{"title":"Direct-to-consumer genetic tests also need to be regulated","authors":"Frances A Flinter","doi":"10.1136/bmj.r144","DOIUrl":"https://doi.org/10.1136/bmj.r144","url":null,"abstract":"Gram and colleagues describe valid concerns arising from the growing market for medical direct-to-consumer (DTC) tests but do not mention genetic tests.1 Most genetic tests are not regulated. They go to market (often over the internet) without any independent analysis to verify the claims of the company marketing them. Finding a “health risk” on DTC genetic testing often does …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027235","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}
{"title":"When I use a word . . . Lexicographic anniversaries in 2025","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.r164","DOIUrl":"https://doi.org/10.1136/bmj.r164","url":null,"abstract":"Like people, words have birthdays. My definition of the birthday of a word is the year in which it first appeared in a written text, as, for example, documented in the Oxford English Dictionary ( OED ). Of course, many words have had a spoken life before their written one, but I count that as the fetal stage in their development. Their appearance in the world is marked by their first appearance in print, their birthday or anniversary. In some cases the date on the birth certificate, i.e. the earliest recorded date in the dictionary, can be antedated by finding earlier examples of the use of the word in print; in my experience, this happens to about 10% of biomedical words. Counting anniversaries as having occurred in multiples of 50 years, I have searched for biomedical words whose birthdays fell in years ending in ’25 and ’75 and have found 655 of them, about 46 per 1000 new words of all kinds in those years. Among these, I discuss: “body sin,” dating from 1175 and largely obsolete since then, only once, more recently, being used to describe obesity; “licorice,” which dates from at least 1275, but perhaps earlier; and “spittle-evil” a synonym for leprosy, which dates from 1225. The last of these occurs in a 13th century manual of instruction for anchoresses, The Ancrene Riwle , in which God’s grace and the Devil’s work are both likened to the use of medicinal compounds, respectively beneficial and harmful. Indeed, the words medicine, remedy, and remission all occur for the first time in writing in this text. My last example is “pharmacological,” which celebrates its 200th anniversary this year. I have been listing medical anniversaries annually since 2016, and have recently done so for 2025.1 For this purpose I have counted an anniversary …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030996","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}
{"title":"Matthew James Young","authors":"Donya Young, Brendan Boylan","doi":"10.1136/bmj.r151","DOIUrl":"https://doi.org/10.1136/bmj.r151","url":null,"abstract":"Matt was born in Hampshire and attended Prices Grammar School. He was advised to follow either a career with the Forestry Commission or in medicine—he opted for the latter, becoming the first in his family to attend university. He spent his pre-clinical year at King’s College London in the Strand where he met his future wife, Donya. He graduated in 1986 and trained as a GP on the Sidcup scheme. Matt was a good, kind man, and applied these attributes unequivocally to those he came across both in and out of work. He had …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027234","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}
{"title":"Getting assisted dying conversations right for patients","authors":"Jason W Boland","doi":"10.1136/bmj.r130","DOIUrl":"https://doi.org/10.1136/bmj.r130","url":null,"abstract":"Approximately 1% of the population and almost one third of hospital inpatients are in the last year of life.123 All clinicians need to be skilled at identifying these patients and initiating compassionate and skilful discussions about their care. Many already do. After the recent vote in the UK parliament, there will now be less stigma for patients to raise assisted dying with us. …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027236","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}
James Radner, Mark Tomlinson, Jasmine Lam, Rob Hughes
{"title":"Children First? We need to rethink global governance to prioritise child health","authors":"James Radner, Mark Tomlinson, Jasmine Lam, Rob Hughes","doi":"10.1136/bmj.r150","DOIUrl":"https://doi.org/10.1136/bmj.r150","url":null,"abstract":"In response to the new US administration’s policies endangering children and global health, we need to reconstruct the international system based on respect for children, solidarity, and hope, write James Radner and colleagues This year marks a time of extreme peril for the world’s children. Emergencies including brutal violence, climate disasters, state failure, and extreme poverty have left over 200 million children globally at “a historically high level” of humanitarian need.1 Children in humanitarian and low income settings, and in the US, face a new threat that the world community must attend to: the arrival of an “America First” government under Donald Trump. This is a dangerous development, but it also presents an opportunity for the world community to rethink and develop new models for helping children—something that we almost all say is our priority. For a taste of what is coming, consider some of the executive orders Trump signed on his first day. One order disbanded the task force charged with reuniting families after children were forcibly taken from their parents at the US southern border by the first Trump administration. An estimated 1000 children are still separated, and their treatment has been described as …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027232","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}
The BMJPub Date : 2025-01-23DOI: 10.1136/bmj-2024-079567
Yan Jing Chen, Ling Wang
{"title":"Linear erythematous plaques","authors":"Yan Jing Chen, Ling Wang","doi":"10.1136/bmj-2024-079567","DOIUrl":"https://doi.org/10.1136/bmj-2024-079567","url":null,"abstract":"This middle aged woman presented with a 40 year history of a gradually expanding itchy rash on her left leg. She had no relevant personal or family history and took no regular medications. On examination, extensive well defined, erythematous, plaques with raised edges and …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020424","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}
The BMJPub Date : 2025-01-23DOI: 10.1136/bmj-2024-082028
Jiahao Meng, Pan Liu, Shuguang Gao
{"title":"Skin puckering of the upper arm","authors":"Jiahao Meng, Pan Liu, Shuguang Gao","doi":"10.1136/bmj-2024-082028","DOIUrl":"https://doi.org/10.1136/bmj-2024-082028","url":null,"abstract":"A teenage boy presented to the emergency department three hours after he injured his left shoulder when he fell while running. He had persistent pain and was unable to move his left shoulder. There was noticeable skin puckering at the proximal end of the humerus near the shoulder, accompanied by subcutaneous bruising (fig 1). On examination there was tenderness in the shoulder joint, limited shoulder movement, weakness in forearm flexion, normal distal arterial pulse, and no sensory abnormalities. No emptiness in the shoulder socket was detected on palpation, and the humeral head could not be felt beneath the anterior-inferior aspect of the coracoid process. The patient’s temperature and other vital signs were normal, as was sensation in other areas. A radiograph of the left shoulder joint was taken on initial examination (fig 2). Fig 1 General appearance of left shoulder …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020426","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}
The BMJPub Date : 2025-01-23DOI: 10.1136/bmj.q2656
Katharine Lang
{"title":"Can weight loss drugs like Ozempic treat obesity in children?","authors":"Katharine Lang","doi":"10.1136/bmj.q2656","DOIUrl":"https://doi.org/10.1136/bmj.q2656","url":null,"abstract":"GLP-1 agonists for weight loss are now commonly used for adults, but might they also be an effective treatment for younger people? Katharine Lang reports Obesity in children and adolescents is a growing problem. In 2022, according to NHS data, 15% of children aged between 2 and 15 were living with obesity in the UK.1 In the US the figure is closer to 20%, or one in five of those aged under 19.2 Untreated obesity in children and adolescents can lead to lifelong health problems, including type 2 diabetes, chronic kidney disease, and cardiovascular disease, as well as mental health problems.34 Glucagon-like peptide-1 (GLP-1) receptor agonist drugs such as liraglutide (Saxenda) and semaglutide (Ozempic, Wegovy) are being hailed as game changers in treating adult obesity, and possibly many other health conditions.5 Could they be equally useful in the treatment of younger people with obesity? Yes, says Julian Hamilton-Shield, professor in diabetes and medical endocrinology at the University of Bristol. “It’s certainly the case that adolescents and children seem to respond to these drugs in the same way that adults do, in that they lose large amounts of weight, it reduces their appetite, and they’re able to leave food on a plate which they have never been able to do before. I would argue that the evidence is, overall, that they are clinically very effective.” GLP-1 agonists are not yet widely available for children and adolescents, however, as the National Institute for Health and Care Excellence (NICE) has yet to publish guidance on their use in this age group. NICE told The BMJ that it is “unable to make a recommendation on liraglutide for managing obesity in those aged 12 to 17 because manufacturers Novo Nordisk did not provide an evidence submission.”6 NICE is also …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020425","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}
The BMJPub Date : 2025-01-23DOI: 10.1136/bmj.q2526
Helen Saul, Samantha Cassidy, Laura Swaithes, Trisha Greenhalgh, Rebecca Payne
{"title":"How to make remote consultations safer","authors":"Helen Saul, Samantha Cassidy, Laura Swaithes, Trisha Greenhalgh, Rebecca Payne","doi":"10.1136/bmj.q2526","DOIUrl":"https://doi.org/10.1136/bmj.q2526","url":null,"abstract":"Payne R, Clarke A, Swann N, et al. Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis. BMJ Quality and Safety 2023;0:1–14. To read the full NIHR Alert, go to: <https://evidence.nihr.ac.uk/alert/how-to-make-remote-consultations-safer/>","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020681","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}
{"title":"Exercise training in heart failure … and other research","authors":"Tom Nolan","doi":"10.1136/bmj.r65","DOIUrl":"https://doi.org/10.1136/bmj.r65","url":null,"abstract":"Tom Nolan reviews this week’s research Exercise for 30 minutes three times a week on an exercise bike for a month; then make the sessions an hour long and add resistance training with two sets of 12-15 reps on seven different weight machines, and keep that up for a whole year. No, this isn’t my overly ambitious new year’s fitness regimen, but the intervention in a study of combined endurance and resistance exercise training in heart failure with preserved ejection fraction. Unsurprisingly, most of the 83 people randomised to exercise training weren’t able to adhere to this (although 47.5% managed at least two sessions a week). At the end of the study there was no difference in modified Packer score, which incorporates mortality and …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020682","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}
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