nodes, the liver, the brain and the bones. Frequently found pathogens are Staphylococcus aureus, Aspergillus species, Klebsiella species, Burkholderia cepacia, Serratia marcescens and Salmonella species.
Sources of data
CGD is a rare (~1:250 000 individuals) disease caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This enzyme generates superoxide and is essential for intracellular k...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Roos, D. Tags: Invited review Source Type: research
Core decompression versus other joint preserving treatments for osteonecrosis of the femoral head: a meta-analysis
Introduction
Osteonecrosis of femoral head (ONFH) leads to hip osteoarthritis (HOA); among joint preserving treatments (JPT), the role of core decompression (CD) is still debated. We assessed the efficacy of CD compared with all other JPT in delaying the natural osteonecrosis evolution to HOA.
Sources of data
Following the PRISMA checklist, the Medline and Scopus databases were searched. Fifteen- to 70-year-old subjects with ONFH with a minimum follow-up of 24 months were considered. The outcomes evaluated were patient clinical status, radiographic progression and total hip arthroplasty (THA) or further surgery (FS) need....
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Sadile, F., Bernasconi, A., Russo, S., Maffulli, N. Tags: Invited review Source Type: research
Public access defibrillation: improving accessibility and outcomes
Background
Worldwide, out-of-hospital cardiac arrest (OHCA) remains a serious problem. Public access defibrillation (PAD) has been shown to be effective in improving survival in OHCA with good neurological outcome.
Sources of data
Original articles, reviews and national/international guidelines.
Areas of agreement
Limitations to how much we can improve ambulance response times mean that the public have an essential role to play in OHCA survival. Training of laypersons in the use of automated external defibrillators (AEDs) has been shown to improve outcomes. Placement of AEDs should be related to underlying population dem...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Mao, R. D., Ong, M. E. H. Tags: Invited review Source Type: research
Devolution and health in the UK: policy and its lessons since 1998
Introduction
Since devolution in 1998, the UK has had four increasingly distinct health systems, in England, Northern Ireland, Scotland and Wales.
Sources of data
Secondary literature and authors’ own research since 1998.
Areas of agreement
From a similar starting point, there has been a considerable distancing of the four health systems from each other in policies, priorities and organization.
Areas of controversy
The comparative efficiency and quality of the different systems as well as the wisdom of their greater or lesser reliance on integration and competition.
Growing points
Better and more comparable publi...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Greer, S. L. Tags: Invited review Source Type: research
Can a good tree bring forth evil fruit? The funding of medical research by industry
Background
Systematic reviews analysing the influence of funding on the conduct of research have shown how Conflicts of Interest (COIs) create bias in the production and dissemination of data.
Sources of data
The following is a critical analysis of current opinions in respect to COIs created by industry funding of medical research in academic institutions.
Areas of agreement
Effective mechanisms are necessary to manage COIs in medical research, and to prohibit COIs that clearly affect validity of research conduct and outcomes.
Areas of controversy
While most hold that industry investment in university research is not a ...
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Capps, B. Tags: Invited review Source Type: research
Editor's Choice
(Source: British Medical Bulletin)
Source: British Medical Bulletin - June 11, 2016 Category: Journals (General) Authors: Vetter, N. Tags: Editorial Source Type: research
Radiofrequency energy in the arthroscopic treatment of knee chondral lesions: a systematic review
Introduction
Cartilage debridement is one of the recommended procedures for the management of chondral defects. Radiofrequency probes allow to debride the cartilage, but may induce subchondral bone necrosis.
Sources of data
Medline, Cochrane and Google Scholar were searched to identify studies on arthroscopic debridement of the articular cartilage of the knee using radiofrequency chondroplasty. The methodological quality of the studies was assessed using the Coleman methodology score (CMS).
Areas of agreement
Monopolar and bipolar radiofrequency devices provide significantly better clinical outcomes, especially for patie...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Rocco, P., Lorenzo, D. B., Guglielmo, T., Michele, P., Nicola, M., Vincenzo, D. Tags: Sports Medicine Articles Source Type: research
The aetiopathogenesis of fatigue: unpredictable, complex and persistent
Background
Chronic fatigue syndrome is a common condition characterized by severe fatigue with post-exertional malaise, impaired cognitive ability, poor sleep quality, muscle pain, multi-joint pain, tender lymph nodes, sore throat or headache. Its defining symptom, fatigue is common to several diseases.
Areas of agreement
Research has established a broad picture of impairment across autonomic, endocrine and inflammatory systems though progress seems to have reached an impasse.
Areas of controversy
The absence of a clear consensus view of the pathophysiology of fatigue suggests the need to switch from a focus on abnormali...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Clark, J. E., Fai Ng, W., Watson, S., Newton, J. L. Tags: Geriatric Medicine Articles Source Type: research
Vertebral osteomyelitis in adults: an update
Introduction
The incidence of vertebral osteomyelitis is increasing, attributed to an ageing population with inherent co-morbidities and improved case ascertainment.
Sources of data
References were retrieved from the PubMed database using the terms ‘vertebral osteomyelitis' and ‘spondylodiscitis' between January 1, 2009 and April 30, 2014 published in English as checked in May 2014 (>1000 abstracts checked).
Areas of agreement
Blood cultures and whole spine imaging with magnetic resonance imaging are essential investigations. Thorough debridement is the mainstay of surgical management, although placing met...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Nickerson, E. K., Sinha, R. Tags: Infectious Diseases Articles Source Type: research
Contemporary management of acute and chronic deep venous thrombosis
Introduction
This review aims to provide an update on the management of deep vein thrombosis (DVT).
Sources of data
A systematic search of PubMed, Google Scholar and Cochrane databases was carried out.
Areas of agreement
Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT. Compression bandaging can help heal a venous ulcer.
Areas of controversy
Compression hosiery to prevent post thrombotic syndrome. Long-term evidence to show clinical benefit of using...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Saha, P., Black, S., Breen, K., Patel, A., Modarai, B., Smith, A. Tags: Cardiovascular Disease Articles Source Type: research
Ebola virus disease: emergence, outbreak and future directions
Background
The West African Ebola crisis of 2013–15 is the largest outbreak since Ebola was first identified; Ebola has high case fatality.
Sources of Data
Pubmed with terms ‘Ebola’ and ‘EVD’ from January 1976 to June 2015. Public domain material.
Areas of Agreement
The emergence of Ebola virus, virology, clinical features and the major elements of the 2014 outbreak and the public health response. Ebola is only transmitted by direct contact with infected individuals (including dead bodies) and their body fluids. Methods of control in hospitals and burials, and protection of healthcare worker...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Lever, R. A., Whitty, C. J. M. Tags: Infectious Diseases Articles Source Type: research
Freezing and non-freezing cold weather injuries: a systematic review
Introduction
The debilitating impact of cold weather on the human body is one of the world's oldest recorded injuries. The severe and life-changing damage which can be caused is now more commonly seen recreationally in extreme outdoor sports rather than in occupational settings such as the military. The diagnosis and treatment of these injuries need to be completed carefully but quickly to reduce the risk of loss of limb and possibly life. Therefore, we have conducted a systematic review of the literature surrounding cold weather injuries (CWIs) to ascertain the epidemiology and current management strategies.
Sources of d...
Source: British Medical Bulletin - March 8, 2016 Category: Journals (General) Authors: Heil, K., Thomas, R., Robertson, G., Porter, A., Milner, R., Wood, A. Tags: Sports Medicine Articles Source Type: research
