British medical bulletin
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British medical bulletin · Jan 2013
Policy reform to realize the commitments of the Political Declaration on noncommunicable diseases.
Noncommunicable diseases (NCDs) caused an estimated 36 million deaths in 2008. Recognizing that NCDs are a global health and development priority, Heads of State and government adopted the Political Declaration on NCDs (resolution A/RES/66/2) at the United Nations General Assembly in September 2011. ⋯ Policy reform and accelerated national scale-up action, particularly in low-and-middle-income countries, must be guided by translation research and feedback information from monitoring and evaluation.
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British medical bulletin · Jan 2013
New strategies for the restoration of hearing loss: challenges and opportunities.
For most types of hearing impairments, a definitive therapy would rest on the ability to restore hair cells and the spiral ganglion neurons. The only established technique to treat deafness is based on the functional replacement of hair cells with a cochlear implant, but this still has important limitations. ⋯ In this chapter, I discuss the latest advances in the field and how they are being translated into a clinical application.
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British medical bulletin · Jan 2013
ReviewUpdate on the long-term complications of renal transplantation.
Powerful immunosuppressive regimens have reduced rejection risk, leading to an expanding cohort of long-term kidney transplant recipients who are likely to encounter practitioners in other specialties. ⋯ Markers to guide individualized optimal immunosuppression and predict the development of complications would allow for targeted early intervention.
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The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. ⋯ The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.
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British medical bulletin · Jan 2013
ReviewThe neuroinflammatory response of postoperative cognitive decline.
Aseptic surgical trauma provokes a homeostatic neuroinflammatory response to promote healing and protect the organism from further injury. When this response is dysregulated, harmful consequences can follow, including postoperative cognitive decline. ⋯ The mechanisms that lead to exaggerated and persistent neuroinflammation and the best way to counteract it are still unknown. AREAS FOR DEVELOPING RESEARCH: It is imperative that we identify the underlying processes that increase the risk of cognitive decline in elderly surgical patients. In this review we explore non-resolution of inflammation as an underlying cause of developing exaggerated and persistent POCD. If interventions can be developed to promote resolution of neuroinflammation, the patient's postoperative recovery will be enhanced and long-term consequences can be prevented.