MinervaBMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7374.1250 (Published 23 November 2002) Cite this as: BMJ 2002;325:1250
One of the essential ingredients of a high quality service is leadership. Another is that all work must be infused with compassion. Compassion is said to recognise the importance of every individual's action. Compassion does not forever forgive bad behaviour; it supports good effort while not tolerating destructive action (Academic Emergency Medicin e 2002;9:1067-9).
People with diabetes may need to watch not just what food they eat, but how they cook it (www.pnas.org/cgi/doi/10.1073/pnas.242407999). “Advanced glycation end products” are the toxic byproducts of spontaneous interactions between sugars, fats, and proteins, which trigger inflammation. They form quickly when food is cooked at high temperatures. With food cooked at lower temperatures, the low grade inflammatory state that leads to accelerated vascular disease in people with diabetes might be prevented—and indeed, eating food cooked at a reduced heat lowered concentrations of advanced glycation end products and of inflammatory markers.
Considerable controversy remains as to whether all the effort put into achieving a laparoscopic approach is worthwhile. A small controlled study comparing laparoscopic against abdominal hysterectomy for benign pathology found that laparoscopic surgery took 50% longer to complete—but these patients had significantly fewer complications, needed less pain relief, and …
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