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Mashup Score: 1Revolving doors: board memberships, hedge funds, and the FDA chiefs responsible for regulating industry - 5 hour(s) ago
The US Food and Drug Administration says that it takes conflicts of interest seriously. But financial entanglements with the drug industry are common among its leaders. Peter Doshi reports At his public confirmation hearing in late 2021, Robert Califf, President Biden’s nominee to lead the US Food and Drug Administration (FDA), faced pointed questions about his financial relationships with industry. Bernie Sanders, the senator from Vermont, asked, “At a time when the American people are outraged by the high cost of prescription drugs, deeply disturbed about what happened with Purdue and Oxycontin, what kind of comfort can you give to the American people when you have been so closely tied to the pharmaceutical industry yourself?” He added, “How can the American people feel comfortable you’re going to stand up to this powerful special interest?” Califf responded: “Senator Sanders, I have a history of doing that. But I’d also point out that this administration has the most stringent ethic
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 6Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study - 6 hour(s) ago
Objective To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality. Design Population based cohort study. Setting Female registered nurses from 11 US states in the Nurses’ Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018). Participants 74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline. Main outcome measures Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes). Results 30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 y
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Mashup Score: 13What do we know about covid-19’s effects on the gut? - 9 hour(s) ago
Not just a respiratory infection, covid can cause symptoms throughout the body. Gastrointestinal symptoms are common in both acute and long covid, with gut issues often persisting long after initial infection. Katharine Lang investigates Lack of appetite, nausea, vomiting, diarrhoea, and abdominal pain. These may not be the symptoms people expect with covid, but around 50% of people experience them after SARS-CoV-2 infection, and in some people they’re the only symptoms.1 Gastrointestinal (GI) symptoms may be the first sign of infection or may develop later and persist as part of long covid. Sheena Cruickshank, immunologist at the University of Manchester, tells The BMJ why doctors didn’t initially recognise GI symptoms as part of covid-19. “The frequency of gastric symptoms—anorexia, pain, diarrhoea, vomiting, rectal bleeding—has varied considerably from 12-61% in publications,” she says, explaining that this variance may be due to GI symptoms not being reported as linked to covid. “H
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Mashup Score: 8Toxic household exposures in children - 11 hour(s) ago
### What you need to know Poisoning is a leading cause of unintentional injury in children worldwide accounting for 11% of all unintentional injuries in children under 15 years old.1 Fatal poisoning rates are four times higher in low and middle income countries compared with high income countries.1 Across Europe, agents most commonly ingested include medications and household products.2 In the UK, poisoning is the third most common cause of injury related admission to hospital, equating to around 4000-5000 admissions per year (box 1).1011 Most children ingesting poisonous substances do not require hospital admission, and many can be managed at home or in the community.11 However, these decisions require adequate clinical assessment and access to appropriate information on the chemicals involved. This article offers an approach to assessing a child with suspected exposure to toxic household chemicals for those working in community settings. Box 1 ### Rise in poisoning from household exp
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Mashup Score: 0David Oliver: How well is the duty of candour enforced in the NHS? - 12 hour(s) ago
Readers of The BMJ who are registered clinicians working in the UK will be well aware of the professional duty of candour and transparency over incidents that put patients at risk or harm them. It was strongly reinforced in 2015 (updated in 2022) in joint guidance by the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC),12 as well as in updated professional codes of practice.34 This duty, which can also feature in our employment contracts, comes with a “must” and not a “should”: it applies equally to registered doctors, nurses, and midwives in management and professional leadership roles, who are expected to create a culture where staff can raise concerns without fear and can have them listened to and acted on. Aside from the professional duty of candour, some readers may be less aware of the statutory duty of candour for healthcare organisations and their executives. It’s still fairly rare to see the “duty of candour” referred …
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Mashup Score: 427Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: population based cohort study - 12 hour(s) ago
Objective To investigate the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC). Design Population based cohort study. Setting Swedish Covid-19 Investigation for Future Insights—a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden. Participants All adults (≥18 years) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated. Main outcome measure The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC w
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Mashup Score: 15
Staffing shortages play a key role in unsafe maternity care, an analysis of 92 cases by the Maternity and Newborn Safety Investigations (MNSI) programme has found.1 The 92 pregnant women studied had been allocated to give birth in midwifery units, intended for those deemed low risk, but had to be transferred to hospital because they or their babies needed additional care. Thirty of the babies died—19 during labour and 11 during the first six days of life—and 62 babies required therapeutic cooling for potential brain injury. As well as insufficient staff numbers, difficulties in monitoring babies’ heart rate also played a role in poor care and were affected by the staff shortages, MNSI’s national learning report found. “The mismatch between demand and capacity frequently led to delays in care and/or safety-critical monitoring tasks during labour,” it noted. …
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Mashup Score: 10Deprescribing in older adults with polypharmacy - 20 hour(s) ago
Polypharmacy is common in older adults and is associated with adverse drug events, cognitive and functional impairment, increased healthcare costs, and increased risk of frailty, falls, hospitalizations, and mortality. Many barriers exist to deprescribing, but increased efforts have been made to develop and implement deprescribing interventions that overcome them. This narrative review describes intervention components and summarizes findings from published randomized controlled trials that have tested deprescribing interventions in older adults with polypharmacy, as well as reports on ongoing trials, guidelines, and resources that can be used to facilitate deprescribing. Most interventions were medication reviews in primary care settings, and many contained components such as shared decision making and/or a focus on patient care priorities, training for healthcare professionals, patient facing education materials, and involvement of family members, representing great heterogeneity in
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Mashup Score: 8Why I . . . go mountaineering - 20 hour(s) ago
GP Adam Booth talks to Kathy Oxtoby about his experiences of climbing some of the highest mountains in the world, including Everest—twice “It feels infinite,” Adam Booth says of the view when standing at the summit of Mount Everest (also known as Chomolungma and Sagarmatha). “You see the curvature of the earth, the whole of the Himalayan chain spread out in two directions—the arid, expansive Tibet on one side and the lush green foothills of Nepal on the other. It’s an incredible experience.” Those minutes gazing out from earth’s highest mountain were “profound moments in my life,” he says. “With all the preparation and physical training, I’d been building up to those moments for years.” A part time GP at Prescott Surgery in Baschurch, Shropshire, Booth’s love of mountaineering has brought him huge fulfilment in life. “When I’m on the summit of a …
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Mashup Score: 181Deprescribing in older adults with polypharmacy - 1 day(s) ago
Polypharmacy is common in older adults and is associated with adverse drug events, cognitive and functional impairment, increased healthcare costs, and increased risk of frailty, falls, hospitalizations, and mortality. Many barriers exist to deprescribing, but increased efforts have been made to develop and implement deprescribing interventions that overcome them. This narrative review describes intervention components and summarizes findings from published randomized controlled trials that have tested deprescribing interventions in older adults with polypharmacy, as well as reports on ongoing trials, guidelines, and resources that can be used to facilitate deprescribing. Most interventions were medication reviews in primary care settings, and many contained components such as shared decision making and/or a focus on patient care priorities, training for healthcare professionals, patient facing education materials, and involvement of family members, representing great heterogeneity in
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
The US Food and Drug Administration says that it takes conflicts of interest seriously. But financial entanglements with the drug industry are common among its leaders. Peter Doshi reports 🔗 https://t.co/LM9hJdDo1F https://t.co/HatkDZyvAM