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Doctors and vets working together for antibiotic stewardship

Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance - but the professions are using different methods to combat resistance and reduce overuse. In this roundtable, we bring medics and vets together to discuss the problem - where antibiotic resistance arises, how...




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How often do hospital doctors change long term medication during an inpatient stay?

More than ½ of patients leave hospital with changes to four or more of their long-term medications - but how appropriate are those changes? New research published on bmj.com looks at antihypertensive medication prescription changes to try and model that - and found that more than half of intensifications occurred in patients with previously well...




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Assisted dying: should doctors help patients to die?

The Royal College of Physicians will survey all its members in February on this most controversial question. It says that it will move from opposition to neutrality on assisted dying unless 60% vote otherwise. The BMJ explores several conflicting views. From Canada, palliative care doctor Sandy Buchman explains why he sees medical aid in dying...




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Talk Evidence - Shoulders, statins and doctors messes

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. They start by talking about shoulders - what does the evidence say about treating subacromial pain, and why the potential for a subgroup effect shouldn't change our views about stop surgery (for now, more research needed). (16.00)...




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Introducing Sharp Scratch - our new podcast for students and junior doctors

Here's a taster for our new student podcast - Sharp Scratch. We're talking about the hidden curriculum, things you need to know to function as a doctor, but are rarely formally taught. This is a taster - if you enjoy, subscribe! https://podcasts.apple.com/gb/podcast/student-bmj-podcast/id331561304 Sharp Scratch episode 1: Surviving the night...




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Doctors and extinction rebellion

Starting in the middle of April, the group “Extinction Rebellion” have organised a series of non-violent direct action protests. Most notably bringing central London to a standstill - but these events are now continuing around the country. Predictably, they have received a lot of criticism - they have also received a lot of support - amongst...




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Thoroughly and deliberately targeted; Doctors in Syria

As Syria enters its ninth year of conflict, doctors are struggling to provide health care to a badly damaged country. While dealing with medicine shortages, mass casualties and everything that comes with working in a warzone, healthcare facilities and their staff are also facing an unprecedented number of targeted and often repeated attacks....




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Creating support for doctors in the NHS

The NHS Practitioner Health Programme - once only for doctors in London, now it’s being rolled out across the NHS to provide the largest, publicly funded, comprehensive physician health service, in the world. However, while helping the individual is essential, systemic change needs to be made to support doctors in our healthcare system. Clare...




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Behind the campaign promises - Doctors in parliament

The UK general election is happening this week, and you’ve probably made your mind up which MP you’re voting for already - and maybe the NHS has influenced that decision. This year has seen an increase in the number of doctors running for parliament, and in this podcast we find out what motivates doctors to step away from clinical practice, and...




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Wellbeing – how one junior doctor found a way to support frontline staff

How can we help frontline clinicians? Sometimes medics may feel uneasy or even guilty and that they could be doing more. That was what a junior doctor in Abergavenny in Wales felt and she did something about it. In this podcast, we speak to Josie Cheetham about how she started her initiative to provide support boxes in hospitals for her...




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Glucose-Induced Reactive Oxygen Species Cause Apoptosis of Podocytes and Podocyte Depletion at the Onset of Diabetic Nephropathy

Katalin Susztak
Jan 1, 2006; 55:225-233
Complications




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Doctor alleged to have performed “designer vagina” surgery won’t be prosecuted




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NHS increases efforts to recruit doctors from overseas




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David Oliver: Is abuse towards doctors in government roles unfair?




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Self-protection: how NHS doctors are sourcing their own PPE




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Doctors as Taxi Drivers: The Costs of Brain Waste among Highly Skilled Immigrants in the United States

A report release and presentation of first-ever U.S. estimates on the actual economic costs of skill underutilization for immigrants, their families, and the U.S. economy, in terms of forgone earnings and unrealized federal, state, and local taxes.




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What Did the Doctor Say?


Sep 1, 2010; 28:176-176
Patient Information




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Standardizing Clinically Meaningful Outcome Measures Beyond HbA1c for Type 1 Diabetes: A Consensus Report of the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators, the American Diabetes Association, the Endo

Gina Agiostratidou
Dec 1, 2017; 40:1622-1630
Continuous Glucose Monitoring and Risk of Hypoglycemia




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Staging Presymptomatic Type 1 Diabetes: A Scientific Statement of JDRF, the Endocrine Society, and the American Diabetes Association

Richard A. Insel
Oct 1, 2015; 38:1964-1974
Scientific Statement




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Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society

Elizabeth R. Seaquist
May 1, 2013; 36:1384-1395
Scientific Statement




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Staging Presymptomatic Type 1 Diabetes: A Scientific Statement of JDRF, the Endocrine Society, and the American Diabetes Association

Richard A. Insel
Oct 1, 2015; 38:1964-1974
Scientific Statement




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As the Trump Administration Seeks to Remove Families, Due-Process Questions over Rocket Dockets Abound

The U.S. government is operating accelerated dockets to handle the rising number of cases of families in immigration court. While it is essential to have timely, fair case processing and removal of those who have truly had their day in court and been found to be removable, using “rocket” dockets to speed up proceedings only heightens the breakdowns that are a recurring feature of the court system on its best day, as this commentary explains.




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Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7 to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (~5.0 million) using the Endocrine Society’s approach and 7.3% (~2.3 million) using the standard approach. Treatment eligibility ranged from 5.4 to 0.06% and 11.8–1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (~18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.




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The Color of Health Care: Diagnosing Bias in Doctors

Long before word recently broke that white referees in the National Basketball Association were calling fouls at a higher rate on black athletes than on white athletes, and long before studies found racial disparities in how black and white applicants get called for job interviews, researchers no...




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Forum 2019 : 3C: What documents a practitioner should or shouldn't release to a client : slides / presented by Jon Clarke, Cowell Clarke, Peter Jackson, Duncan Basheer Hannon, Rebecca Sandford, HWL Ebsorth Lawyers.




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Forum 2019 : 7A Cross examination of documents / paper presented by: Edward Stratton-Smith, Edmund Barton Chambers.




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Understanding documents for genealogy & local history / Bruce Durie.

Archival materials -- Handbooks, manuals, etc.




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Honourable healers : pioneering women doctors : Elizabeth Blackwell, Elizabeth Garrett Anderson and Constance Stone / Merrilyn Murnane.

Stone, E. Constance (Emma Constance), 1856-1902.




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Counting backwards : a doctor's notes on anesthesia / Henry Jay Przybylo, MD.

Przybylo, Henry Jay.




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Des maladies de la France dans leurs rapports avec les saisons, ou, Histoire médicale et meteorologique de la France. [t. 1] / par le Docteur Fuster.

Paris : Dufart, 1840.




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Des pressions centripetes (Epreuve de Gelle) etude de semeiologie auriculaire / par Le Docteur Georges Gelle.

Paris : Société d’éditions scientifiques, 1895.




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Die Cladoceren der Umgebung von Basel / vorgelegt von Theodor Stingelin.

Genf : Rey & Malavallon, 1895.




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Directions for using the improved sliding scale of chemical equivalents : with a short explanation of the doctrine of definite proportions / by David Boswell Reid.

Edinburgh : J. Dunn, 1826.




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The doctor in history, literature, folk-lore, etc / Edited by William Andrews.

Hull : Andrews, 1896.




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Doctrina de morbis cutaneis / Josephi Jacobi Plenck.

Viennae : Apud Rudolphum Graeffer, 1783.




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Doctrina de morbis oculorum / Josephi Jacobi Plenck.

Viennae : Apud Rudolphum Graeffer, 1783.




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Doctrine nouvelle sur la reproduction de l'homme, suivie du tableau des variétés de l'espèce humaine / par M. Tinchant.

Paris : Trouvé, 1822.




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Documents and dates of modern discoveries in the nervous system.

London : J. Churchill, 1839.




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Documents inédits sur la grande peste de 1348 (Consultation de la Faculte de Paris, consultation d'un praticien de Montpellier, description de Guillaume de Machaut) / publiés avec une introduction et des notes par L.-A. Joseph Michon.

Londres : Paris, 1860.




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Documents pour servir à l'histoire de la grossesse extra-utérine, douze observations / par A. Pinard.

Paris : G. Steinheil, 1892.




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[Documents relating to James Gregory and the Royal College of Physicians of Edinburgh, 1805-07].

Edinburgh : printed by James Ballantyne & Co, [1807?]




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Documents sur l'hystérectomie abdominale totale pour fibromyomes utérins / Fr Guermonprez.

Paris : Bailliere, 1896.




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Du role de l'épiploïte aiguë ou chronique (adhérences épiploïques) au cours des appendicites / par le Docteur Leon Levrey.

Paris : Steinheil, 1899.




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Du traitement des maladies du coeur par la méthode des Drs Schott, de Nauheim / par le docteur Moeller, médecin praticien à Bruxelles, membre titulaire de l'Académie royale de médecine de Belgique, etc / par la methode des drs

Bruxelles : A. Manceaux, 1893.




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Erfahrungen auf dem Gebiete der Hals- und Nasen-Krankheiten nach den Ergebnissen des ambulatoriums / von Docent Dr O. Chiari.

Leipzig : Toeplitz & Deuticke, 1887.




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Essai clinique et expérimental sur la fièvre des tuberculeux (toxicité des crachats, toxicité des urines) / par Le Docteur Edouard Chretien.

Paris : Steinheil, 1896.




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Essai sur la syringomyelie / par le Docteur Critzman.

Paris : G. Steinheil, 1892.




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Role of doctors for youth and smoking in international youth year / [distributed by Cleanair]

Calcutta, India : Cleanair, Campaign for Smoke-free Environment, [198-?]




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Drug abuse treatment client characteristics and pretreatment behaviors : 1979-1981 TOPS admission cohorts / Robert L. Hubbard, Robert M. Bray, Elizabeth R. Cavanaugh, J. Valley Rachal, S. Gail Craddock, James J. Collins, Margaret Allison ; Research Triang

Rockville, Maryland : National Institute on Drug Abuse, 1986.




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Drug use before and during drug abuse treatment : 1979-1981 TOPS admission cohorts / S. Gail Craddock, Robert M. Bray, Robert L. Hubbard.

Rockville, Maryland : National Institute on Drug Abuse, 1985.