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Archive for the ‘life’ Category

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BMJ  2007;335:470-471 (8 September):

News

Proliferation of firearms is growing global health problem

John Zarocostas

The growing number of civilians holding firearms is fuelling gun crime worldwide and is putting healthcare systems, especially in poor countries, under stress, an expert report says. Gun crime kills about 250 000 people a year and injures many more.

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Clinical Review, BMJ  2007;335:929-932 (3 November).

Summary points

  • A favourable outcome depends on early, aggressive, treatment
  • Antimicrobial treatment must take into account both patient susceptibilities and local resistance patterns; advice from infectious disease or microbiology colleagues is often helpful
  • Volume resuscitation and cardiovascular support should be titrated to simple clinical end points
  • Subtle signs of organ hypoperfusion should be sought in physically robust patients
  • The role of activated protein C and low dose steroids remains to be clarified

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DRINKING SENSIBLY

With the festive season in full swing, Ian Gilmore and Nick Sheron urge the implementation of policies to curb excess drinking to reduce the harms of alcohol in the UK (read more), whereas Christopher Cook and colleagues consider a classical Greek text that makes it obvious that drunkenness has a long tradition in Western civilisation (Classically intoxicated), and A&E doctor Robert J Douglas from Australia recommends CHAMPAGNE as the safer choice for celebrations.

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Editorials, BMJ  2007;335:897 (3 November).

The possible influence of diet on the risk of cancer is constantly topical. The subject is important because people can change their diets, and even a moderate effect on risk could prevent several thousand cancers each year in a country the size of the United Kingdom. However, apart from the confirmed adverse effects of alcohol and obesity on the risk for some types of cancer, progress in understanding has been slow and the evidence remains confusing.

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BMJ  2007;335:715-718 (6 October), by: Anne B Ballinger, consultant gastroenterologist.

Colorectal cancer is common, the presenting symptoms are non-specific, and the stage of disease at diagnosis is closely related to survival.

Summary points

  • The lifetime risk of developing colorectal cancer is about 5%
  • Increasing age and a family history of colorectal cancer are the greatest risk factors for the disease
  • Patients presenting with suspicious symptoms and signs should be referred and investigated urgently in a specialised unit
  • Colonoscopy and computed tomographic colonography are of equal sensitivity for detection of colorectal cancer
  • Colonoscopy allows biopsy of suspicious lesions and removal of polyps
  • Population screening by testing for faecal occult blood has begun in the United Kingdom

>>>>> CLICK here for more …..

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A database analysis reported by James N Armitage and colleagues shows that mortality in men admitted to hospital with acute urinary retention is high and increases strongly with age and comorbidity – as many as one in four men admitted to hospital with acute urinary retention will die within a year.

Katia M C Verhamme and Miriam C J M Sturkenboom, in an accompanying editorial, say that since the increased mortality seen in men admitted to the hospital for acute urinary retention is probably the result of comorbid conditions and frailty, multidisciplinary care is warranted in these men.

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BMJ  2007;335:639 (29 September).  

The US has a dismal record on health, despite outspending by a considerable margin every other developed nation in the world.

 Americans and their elected politicians are generally complacent about this sorry state of affairs, writes one leading doctor. Healthcare professionals are probably the best people to unite and shake them out of their complacency.

To do nothing is to accept the US position at the bottom of the league tables on health, when in so many other areas only first place will do.

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