Designing delivery models of traditional and complementary medicine services: a review of international experiences
AbstractBackgroundThe World Health Organization advocates integration of traditional and complementary medicine (T&CM) into the conventional health services delivery system. Integrating quality services in a patient-centred manner faces substantial challenges when T&CM is delivered within a health system dominated by conventional medicine. This review has synthesized international experiences of integration strategies across different contexts.Sources of dataPublications describing international experiences of delivering T&CM service in conventional healthcare settings were searched. Backward and forward citati...
Source: British Medical Bulletin - March 3, 2021 Category: General Medicine Source Type: research
Quadriceps muscle group function and after total knee arthroplasty —asystematic narrative update
This article systematically summarizes the present evidences, published in the last 20 years, regarding the pre- and post-operative factors, which may influence recovery of the function of the quadriceps muscle group following total knee arthroplasty (TKA). We following the PRISMA methodology, including meta-analyses and high-level evidence studies (prospective trials, and, when una vailable, retrospective studies).Sources of dataPubmed and Cochrane databases: 582 articles were identified and 54 of them were selected.Areas of agreementTourniquets inflated at high pressure exert a detrimental effect on the quadriceps musc...
Source: British Medical Bulletin - February 1, 2021 Category: General Medicine Source Type: research
Repurposing approved drugs for cancer therapy
AbstractBackgroundMany drugs approved for other indications can control the growth of tumor cells and limit adverse events (AE).Data sourcesLiterature searches with keywords ‘repurposing and cancer’ books, websites:https://clinicaltrials.gov/, for drug structures:https://pubchem.ncbi.nlm.nih.gov/Areas of agreementIntroducing approved drugs, such as those developed to treat diabetes (Metformin) or inflammation (Thalidomide), identified to have cytostatic activity, can enhance chemotherapy or even replace more cytotoxic drugs. Also, anti-inflammatory compounds, cytokines and inhibitors of proteolysis can be used to contr...
Source: British Medical Bulletin - February 1, 2021 Category: General Medicine Source Type: research
Small interfering RNAs in tendon homeostasis
AbstractBackgroundTenogenesis and tendon homeostasis are guided by genes encoding for the structural molecules of tendon fibres. Small interfering RNAs (siRNAs), acting on gene regulation, can therefore participate in the process of tendon healing.Sources of dataA systematic search of different databases to October 2020 identified 17 suitable studies.Areas of agreementSiRNAs can be useful to study reparative processes of tendons and identify possible therapeutic targets in tendon healing.Areas of controversyMany genes and growth factors involved in the processes of tendinopathy and tendon healing can be regulated by siRNAs...
Source: British Medical Bulletin - January 18, 2021 Category: General Medicine Source Type: research
Medium-term results of arthroscopic treatment for femoroacetabular impingement
AbstractIntroductionFemoroacetabular impingement (FAI) is a dynamic pathomechanical process of the femoral head –neck junction. Arthroscopic surgery for FAI has increased exponentially in the last decade, and this trend is expected to increase.Source of dataRecent published literatures.Areas of agreementFAI promotes quick rehabilitation and low complication rates in the short-term follow-up.Areas of controversyDespite the growing interest on arthroscopic surgery for FAI, current evidence regarding the medium- and long-term role of arthroscopy are unsatisfactory.Growing pointsSystematically summarize current evidences, an...
Source: British Medical Bulletin - January 18, 2021 Category: General Medicine Source Type: research
Osteotomies for avascular necrosis of the femoral head
AbstractBackgroundIn osteonecrosis of the femoral head (ONFH), blood supply is insufficient for the metabolic requirements of the bone. The initial management is conservative, and, in case of failure, surgery is indicated. Osteotomies aim to change the spatial position of the necrotic portion of the femoral head. This systematic review evaluates the effectiveness and safety of osteotomies for ONFH.Source of dataThe systematic review, organized, conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was performed on PubMed and Google Scholar. We analysed outcomes ...
Source: British Medical Bulletin - January 18, 2021 Category: General Medicine Source Type: research
Vaccination ethics
This article focuses on ethical issues around vaccination behaviour and policies. It will not cover ethical issues around vaccination research.Sources of dataLiterature on ethics of vaccination decisions and policies.Areas of agreementIndividuals have a moral responsibility to vaccinate, at least against certain infectious diseases in certain circumstances.Areas of controversySome argue that non-coercive measures are ethically preferable unless there are situations of emergency. Others hold that coercive measures are ethically justified even in absence of emergencies.Growing pointsConscientious objection to vaccination is ...
Source: British Medical Bulletin - December 26, 2020 Category: General Medicine Source Type: research
Therapeutic applications of trans-splicing and Gambling in children and adolescents
(Source: British Medical Bulletin)
Source: British Medical Bulletin - December 15, 2020 Category: General Medicine Source Type: research
Cellular therapies for the treatment of immune-mediated GI and liver disease
AbstractIntroductionImmune-mediated liver and gastrointestinal diseases are chronic conditions that lack curative treatments. Despite advances in the understanding and treatment of these conditions, they frequently remain refractory to treatment and represent a significant unmet need. Cellular therapies are an emerging option and hold the potential to have a major impact.Data sourcesA literature review was carried out using Pubmed. Keywords used for search were ‘ATMP’, ‘immune mediated’, ‘autoimmune liver disease’ and ‘immune mediated gastrointestinal conditions’, ‘cell therapy’, ‘MSC’, ‘HSCT’, ...
Source: British Medical Bulletin - December 9, 2020 Category: General Medicine Source Type: research
Nuclear magnetic resonance spectroscopy of biofluids for osteoarthritis
Conclusions are sometimes conservative or overinflated, which may reflect the variation in reporting standards. NMR metabolic experimental design may require further consideration, as do the animal models used for such studies.Growing pointsThere are various aspects which require improvement within the field. These include stricter adherence to the Metabolomics Standards Initiative, inclusive of the standardization of metabolite identifications; increased utilization of integrating NMR metabolomics with other ‘omic’ disciplines; and increased deposition of raw experimental files into open access online repositories, al...
Source: British Medical Bulletin - December 8, 2020 Category: General Medicine Source Type: research
Thiopurines and non-melanoma skin cancer: partners in crime in inflammatory bowel diseases
AbstractIntroductionSeveral studies have shown that inflammatory bowel diseases (IBD) patients treated with thiopurines have an increased risk of developing skin cancer.Sources of dataThis review is based on recent published literature regarding the use of thiopurines in IBD and skin malignancies.Areas of agreementExposure to thiopurines is significantly associated with nonmelanoma skin cancer, but not with melanoma. Primary and secondary prevention including sun-protective measures and regular dermatologic screening are recommended in IBD patients, particularly in those exposed to thiopurines.Areas of controversyBoth when...
Source: British Medical Bulletin - November 16, 2020 Category: General Medicine Source Type: research
New horizons for idiopathic intracranial hypertension: advances and challenges
AbstractIntroductionIdiopathic intracranial hypertension (IIH) is becoming a recognized condition due to the increasing incidence linked to a global obesity epidemic.Sources of dataAll English papers on PubMed, Cochrane and Scholar between inception until 1 March 2020 were considered.Areas of agreementStudies suggest central adiposity has a pathogenic role. Recent weight gain is a risk factor and weight loss has a key role in management.Areas of controversyInterpretation of abnormal lumbar puncture opening pressure is debated. There is an increasing recognition of obesity stigma and how this should be approached.Growing po...
Source: British Medical Bulletin - November 16, 2020 Category: General Medicine Source Type: research
Ozone injection therapy for intervertebral disc herniation
AbstractIntroductionLumbar disc herniation (LDH) is a common cause of low back pain (LBP). Recently, in the setting of LBP caused by LDH, a growing interest in ozone therapies has been observed.Source of dataRecent published literatures.Areas of agreementBeing low back pain more common in the elderlies, exploring conservative alternatives to the surgical intervention is of especial interest.Areas of controversyEfficacy and feasibility of ozone injections for LDH is debated. Several clinical studies showed controversial results, and the true benefit has not yet been clarified.Growing pointsSystematically summarize current e...
Source: British Medical Bulletin - October 31, 2020 Category: General Medicine Source Type: research
The challenges presented by haematopoietic stem cell transplantation in children with primary immunodeficiency and Covid-19 and the ‘new normal’: are remote video consultations here to stay
These important subjects have full free online access. In addition, as usual, the Bulletin has a section to celebrate its amazing archive (see end of ‘In this Issue’). TheBritish Medical Bulletin (BMB) has been further developing its website and now has a fascinating section on the Nobel Prize winners who wrote for the Bulletin and went on to win the accolade. (Source: British Medical Bulletin)
Source: British Medical Bulletin - October 14, 2020 Category: General Medicine Source Type: research
Narrative review of non-pharmaceutical behavioural measures for the prevention of COVID-19 (SARS-CoV-2) based on the Health-EDRM framework
AbstractIntroductionNon-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated.Sources of dataKeyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication databases. Using the Oxford Centre for Evidence-Based Medicine ...
Source: British Medical Bulletin - October 8, 2020 Category: General Medicine Source Type: research
