Medical Journal News

New England Journal of Medicine, Volume 392, Issue 14, Page 1453-1455, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1455-1456, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1451-1452, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1444-1446, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1427-1427, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1428-1437, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1418-1426, April 10, 2025.

Babies and children aged three months to 11 years with uncomplicated community acquired pneumonia should be offered a three day rather than five day course of antibiotics, the National Institute for Health and Care Excellence (NICE) has said in a draft guideline.1The recommendation follows evidence that for this group of patients a three day course of antibiotics was as effective as a five day course. It is also in line with shorter antibiotic courses for many common infections, such as urinary tract infections and acute bronchitis.Jonathan Benger, chief medical officer and interim director of the centre for guidelines at NICE, said that shorter courses of treatment also reduce the risk of antimicrobial resistance and save NHS resources.The draft guideline includes children for the first time and combines previous guidance on community acquired pneumonia and hospital acquired pneumonia published in 2019.It recommends using steroids in addition to antibiotics for adults with...

Lobbying by the advertising industry is thwarting plans that aim to protect public health by banning junk food advertisements from bus stops and billboards, The BMJ has found.Advertising companies and their representatives are warning local authorities in financial crisis that the councils’ advertising revenues will plummet if they restrict the promotion of food products high in fat, salt, or sugar (HFSS). These warnings have led some local authorities in England to shelve their plans despite the potential benefits to public health, The BMJ’s investigation discovered.media-1vid1Video 1Deny, dilute, delay—how advertisers are fighting billboard bansbmj.r667-vid1Those councils who push ahead with their plans despite such lobbying are facing delays of up to eight years to enforce the bans, because of their existing contracts with the advertising firms. Even when the bans come into effect they allow adverts for products such as McDonald’s chicken nuggets and KFC burgers to continue to be displayed (box...

In this paper by Gao C and colleagues (BMJ 2025;399:e082945, doi:10.1136/bmj-2024-082945, published), in the pdf, figure 2 had missing data for number censored at days 365, the HTML live figure was unaffected. Additionally, in figure 3, the number in the hierarchical component for death in the Ties box, should have been 929 398.

Last month NHS England issued a press release announcing a “nationwide rollout” of an “artificial intelligence tool that predicts falls and viruses.”1 It said that the tool, developed by the care provider Cera, was being “rolled out across the NHS” and “can predict a patient’s risk of falling with 97% accuracy, preventing as many as 2000 falls and hospital admissions each day.”The press release quoted senior government officials backing the tool as a “perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital.” The announcement was covered across several media outlets, including ITV News, the Independent, and the London Standard.23 The NHS Confederation issued a response, welcoming the rollout of the technology, but warning of the need for robust evaluation of AI in the health service.4How will the NHS roll out the AI?The BMJ approached Cera and NHS...

by Marie Payen de la Garanderie, Anaïs Hasenbohler, Nicolas Dechamp, Guillaume Javaux, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Laurent Bourhis, Raphaël Porcher, Fabrice Pierre, Xavier Coumoul, Emmanuelle Kesse-Guyot, Benjamin Allès, Léopold K. Fezeu, Emmanuel Cosson, Sopio Tatulashvili, Inge Huybrechts, Serge Hercberg, Mélanie Deschasaux-Tanguy, Benoit Chassaing, Héloïse Rytter, Bernard Srour, Mathilde Touvier

Background

Mixtures of food additives are daily consumed worldwide by billions of people. So far, safety assessments have been performed substance by substance due to lack of data on the effect of multiexposure to combinations of additives. Our objective was to identify most common food additive mixtures, and investigate their associations with type 2 diabetes incidence in a large prospective cohort.

Methods and Findings

Participants (n = 108,643, mean follow-up =  7.7 years (standard deviation (SD) =  4.6), age =  42.5 years (SD =  14.6), 79.2% women) were adults from the French NutriNet-Santé cohort (2009–2023). Dietary intakes were assessed using repeated 24h-dietary records, including industrial food brands. Exposure to food additives was evaluated through multiple food composition databases and laboratory assays. Mixtures were identified through nonnegative matrix factorization (NMF), and associations with type 2 diabetes incidence were assessed using Cox models adjusted for potential socio-demographic, anthropometric, lifestyle and dietary confounders. A total of 1,131 participants were diagnosed with type 2 diabetes. Two out of the five identified food additive mixtures were associated with higher type 2 diabetes incidence: the first mixture included modified starches, pectin, guar gum, carrageenan, polyphosphates, potassium sorbates, curcumin, and xanthan gum (hazard ratio (HR)per an increment of 1SD of the NMF mixture score = 1.08 [1.02, 1.15], p = 0.006), and the other mixture included citric acid, sodium citrates, phosphoric acid, sulphite ammonia caramel, acesulfame-K, aspartame, sucralose, arabic gum, malic acid, carnauba wax, paprika extract, anthocyanins, guar gum, and pectin (HR = 1.13 [1.08,1.18], p < 0.001). No association was detected for the three remaining mixtures: HR =  0.98 [0.91, 1.06], p = 0.67; HR =  1.02 [0.94, 1.10], p = 0.68; and HR =  0.99 [0.92, 1.07], p = 0.78. Several synergistic and antagonist interactions between food additives were detected in exploratory analyses. Residual confounding as well as exposure or outcome misclassifications cannot be entirely ruled out and causality cannot be established based on this single observational study.

Conclusions

This study revealed positive associations between exposure to two widely consumed food additive mixtures and higher type 2 diabetes incidence. Further experimental research is needed to depict underlying mechanisms, including potential synergistic/antagonist effects. These findings suggest that a combination of food additives may be of interest to consider in safety assessments, and they support public health recommendations to limit nonessential additives.

Trial Registration

The NutriNet-Santé cohort is registered at clinicaltrials.gov (NCT03335644). https://clinicaltrials.gov/study/NCT03335644.

This week is National Public Health Week in the United States and perhaps the saddest one in the 70 years of this celebration. Last week, President Donald Trump’s administration enacted mass firings of staff, or a “reduction in force,” at agencies that form the scaffolding of public health in the US.1 This action continued the attacks on science and health that have quickly become a signature of the new presidency.2The scope and depth of the cuts to staff are vast, including the Centers for Disease Control and Prevention, the National Institutes of Health, the US Food and Drug Administration (FDA), Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Centers for Medicare and Medicaid Services, and many other offices.Collectively, these cuts impair government functions that are vital to society, including (but not limited to) the ability to ensure the safety of new medications, devices, food, and other...

Patients in hospital emergency departments are being put at risk because they are not getting time critical medication (TCM) for chronic conditions such as diabetes and Parkinson’s disease on time, says a report by the Royal College of Emergency Medicine.1Analysis of data from 136 UK emergency departments on patients with diabetes or Parkinson’s disease who take certain TCM such as insulin injections and levodopa found that two thirds did not receive their drugs around the expected time. This could potentially exacerbate symptoms or complications and lead to deterioration and increased mortality.Just over half (7197) of the 13 478 eligible patients were not identified within 30 minutes of their arrival in the emergency department, the analysis showed, and just 32% of 10 850 doses that patients should have had were administered within 30 minutes of their scheduled time. This proportion was 39% for levodopa and 22% for insulinIn light of the...

My name is Biotic. Andi Biotic.The UK Health Security Agency (UKHSA) has a new superhero in the form of a pill shaped cartoon character known as Andi Biotic. He’s heading up a campaign to tackle misconceptions about antibiotics among 18 to 34 year olds, as part of the ongoing “Keep Antibiotics Working” programme.A dose of good messaging?The agency is piloting this new six week digital campaign, which is being promoted across YouTube,1 Instagram, and Facebook, and by GP practices and pharmacies, to test its “potential to capture people’s attention and imagination” in order to “help raise awareness of good antibiotic stewardship.”A hard pill to swallowIndeed. An Ipsos survey of nearly 6000 UK residents aged 16 and older, commissioned by the UKHSA last year, found that over half of respondents incorrectly believed they either could not do anything personally to prevent antibiotics becoming less effective at treating infections (26%, 1535) or...

bmj;389/apr08_4/r697/FAF1faSheila Bhattacharya (née Burns) was born in St Leonards-on-Sea, East Sussex, in 1924. Her father, Robert Burns, a classics scholar, had been a colonial administrator in St Kitts and West Africa, while her mother, a highly independent Glaswegian woman, had served as a nurse in the first world war.Sheila had a passion for literature and had intended to study English at university, but the onset of the second world war while she was finishing school was the great event of her life, changing her outlook. Encouraged by her mother, she decided to study medicine and got a place at Newnham College, Cambridge, in 1942. She then decided instead to volunteer for war work and was sent to an explosives research laboratory at Woolwich Arsenal where she learnt about life beyond her privileged upbringing. It was dangerous work handling unstable chemicals, and more so during the V1 and V2 missile attacks....

The UK government should train and employ more health visitors and school nurses as part of a package of measures to tackle the rise in mental health problems among children and young people, a charity has urged.1The Centre for Mental Health, a charity that aims to tackle mental health inequalities, noted that one in five 8 to 25 year olds are now affected by mental health problems. It urged the government to invest in evidence based preventative strategies to reverse the trend, spanning the perinatal period and early years to schools and colleges, through to adulthood and employment.Cuts to health visitors and school nurses under successive governments have led to more children falling through the gaps of early support and going on to need specialist care, the report said.Increasing health visitor and school nurse numbers will benefit babies, children, and families for decades to come, alongside other interventions such as...

In January 2025, the UK government announced that an independent commission is to be set up on social care in England led by Louise Casey, a crossbench peer. The commission will explore problems facing social care and provide recommendations for creating a “national care service.”1 The announcement has elicited considerable (tending towards negative) response.2 Some query the basis for a commission, calling it a “cop out” in light of the urgent need for funding and reform.3 Others decry the long duration, with the commission expected to finally report by 2028, and point to a field already crowded with many similar exercises.4I view things somewhat differently. I agree that social care cannot afford to wait but suggest that the necessary change must be profound and that the commission can be justified as a way of proceeding. The organisational and funding issues are substantial, but we must recognise that reform in complex...

The US has reported 6600 cases of whooping cough (pertussis) in the first three months of 2025, more than four times the number at the same point last year and 25 times as many as had been reported at the same point in 2023.If the current trend continues, the country will be on course for the highest number of infections since vaccination was introduced in 1948.The state of Louisiana last week reported that two people had died from pertussis in the past six months. Both were infants, who are most at risk of serious complications. Two other US deaths have been reported this year: a school age child in North Dakota and an adult in Idaho.Pertussis remains one of the world’s deadliest infectious diseases. The World Health Organization estimated that in 2014 there were 24.1 million cases and 160 700 deaths in children under 5 worldwide.The number of cases typically...

New England Journal of Medicine, Ahead of Print.