The last choice

This is the final US editor's choice column. It's been a pleasure reviewing the journal each week from an American perspective. Here are some attributes of the BMJ that I think make it especially interesting to US readers, with examples from this week's issue.

The journal's global focus is well represented by two articles on HIV testing in resource-poor countries (doi: 10.1136/bmj.39210.582801.BE, doi: 10.1136/bmj.39268.719780.BE) and an international survey to determine cut-offs to define thinness in children and adolescents by using body mass index (doi: 10.1136/bmj.39238.399444.55). The last, by Tim Cole et al, is a particular advance, since undernutrition is better assessed as thinness (low body mass index for age) than as wasting (low weight for height). As Noël Cameron points out in a related editorial (doi: 10.1136/bmj.39281.439178.80), the next step is to test the associations between these new thinness measures and morbidity in children and adolescents.

Every week also brings evidence based, practical clinical advice. J Townshend and colleagues review the diagnosis of asthma in children, giving tips to distinguish atopic asthma from episodic viral wheeze (doi: 10.1136/bmj.39234.651412.AE). Stephen Pilling and associates summarize two new guidelines from the National Institute for Health and Clinical Excellence (NICE) on psychosocial and detoxification interventions for drug abuse in primary and secondary care settings (doi: 10.1136/bmj.39265.639641.AD).

Especially since the journal's redesign six months ago, the BMJ is known for interesting medical feature articles. Harvey Chochinov defines the ABCDs of providing bedside care with dignity (doi: 10.1136/bmj.39244.650926.47), and Alison Tonks writes about the development of oral vaccines (doi: 10.1136/bmj.39275.480000.A). This week also brings the conclusion of a three-part interactive case report with commentaries from a clinical specialist, an educational specialist, and the presenting doctor (p 205).

Finally, and perhaps most important, are the offbeat, unusual, or humorous pieces. So we learn of the death of the Russian hematologist who survived internal exile to develop and test the now standard field treatment for poisonous snakebites and who introduced the concept of disseminated intravascular coagulation (doi: 10.1136/bmj.39262.632523.BE). And we meet an American cat who can unfailingly predict death in nursing home patients (doi: 10.1136/bmj.39287.382650.4E).

Other things that distinguish BMJ from the rest of the weekly English language general medical journals include prominent and frequent primary care research articles and qualitative studies. Neither of these appears this week, but keep reading and you'll see them soon.