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Mashup Score: 7Diagnosing cancer in English community pharmacies - 7 hour(s) ago
Stephen Bradley and colleagues argue that plans to involve community pharmacies in diagnosing cancer are unlikely to transform cancer detection in primary care Cancer is diagnosed at more advanced stages, and consequently with poorer outcomes, in the UK than in many other high income countries.1234 Although these disparities have been observed over decades, worsening access to general practice appointments, particularly since the coronavirus pandemic, has led to concern that people with cancer symptoms are experiencing additional delays to diagnosis. Achieving timely diagnosis for many cancers is crucial to improving outcomes as even relatively short delays are associated with reduced likelihood of survival.5 Involving community pharmacy in detecting symptomatic cancer has long been proposed as a means of expediting diagnosis.6 In 2022 England’s NHS announced ambitious plans to enable community pharmacists to arrange tests for possible cancer symptoms,7 although the ongoing pilot schem
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Mashup Score: 3Who is accountable for the medical unemployment crisis? - 8 hour(s) ago
The story of vaccination against human papillomavirus in teenage girls is one of success. Cervical cancer rates have dropped markedly in all socioeconomic groups (doi:10.1136/bmj-2023-077341).1 An equitable implementation plan has achieved equitable benefits (doi:10.1136/bmj.q996).2 A less good health story is the murky use of dubious medical labels to deflect from unlawful death. “Excited delirium,” a term used to explain protestor George Floyd’s death in police custody, is now banned in California and Colorado and removed from police forms in the UK (doi:10.1136/bmj.q1047).3 What binds these extremes is the role of the leadership of health professionals and health systems (doi:10.1136/bmj.q1033 doi:10.1136/bmj.q1069)—the power to do good alongside culpability or complicity in harm. Health professionals need the right environment to …
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Mashup Score: 3Who is accountable for the medical unemployment crisis? - 9 hour(s) ago
The story of vaccination against human papillomavirus in teenage girls is one of success. Cervical cancer rates have dropped markedly in all socioeconomic groups (doi:10.1136/bmj-2023-077341).1 An equitable implementation plan has achieved equitable benefits (doi:10.1136/bmj.q996).2 A less good health story is the murky use of dubious medical labels to deflect from unlawful death. “Excited delirium,” a term used to explain protestor George Floyd’s death in police custody, is now banned in California and Colorado and removed from police forms in the UK (doi:10.1136/bmj.q1047).3 What binds these extremes is the role of the leadership of health professionals and health systems (doi:10.1136/bmj.q1033 doi:10.1136/bmj.q1069)—the power to do good alongside culpability or complicity in harm. Health professionals need the right environment to …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 9
Objectives To evaluate the clinical effectiveness of long acting progestogens compared with the combined oral contraceptive pill in preventing recurrence of endometriosis related pain. Design The PRE-EMPT (preventing recurrence of endometriosis) pragmatic, parallel group, open label, randomised controlled trial. Setting 34 UK hospitals. Participants 405 women of reproductive age undergoing conservative surgery for endometriosis. Interventions Participants were randomised in a 1:1 ratio using a secure internet facility to a long acting progestogen (depot medroxyprogesterone acetate or levonorgestrel releasing intrauterine system) or the combined oral contraceptive pill. Main outcome measures The primary outcome was pain measured three years after randomisation using the pain domain of the Endometriosis Health Profile 30 (EHP-30) questionnaire. Secondary outcomes (evaluated at six months, one, two, and three years) included the four core and six modular domains of the EHP-30, and treatme
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Mashup Score: 6Mental health: MPs condemn overreliance on pills - 1 day(s) ago
A group of MPs have called for a radical overhaul of the way poor mental health is managed in the UK to move away from its “overreliance on psychiatric drugs.” The Beyond Pills All Party Parliamentary Group (APPG) says there needs to be a paradigm shift away from “the traditional biomedical model” towards a more holistic approach that tackles the social, economic, and psychological determinants of mental health. In a report1 they point to the impact on mental health of toxic relationships, abuse, and violence as well as the role of wider societal factors such as economic insecurity, poverty, poor housing, inadequate nutrition, and damaged communities. Despite …
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Mashup Score: 16Matt Morgan: Rekindling the NHS’s foundational flame - 1 day(s) ago
One of the joys of writing this column is receiving emails from readers who work across a wide spectrum of medicine, from students to retired professors. I read one such email from a retired, fellow Cardiff alumnus in response to my last column discussing the new play Nye . After I’d watched the play at the National Theatre1—which dramatises the NHS’s origins through the eyes of Aneurin Bevan, former minister of health and architect of the NHS—a quote from Mark Twain came to my mind: “History doesn’t repeat itself, but it often rhymes.” Bevan’s proposals for a universal healthcare system came at a time …
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Mashup Score: 37Helen Salisbury: Training our replacements - 1 day(s) ago
Are there limits on what people should be allowed to do in the medical or surgical field when they’re not a doctor and not training to be one? We teach someone our skills so that they may one day exercise them independently, and almost from the moment we qualify as doctors we start training our replacements. The time available for this training is finite, so we should think carefully about how we spend those precious hours and who exactly will replace us. If a medical associate practitioner (anaesthesia associate, surgical care practitioner, or physician associate) should never …
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Mashup Score: 28
Patients are often the beneficiaries of medicine, but they can be its victims too. Most people in the western world are likely to know by their 60s that they have at least one chronic condition or risk factor, if not several. As they age further the number of these will almost certainly increase, along with regular check-ups, investigations, and an escalating amount of treatment. Some of the effects of this may be positive in terms of a person’s longevity and quality of life, although good nutrition, housing, education, and a decent income are likely to have been more important. Over time, however, their risks of harm will also become greater. These may include …
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Mashup Score: 19Cardiovascular toxicity of immune therapies for cancer - 2 day(s) ago
In addition to conventional chemoradiation and targeted cancer therapy, the use of immune based therapies, specifically immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T cell therapy (CAR-T), has increased exponentially across a wide spectrum of cancers. This has been paralleled by recognition of off-target immune related adverse events that can affect almost any organ system including the cardiovascular system. The use of ICIs has been associated with myocarditis, a less common but highly fatal adverse effect, pericarditis and pericardial effusions, vasculitis, thromboembolism, and potentially accelerated atherosclerosis. CAR-T resulting in a systemic cytokine release syndrome has been associated with myriad cardiovascular consequences including arrhythmias, myocardial infarction, and heart failure. This review summarizes the current state of knowledge regarding adverse cardiovascular effects associated with ICIs and CAR-T.
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Mashup Score: 17
Naloxone, a drug used to reverse the effects of opioid overdose, is to be made more accessible across the UK, after the government announced plans to enable more services and individuals to provide take home supplies.1 Following a six week consultation earlier this year, the Department of Health and Social Care (DHSC) said …
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NHS England has announced plans to enable community pharmacies to arrange referrals for people with possible #cancer symptoms. This is unlikely to transform cancer detection in primary care, argue @DrMeenaRafiq @BoomboomchiefsT @Thatyoungdr https://t.co/Wm69ojzPGf