The BMJ: Leading Medical Research, News, Education, Opinion
Lebanon: Israeli attack endangers a healthcare system reliant on Hezbollah. With 3.5 million people in need, a doctor exodus, and some regions served by the very military group that Israel seeks to rout, Lebanon’s healthcare system is in crisis. Sally Howard reports. News. ∙ Lebanon’s health system struggles as dozens of clinics close ...
Interpreting raised serum ferritin levels | The BMJ
Aug 3, 2015 · Ferritin is an intracellular iron storage protein and a marker of iron stores. Normal serum ferritin levels vary between laboratories but generally concentrations >300 µg/L in men and postmenopausal women and >200 µg/L in premenopausal women are regarded as elevated. 1 Low ferritin values provide absolute evidence of iron deficiency. 2 Raised ...
Interpreting iron studies | The BMJ
Jun 15, 2017 · Box 1: Suggested indications for iron studies. Investigation of. iron overload (haemochromatosis) 1. o at early stages can be asymptomatic or present with vague symptoms such as fatigue, weakness, or generalised joint pains. o later manifestations might include deranged liver enzymes, cirrhosis, erectile dysfunction, arthritis, or cardiomyopathy.
Sepsis: pathophysiology and clinical management | The BMJ
May 23, 2016 · Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic …
Diagnosis and management of sensory polyneuropathy - The BMJ
May 8, 2019 · Sensory polyneuropathies, which are caused by dysfunction of peripheral sensory nerve fibers, are a heterogeneous group of disorders that range from the common diabetic neuropathy to the rare sensory neuronopathies. The presenting symptoms, acuity, time course, severity, and subsequent morbidity vary and depend on the type of fiber that is affected and …
Covid-19: Two rare vaccine side effects detected in large ... - The BMJ
Feb 26, 2024 · The largest vaccine safety study to date has identified two new, but very rare, side effects associated with covid-19 vaccines—transverse myelitis and acute disseminated encephalomyelitis. The Global Vaccine Data Network cohort study included 99 million vaccinated people from 10 sites across eight countries. Researchers compared the observed with …
Latest guidance on the management of gout | The BMJ
Jul 18, 2018 · Gout is the most common inflammatory arthritis and its incidence in the UK has steadily increased from 1.5% in 1997 to 2.5% in 2012. 1 2 It is characterised by deposition of monosodium urate crystals in joints and tissues and usually presents with intermittent painful attacks followed by long periods of remission. 3 Here, we review the latest ...
Recognising and explaining functional neurological disorder
Oct 21, 2020 · Functional disorders are conditions whose origin arises primarily from a disorder of nervous system functioning rather than clearly identifiable pathophysiological disease—such as irritable bowel syndrome, fibromyalgia, and functional neurological disorder (FND)—they are the second commonest reason for new neurology consultations. 1 FND is common in emergency …
Investigating raised creatine kinase | The BMJ
Jun 23, 2021 · A 76 year old man with hypercholesterolaemia is referred to the lipid clinic because of persistently raised creatine kinase activity of 1000 IU/L or above (reference range 40-320 IU/L) after trying multiple statins. He describes no significant myalgia but had some proximal muscle weakness, which is demonstrated when he stands up from a seated position and when …
Management of acute upper gastrointestinal bleeding | The BMJ
Mar 25, 2019 · Upper gastrointestinal bleeding (UGIB) is a common medical emergency, with a reported mortality of 2-10%. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 70-80 g/L are …