https://www.ema.europa.eu/medicines/human/referrals/adrenaline-auto-injectors https://www.ema.europa.eu/documents/referral/adrenaline-auto-injectors-article-31-referral-chmp-assessment-report_en.pdf https://www.npa.co.uk/representing-you/campaigns/medicines-supply-chain/   https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.12595 https://www.sps.nhs.uk/category/shortages-discontinuations-and-expiries/shortages/ https://www.abpi.org.uk/what-we-do/pricing-regulation/medicines-supply-chain-working-towards-a-solution/ https://psnc.org.uk/dispensing-supply/supply-chain/branded-shortages/ https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2018/06/nhse-sw-msg-jun-18.pdf https://psnc.org.uk/our-news/adrenaline-150-micrograms-auto-injectors-supply-urgent-actions-required-by-pharmacy-teams/ https://dtb.bmj.com/content/53/3/33 https://psnc.org.uk/wp-content/uploads/2018/10/20181012-Letter-to-patients.pdf https://www.leighday.co.uk/LeighDay/media/LeighDay/documents/Product%20liability/Inquest-Dr-Sean-Cummings-Summing-Up.pdf https://www.npa.co.uk/representing-you/campaigns/medicines-supply-chain/ https://amp.usatoday.com/amp/576221001

https://www.england.nhs.uk/2018/10/turnbull-and-fry-effect-will-safe-lives-says-nhs-chief/ https://prostatecanceruk.org/about-us/news-and-views/2018/2/stephen-fry-calls-for-all-men-to-know-their-risk-after-his-treatment-for-prostate-cancer https://www.mja.com.au/journal/2005/183/5/impact-news-celebrity-illness-breast-cancer-screening-kylie-minogues-breast https://www.thebreastonline.com/article/S0960-9776(06)00073-7/fulltext https://www.bmj.com/content/355/bmj.i6357 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500405/ https://academic.oup.com/jnci/article/105/14/1050/965030 https://www.pubfacts.com/detail/25539779/Deliberative-democracy-and-cancer-screening-consent-a-randomised-control-trial-of-the-effect-of-a-community-jury-on-mens-knowledge-about-and-intentions-to-participate-in-PSA-screening

One of my favourite subjects. I wrote a lot in the Patient Paradox about placebos. I don’t think we need placebos to get what have been called ‘placebo effects’. I’m so sad that doctors and patients have been pushed apart by the mechanistic, industrial approach of medicine in the last decade. Here’s hoping the next […]

Consent Form Screening Screening Information Sheet http://www.bmj.com/content/353/bmj.i1156 http://legacy.screening.nhs.uk/suddencardiacdeath Comparative study of death rates from sudden cardiac death Italy BMJ overview     

Lancet 2012 on multimorbidity http:/http://www.thelancet.com/cms/attachment/2009245825/2032056163/gr1.jpg Guidelines and multi morbidity = BMJ Guidelines and drug interactions  Burdens of treatment  the work done by patients when doctors stick to guidelines Polypharmacy aids  for deprescribing Drug Drug interactions 

ASTHMA Dutch study in question http://bjgp.org/content/66/644/e152 SIGN guidelines on asthma Click to access pat141_CHILDREN.pdf In children with mild, intermittent wheeze and other respiratory symptoms which occur only with viral upper respiratory infections (colds), it is often reasonable to give no specific treatment and to plan a review of the child after an interval agreed with […]

http://www.ncbi.nlm.nih.gov/pubmed/26689397 “Multiple studies of ovarian cancer and genital talc use have led only to consensus about possible carcinogenicity. Seeking greater clarity, we examined this association in 2041 cases with epithelial ovarian cancer and 2100 age-and-residence-matched controls. METHODS: We defined genital talc use as regular application to the genital/rectal area directly, on sanitary napkins, tampons, or […]

The ‘ 20% more likely to have a stroke at the weekend’ quote used by various politicians – seems to have come from study in PLOS 2004 – 2012 DATA http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0131836#sec014 However ,20% is relative risk – one needs to know the absolute risk to make sense of that. If admitted at weekend death rate […]

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 […]