Medical Journal News

Israel’s recent large scale military operations1 in Lebanon have caused a displacement crisis of staggering proportions. As of late September, more than 2300 people have been killed, over 10 000 injured and nearly 1.2 million people23—about one-fifth of Lebanon's population—have been forcibly displaced from their homes. This mass exodus has uprooted families and severed access to essential medical care.4 The scale of the attacks and speed of population displacement present unprecedented challenges for an already fragile healthcare system. This crisis demands immediate action from the global health community and calls for a coordinated international response.Lebanon is grappling with economic collapse5 driven by political instability, corruption, and a severe banking crisis. It now faces the challenge of managing the physical and psychological health and trauma of its displaced population. The conditions in displacement shelters across Lebanon are a public health catastrophe. Nearly 900 repurposed schools, abandoned buildings, and other makeshift structures6...

A week before the chancellor of the exchequer Rachel Reeves delivered her first budget, the Nuffield Trust published analysis showing that the NHS in England was facing £4.8bn worth of unfunded cost pressures in the current financial year.1 This was our “keeping the lights on” assessment of the funding shortfall that the budget needed to tackle, rather than an estimate of what would be needed to do both that and also make any start on meeting the improvement aspirations set out in the Labour government’s manifesto.The bulk of that shortfall—around £3.45bn—reflected the fact that the funding envelope set by the previous government provided coverage for NHS staff pay increases of just 2%, compared to the average final settlement for the year of 5.5%. The remaining £1.35bn reflects the rate of overspending by NHS providers even before the pay settlements were implemented.Have Reeves’ headline average annual real terms increases of 4%...

I’ve been consulting in palliative medicine for 17 years. I’ve seen patients facing frightening diagnoses and hospital admission experience a loss of dignity and worry about burdening loved ones. The cornerstone of palliative care is to reaffirm patients’ inherent dignity, helping them live well as they navigate the challenges of serious illness, as rooted in the work of Cicely Saunders, UK physician and founder of the modern hospice. In the words of Dame Cicely, reminding patients that “they matter.Canada’s medical assistance in dying (MAID) laws have affected my field more quickly than I’d expected. There’s now this sense that by wanting to address the patient’s suffering palliative care doctors are trying to convince someone out of getting an assisted death.I’ve seen patients receiving MAID [which encompasses both euthanasia—where the doctor administers the drug—and assisted suicide—where the patient takes the drug themselves] within 24 hours of approval. It can happen without...

The rogue breast surgeon Ian Paterson has told a coroner’s court that he did not seek specific consent for the cleavage sparing mastectomies he carried out because the operation was merely an “adaptation” of the standard procedure, which did not need separate consent.Giving evidence at an inquest into the death of Elaine Turbill, Paterson told Birmingham and Solihull Coroner’s Court that he had adapted the traditional mastectomy to allow more subcutaneous fatty tissue to remain. “It was a limited intraoperative adaptation,” he said. “It was done to improve cosmesis, and I never considered it to be a separate procedure and never described it as such.”Paterson, who was jailed for 20 years in 2017 for wounding 10 patients on whom he performed unnecessary operations at private hospitals,1 was giving evidence on 31 October via video link from prison to the court, which is holding inquests into the deaths of 62 of...

NHS England is piloting a new device that can be attached to a smartphone to enable nurses to capture live endoscopy examinations of the throat, as part of plans to rule out suspected throat cancer faster.The adaptor aligns the iPhone camera with a 32 mm conventional endoscope eyepiece. The high definition footage can be instantly shared with specialist physicians who can look for signs of cancer and report directly back to the patient. The device, developed by Endoscope-i, is one of 14 projects to receive a share of £25m as part of the NHS cancer programme’s “innovation open call.”An initial trial of the device and its app in triaged low risk patients at North Midlands University Hospitals NHS Trust found that no cancers were missed and patients received their results within 23 hours of the test, NHS England has said. So far around 1800 patients have taken part in the...

New England Journal of Medicine, Volume 391, Issue 18, November 7, 2024.

New England Journal of Medicine, Volume 391, Issue 18, Page 1670-1671, November 7, 2024.

New England Journal of Medicine, Volume 391, Issue 18, Page 1668-1670, November 7, 2024.

Advocates for action on rare diseases are having a moment. Oct 28 saw the launch of the European Rare Diseases Research Alliance, an ambitious initiative with a substantial budget of €380 million that unites more than 170 organisations to drive research in prevention, diagnosis, and treatment of rare diseases. This development follows the 2021 UN Resolution on Addressing the Challenges of Persons Living with a Rare Disease and their Families, which put addressing the needs of people with rare diseases—in terms of health, employment, education, poverty, and gender equity—on the highest political agenda.

“Our knowledge being limited means we need to limit our actions”, said Ali Hossaini at the launch of The Work of Art in the Age of Planetary Destruction. Hossaini is a biochemist turned artist. While our knowledge may be limited, our creativity is unlimited. And that unbounded space for imaginative exploration enables him to pursue his goals of “beauty, truth, and the good”. Instead of seeking to control nature, the signature style of 21st-century life, Hossaini's wish is simply to be a participant in nature's full experience.

Aside from abortion, health issues have largely been neglected in the run-up to the Nov 5 election. What have the candidates proposed to improve health? Susan Jaffe reports.

Physician Magda Robalo has dedicated her career to supporting health equity in Africa. At the age of 16 years, she moved from her home in Guinea-Bissau to Portugal, later studying medicine at the Universidade do Porto and then public health and tropical medicine at the Universidade Nova. After graduating, Robalo's plan was to specialise in neurosurgery, until her final residency took her to the Egas Moniz Hospital in Lisbon, which, she says, “from colonial times, was dedicated to infectious tropical diseases.

In May, 2020 a new law in England changed the rules around organ donation, intended to help alleviate the desperate shortage of available organs for people on the transplant list. Max and Keira's Law, or the Organ Donation (Deemed Consent) Act 2019 altered the framework around the choice to donate from an opt-in to an opt-out. It is vital that everyone entering the database as a potential organ donor or recipient is registered as a number rather than a name, and that those waiting for a suitable organ understand that it is not a queue, but a matching service—it is not how long you have been on it that matters, but how critically vulnerable the recipient, and how compatible with the donor organ.

Which landscapes help us recover? For the Instagram generation, detox and rehab may summon images of tropical climates and luxurious minimalism. The Outrun is an antidote. Scotland's Northern Isles, with their unending surge of empty sea and salted wind hitting the rocks, where few trees grow and the flatness of the landscape declares the absence of natural or man-made distraction, are an uncertain and risky terrain for getting better.

Physician, scientist, and discoverer of surfactant. He was born in Auburn, NY, USA, on March 16, 1923 and died on Sept 3, 2024 in Tiburon, CA, USA, aged 101 years.

Global health security has become a focal point following the COVID-19 pandemic. The Pandemic Fund, launched in 2022, aims to provide financial support to low-income and middle-income countries for pandemic prevention, preparedness, and response.

With great interest we read the Article1 by Martin Bendszus and colleagues presenting results of the randomised TENSION trial. With enthusiasm, we acknowledge the important conclusions of the TENSION trial, particularly in the context of the TESLA trial,2 which was published in September, 2024, and we would like to congratulate the authors. In the TENSION trial, the treatment effect of thrombectomy on functional independence was 18·4%, which was similar to the effect shown in the HERMES meta-analysis3 (ie, 19·5%) for patients with predominantly smaller lesion volumes.

The Article authored by Martin Bendszus and colleagues1 has sparked our interest as it provides evidence that patients presenting with acute ischaemic stroke with a large core lesion might attain functional independence and have reduced mortality rates through the administration of endovascular treatment, in contrast to individuals who receive standard medical management. Although we appreciate the authors’ meticulous and comprehensive investigation, we would like to offer some critical observations regarding some assertions made in the study.

We read the Article1 by Martin Bendszus and colleagues with great interest. In this paper, the authors aimed to compare the safety and efficacy of thrombectomy in acute stroke patients with an Alberta Stroke Program Early CT Score (ASPECTS) score of 3–5. The assessment was done with the use of non-contrast CT or MRI, within an extended time window of 12 h, as compared with medical treatment (standard of care) alone. Previous trials have relied on diffusion-weighted imaging-ASPECTS or perfusion CT for ASPECTS scoring, while the TENSION trial utilises non-contrast CT, a more clinically practical approach.

We thank Gabriel Broocks and Andre Kemmling, Hong-Jie Jhou and colleagues, and Zhenzhen Wang and colleagues for their interest in and comments on our Article.1 We agree with Broocks and Kemmling that it might appear contradictory that the observed clinical benefit of thrombectomy in TENSION was not reflected by a significant reduction in infarct volumes at 24 h, although mean infarct volume at 24 h was numerically lower in patients assigned to endovascular thrombectomy (205·8 mL vs 277·7 mL). The same result was observed in the ANGEL-ASPECT trial of thrombectomy for patients with stroke with large infarct.