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An orally bioavailable SARS-CoV-2 main protease inhibitor exhibits improved affinity and reduced sensitivity to mutations Sci. Transl. Med. (IF 17.1) Pub Date : 2024-03-13 Michael Westberg, Yichi Su, Xinzhi Zou, Pinghan Huang, Arjun Rustagi, Jaishree Garhyan, Puja Bhavesh Patel, Daniel Fernandez, Yan Wu, Chenzhou Hao, Chieh-Wen Lo, Marwah Karim, Lin Ning, Aimee Beck, Panatda Saenkham-Huntsinger, Vivian Tat, Aleksandra Drelich, Bi-Hung Peng, Shirit Einav, Chien-Te K. Tseng, Catherine Blish, Michael Z. Lin
Inhibitors of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) such as nirmatrelvir (NTV) and ensitrelvir (ETV) have proven effective in reducing the severity of COVID-19, but the presence of resistance-conferring mutations in sequenced viral genomes raises concerns about future drug resistance. Second-generation oral drugs that retain function against these mutants
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A day in the life of a medical student from Ukraine BMJ (IF 105.7) Pub Date : 2024-03-18 Éabha Lynn
In our series taking you to meet medical students from across the globe from the comfort of your own home, BMJ student spoke to a medical student who has made a truly international curriculum for herself and her peers in the wake of war and destruction in her home country You have just set off from home to attend your placement or to meet your friends for a cocktail or a cup of coffee. Life goes on
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Switching from disposable to reusable PPE BMJ (IF 105.7) Pub Date : 2024-03-18 Rebecca Bromley-Dulfano, Joshua Chan, Navami Jain, James Marvel
### What you need to know Sustainable sourcing, use, and disposal of personal protective equipment (PPE) can help healthcare providers reduce the environmental impacts of their work. In this article we review supporting evidence and provide guidance for healthcare institutions to adopt reusable forms of PPE as safe, cost saving, and sustainable alternatives to single use disposables. The first step
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Peter McGuffin: psychiatrist and researcher who set out to find better ways of defining severe mental illness BMJ (IF 105.7) Pub Date : 2024-03-18 John Illman
Photo credit: King’s College London There was always something different about Peter McGuffin, professor of psychiatric genetics at the Institute of Psychiatry, Psychology, and Neuroscience Centre, London (IOPPNC). In 1963, when many 15 year olds discovered the Beatles, he found psychoanalysis. After locating Freud’s introductory lectures in his local library on the Isle of Wight, he decided to become
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Evidence based exercise prescriptions in primary care BMJ (IF 105.7) Pub Date : 2024-03-18 Ediriweera Desapriya, Shaluka Manchanayake, Hasara Illuppelle, Peter Tiu, Crystal Ma
Noetel and colleagues’ study provides compelling evidence supporting the effectiveness of various exercise modalities in alleviating symptoms of depression.1 This empowers primary care doctors to make recommendations grounded in solid evidence, tailored to the unique preferences, abilities, and needs of individual patients. Many types of exercise—for example, walking, jogging, strength training, yoga
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Long covid and myalgic encephalomyelitis/chronic fatigue syndrome are overlapping conditions BMJ (IF 105.7) Pub Date : 2024-03-18 Vikki McKeever
Ladds and colleagues’ practice pointer explores the complexities of post-viral cognitive symptoms and provides guidance on management strategies.1 But there is no mention of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Given that debilitating fatigue, post-exertional malaise, and cognitive issues are the core symptoms of ME/CFS it would be prudent to describe the clear overlaps between
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ONS refines method to estimate excess deaths BMJ (IF 105.7) Pub Date : 2024-03-18 Veena Raleigh
This upgrade should improve our understanding of short term changes in mortality As the UK emerges from the ravages of the pandemic, the Office for National Statistics (ONS) has announced a new method for estimating excess deaths in the UK.1 Measurement of excess deaths became widely used in 2020 when timely data on the effect of covid-19 on mortality was vital for monitoring the spread of the virus
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Use of nitrous oxide for execution is a concerning development in ongoing medicalisation of the death penalty BMJ (IF 105.7) Pub Date : 2024-03-18 British Medical Journal Publishing Group
This article ( BMJ 2024;384:q593, doi:10.1136/bmj.q593 …
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Can I share my political views online? BMJ (IF 105.7) Pub Date : 2024-03-18 Abi Rimmer
While social media may seem like a place for sharing personal feelings rather than professional opinions, doctors must remain aware of how they could be perceived, Abi Rimmer hears Emma Davies, medicolegal consultant at the Medical Protection Society, says, “Given the conflicts around the world and the pressures on the NHS, it’s expected that we’ll have our own opinions on these emotive matters. Social
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Statins, risk, and personalised care BMJ (IF 105.7) Pub Date : 2024-03-18 Sam Finnikin, Brian Finney, Rani Khatib, James McCormack
Sam Finnikin and colleagues argue that guidelines should focus less on population level risk thresholds and more on shared decision making conversations based on individualised risk and patient preferences Statins are the most prescribed medications in England with over 82 million prescriptions issued in the 12 months to July 2023.1 However, the 2023 update of guidelines from the UK National Institute
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UK Public Health Science 2024: a call for abstracts Lancet (IF 168.9) Pub Date : 2024-03-18 Daniel R R Bradford, Francesco Aletta, UK Public Health Science conference organising committee
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Music and medicine: quickening the tempo of progress Lancet (IF 168.9) Pub Date : 2024-03-18 Wen G Chen, Emmeline Edwards, Sunil Iyengar, Robert Finkelstein, Deborah F Rutter, Renée Fleming, Francis S Collins
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A timeline of biomarker changes before Alzheimer’s disease Nat. Med. (IF 82.9) Pub Date : 2024-03-15
Longitudinal data from the China Cognition and Aging Study map the sequential biomarker changes that begin almost two decades before clinical onset of Alzheimer’s disease.
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What I Do Not Tell the Medical Student N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-16 Erica Andrist
What do we tell medical students who are wowed by senior physicians’ power and control over patients’ conditions and outcomes when we know this power and control are largely illusory?
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Rhino-orbital-cerebral Mucormycosis N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-16 Cristian-Mihail Niculae, Laura Craciun
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David Oliver: Senior medical leaders have mishandled doctors’ concerns over physician and anaesthesia associates BMJ (IF 105.7) Pub Date : 2024-03-15 David Oliver
On 13 March the Royal College of Physicians (RCP) held an extraordinary general meeting of fellows to discuss the role of physician associates (PAs) in the NHS.1 Such meetings have been rare events in the college’s history. Its members and fellows aren’t known for being radical firebrands, and medical royal colleges are not trade unions or single issue campaigning charities. We seem to have reached
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When I use a word . . . Medicines regulation—penicillin BMJ (IF 105.7) Pub Date : 2024-03-15 Jeffrey K Aronson
Penicillin has a history that antedates its discovery by Alexander Fleming in London and its isolation and purification by Howard Florey, Ernst Chain, and Norman Heatley in Oxford. Before that it had been used as a raw broth of Penicillium organisms in local treatment of infections such as furuncles and conjunctivitis. After its introduction for parenteral administration and its manufacture in the
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Study identifies risk factors that may lead to secondary cancers CA: Cancer J. Clin. (IF 254.7) Pub Date : 2024-03-13 Mike Fillon
“Second primary cancer occurs with different frequency depending on the site of the first cancer, and we find a higher cumulative incidence in cancer sites with a relatively good or good survival. To the best of our knowledge these results are useful in the counselling of patients with cancer and the data provide new evidence for personalized survivorship care.” Trille Kristina Kjaer, PhD A study using
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Telehealth enables safe medication abortion in shifting health and legal contexts Nat. Med. (IF 82.9) Pub Date : 2024-03-15 Dana M. Johnson, Abigail R. A. Aiken, Terri-Ann Thompson
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Prolonged benefits of bariatric surgery for patients with Type 2 Diabetes Nat. Med. (IF 82.9) Pub Date : 2024-03-15
People with type 2 diabetes who underwent bariatric surgery compared to medical or lifestyle interventions had better long-term outcomes, such as greater diabetes remission and less reliance on medication.
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Assessing robustness to worst case publication bias using a simple subset meta-analysis BMJ (IF 105.7) Pub Date : 2024-03-15 Maya B Mathur
This article discusses a simple method, known as a meta-analysis of non-affirmative studies, to assess how robust a meta-analysis is to publication bias that favors affirmative studies (studies with significant P values and point estimates in the desired direction) over non-affirmative studies (studies with non-significant P values or point estimates in the undesired direction). This method is a standard
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Homeless healthcare: a missing component in medical training? BMJ (IF 105.7) Pub Date : 2024-03-15 Lydia Shackshaft
Medics should be equipped with knowledge and skills that can help them provide equitable care to homeless people, writes Lydia Shackshaft Homelessness is rising in the UK and hospital attendances by people experiencing homelessness are increasing correspondingly.12 Yet medical education currently leaves junior doctors feeling uninformed and underprepared to care for this group of people, raising the
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Godwin Chandrarajan Reginald BMJ (IF 105.7) Pub Date : 2024-03-15 M S Thambirajah
Godwin Chandrarajan Reginald (“Reggie”) came to the UK from Sri Lanka (formerly Ceylon) in 1976. He worked in community paediatrics in Nuneaton, West Midlands, for …
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Bernard Guratsky BMJ (IF 105.7) Pub Date : 2024-03-15 John Sprigge
A graduate of Quarry Bank Grammar School and Liverpool University Medical School, Bernard Guratsky trained on the Liverpool School of Anaesthesia programme. He was quietly proud of his Jewish and Liverpool backgrounds. He …
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David Ian Shepherd BMJ (IF 105.7) Pub Date : 2024-03-15 Duncan Shepherd
David Ian Shepherd, who was born on 4 October 1944 in Aberdeen, has died at the age of 79. He went to primary school in Peter Culter and was awarded a scholarship to attend Robert Gordon’s College. David initially intended to read law at university, but a spell in hospital for ear surgery changed his mind to medicine. After graduating he stayed in Aberdeen and progressed from house officer to senior
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Fayek Dimitri Salama BMJ (IF 105.7) Pub Date : 2024-03-15 Ellis Morgan, John Duffy
Fayek Dimitri Salama was born in Cairo. At the age of 23 he qualified from Ain-Shams Medical School, Cairo, where he remained through the early 1960s, completing the diploma in surgery, before choosing to specialise in thoracic surgery. In 1967 he moved to the UK where he continued his training in cardiothoracic surgery with appointments as registrar at Hawkmoor Hospital, Devon; Broomfield Hospital
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Robert Geoffrey Chaytor BMJ (IF 105.7) Pub Date : 2024-03-15 Caroline Jeffery
Robert Geoffrey Chaytor (“Geoffrey”) qualified from the medical school, King’s College, Newcastle, when it was still part of Durham University. He served in the Royal Army Medical Corps for three years in Burma, Egypt, Palestine, and Sudan. After training as an ear, nose, and throat (ENT) surgeon he was appointed consultant in 1952 and opened the new Walkergate Hospital in Newcastle. This had been
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Sobering assessment of Scotland’s NHS BMJ (IF 105.7) Pub Date : 2024-03-15 Gerry McCartney, Neil Craig
Leaders must prioritise prevention, primary care, and the social and commercial determinants of health Audit Scotland’s latest report on the Scottish NHS is sobering reading.1 It highlights costs rising because of inflation, higher utility costs, and pay and prescribing pressures; demand for services rising faster than activity post-pandemic; and operational challenges affecting patient safety and
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Acute rehabilitation following traumatic anterior shoulder dislocation (ARTISAN): pragmatic, multicentre, randomised controlled trial BMJ (IF 105.7) Pub Date : 2024-03-15 British Medical Journal Publishing Group
In the ARTISAN collaborators list of this paper by Kearney and colleagues (BMJ 2024;384:e076925, doi:10.1136/bmj-2023-076925 …
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Issue Information CA: Cancer J. Clin. (IF 254.7) Pub Date : 2024-03-13
No abstract is available for this article.
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Is mandated genetic counseling needed? CA: Cancer J. Clin. (IF 254.7) Pub Date : 2024-03-13 Mike Fillon
With genetic testing becoming more readily available for cancer prevention and surveillance, a new study investigated whether skipping counseling—either before or after testing—is any worse than requiring counseling for patients with a family history of cancer or those known to be at genetic risk for cancer. The results of Making Genetic Testing Accessible (MAGENTA), a four-armed randomized clinical
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Genome-wide repeat landscapes in cancer and cell-free DNA Sci. Transl. Med. (IF 17.1) Pub Date : 2024-03-13 Akshaya V. Annapragada, Noushin Niknafs, James R. White, Daniel C. Bruhm, Christopher Cherry, Jamie E. Medina, Vilmos Adleff, Carolyn Hruban, Dimitrios Mathios, Zachariah H. Foda, Jillian Phallen, Robert B. Scharpf, Victor E. Velculescu
Genetic changes in repetitive sequences are a hallmark of cancer and other diseases, but characterizing these has been challenging using standard sequencing approaches. We developed a de novo kmer finding approach, called ARTEMIS (Analysis of RepeaT EleMents in dISease), to identify repeat elements from whole-genome sequencing. Using this method, we analyzed 1.2 billion kmers in 2837 tissue and plasma
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Hepatic danger signaling triggers TREM2+ macrophage induction and drives steatohepatitis via MS4A7-dependent inflammasome activation Sci. Transl. Med. (IF 17.1) Pub Date : 2024-03-13 Linkang Zhou, Xiaoxue Qiu, Ziyi Meng, Tongyu Liu, Zhimin Chen, Peng Zhang, Henry Kuang, Tong Pan, You Lu, Ling Qi, David P. Olson, X. Z. Shawn Xu, Y. Eugene Chen, Siming Li, Jiandie D. Lin
Metabolic dysfunction–associated steatohepatitis (MASH), formerly known as nonalcoholic steatohepatitis (NASH), is an advanced stage of metabolic fatty liver disease. The pathogenic mechanisms of MASH center on hepatocyte injury and the ensuing immune response within the liver microenvironment. Recent work has implicated TREM2+ macrophages in various disease conditions, and substantial induction of
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Self-help mobile messaging intervention for depression among older adults in resource-limited settings: a randomized controlled trial Nat. Med. (IF 82.9) Pub Date : 2024-03-14 Marcia Scazufca, Carina Akemi Nakamura, Nadine Seward, Thiago Vinicius Nadaleto Didone, Felipe Azevedo Moretti, Marcelo Oliveira da Costa, Caio Hudson Queiroz de Souza, Gabriel Macias de Oliveira, Monica Souza dos Santos, Luara Aragoni Pereira, Mariana Mendes de Sá Martins, Pepijn van de Ven, William Hollingworth, Tim J. Peters, Ricardo Araya
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Acquired blood mutations cause acute kidney injury via dysregulated inflammation Nat. Med. (IF 82.9) Pub Date : 2024-03-13
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Intraventricular CARv3-TEAM-E T Cells in Recurrent Glioblastoma N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-13 Bryan D. Choi, Elizabeth R. Gerstner, Matthew J. Frigault, Mark B. Leick, Christopher W. Mount, Leonora Balaj, Sarah Nikiforow, Bob S. Carter, William T. Curry, Kathleen Gallagher, Marcela V. Maus
In this first-in-human, investigator-initiated, open-label study, three participants with recurrent glioblastoma were treated with CARv3-TEAM-E T cells, which are chimeric antigen receptor (CAR) T cells engineered to target the epidermal growth factor receptor (EGFR) variant III tumor-specific antigen, as well as the wild-type EGFR protein, through secretion of a T-cell–engaging antibody molecule (TEAM)
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The Journal’s Historical “Indian Problem” N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14
To the Editor: The Perspective article by Jones et al. (Jan. 4 issue)1 discusses outside perceptions of Indigenous peoples. These communities have maintained their cultures and medicinal practices despite centuries of undue adversity. How can medicine respond? By understanding determinants of Indigenous health, our health systems can tailor care protocols and patient resources, given that the integration
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Wearable Technology in Clinical Practice for Depressive Disorder N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14
To the Editor: Fedor et al. (Dec. 28 issue)1 review a topic of growing interest: the potential of wearable devices to gather objective measures to aid in the treatment of depression. However, in psychiatry, we posit that subjectivity plays a primary role in treatment2; the evaluation of depression is more complex than a simple sum of symptoms.3,4 Furthermore, medication that is commonly used to treat
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Lumasiran, Isolated Kidney Transplantation, and Continued Vigilance N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Justine Bacchetta, Stéphanie Clavé, Peggy Perrin, Sandrine Lemoine, Anne-Laure Sellier-Leclerc, Lisa J. Deesker
Although lumasiran targets glycolate oxidase and decreases hepatic oxalate synthesis, systemic oxalate release continues after single-organ kidney transplantation, requiring close follow-up with rigorous hyperhydration.
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Improving Noninvasive Colorectal Cancer Screening N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 John M. Carethers
Noninvasive colorectal cancer screening commenced historically with the use of guaiac-based tests that require the addition of hydrogen peroxide to oxidize the presence of substances such as blood in stool. Large, randomized, controlled trials of these tests in a screened population showed the detection of earlier-stage cancers that could be curable, a reduction in mortality from colorectal cancer
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Case 8-2024: A 55-Year-Old Man with Cardiac Arrest, Cardiogenic Shock, and Hypoxemia N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Robert O. Roswell, Man Piu Wong, Ada C. Stefanescu Schmidt, Milena Petranovic, Emily K. Zern, Daniel Burkhoff, Thoralf M. Sundt, Patrick T. O’Gara, Cynthia K. Harris
A 55-year-old man had an out-of-hospital cardiac arrest. An evaluation showed 2-mm ST-segment elevations in the inferior leads on electrocardiography, cardiogenic shock, and a new systolic murmur. A diagnosis was made.
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Cavernous Malformations of the Central Nervous System N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Edward R. Smith
Cerebral cavernous malformations occur in 0.5% of the population; 85% are sporadic, and 15% are familial or radiation-induced. Several genetic variants, including variants in CCM, drive their development.
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RSV Prefusion F Protein–Based Maternal Vaccine — Preterm Birth and Other Outcomes N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Ilse Dieussaert, Joon Hyung Kim, Sabine Luik, Claudia Seidl, Wenji Pu, Jens-Ulrich Stegmann, Geeta K. Swamy, Peggy Webster, Philip R. Dormitzer
Background Vaccination against respiratory syncytial virus (RSV) during pregnancy may protect infants from RSV disease. Efficacy and safety data on a candidate RSV prefusion F protein–based maternal vaccine (RSVPreF3-Mat) are needed. Methods We conducted a phase 3 trial involving pregnant women 18 to 49 years of age to assess the efficacy and safety of RSVPreF3-Mat. The women were randomly assigned
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Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Régis Peffault de Latour, Alexander Röth, Austin G. Kulasekararaj, Bing Han, Phillip Scheinberg, Jaroslaw P. Maciejewski, Yasutaka Ueda, Carlos M. de Castro, Eros Di Bona, Rong Fu, Li Zhang, Morag Griffin, Saskia M.C. Langemeijer, Jens Panse, Hubert Schrezenmeier, Wilma Barcellini, Vitor A.Q. Mauad, Philippe Schafhausen, Suzanne Tavitian, Eloise Beggiato, Lee Ping Chew, Anna Gaya, Wei-Han Huang, Jun
Background Persistent hemolytic anemia and a lack of oral treatments are challenges for patients with paroxysmal nocturnal hemoglobinuria who have received anti-C5 therapy or have not received complement inhibitors. Iptacopan, a first-in-class oral factor B inhibitor, has been shown to improve hemoglobin levels in these patients. Methods Download a PDF of the Research Summary. In two phase 3 trials
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Next-Generation Multitarget Stool DNA Test for Colorectal Cancer Screening N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Thomas F. Imperiale, Kyle Porter, Julia Zella, Zubin D. Gagrat, Marilyn C. Olson, Sandi Statz, Jorge Garces, Philip T. Lavin, Humberto Aguilar, Don Brinberg, Charles Berkelhammer, John B. Kisiel, Paul J. Limburg
Background A next-generation multitarget stool DNA test, including assessments of DNA molecular markers and hemoglobin level, was developed to improve the performance of colorectal cancer screening, primarily with regard to specificity. Methods In a prospective study, we evaluated a next-generation multitarget stool DNA test in asymptomatic adults 40 years of age or older who were undergoing screening
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A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening N. Engl. J. Med. (IF 158.5) Pub Date : 2024-03-14 Daniel C. Chung, Darrell M. Gray, Harminder Singh, Rachel B. Issaka, Victoria M. Raymond, Craig Eagle, Sylvia Hu, Darya I. Chudova, AmirAli Talasaz, Joel K. Greenson, Frank A. Sinicrope, Samir Gupta, William M. Grady
Background Colorectal cancer is the third most diagnosed cancer in adults in the United States. Early detection could prevent more than 90% of colorectal cancer–related deaths, yet more than one third of the screening-eligible population is not up to date with screening despite multiple available tests. A blood-based test has the potential to improve screening adherence, detect colorectal cancer earlier
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25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis BMJ (IF 105.7) Pub Date : 2024-03-13 Jon Shelton, Ewa Zotow, Lesley Smith, Shane A Johnson, Catherine S Thomson, Amar Ahmad, Lars Murdock, Diana Nagarwalla, David Forman
Objective To examine and interpret trends in UK cancer incidence and mortality for all cancers combined and for the most common cancer sites in adults aged 35-69 years. Design Retrospective secondary data analysis. Data sources Cancer registration data, cancer mortality and national population data from the Office for National Statistics, Public Health Wales, Public Health Scotland, Northern Ireland
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Even short periods of diabetes remission are linked to lower risk of heart attack and stroke BMJ (IF 105.7) Pub Date : 2024-03-14 Helen Saul, Brendan Deeney, Laura Swaithes, Hilda Hounkpatin, Hajira Dambha-Miller
Dambha-Miller H, Hounkpatin HO, Stuart B, Farmer A, Griffin S. Type 2 diabetes remission trajectories and variation in risk of diabetes complications: a population-based cohort study. PLoS ONE 2023;18. doi:[10.1371/journal.pone.0290791][1]. To read the full NIHR Alert, go to: [1]: /lookup/doi/10.1371/journal.pone.0290791
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The impact of response times on effect of thrombolysis and other research BMJ (IF 105.7) Pub Date : 2024-03-14 Tom Nolan
Tom Nolan reviews this week’s research One of the many terrifying aspects of our healthcare system that we seem to be quietly accepting of is ambulance response times. In England in December 2023 the median response time for a category 2 emergency call—which includes stroke calls—was 45 minutes, compared with a target of 18 minutes. Of the callouts, 10% had a wait time of 1 hour 40 minutes or longer
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Colin Walker: early pioneer of neonatal intensive care who developed national database for newborn infants BMJ (IF 105.7) Pub Date : 2024-03-13 Penny Warren
When paediatrician Colin Walker began his career, the care of frail newborns consisted of little more than keeping them warm and offering fluids. Walker, who has died aged 100, was instrumental in a huge sea change in neonatal care. He pioneered an intensive care service in Tayside, establishing the special care unit at Dundee Royal Infirmary, and he set up a computerised clinical data collection service
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A parrot’s beak in the lumbar spine BMJ (IF 105.7) Pub Date : 2024-03-14 Hang Tang, Shuguang Gao
This computed tomography (CT) scan shows the spine of a man in his 50s who presented to hospital with low back pain and limited mobility of the lumbar spine for four months (fig 1). Lumbar radiographs showed worm eaten bone destruction with sclerosis of …
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Hypothyroidism . . . and other stories BMJ (IF 105.7) Pub Date : 2024-03-14 British Medical Journal Publishing Group
Don’t be in a hurry to diagnose or treat older adults suspected of having subclinical hypothyroidism. That’s the message from an analysis of pooled data from two randomised trials. Two thousand people with biochemical subclinical hypothyroidism (defined as an elevated thyroid stimulating hormone (TSH) measurement combined with a free thyroxine level within the laboratory reference range) were assessed
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Less than full time working beyond parenting: the increasing number of doctors going LTFT for wellbeing reasons BMJ (IF 105.7) Pub Date : 2024-03-13 Erin Dean
More doctors are choosing to work less than full time to boost their wellbeing and work-life balance, Erin Dean reports on what this means for doctors and the NHS Sam Naushahi is absolutely clear that he wouldn’t still be working as a general practice registrar if he hadn’t been able to cut down his hours from full time. About 18 months ago, the 36 year old dropped to 80% of a full time post at his
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How general practice is paying for the cost-of-living crisis BMJ (IF 105.7) Pub Date : 2024-03-14 Samir Jeraj
The UK is failing on poverty—and primary care services are feeling the effects, reports Samir Jeraj “I’ve got one patient—the benefits she gets only cover her rent and bills. She has nothing left over for food,” a GP in east London explains to The BMJ . “For the past few months she’s been using that money just to pay for her sustenance. She doesn’t go out of the house because she can’t afford to do
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Unilateral skin eruptions BMJ (IF 105.7) Pub Date : 2024-03-14 Karun Saathveeg Sam, Pooja Khosla, Vinus Taneja, Rishikesh Dessai
A woman in her 40s, with a history of bronchial asthma and hypertension, presented with a seven day history of sudden onset bullous skin lesions, associated with itching and a burning sensation (fig 1). She had no personal or family history of bleeding disorders. The lesions initially appeared on her right foot, progressed to the right thigh, and then evolved to hyperpigmented macules within seven
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Cancer trends in the UK BMJ (IF 105.7) Pub Date : 2024-03-13 Freddie Bray
Grounds for optimism but warning signs must not be ignored Cancer is a major public health problem in the UK, and in most high income countries. The disease is the leading cause of death in both men and women, and one in four people die prematurely from it at ages 30-69 years.1 A comprehensive assessment of the evolution of cancer incidence and mortality rates over time is not straightforward because
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Doctors’ industrial action: in search of an endgame BMJ (IF 105.7) Pub Date : 2024-03-14 Kamran Abbasi
To those, like me, who lived through the miners’ strike in South Yorkshire in the 1980s, it’s clear that the then prime minister Margaret Thatcher was driven by hard ideology and harder economics rather than, as retrospectively claimed, that she championed climate action. The end of the slave trade was driven by hard economics more than the principle of ending slavery. Indeed, slavery continued for
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Intrathecal bivalent CAR T cells targeting EGFR and IL13Rα2 in recurrent glioblastoma: phase 1 trial interim results Nat. Med. (IF 82.9) Pub Date : 2024-03-13 Stephen J. Bagley, Meghan Logun, Joseph A. Fraietta, Xin Wang, Arati S. Desai, Linda J. Bagley, Ali Nabavizadeh, Danuta Jarocha, Rene Martins, Eileen Maloney, Lester Lledo, Carly Stein, Amy Marshall, Rachel Leskowitz, Julie K. Jadlowsky, Shannon Christensen, Bike Su Oner, Gabriela Plesa, Andrea Brennan, Vanessa Gonzalez, Fang Chen, Yusha Sun, Whitney Gladney, David Barrett, MacLean P. Nasrallah, Wei-Ting
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Identification and management of co-infections in people with malaria BMJ (IF 105.7) Pub Date : 2024-03-13 Aubrey J Cunnington, Aula Abbara, Flavia Kaduni Bawa, Jane Achan
### What you need to know A 16 year old Ugandan girl is brought to the emergency department with a three day history of fever, headache, cough, and myalgia. She has had several episodes of malaria in the past. On admission, she is febrile, tachycardic, tachypnoeic, and has oxygen saturations of 90% in air. A malaria rapid antigen test is positive for Plasmodium falciparum and a chest radiograph shows