IMR Press

Rational Medicine: The Culture of Stewardship and the Role of the Physician Rahul Mukherjee 1,* 1 Department of Respiratory Medicine, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, B9 5SS Birmingham, UK *Correspondence: r.mukherjee@nhs.net (Rahul Mukherjee) Br. J. Hosp. Med. (Lond) 2026, 87(8), 55476; https://doi.org/10.31083/BJHM55476 (registering DOI) Submitted: Revised: Accepted: Published: Copyright: © 2026 The Author(s). Published by IMR Press.

[1]Trainee Emergency Research Network (TERN). Understanding corridor and escalation area care in 165 UK emergency departments: a multicentre cross-sectional snapshot study. Emergency Medicine Journal: EMJ. 2026; 43: 72–80. https://doi.org/10.1136/emermed-2025-215301 [2]Royal College of Nursing. RCN briefing: “Beyond Winter Pressures: The endemic crisis of corridor care in the UK”. 2026.

[1]Bailey CJ. Metformin: historical overview. Diabetologia. 2017; 60: 1566–1576. https://doi.org/10.1007/s00125-017-4318-z [2]Teede HJ, Khomami MB, Morman R, Laven JSE, Joham AE, Costello MF, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026; 407: 2329–2339. https://doi.org/10.1016/S0140-6736(26)00717-8 [3]Attia GM, Almouteri MM, Alnakhli FT.

Developments in the Treatment of Status Epilepticus in Adults: What Is Established, What Is New and What Is on the Horizon?

[1]Porter ME. What is value in health care? The New England Journal of Medicine. 2010; 363: 2477–2481. https://doi.org/10.1056/NEJMp1011024 [2]Cossio-Gil Y, Omara M, Watson C, Casey J, Chakhunashvili A, Gutiérrez-San Miguel M, et al. The Roadmap for Implementing Value-Based Healthcare in European University Hospitals-Consensus Report and Recommendations. Value in Health. 2022; 25: 1148–1156. https://doi.org/10.1016/j.jval.2021.11.1355 [3]Chin DZ, Sia WJ, Lv Y, Angelina E, Teo TXR, Tan HY, et al.

1. Introduction Whole-body computed tomography (WBCT) is the standard imaging modality for adult major trauma patients, offering rapid detection of life-threatening injuries. However, the diagnostic utility of WBCT depends critically on the quality of clinical information provided at the time of request. Inadequate information can lead to misinterpretation, delayed reporting, unnecessary additional imaging, and inappropriate scanning [1].

1. Introduction Ultrasound elastography has emerged as a significant noninvasive method for assessing the mechanical characteristics of tissues—demonstrating clinical applicability, among others, in hepatology, oncology, and musculoskeletal imaging. Despite its potential, the reliability and comparability of quantitative elastographic studies are susceptible to various confounding factors that can conceal real tissue stiffness.

1. Introduction Acute cholangitis secondary to choledocholithiasis is a potentially life-threatening condition that requires timely biliary decompression, most commonly achieved by endoscopic retrograde cholangiopancreatography (ERCP) [1]. However, ERCP can become technically demanding in patients with significant anatomical limitations that interfere with endoscopic access, airway management, or procedural positioning [2].

[1]Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements. 2022; 12: 7–11. https://doi.org/10.1016/j.kisu.2021.11.003 [2]Shahbazi F, Doosti-Irani A, Soltanian A, Poorolajal J. Global trends and projection of aetiology-based chronic kidney disease incidence from 1990 to 2030: a Bayesian age-period-cohort modelling study. BMJ Open. 2025; 15: e088104. https://doi.org/10.1136/bmjopen-2024-088104 [3]Jankowski J, Floege J, Fliser D, Böhm M, Marx N.

[1]Valente MAE, Voors AA, Damman K, Van Veldhuisen DJ, Massie BM, O'Connor CM, et al. Diuretic response in acute heart failure: clinical characteristics and prognostic significance. European Heart Journal. 2014; 35: 1284–1293. https://doi.org/10.1093/eurheartj/ehu065 [2]Voors AA, Davison BA, Teerlink JR, Felker GM, Cotter G, Filippatos G, et al. Diuretic response in patients with acute decompensated heart failure: characteristics and clinical outcome--an analysis from RELAX-AHF.