At the time of writing, the outbreak of invasive meningococcal disease in Kent includes 18 confirmed cases, 13 of which have been identified as type B (MenB), plus 11 suspected cases.1 Sadly, this has included two fatal infections. This outbreak is notable for its large number of cases in a short period, described as “unprecedented” by the UK Health Security Agency (UKHSA),2 and for the response, with extensive media coverage and widespread public anxiety about the perceived risk nationwide.The acquisition of Neisseria meningitidis requires close contact, with transmission occurring through saliva or respiratory droplets from a person carrying the organism.3 Most transmission events result in carriage, and around 10% of the population carry N meningitidis at any time.4 In the pre-vaccination era this rate was as high as 33% in adolescents with additional risk factors, which included attendance at pubs or clubs and cigarette smoking—echoing the discussion about the current...

Rules regarding ways doctors must keep their personal beliefs in check when treating patients are being updated by the General Medical Council.The regulator has launched a consultation1 on proposed changes to its personal beliefs and medical practice guidance,2 which was last fully updated in 2013.The GMC said it was updating the guidance to reflect legal, social, and cultural changes. Examples include the government’s recently published guidance on defining “anti-Muslim hostility”3 and debates over assisted dying legislation.The regulator said it wanted to allow doctors to practise in line with their beliefs and values, while respecting patients’ own beliefs and “maintaining good and safe care.”It follows cases such as that of Kent GP Richard Scott, who was given a formal warning by a medical practitioners tribunal in 2023 after telling a vulnerable young patient seeking mental health treatment that he needed to reconnect with God.4The GMC clarified that the guidance does not...

bmj;392/mar20_2/s520/FAF1faRalph Ross Russell—or R3, as he was affectionately known—became a neurologist at a time when strokes were not deemed worthy of academic attention. He was one of the first to make study of the condition into a research and clinical specialty, paving the way for better understanding and care, and playing a pivotal role in turning the treatment of stroke into the medical success story that it often is today.From the outset of his career Ross Russell was at the forefront of academic research in neurology. His first senior position was as a research scholar and lecturer in medicine in Oxford under George Pickering, regius professor of medicine, at the time of much debate on the nature of hypertension and when vasospasm as the cause of transient ischaemic attacks (TIAs) was being challenged. Ross Russell’s research focused on the mechanism of hypertension and its role in cerebrovascular disease, research he...

bmj;392/mar20_1/s505/FAF1faLeo was born in Leipzig, Germany, in 1930 into a poor Orthodox Jewish family who had fled the pogroms in Poland after the first world war. His father became a communist and was in and out of prison from 1932. Leo escaped Nazi Germany and arrived in the UK in September 1939 as part of Kindertransport, aged 8. Leo and his four sisters and brother were the only members of their family to survive the Holocaust. Leo was educated at Battersea Grammar School and won a scholarship to study medicine at Guy’s Hospital.After house jobs he did national service, eventually reaching the rank of captain. On returning to London he became a paediatric resident at New Cross and St Olave’s hospitals before becoming a junior registrar at Great Ormond Street. In 1961 he obtained a research fellowship at Denver University Medical School. He returned to the UK in 1964 to...

A plastic surgeon who is serving a life sentence for attempting to murder a colleague and burn down his home has been struck off the UK medical register.Jonathan Peter Brooks was convicted of attempted murder and arson with intent to endanger life last April.Leicester Crown Court, sitting at Loughborough, heard that Brooks hated Graeme Perks, who had recently retired as head of plastic surgery at Nottingham University Hospitals NHS Trust and was a witness against Brooks in disciplinary proceedings.Brooks went to Perks’ house in the early hours of the morning of 14 January 2021, a few days into the disciplinary hearing.Brooks, dressed in camouflage and equipped with petrol cans, a knife, and a crowbar, broke in through the conservatory and doused the foot of the staircase in petrol.Perks was woken by the sound of smashing glass and came downstairs and interrupted Brooks before he could start the fire, but was...

Heritability of human life spanEstimates of the genetic contribution to human life span have been surprisingly low, often around 20% or less. A reanalysis of Scandinavian twin cohorts suggests that these figures are distorted by mortality from extrinsic causes, including infection, violence, and unintentional harms (Science doi:10.1126/science.adz1187). When such deaths are excluded, heritability of intrinsic life span rises to about 50%, similar to that of other complex traits such as body mass index, blood pressure, or general cognitive ability.Maternal diabetes and epilepsy in offspringMaternal diabetes was linked to an increased risk of epilepsy in offspring in a Canadian birth cohort of more than two million children (Pediatrics doi:10.1542/peds.2025-071138). After adjustment for socioeconomic and clinical factors, the risk of epilepsy was 30-40% higher among children of mothers with type 1 or type 2 diabetes and about 15% higher among those exposed to gestational diabetes, compared with children of mothers without diabetes....

The US Centers for Disease Control and Prevention (CDC) recently agreed to fund a $1.6m(£1.2m) study on the hepatitis B vaccine that has glaring similarities to unethical biomedical research of the past.1 The study is on hold while the African CDC assesses its ethics and necessity, but even the fact that this potentially harmful study was proposed reveals the extent of backsliding in science, ethics, and research funding. We are regressing to the days when research on Black subjects was detrimental to their health rather than beneficial. The healthcare community must act to defend decades of progress and protect the health of Black people globally.The proposed study was planned to take place in the West African country of Guinea-Bissau where hepatitis B affects 18% to 19% of the population.2 The research team has already conducted 25 years of research there, with results from 10 studies never becoming publicly available.3This new...

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

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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
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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

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Med Intensiva. 2023;47:212-20

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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
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I. Astola Hidalgo, A. Fernández Rodríguez, E. Martínez Revuelta, M. Martínez Revuelta, A.M. Ojea, P. Herrero Puente, D. Escudero Augusto
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F.J. Casadiego Monachello, M.C. de la Torre Terron, J.A. Mendez Barraza, S. Casals Vila
Med Intensiva. 2023;47:235-7

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M.V.F. Garcia, R. Souza, P. Caruso
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J.M. Pérez Villares, L. Alarcón Martínez, P. Fernández Florido
Med Intensiva. 2023;47:239-41

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

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M. Cuervas-Mons Tejedor, J.D. López Castilla, E. Sánchez Valderrábanos
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L.I. Perez-Sanchez, N. Mamolar Herrera, J.J. Velasco Gómez
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Med Intensiva. 2023;47:246-7

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