Return to sport following surgical management of triangular fibrocartilage tears: a systematic review
AbstractIntroductionThis review aims to provide information on return rates and times to return to sport following surgical management of triangular fibrocartilage (TFC) tears.Sources of dataA systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, Medline, PEDro, Scopus, SPORTDiscus and Web of Science was performed using the keywords ‘triangular’, ‘fibro-cartilage’, ‘complex’, ‘tear’, ‘distal radio-ulnar joint’, ‘athletes’, ‘sports’, ‘non-operative’, ‘conservative’, ‘operative’ and ‘return to sport’.Areas of agreementIn all of the 10 studies included, conservative manage...
Source: British Medical Bulletin - April 3, 2019 Category: General Medicine Source Type: research
Biological and chemical changes in fluoroquinolone-associated tendinopathies: a systematic review
AbstractIntroductionThe present systematic review investigates the biological and chemical mechanisms that affect the health and structure of tendons following the use of fluoroquinolones (FQs).Sources of dataA total of 12 articles were included, organized, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Areas of agreementFive mechanisms were identified: arrest of proliferation through a decreased activity of cyclin B, CDK-1, CHK-1, and increased PK-1; decrease tenocytes migration through decreased phosphorylation of FAK; decrease type I collagen metabolism ...
Source: British Medical Bulletin - February 27, 2019 Category: General Medicine Source Type: research
How to talk about genome editing and retinal gene therapy
(Source: British Medical Bulletin)
Source: British Medical Bulletin - May 17, 2018 Category: General Medicine Source Type: research
How to talk about genome editing
AbstractBackgroundHuman genome editing is an area of growing prominence, with many potential therapeutic applications.Sources of dataA project by two UK charities, whose participants included fertility sector patients and practitioners and also people affected by genetic disease and rare disease. Scientific research into, and wider discussion of, genomics and genome editing.Areas of agreementThere is a need for improved public and professional understanding of genome editing.Areas of controversyThe way genome editing is discussed is often inconsistent and confusing. Simply defining and explaining the term ‘genome’ can ...
Source: British Medical Bulletin - April 25, 2018 Category: General Medicine Source Type: research
Maternal vitamin D supplementation during pregnancy
AbstractIntroductionMaternal vitamin D status in pregnancy has been linked to many health outcomes in mother and offspring. A wealth of observational studies have reported on both obstetric outcomes and complications, including pre-eclampsia, gestational diabetes, mode and timing of delivery. Many foetal and childhood outcomes are also linked to vitamin D status, including measures of foetal size, body composition and skeletal mineralization, in addition to later childhood outcomes, such as asthma.Sources of dataSynthesis of systematic and narrative reviews.Areas of agreement and controversyThe findings are generally incon...
Source: British Medical Bulletin - April 19, 2018 Category: General Medicine Source Type: research
Common mental disorders and work
AbstractBackgroundGovernments and employers ’ organizations have sustained focus on common mental disorders (CMD), how they impact a person’s ability to gain or continue work, the costs of sickness absence, presenteeism and job loss, and the positive impact of work on wellbeing.Sources of dataScientific literature, mainly systematic reviews and grey literature, i.e. publications not accessible through medical databases.Areas of agreementCMD are a major cause of disability, unemployment and dependency on welfare benefits. Good and healthy work is important for maintaining mental health and for promoting recovery from me...
Source: British Medical Bulletin - April 19, 2018 Category: General Medicine Source Type: research
Treatment of type 2 diabetes: future approaches
AbstractIntroduction or backgroundType 2 diabetes, which accounts for ~90% of all diabetes, is a heterogeneous and progressive disease with a variety of causative and potentiating factors. The hyperglycaemia of type 2 diabetes is often inadequately controlled, hence the need for a wider selection of glucose-lowering treatments.Sources of dataMedline, PubMed, Web of Science and Google Scholar.Areas of agreementEarly, effective and sustained control of blood glucose defers the onset and reduces the severity of microvascular and neuropathic complications of type 2 diabetes and helps to reduce the risk of cardiovascular (CV) c...
Source: British Medical Bulletin - April 18, 2018 Category: General Medicine Source Type: research
The cost-effectiveness of follow-up strategies after cancer treatment: a systematic literature review
AbstractIntroductionThe cost of treatment and follow-up of cancer patients in the UK is substantial. In a budget-constrained system such as the NHS, it is necessary to consider the cost-effectiveness of the range of management strategies at different points on cancer patients ’ care pathways to ensure that they provide adequate value for money.Sources of dataWe conducted a systematic literature review to explore the cost-effectiveness of follow-up strategies of patients previously treated for cancer with the aim of informing UK policy. All papers that were considered to be economic evaluations in the subject areas descri...
Source: British Medical Bulletin - April 12, 2018 Category: General Medicine Source Type: research
Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review
AbstractIntroductionTrapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility.Sourced of dataWe searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords ‘artelon’, ‘thumb’, ‘carpometacarpal’, ‘trapeziometacarpal’ and ‘rhizoarthrosis’; 11 studies were identified.Areas of agreementThe use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared to c...
Source: British Medical Bulletin - April 6, 2018 Category: General Medicine Source Type: research
Genetic counselling in the era of genomic medicine
AbstractBackgroundGenomic technology can now deliver cost effective, targeted diagnosis and treatment for patients. Genetic counselling is a communication process empowering patients and families to make autonomous decisions and effectively use new genetic information. The skills of genetic counselling and expertise of genetic counsellors are integral to the effective implementation of genomic medicine.Sources of dataOriginal papers, reviews, guidelines, policy papers and web-resources.Areas of agreementAn international consensus on the definition of genetic counselling. Genetic counselling is necessary for implementation ...
Source: British Medical Bulletin - April 2, 2018 Category: General Medicine Source Type: research
Conscientious objection in medicine: accommodation versus professionalism and the public good
AbstractIntroductionIn recent years questions have arisen about the moral justification for the accommodation of health care professionals who refuse, on conscience grounds as opposed to professional grounds, to provide particular professional services to eligible patients who request that kind of service.Source of dataLiterature review.Areas of disagreementCentral to concerns about the accommodation claims of conscientious objectors is that health care professionals volunteer to join their professions that typically they are the monopoly providers of such services and that a health care professional ’s refusal to provid...
Source: British Medical Bulletin - March 28, 2018 Category: General Medicine Source Type: research
Fortune and hindsight: gene patents ’ muted effect on medical practice
AbstractIntroductionPhysicians have long worried about gene patents ’ potential to restrict their medical practices. Fortune and hindsight have proven these worries exaggerated both in the UK and elsewhere. Neither current nor future medical practices appear to be impinged by gene patents, although they may be subject to future intellectual property disputes.Sources of dataQualitative and quantitative (survey) studies of gene patents ’ effects on medical practice; recent developments in patent law.Areas of agreementTraditional gene patents do not appear to have restricted medical practice in the UK, although their effe...
Source: British Medical Bulletin - March 28, 2018 Category: General Medicine Source Type: research
CD36 and lipid metabolism in the evolution of atherosclerosis
AbstractBackgroundCD36 is a multi-functional class B scavenger receptor, which acts as an important modulator of lipid homeostasis and immune responses.Sources of dataThis review uses academic articles.Areas of agreementCD36 is closely related to the development and progression of atherosclerosis.Areas of controversyBoth persistent up-regulation of CD36 and deficiency of CD36 increase the risk for atherosclerosis. Abnormally up-regulated CD36 promotes inflammation, foam cell formation, endothelial apoptosis, macrophage trapping and thrombosis. However, CD36 deficiency also causes dyslipidemia, subclinical inflammation and ...
Source: British Medical Bulletin - March 9, 2018 Category: General Medicine Source Type: research
Past, present, and future of nitrous oxide
AbstractIntroductionFor a drug that has been omnipresent for nearly 200 years, nitrous oxide ’s (N2O) future seems less certain than its illustrious past. Environmental concerns are coming to the fore and may yet outweigh important clinical benefits.Sources of dataAfter determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered.Areas of agreementThe analgesic and anaesthetic advantages of N2O remain despite a plethora of newer agentsAreas of controversyN2O greenhouse gas effect and its inhibition of key enzyme...
Source: British Medical Bulletin - March 8, 2018 Category: General Medicine Source Type: research
Retinal gene therapy
AbstractIntroductionInherited retinal diseases are the leading cause of sight impairment in people of working age in England and Wales, and the second commonest in childhood. Gene therapy offers the potential for benefit.Sources of dataPubmed and clinicaltrials.gov.Areas of agreementGene therapy can improve vision inRPE65-associated Leber Congenital Amaurosis (RPE65-LCA). Potential benefit depends on efficient gene transfer and is limited by the extent of retinal degeneration.Areas of controversyThe magnitude of vision improvement fromRPE65-LCA gene therapy is suboptimal, and its durability may be limited by progressive re...
Source: British Medical Bulletin - March 1, 2018 Category: General Medicine Source Type: research
