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British Medical Bulletin

Yao Lu, Ruifang Chen, Jingjing Cai, Zhijun Huang, Hong Yuan
Introduction or background: Poorly-controlled hypertension in the first trimester significantly increases maternal and fetal morbidity and mortality. The majority of guidelines and clinical trials focus on the management and treatments for hypertension during pregnancy and breast-feeding, while limited evidence could be applied to the management for hypertension before pregnancy. In this review, we summarized the existing guidelines and treatments of pre-pregnancy treatment of hypertension...
October 29, 2018: British Medical Bulletin
Simon J Crabb, James Douglas
Introduction: Bladder cancer carries a high healthcare burden and a poor prognosis once distant metastatic spread has occurred. Sources of data: We utilised a PubMed/MEDLINE literature search using the terms bladder cancer, chemotherapy, immunotherapy, intra-vesical therapy, surgery and radiotherapy, and current clinical management guidelines (Association of Cancer Physicians, British Association of Urological Surgeons, National Institute for Health and Care Excellence, European Association of Urology)...
October 29, 2018: British Medical Bulletin
Luca Chiapperino
Background: Epigenetics is a burgeoning field of contemporary biosciences, which has attracted a lot of interest both in biomedical and in social sciences. Sources of data: Unsystematic literature analysis and retrospective mapping of highly cited work (source: Web of Science core collection) in the social sciences and humanities engaging with epigenetics. Areas of agreement: Epigenetics poses no new ethical issue over and above those discussed in relation to genetics...
October 17, 2018: British Medical Bulletin
Asim Afaq, Jamshed Bomanji
Introduction: There is an unmet clinical need for early, accurate imaging of recurrent prostate cancer to improve patient outcomes. Staging, by conventional bone scintigraphy and CT have become outdated. 68Ga-PSMA PET/CT imaging in this setting has developed rapidly, with widespread International adoption in line with evidence-based guidelines in this group of patients. Sources of data: A PubMed search of English language articles was performed using following keywords: PSMA, PET/CT, biochemical recurrence, prostate cancer...
September 29, 2018: British Medical Bulletin
Matti Häyry
Background: Scientists have cloned animals since the late 19th century, but the crucial step for ethics was the cloning of the first mammal by somatic cell nuclear transfer in 1997. This suggested that scientists could also clone, and possibly enhance, human beings. Sources of data: This survey examines ethical literature on cloning since the 1960s. Areas of agreement: The one ethical area of agreement in this issue is that we should not try to create new human beings by somatic cell nuclear transfer now...
September 10, 2018: British Medical Bulletin
Robert Grecian, Moira K B Whyte, Sarah R Walmsley
Introduction: It has been known for some time that neutrophils are present in the tumour microenvironment, but only recently have their roles been explored. Sources of data: Comprehensive literature search of neutrophils and cancer (PubMed, Google Scholar and CrossRef) for key articles (systematic reviews, meta-analyses, primary research). References from these articles cross-checked for additional relevant studies. Areas of agreement: Neutrophils are a heterogeneous population with both pro- and antitumour roles, and display plasticity...
August 22, 2018: British Medical Bulletin
Leonardi Osti, Matteo Buda, Mattia Andreotti, Emanuele Gerace, Raffaella Osti, Leo Massari, Nicola Maffulli
Introduction: This systematic review provides a comprehensive description of different surgical techniques for massive rotator cuff tears (MRCTs) using arthroscopic-assisted latissimus dorsi transfer (A-LDT), reporting clinical outcomes and complications. Sources of data: We searched the literature on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'latissimus dorsi', 'tendon', 'transfer', 'rotator cuff tears', 'shoulder' and 'arthroscopy' to identify articles published in English, Spanish, French and Italian...
August 18, 2018: British Medical Bulletin
Lisa Campisi, Nazish Imran, Ahsan Nazeer, Norbert Skokauskas, Muhammad Waqar Azeem
Sources of data: This article is based on key recent published literature including international guidelines and relevant reviews and meta-analyses. Authors have also supplemented this material with their own clinical experience. Areas of agreement: There is an agreement that autism spectrum disorder (ASD) have a strong hereditary component. There is also a consensus that the reported prevalence estimates have increased in the last 5 years. There is strong support for using the broader spectrum disorder conceptualization of the DSM-5...
September 1, 2018: British Medical Bulletin
Andy Greenfield
Introduction or background: Genome editing facilitates alterations to DNA, large or subtle, in a precise fashion. In its most popular form it uses the programmable endonuclease system, CRISPR/Cas9. Edits can be made to any genome, including the human genome. This raises the possibility of genome editing in human embryos in both a research and reproductive context. Sources of data: All reports of genome editing in human embryos are included here, along with key papers examining the science and ethics of human genome editing...
September 1, 2018: British Medical Bulletin
Umile Giuseppe Longo, Mauro Ciuffreda, Joel Locher, Stefan Buchmann, Nicola Maffulli, Vincenzo Denaro
Introduction: Currently, no therapeutic intervention is universally accepted, and the most effective management for restoring motion and diminishing pain in patients with shoulder stiffness has yet to be defined. This systematic review analyses outcomes of conservative and surgical interventions to treat shoulder stiffness. Source of data: A systematic review of literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, Ovid and Google Scholar databases using various combinations of the keywords 'shoulder', 'shoulder stiffness', 'stiff shoulder', 'conservative', since inception of databases to June 2018 was performed...
September 1, 2018: British Medical Bulletin
A Forrester, A Till, A Simpson, J Shaw
Introduction: Around 11 million people are held in prisons internationally, and criminal justice systems are overburdened with a high prevalence of multiple psychiatric disorders. In England and Wales over 200 000 people enter prisons each year, and in many cases, this facilitates their first contact with mental health services. Sources of data: Research, evaluations, government reports and independent reviews. Areas of agreement: Screening, Triage, Assessment, Intervention and Re-integration (STAIR) are necessary components of prison mental health provision, offering an opportunity to improve the wellbeing of a complex population...
September 1, 2018: British Medical Bulletin
Richard A Anderson, Evelyn E Telfer
Introduction: Women are increasingly having children at a later age, but this can conflict with declining fertility in the later 30's and thereafter. Areas of agreement: Declining egg quality and quantity with age are well-established, although egg quality can only be surmised from reproductive success or failure. Areas of controversy: Whether increasing the number of eggs that can be obtained from ovarian stimulation is of value, and whether there are precursor cells within the adult ovary that could become mature eggs...
September 1, 2018: British Medical Bulletin
Neda Farahi, Chrystalla Loutsios, Nicola Tregay, Charlotte Summers, Laurence S C Lok, Prina Ruparelia, Chandra K Solanki, Daniel Gillett, Edwin R Chilvers, A Michael Peters
Introduction: Radionuclides for leucocyte kinetic studies have progressed from non-gamma emitting cell-labelling radionuclides through gamma emitting nuclides that allow imaging of leucocyte kinetics, to the next goal of positron emission tomography (PET). Sources of data: Mostly the authors' own studies, following on from studies of the early pioneers. Areas of controversy: From early imaging studies, it appeared that the majority of the marginated granulocyte pool was located in the lungs...
September 1, 2018: British Medical Bulletin
Andy Greenfield
No abstract text is available yet for this article.
September 1, 2018: British Medical Bulletin
Raf Aerts, Olivier Honnay, An Van Nieuwenhuyse
Introduction: Natural environments and green spaces provide ecosystem services that enhance human health and well-being. They improve mental health, mitigate allergies and reduce all-cause, respiratory, cardiovascular and cancer mortality. The presence, accessibility, proximity and greenness of green spaces determine the magnitude of their positive health effects, but the role of biodiversity (including species and ecosystem diversity) within green spaces remains underexplored. This review describes mechanisms and evidence of effects of biodiversity in nature and green spaces on human health...
September 1, 2018: British Medical Bulletin
Umile Giuseppe Longo, Laura Risi Ambrogioni, Mauro Ciuffreda, Nicola Maffulli, Vincenzo Denaro
Introduction: Sudden cardiac death (SCD) of young athletes during competition or training is a tragic event. The long QT syndrome (LQTS) is an arrythmogenic disorder characterized by prolonged ventricular repolarization leading to torsade de pointes evident at electrocardiogram (ECG). Implantable cardioverter defibrillator is an option to revert ventricular fibrillation to sinus rhythm, although the implantation may result in denial of sports participations to the athlete. The authors reviewed the current literature on LQTS in young athletes, to clarify the role of different screening technologies to prevent SCD...
September 1, 2018: British Medical Bulletin
K Alford, J H Vera
Background: Cognitive disorders are a common issue impacting those living with human immunodeficiency virus (HIV). Effective antiretroviral treatment has lessened the severity but not the frequency of these impairments. Such deficits reduce quality of life and present a significant challenge to clinicians in the context of an ageing HIV population with a growing number of comorbidities. Sources of data: This review is based on recent published literature in the field of HIV-associated cognitive impairment (HAND)...
September 1, 2018: British Medical Bulletin
L J Neilson, S Thirugnanasothy, C J Rees
Introduction: Colonoscopy is the gold standard test for investigating lower gastrointestinal symptoms and is an important therapeutic tool for colonic polypectomy. This paper is aimed at the general physician and examines the role of colonoscopy in very elderly patients by exploring the particular risks in this population, the yield of colonoscopy and potential alternative investigations. Sources of data: Original research and review articles were identified through selective PubMed searches...
September 1, 2018: British Medical Bulletin
Clifford J Bailey, Caroline Day
Introduction or background: Type 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 data: Medline, PubMed, Web of Science and Google Scholar. Areas of agreement: Early, 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) complications...
June 1, 2018: British Medical Bulletin
Sandy Starr
Background: Human genome editing is an area of growing prominence, with many potential therapeutic applications. Sources of data: A 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 agreement: There is a need for improved public and professional understanding of genome editing...
June 1, 2018: British Medical Bulletin
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