SPRINT trial – hypertension. Inside Health 2/2/16

Notes on SPRINT Trial: http://www.nejm.org/doi/full/10.1056/NEJMoa1511939#t=articleResults also of note http://www.cochrane.org/CD006742/HTN_benefits-of-antihypertensive-drugs-for-mild-hypertension-are-unclear http://cks.nice.org.uk/chronic-kidney-disease-not-diabetic#!scenariorecommendation:5 http://cks.nice.org.uk/hypertension-not-diabetic This was a randomised controlled trial 9391 people without diabetes at high risk of CVS events and with BP of over 130mm HG not blinded average bp 121 in rx group, 134.6 in normal rx group outcomes – MI, stroke, HF, death from CVS […]

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folic acid/flour Inside Health 26/1/16

http://www.ffinetwork.org/regional_activity/europe.php all wheat flour (except wholemeal) produced in the UK is subject to legislation which requires calcium, iron, niacin and thiamin to be added at certain specified levels Folic acid factsheet – women wanting to be/pregnant – https://www.bda.uk.com/foodfacts/FolicAcid.pdf 1st reading of a bill to make mandatory in house of lords awaiting second reading – england […]

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Inside Health 12/1/16

Exercise special. I am addicted to parkrun.  I’ve written about it here in the BMJ and you can find out more here . The SPARKLE studies are here and here. The parkrun community are warm and welcoming and new runners/joggers/walkers are always welcome. Links to research I was talking about today NHS guidelines (which I think are too […]

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notes from RCGP Council 21st Nov 2015

: Whistleblowing policy I raised concerns that this should be enshrined in college policy and clear to all members. : ‘Be the best you’ meeting proposal for membership to increase resilience – it sounds like a Martin Lukes column. Resilience comes from strong systems and the best doctors will fail without that. Continuity of care […]

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Radio 4 Today 10/10/15

PFI http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html Transitional costs to HSCA 2012 https://fullfact.org/factchecks/health_and_social_care_act_costs_benefits-29070 Nottingham ISTC buyback http://www.pulsetoday.co.uk/news/commissioning-news/nhs-england-paid-42m-to-buy-independent-treatment-centre-from-private-provider/20004316.fullarticle dementia screening https://www.gov.uk/government/news/recommendation-against-national-dementia-screening healthchecks http://eprints.lse.ac.uk/63456/ private sector http://www.nhs.uk/conditions/breast-implants/pages/pip-introduction.aspx Cancer drugs fund https://www.england.nhs.uk/2015/01/12/cancer-drug-budget/ 7 day GP working  over use low value rx – e.g. arthroscopy part time spiritual healer     Epping Breast Unit is one of the largest breast cancer research facilities north of […]

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Vaginal birth after Caesarian – Inside Health

Almost two-thirds of women who attempt a natural delivery after having a c-section are successful http://www.bjog.org/details/news/5536911/Almost_two-thirds_of_women_who_attempt_a_natural_delivery_after_having_a_c-secti.html NICE on Caesarian section http://www.nice.org.uk/guidance/cg132/resources/guidance-caesarean-section-pdf CSection risks compared to vaginal birth risks http://www.nice.org.uk/guidance/cg132/chapter/Appendix-C-Planned-CS-compared-with-planned-vaginal-birth European stats – http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13284/pdf UK stats  http://www.bmj.com/content/341/bmj.c5065 History of Caesarians https://www.nlm.nih.gov/exhibition/cesarean/part2.html UK historical rates http://www.birthchoiceuk.com/Professionals/BirthChoiceUKFrame.htm?http://www.birthchoiceuk.com/Professionals/CSHistory.htm Parliamentary briefing and from 2002 http://www.parliament.uk/documents/post/pn184.pdf from NCT    American problem: http://www.childbirthconnection.org/article.asp?ck=10554 […]

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Radio 4 Inside Health – cancer drugs fund

National Audit office report England http://www.england.nhs.uk/wp-content/uploads/2014/02/cdf-sum-fin-pos.pdf http://www.costellomedical.com/wp-content/uploads/2014/03/COSTELLO_Medical_Poster_PHP431.pdfhttp://www.bmj.com/content/347/bmj.f5941 v informative by James Rafferty http://blogs.bmj.com/bmj/2014/10/22/james-raftery-nice-and-value-based-pricing-is-this-the-end/ http://blogs.bmj.com/bmj/2014/02/25/james-raftery-nice-proposes-alternative-for-value-based-pricing/ Scotland http://www.scottish.parliament.uk/GettingInvolved/Petitions/PE01407 http://www.scottish.parliament.uk/S4_PublicPetitionsCommittee/General%20Documents/PE1407_A_Scottish_Medicines_Consortium_12.01.12.pdf http://www.scottish.parliament.uk/S4_PublicPetitionsCommittee/General%20Documents/PE1407_F_Scottish_Government_20.01.12.pdf Wales http://www.bbc.co.uk/news/uk-wales-politics-29903416 http://www.wales.nhs.uk/governance-emanual/individual-patient-funding-requests http://gov.wales/docs/dhss/consultation/140429ipfr-report-en.pdf Northern Ireland http://www.bbc.co.uk/news/uk-northern-ireland-32955458 http://www.northernireland.gov.uk/news-dhssps-170215-greater-access-to http://www.northernireland.gov.uk/news-dhssps-170215-greater-access-to   International http://oncology.jamanetwork.com/article.aspx?articleid=2430476 http://oncology.jamanetwork.com/article.aspx?articleid=2430476 http://www.rarercancers.org/index.php?option=com_content&view=article&id=143&Itemid=155 http://www.rarercancers.org/images/stories/about/rcf2012accs.pdf

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Notes from RCGP council 18/9/15

Council 18/sept. 15 I spoke to The media pressure being heaped upon GPs and the attitudes of the CQC/NICE/Department of Health being less than helpful. New GPs may be put off training because of the ongoing unpleasant press. Was there a need to engage these organisations and challenge the culture of trial by press release […]

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