The NHS is on the brink of something important. The federated data platform (FDP), combined with the accelerating use of artificial intelligence (AI), offers the possibility of a health system that’s more coordinated, predictive, and efficient. Although this is the right direction of travel, one question isn’t receiving enough attention: who ultimately controls the data?That question matters because of a little-known piece of US legislation: the CLOUD Act. The Clarifying Lawful Overseas Use of Data Act allows US authorities to compel US companies such as Palantir, the technology company currently contracted to deliver the FDP, to provide data within their “possession, custody, or control.” This is required regardless of where the data are physically stored.This means that data held on UK servers may still fall under US legal jurisdiction if controlled by a US company. This doesn’t mean arbitrary access to NHS patient records, but it does establish a lawful...

I received a diagnosis of type 1 diabetes at the age of 5. I vividly remember hearing my mom being told that type 1 diabetes would be cured by the time I was 30. Because of these conversations, I spent much of my childhood believing that a cure was on the horizon. The idea was reassuring at first, but gradually diabetes became my everyday life, and at age 10, when I got my first insulin pump, I stopped anticipating a cure. Getting the pump made my diabetes feel permanent. Before that, insulin injections had happened in a single moment. Wearing a medical device attached to my body at all times made diabetes feel more real and no longer intermittent. I now carried it with me everywhere.Building knowledge and trustAs a child, I managed my diabetes only because my mom made me or did it for me. Often I heard only...

England now has national strategies for women’s1 and men’s health,2 marking an important policy moment in which sex and gender are being treated more explicitly as health equity concerns. Early coverage has already cast the strategies as competing for limited funding,3 turning the focus from equitable service design into a contest over priority. The task is not choosing between them but using both strategies to change mainstream care.What matters is not weighing women’s and men’s health harms against each other but recognising the shared weaknesses they expose in a health system built around assumptions about whose needs count, how people present to healthcare, and what support they are likely to use.4Overlapping weaknesses make the competition framing particularly damaging. Concern about underinvestment in women’s health is well founded given the historical under-recognition of women’s symptoms, pain, and reproductive health.5 But attention to men’s health is not a competing claim. The renewed...

Pancreatoduodenectomy is one of the most complex procedures in abdominal surgery, removing tumours of the pancreatic head and surrounding organs. Traditionally performed as open surgery, pancreatoduodenectomy carries substantial risks of complications and a long recovery. Robotic surgery has emerged as a promising minimally invasive procedure. However, evidence on its safety and effectiveness remains limited, leaving unresolved which patients benefit most and whether robotic surgery’s better outcomes justify the higher costs.In the linked paper by Jin and colleagues (doi:10.1136/bmj-2026-319692), the Robotic Versus Open Pancreatoduodenectomy for Pancreatic and Periampullary Tumours (PORTAL) trial adds important evidence to randomised literature evaluating minimally invasive pancreatoduodenectomy.1 To date, nine randomised controlled trials have addressed this question.123456789 Of these nine trials, only three (EUROPA, Liu et al, and PORTAL) directly compared robotic pancreatoduodenectomy (RPD) with open pancreatoduodenectomy (OPD).189 The other trials evaluated laparoscopic and open surgical approaches, or, like DIPLOMA-2, included both laparoscopic and robotic techniques, with...

Claire Edwards’s role as a consultant orthopaedic surgeon at Norfolk and Norwich University Hospitals NHS Foundation Trust gives her “that joy of working with your hands and making a visible and functional difference.”“You see change happen before your eyes. Using your hands to create something or to change something is deeply satisfying,” says Edwards, whose other roles include being head of the School of Surgery for the East of England.A hand and wrist surgeon, she enjoys the variety this specialism brings. “It’s about listening to patients, then working together to reach a shared understanding of what might be causing their symptoms and what we can do to help,” she says.As a musician—Edwards plays clarinet and piano—she is interested in treating musicians’ hand problems. “If a violinist has arthritis, I might treat the left hand and right hand quite differently, because the right hand needs to control the bow, and the...

What’s eating you?Not a human being, hopefully. Quite aside from the fact it’s one of humanity’s biggest taboos, cannibalism actually endangers whole populations, say scientists.1They haven’t done an RCT, I hope?Not sure the regulators would approve that one. But experts from Poland and the Czech Republic have suggested that cannibalism became taboo in human societies not because of instinct but because it is harmful to populations who partake in it.Flesh things out for usMichal Misiak of the University of Wroclaw and Petr Turecek of Charles University in Prague used a mathematical model to explore why cannibalism continues to periodically recur in populations, and what factors suppress it. The model assessed cannibalism as a potential food source, weighing up theoretical nutritional benefits against multiple costs including infection.I’m hungry for an explanationTheir findings, published in the Proceedings of the National Academy of Sciences, indicate that sustained cannibalism could lead to societal collapse...

The current Bundibugyo Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda is exposing dangerous gaps in global health security. Experts warn that, amid the aid cuts and ongoing conflict in the region, the outbreak could become one of the deadliest Ebola epidemics to date.1 In the absence of an approved vaccine, the main tools for control are trust, community collaboration, and systemic empathy.Systemic empathy describes how health systems care for people, including their own staff. It prevents stigma, which can catalyse a vicious cycle of contagion. In a stigmatised environment, symptomatic people and their families often avoid medical care out of fear of discrimination, forced isolation, and the denial of proper burial rites.2 At community level, the abrupt enforcement of coercive or heavily militarised measures intensify stigma, fuel rumours, and undermine cooperation.3The arson of an Ebola treatment centre in Rwampara, DRC, on 21 May 2026 is...

We are researchers, trade unionists, members of parliament, bereaved family members, charity leaders, business representatives, and investors who share knowledge and experience of the devastating consequences of work related suicide. We urge the Health and Safety Executive (HSE) to include work related suicides in its current consultation on reportable deaths and injuries.1 Recognising suicide as a potentially work related death is a first urgent step in making workplaces safer and preventing suicide deaths.An estimated 600 suicide deaths per year in the UK are work related.2 Yet, the HSE continues to exclude suicide from reporting requirements, treating it as an exception in relation to every other work related injury or death.This position is dangerously outdated. It ignores the changing demands of work and its impact on psychological harm or despair. It undermines the HSE’s core mission to keep workplaces safe. It places the UK sharply at odds with health and safety...

Ethnicity is a social construct that influences health outcomes and is closely tied to a person’s cultural identity, including language and customs.1 Race is a polemical sociopolitical construct, historically used to divide people based on perceived physical differences.2 Both concepts are closely linked to the social determinants of health and influence disease aetiology, prognosis, treatment, help seeking, and care.3 It is therefore important to recognise and measure ethnicity and race, because exclusion and discrimination based on these factors can amplify structural inequities and population risk factors for disease.45However, the measuring of these variables is challenging because the language and terminology used to describe them is sensitive, owing to, in part, the close association between identity; the aftermath of colonisation, violence, and trauma; and contemporary structural racism and prejudicial norms.67 Ethnicity and race also intersect with other multidimensional variables such as religion, language, and country of birth. Collecting information about these...

The deaths of two children have prompted calls for patients referred to hospital by a GP to be assessed by a doctor.The Doctors’ Association UK (DAUK) campaign group has written to the health and social care secretary, James Murray,1 highlighting the deaths of 8 year old Ethan Hanson and 9 year old Dylan Cope. Neither child was assessed by a doctor while in hospital.Ethan was initially assessed by a GP, who raised the alarm about his condition and advised urgent emergency treatment. But a later assessment by an advanced nurse practitioner saw him treated for constipation and sent home.2 Ethan died in April 2025 from septic shock and perforated appendicitis.Dylan died in December 2022 after a diagnosis of a ruptured appendix and sepsis. He attended the emergency department on referral from his GP for suspected appendicitis. He was examined by a nurse practitioner who failed to refer to the GP’s...

F. Gordo Vidal
Med Intensiva. 2023;47:191-2

Texto completo - PDF

Francisco Álvarez-Lerma, Mercedes Catalán-González, Joaquín Álvarez, Miguel Sánchez-García, Mercedes Palomar-Martínez, Inmaculada Fernández-Moreno, José Garnacho-Montero, Fernando Barcenilla-Gaite, Rosa García, Jesús Aranaz-Andrés, Francisco J. Lozano-García, Paula Ramírez-Galleymore, Montserrat Martínez-Alonso
Med Intensiva. 2023;47:193-202

Resumen - Texto completo - PDF

P. Perelló, J. Gómez, J. Mariné, M.T. Cabas, A. Arasa, Z. Ramos, D. Moya, I. Reynals, M. Bodí, M. Magret
Med Intensiva. 2023;47:203-11

Resumen - Texto completo - PDF

E.P. Gomes, M.M. Reboredo, G.B. Costa, F.S. Barros, E.V. Carvalho, B.V. Pinheiro
Med Intensiva. 2023;47:212-20

Resumen - Texto completo - PDF

L. Zapata, C. Guía, R. Gómez, T. García-Paredes, L. Colinas, E. Portugal-Rodriguez, I. Rodado, I. Leache, A. Fernández-Ferreira, I.A. Hermosilla-Semikina, F. Roche-Campo
Med Intensiva. 2023;47:221-31

Resumen - Texto completo - PDF

I. Astola Hidalgo, A. Fernández Rodríguez, E. Martínez Revuelta, M. Martínez Revuelta, A.M. Ojea, P. Herrero Puente, D. Escudero Augusto
Med Intensiva. 2023;47:232-4

Texto completo - PDF

F.J. Casadiego Monachello, M.C. de la Torre Terron, J.A. Mendez Barraza, S. Casals Vila
Med Intensiva. 2023;47:235-7

Texto completo - PDF

M.V.F. Garcia, R. Souza, P. Caruso
Med Intensiva. 2023;47:237-9

Texto completo - PDF

J.M. Pérez Villares, L. Alarcón Martínez, P. Fernández Florido
Med Intensiva. 2023;47:239-41

Texto completo - PDF

A. González-Castro, E. Cuenca Fito, C. González
Med Intensiva. 2023;47:242

Texto completo - PDF