2015’s top ten On Medicine posts

Another year is drawing to a close, and that means another excellent year of blogs have been posted. To celebrate the fantastic content we’ve covered On Medicine, we highlight the top ten of 2015, featuring blogs about thyroid hormones, cancer, sepsis and an Alzheimer's quiz!

Excuse me Trialist, what are your thoughts?


Research published in Trials explored the first-hand experiences that trialists face when conducting and reporting clinical trials. What did they say and what can we do to tackle the challenges they face?

Randomized controlled trials are praised as one of the highest forms of evidence in healthcare. However, to be valuable, all research must have valid methods, and be reproducible and useable.

Whatever the future may hold for the clinical trial process, we need to ensure that the voice of all parties involved are heard.

Exploring the link between thyroid hormones
and vision loss


Age-related macular degeneration (AMD) is a major cause of vision loss in older people. Here, we spoke to Layal Chaker and Robin Peeters, authors of a study published in BMC Medicine, about why thyroid function and AMD may be linked, and the clinical implications of their findings.

“We demonstrated that higher levels of free thyroxine (FT4) are associated with an increased risk of AMD. This effect remained when we analyzed subjects who had normal thyroid function and when we excluded those that use thyroid medication.

“This implies an intrinsic effect of thyroid hormone in the pathogenesis of AMD. We also discovered an association between higher thyroid hormone levels and retinal pigment alterations. These alterations in pigment are markers of RPE dysfunction and are often observed in early AMD disease, which suggests a role for thyroid hormone during development of AMD.”

Hemoglobin levels at birth affect outcomes
for preterm babies


Research published in BMC Medicine showed that low levels of hemoglobin at birth are associated with greater risk of mortality in preterm infants. In this guest blog, authors Jayanta Banerjee and Narendra Aladangady discussed the findings.

The normal hemoglobin level at birth for preterm infants varies from 15-20g/dl. These levels and blood volume of the infant can be improved by delaying clamping of the umbilical cord for 30 to 120 seconds at delivery. Though the increased blood volume is noted soon after delivery, the raised hemoglobin becomes apparent after several minutes to hours following birth.

Providing additional placental blood to the preterm infant by delaying clamping of the umbilical cord appears to be associated with better stability of the circulatory state, and reduced risk of respiratory distress syndrome, brain hemorrhage, necrotising enterocolitis, and requirement for blood transfusion. However, this has not shown to have improved survival of preterm infants and thus this was the aim of our study.

Physical activity and cancer: it’s time
for a paradigm shift


In this guest post Jo Foster, Physical Activity Lead at Macmillan Cancer Support, looked at the findings of a research article published in BMC Medicine and told us more about Macmillan’s physical activity drive.

Macmillan Cancer Support welcomes new evidence from the Physical Activity during Cancer Treatment (PACT) study suggesting a supervised physical activity programme, offered early in breast cancer treatment, showed positive effects on physical fatigue, submaximal cardiorespiratory fitness and muscle strength.

It is time for a paradigm shift in the way we look at physical activity. Prescribing physical activity early during treatment of breast cancer, indeed for all cancers at all stages of cancer care, can and should be recommended.

Reproductive factors and their possible
long-term health consequences in women


Research published in BMC Medicine investigated the association between reproductive factors and women’s long term health. Co-author Melissa Merritt discussed the results further.

As a researcher working on ovarian cancer I have spent much time considering how reproductive factors influenced the risk of developing ovarian cancer. Reproductive events are an integral part of a woman’s life, beginning from the age when they begin to menstruate, considerations of contraception and child bearing, through to the menopause.

It was apparent that fewer studies have investigated how reproductive events influenced women’s long-term health. The focus of our study was to evaluate a range of reproductive factors such as having children, breastfeeding, oral contraceptive use, and age at menarche, in relation to risk of all-cause mortality and cause-specific mortality.

A day in the life of a nephrologist


Evi Nagler, nephrologist and guideline specialist, identified inconsistencies in guidelines for managing hyponatremia in research published in BMC Medicine. For World Kidney Day this year, we asked her to tell us about a typical day in the life of a nephrologist, how she was inspired to work in nephrology, and some of the challenges she faces.

What are the biggest challenges about working in this field?

Last week I spent 55 hours at work, that’s 11 hours a day. On Saturday I had admin to catch up with. Sunday halfway through brunch, I suddenly remembered I had forgotten to call a patient with her lab results…it is a crazy life.

A day in the life of a urologist


Stacy Loeb is a urologist at New York University in New York City. In honor of Prostate Cancer Awareness Month in the UK and the launch of BMC Medicine‘s Spotlight on prostate cancer article collection, we asked her to tell us about a typical day in her life, how she was inspired to work on prostate cancer, and what she thinks are the greatest challenges in the field of urology.

What’s the most important thing you think non-specialists should know about urology?

Medical students who are considering urology should know that it is a dynamic field, and there is really something for everyone. Whether you prefer adult or pediatric patients, major surgery or office procedures, clinical work or research, there are a multitude of possibilities.

What is sepsis?


In recognition of Sepsis Awareness Month in September, Dr Gando, Editor-in-Chief of Journal of Intensive Care, told more about the syndrome in this blog. Although old, sepsis is not yet fully characterized and this deregulated inflammation, which occurs with severe infection, affects millions of people worldwide.

Sepsis has been accepted as a syndrome of systemic inflammation that occurs in response to infection. In addition, another important concept recognized worldwide is that the presence of viable pathologic organisms in the blood is unnecessary for the diagnosis of sepsis.

They say that by 2020, sepsis will have become a household word synonymous with the need for emergency intervention. Lay people will better understand the early warning signs of sepsis. In addition, families’ expectations of the delivery of care will have risen such that delays will be routinely questioned.

Quiz: What do you know about Alzheimer’s?


September marked World Alzheimer’s Month and in recognition of this, we put together a quiz to test whether you know your facts from fiction on this widespread disease.

Alzheimer’s disease is increasing around the world, and the aim of World Alzheimer’s Month is to raise awareness and challenge the stigmatization and misinformation that surrounds the disease. Why not see how well you do!

Top tips for new doctors – from
someone who’s been there


In the UK, the beginning of August marks the point at which newly graduated medical students become foundation doctors. Here, Rachel Williams – now a trainee anesthetist – gave her top tips for those new on the wards.

Being nervous is normal, be organized, ask questions, and of course… have fun!


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