The BMJ最新文献

筛选
英文 中文
Cancer related lymphedema 癌症相关淋巴水肿
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj-2024-081351
Andrea L Cheville, Sarah A McLaughlin, Gretchen E Glaser, Judy C Boughey
{"title":"Cancer related lymphedema","authors":"Andrea L Cheville, Sarah A McLaughlin, Gretchen E Glaser, Judy C Boughey","doi":"10.1136/bmj-2024-081351","DOIUrl":"https://doi.org/10.1136/bmj-2024-081351","url":null,"abstract":"Lymphedema is a prevalent, incurable, and morbid condition with the potential to degrade the health and quality of life of patients living with cancer and beyond cancer. Effective long term control requires coordination by an interdisciplinary team to ensure that lymphedema progression, complications, and related disablement are detected and appropriately addressed. This review provides an overview of lymphatic function and lymphedema pathogenesis with focused discussion of the unique characteristics of cancer related lymphedema (CRL) including natural history, clinical presentation, and risk factors for onset and progression. Surgical practice changes and supportive evidence for lymph node sparing and lymphatic reconstruction for CRL prevention are described. The review outlines evaluations to diagnose, stage, and monitor CRL, and characterizes evidence for current CRL prevention and management practices, including surgeries to restore lymphatic function. Multimodal management with complete decongestive therapy remains first line treatment for CRL, though patient-specific customization might be required to optimize patients’ clinical response and quality of life as outlined in the review.","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"645 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brian Whitaker 布莱恩·惠特克
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1381
Dilys Whitaker
{"title":"Brian Whitaker","authors":"Dilys Whitaker","doi":"10.1136/bmj.r1381","DOIUrl":"https://doi.org/10.1136/bmj.r1381","url":null,"abstract":"After qualification Brian held various posts at Leeds General Infirmary and Halifax General Hospital before moving to Ripponden, West Yorkshire, and joining Neil Hamlin in a two man general practice. It was one of the first in the area to have an appointment system. Brian was instrumental in setting up …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Volunteering in free clinics carries a moral cost for medical students 对医科学生来说,在免费诊所做志愿者需要付出道德代价
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1306
Jason Denoncourt
{"title":"Volunteering in free clinics carries a moral cost for medical students","authors":"Jason Denoncourt","doi":"10.1136/bmj.r1306","DOIUrl":"https://doi.org/10.1136/bmj.r1306","url":null,"abstract":"It is unjust for the United States to rely on the charity and goodwill of overburdened medical students and physicians to provide free healthcare “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.” When I heard this quote by Canadian physician, William Osler, it reminded me of the humanistic ideals that drew me—and many others—to medicine. I find it aspirational, yet increasingly out of reach. At times, the US health system feels more like a corporate enterprise than a caregiving institution, too often leaving patients behind. An estimated one in seven adults—and nearly one in four adults with social risk factors—report difficulty accessing basic medical care in the United States.1 Free clinics are left to fill the gaps. This reliance shows deeper problems in the US health system and raises challenging ethical questions for the medical students who often staff them. Free clinics are praised for providing essential charitable care, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Margaret Helen Herbert 玛格丽特·海伦·赫伯特
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1376
Ruth Herbert
{"title":"Margaret Helen Herbert","authors":"Ruth Herbert","doi":"10.1136/bmj.r1376","DOIUrl":"https://doi.org/10.1136/bmj.r1376","url":null,"abstract":"After qualifying from Guy’s Hospital, London, and completing her GP vocational training in Aberystwyth, Helen Herbert joined her father’s practice in Aberaeron, Ceredigion, in 1984. She led the practice in tackling the challenges of the NHS and strongly upheld the traditional values of general practice. …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethnicity and childhood cancer survival 种族和儿童癌症存活率
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1350
Jessica Bate, Neil Ranasinghe, Gita Patel, Richard G Feltbower
{"title":"Ethnicity and childhood cancer survival","authors":"Jessica Bate, Neil Ranasinghe, Gita Patel, Richard G Feltbower","doi":"10.1136/bmj.r1350","DOIUrl":"https://doi.org/10.1136/bmj.r1350","url":null,"abstract":"We need high quality data to analyse outcomes Evidence suggests ethnic inequalities in cancer outcomes among children in the UK. A study of children with cancer between 1981 and 1996 showed no significant difference in survival overall when comparing white and non-white children but found higher mortality for children of South Asian origin with acute lymphoblastic leukaemia and for black children with neuroblastoma compared with white children.1 A historical regional study of patients under 30 with cancer between 1990 and 2005 concluded poorer survival outcomes for South Asians compared with non-South Asian children and young adults with leukaemia and lymphoma but better outcomes for South Asian children and young adults with other solid tumours, independent of socioeconomic deprivation.2 A study from Yorkshire examining survival from 1997 to 2016 revealed long term improvement in survival rates for all cancers combined, including in children from South Asian background, whose five year survival for all cancers rose from 64.4% to 80.7%.3 Although the survival gap between South Asians and other ethnic groups for leukaemia and solid tumours outside the central nervous system (CNS) narrowed, persistent …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The antivaccine movement threatens health in the US and worldwide 反疫苗运动威胁着美国和全世界的健康
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1383
Anna Kirkland, Scott L Greer
{"title":"The antivaccine movement threatens health in the US and worldwide","authors":"Anna Kirkland, Scott L Greer","doi":"10.1136/bmj.r1383","DOIUrl":"https://doi.org/10.1136/bmj.r1383","url":null,"abstract":"Robert F Kennedy Jr and others in the antivaccine movement are using the power of the US government to promote disinformation and flawed science, write Anna Kirkland and Scott Greer With Robert F Kennedy Jr at the head of the Department of Health and Human Services, antivaccination rhetoric is dominating the largest federal US agency and its responsibility to protect health. Recent developments that have caused concern include removing all members of a scientific committee that advises the Centers for Disease Control and Prevention (CDC) on vaccines and replacing them with people who are highly conflicted and mostly involved in antivaccine activism.1 This decision was based on an antivaccination talking point: that scientists and doctors were on the payroll of the drug industry. This was, unsurprisingly, shown to be incorrect.23 In its first meeting the new panel said that it would review vaccination schedules.4 Kennedy also appointed the oncologist and haematologist Vinay Prasad as the Food and Drug Administration’s (FDA) top vaccine official.5 Prasad, an outspoken critic of the drug industry and covid vaccines, has called for more research into links between childhood vaccination and autism.5 The language of conspiracy and misinformation has been used by Kennedy …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gabapentinoid pharmacovigilance in Africa 非洲加巴喷丁类药物警戒
The BMJ Pub Date : 2025-07-03 DOI: 10.1136/bmj.r1355
FP Omullo
{"title":"Gabapentinoid pharmacovigilance in Africa","authors":"FP Omullo","doi":"10.1136/bmj.r1355","DOIUrl":"https://doi.org/10.1136/bmj.r1355","url":null,"abstract":"Yuen and colleagues present UK data on the temporal association between gabapentinoid use and self-harm.1 Extrapolating these findings to the African population requires a pragmatic approach owing to diverging prescribing practices, regulatory disparities, and healthcare system limitations. Across many African nations, gabapentinoids are frequently prescribed off-label …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addressing the indirect health burden of covid-19 应对covid-19的间接卫生负担
The BMJ Pub Date : 2025-07-02 DOI: 10.1136/bmj.r1268
Zhihao Lei
{"title":"Addressing the indirect health burden of covid-19","authors":"Zhihao Lei","doi":"10.1136/bmj.r1268","DOIUrl":"https://doi.org/10.1136/bmj.r1268","url":null,"abstract":"Consider collateral impacts when planning for future crises The covid-19 pandemic’s impact extends far beyond the direct effects of infection and death, resulting in sharp increases in other causes of illness and death that demand attention. A new time-series analysis of the Global Burden of Disease data by Chen and colleagues (doi:10.1136/bmj-2024-083868) quantifies these shifts and identifies which conditions had excess burden during 2020-21.1 Their key finding is that many countries had greater than expected morbidity and mortality from non‐covid causes—a signal that health systems were strained in multiple ways. As such, policy makers must look past the virus itself and address collateral impacts. Health experts have noted that assessing health-system resilience now is “vital in helping policymakers plan for sustainable recovery” and to strengthen systems for future crises.2 The indirect health burdens have been profound. For example, a modelling study suggested that even modest service disruptions related to covid-19 in Africa could nearly double annual malaria deaths if routine programmes were interrupted.3 In practice, the findings suggest that malaria control campaigns could not simply be paused without consequences. Likewise, the pandemic has provoked a mental health crisis. The …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Africa’s invisible Parkinson’s problem 非洲看不见的帕金森病问题
The BMJ Pub Date : 2025-07-02 DOI: 10.1136/bmj.r1123
Frank Burkybile
{"title":"Africa’s invisible Parkinson’s problem","authors":"Frank Burkybile","doi":"10.1136/bmj.r1123","DOIUrl":"https://doi.org/10.1136/bmj.r1123","url":null,"abstract":"Parkinson’s disease diagnoses are rising across East Africa—hinting at a shift in healthcare priorities. Frank Burkybile reports One sunny afternoon in Nairobi a crowd of 200 patients, care givers, family members, and healthcare workers gather at the Visa Oshwal Community Centre. Bright banners celebrating world Parkinson’s day are hung along the walls, each displaying hopeful messages about resilience and community strength. Every participant’s presence is a quiet triumph; they have navigated a long journey with Parkinson’s disease, often endured without a proper diagnosis or access to informed healthcare.12 Some have only recently learnt their condition had a name, after years spent silently experiencing symptoms they didn’t understand. Parkinson’s in East Africa carries burdens on a scale largely unknown to patients in Europe or North America—stigma, isolation, crippling financial costs, insufficiently trained medical professionals, and inconsistent access to affordable drugs. The crisis underscores a need to rethink healthcare priorities. …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One in five calls under Martha's rule leads to change or escalation, figures show. 数据显示,在玛莎的规则下,五分之一的电话会导致改变或升级。
The BMJ Pub Date : 2025-07-02 DOI: 10.1136/bmj.r1380
Emma Wilkinson
{"title":"One in five calls under Martha's rule leads to change or escalation, figures show.","authors":"Emma Wilkinson","doi":"10.1136/bmj.r1380","DOIUrl":"https://doi.org/10.1136/bmj.r1380","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"150 1","pages":"r1380"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信