British medical bulletin
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British medical bulletin · Oct 2020
Clozapine in the treatment of refractory schizophrenia: a practical guide for healthcare professionals.
Clozapine remains the only medication licensed for treating refractory schizophrenia. However, it remains underutilized in part due to concerns regarding adverse events. ⋯ There is a need for more research on assessing clozapine dosage (i) as patients get older, (ii) with respect to exposure to cigarette smoke and (iii) optimizing response if adverse events or other factors limit dosage.
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British medical bulletin · Oct 2020
ReviewWhat prevents health policy being 'evidence-based'? New ways to think about evidence, policy and interventions in health.
Evidence-based policy decision-making is a dominant paradigm in health but realizing this ideal has proven challenging. ⋯ An 'evidence-making intervention' approach offers a framework for conceptualizing how evidence and interventions are made relationally in practices, thus working with the politics and contingencies of implementation and policy-making.
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British medical bulletin · Oct 2020
Covid-19 and the 'new normal': are remote video consultations here to stay?
During the UK Covid-19 lockdown, video consultations (telemedicine) were encouraged. The extent of usage, and to which concerns to earlier implementation were set aside, is unknown; this is worthy of exploration as data becomes available. ⋯ Examination of telemedicine use during the Covid-19 crisis to ensure that the benefits and usage continue into the post-lockdown, 'new normal' world.
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Tendon is a composite material with a well-ordered hierarchical structure exhibiting viscoelastic properties designed to transfer force. It is recognized that the incidence of tendon injury increases with age, suggesting a deterioration in homeostatic mechanisms or reparative processes. This review summarizes epigenetic mechanisms identified in ageing healthy tendon. ⋯ Metanalysis through integration of multiple datasets and platforms will enable a holistic understanding of the epigenome in ageing and its relevance to disease.
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British medical bulletin · Jul 2020
ReviewNon-insulin therapies in addition to insulin in Type 1 DM treatment.
Complications of Type 1 diabetes (T1DM) remain prevalent due to suboptimal glycaemic control despite advances in analogue insulin, its delivery and technological advances in glucose monitoring. Intensive insulin therapy is associated with hypoglycaemia and weight gain. Non-insulin-dependent glucose lowering strategies may provide a strategy in improving glycaemic control without hypoglycaemia and weight gain. ⋯ There is a need for larger clinical trials with SGLT2 inhibitors in T1DM and real world studies to clarify safety.