Medical Journal News

We appreciate the Correspondence from Elif Hindié and David Groheux highlighting two important points from our PET-based, pathological complete response-adapted PHERGain strategy.1 This study met its two primary endpoints: the proportion of PET responders in group B with a pathological complete response (37·9%), and the 3-year invasive disease-free survival rate for the entire adaptive group (94·8%), which was similar to standard neoadjuvant treatment with chemotherapy, trastuzumab, and pertuzumab (HP), despite around 30% of patients completely omitting chemotherapy and a delay in chemotherapy administration for the remaining patients.

The Lancet. Cancer registries: the bedrock of global cancer care. Lancet 2025; 405: 353—In this Editorial, the spelling of Michel P Coleman's name has been corrected. This change has been made to the online version as of March 27, 2025.

Bowman SJ, Fox R, Dörner T, et al. Safety and efficacy of subcutaneous ianalumab (VAY736) in patients with primary Sjögren's syndrome: a randomised, double-blind, placebo-controlled, phase 2b dose-finding trial. Lancet 2022; 399: 161–71—In figure 2E of this Article, the least-squares mean change from baseline in ESSPRI scores of the placebo group and the ianalumab 300 mg group were plotted incorrectly. In figure 2F, the percentages for ianalumab 50 mg at baseline, ianalumab 50 mg at week 24, and ianalumab 300 mg at week 24 were incorrect.

Ageing is a scientifically fascinating and complex biological occurrence characterised by morphological and functional changes due to accumulated molecular and cellular damage impairing tissue and organ function. Ageing is often accompanied by cognitive decline but is also the biggest known risk factor for Alzheimer's disease, the most common form of dementia. Emerging evidence suggests that sedentary and unhealthy lifestyles accelerate brain ageing, while regular physical activity, high cardiorespiratory fitness (CRF), or a combination of both, can mitigate cognitive impairment and reduce dementia risk.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

An error in ranking applicants for radiology specialty training programmes has led to job offers for some doctors being retracted.Resident doctors who applied for radiology were sent the outcomes of their applications on 24 March. They later received an update telling them that the offers had been made in error, as only one component of the multistage selection process had been taken into account. Offers based on the correct rankings were reissued two days later.Ahmed Mohamed had applied for radiology for the second time, having failed to secure a job offer last year. He told The BMJ that he was “so, so happy and excited” when he got an email telling him that he had been successful this time. But, after calling his family to celebrate, he had to tell them hours later that his offer was in question. He then spent two days constantly checking his emails. When the...

The latest YouTube craze?Thankfully not. Instead, this is good news. Surgeons have linked the move to a cashless society to a dramatic drop in children needing operations for accidentally swallowing small items such as coins.Cash isn’t king?Researchers reviewed hospital episode statistics (HES) between 2000 and 2022 for procedures to remove foreign bodies from the alimentary tract, respiratory tract, and nasal cavity in 0-14 year olds. The study, published in the Annals of the Royal College of Surgeons of England, found the total number of procedures fell from 2405 in 2012 to 1716 in 2022—a 28% reduction.1 Lead study author Akash Jangan, an ear, nose, and throat registrar, said, “Our research shows that using cashless payment methods instead of coins has potentially helped keep children safe and reduced the need for surgery.”The penny dropsThere are likely to be fewer lying around the house. Contactless payments were first introduced in the UK...

“What has happened has the potential to bring about massive retrogression. I’m very, very scared for the future,” Deborah Ikeh, executive director of the Debriche Health Development Centre, a non-governmental organisation (NGO) that supports community led monitoring of tuberculosis (TB) in Nigeria, says about US cuts to foreign aid.On 20 January President Donald Trump signed an executive order pausing foreign development assistance, including the United States Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR), for 90 days, pending a programme by programme review.A brief respite came a week later when the US State Department signed a waiver preserving funding for “life saving humanitarian assistance.” But then in late February the Trump administration added further confusion by terminating nearly 10 000 contracts, including some with organisations that had previously been covered under the waiver.The result is panic and uncertainty. Johns Hopkins University is reportedly being...

In the past two years we have been involved in an expert panel convened by the Royal Society of Canada and the Canadian Academy of Health Sciences on Canada’s past and future global health role. Our report, published on 27 March 2025, aims to provide strategic insights and advice on Canada’s role in global health for the next two decades.1 The need for global leadership in health is clear: growing economic and climate threats, divisive politics, backlash against human rights, and powerful waves of misinformation threaten past gains in global health and cooperation. As we enter a new era shaped by isolationist geopolitics and the US retreating in global affairs, Canada’s role as a middle power, actively engaged in multilateralism, is more important than ever.2Greater clarity around Canada’s global health role is also relevant to current domestic affairs. The new leader of the Liberal party, Mark Carney, was appointed as...

Vaccination has been so successful in protecting whole populations from disease that it is now an often-repeated phrase that vaccines are victims of their own success. As vaccination rates rise, vaccine-preventable diseases become less common within society, creating the illusion that vaccination against these diseases is no longer necessary. This means that the more successful vaccines are, the harder health authorities must work to make their value apparent. During the covid-19 pandemic the need to vaccinate against SARS-CoV-2 was paramount, but uptake was nevertheless a challenge. It would be wrong, however, to view vaccination failures as being only the fault of those who do not want to vaccinate. Government failings should also be considered.These failings have been highlighted by the ongoing UK covid inquiry. Module four, which focused on vaccines and treatments, concluded in January 2025.1 The inquiry emphasised that the covid-19 vaccination is a success story from the pandemic,...

AbstractIdentifying patients with chest pain that is of cardiac origin is crucial owing to the high mortality and morbidity of cardiovascular diseases. History, electrocardiogram, and cardiac biomarkers are the core elements of the assessment. High sensitivity cardiac troponins (hs-cTn) are the preferred biomarkers for diagnosing acute myocardial infarction, allowing for more accurate detection and exclusion of myocardial injury. However, elevations in hs-cTn can occur in patients who are not experiencing acute myocardial infarction. Therefore, it is important for clinicians to recognize how to integrate hs-cTn levels into their clinical decision making process. Structured risk assessments, using evidence based diagnostic protocols, should be employed to estimate the risk of acute coronary syndrome and adverse events in patients with chest pain. Clinical decision pathways should be used routinely in emergency departments. Patients at intermediate or high risk of obstructive coronary artery disease might benefit from cardiac imaging and further testing. Patients should be involved in decision making, with information provided about risks, radiation exposure, costs, and alternative options to facilitate informed decision making.

Unlike true experiments that are conducted by researchers for scientific purposes, natural experiments occur when infrastructure, policies, or services are introduced or changed by governments or healthcare systems. Interventions of this kind are sometimes amenable to randomised controlled trials, for example, if the advantages of randomisation can be negotiated with policy makers or providers at the planning stage and the findings are likely to be transferable across several contexts. Although the randomised controlled trial remains an important method, there are occasions when a trial will not be appropriate or feasible for answering questions about infrastructure, policy, or service changes. However, provided that the intervention divides a population into groups that are otherwise similar, researchers can evaluate the health effects of the changes in a natural experimental evaluation. Natural experiments therefore generate valuable opportunities for evaluating population health, health systems, and other interventions, including those that are, for practical or ethical...

BiographiesJohn-Arne Røttingen was appointed chief executive officer (CEO) of the Wellcome Trust in October 2023. A doctor-scientist, he was previously Norway’s ambassador for global health, chief executive of the Research Council of Norway, and was the founding CEO of the Coalition for Epidemic Preparedness Innovations. His research encompasses epidemiology, clinical trials, and global health policy.Victor Adebowale has been chair of the NHS Confederation in a personal capacity since April 2020. He is the former CEO of Turning Point, a social enterprise, and has been a crossbench peer at the House of Lords since 2001. He has led commissions on mental health and housing. He holds an MA in advanced organisational consulting from City University and the Tavistock Institute of Human Relations and founded the Race and Health Observatory.VA: You’ve had a distinguished career in research funding, including leading Norway’s research efforts. How did issues of race, diversity, and equity play...

In November 2024, the Terminally Ill Adults (End of Life) Bill was passed in the UK House of Commons by a majority of 330 to 275. One key consensus in the debates surrounding the bill was that while palliative care in the UK can be excellent, its provision and funding are often inconsistent, inadequate, and must be improved. In response, a commission on palliative care has been established by Rachael Maskell MP to drive improvements in palliative and end-of-life care in the UK. More recently the Expert Panel of the parliamentary Health and Social Care Committee has announced it is undertaking an independent evaluation of the state of palliative care in England. The 1946 NHS Act established a health service focused on improving physical and mental health and treating illness. This wording led many to assume that palliative care, which puts the person and their concerns before their illness,...

A group of whistleblowing doctors who raised the alarm about patient safety in the emergency department at Scotland’s largest hospital have had their concerns upheld.An investigation by Healthcare Improvement Scotland (HIS) into conditions at Glasgow’s Queen Elizabeth University Hospital concluded that NHS Greater Glasgow and Clyde seemed “to have allowed an abrasive culture to develop, with evidence of poor and disrespectful behaviours, which makes it very difficult for staff at all levels of the organisation to feel safe to challenge and appropriately address this culture.”1Staff complained of insufficient capacity to meet demands for emergency care, leading to long delays in treatment and patients being cared for in unsuitable areas such as corridors. After two years of trying and failing to get senior management to act a group of 29 doctors raised their patient safety concerns directly with HIS.HIS decided to review conditions at all three of the health board’s emergency...