BMJ talk medicine

The highlights of this edition brought to you by the Editor-in-Chief of Frontline Gastroenterology Mark Beattie.

Read the UpFront of the January 2023 issue of Frontline Gastroenterology:

https://fg.bmj.com/content/14/1/1

The full issue is now online: https://fg.bmj.com/content/14/1

Listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify.

The International Association for the Study of Pain defines pain as: “An unpleasant sensory or emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Pain is both a disease and a symptom.” The inclusion of the word emotional in the definition alludes to the fact that consciousness is part of the pain pathway. Despite the knowledge that neurocognitive aspects of human psychology are intimately related to pain, very little research exists examining behavioral interventions. In this month’s RAPM Focus, Editor-in-Chief Brian Sites, MD, joins Jessie Markovits, MD, the lead author of “Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomized clinical trial,” first published in June 2022

(https://rapm.bmj.com/content/47/9/534). In this provocative study, 64 patients got either a 10-minute hypnosis session or an enhanced control during a hospital medicine pre-op visit before total knee

arthroplasty.

Dr. Jessie Markovits completed medical school at Tulane School of Medicine in New Orleans, followed by an internal medicine residency at Stanford. Her current appointment is associate professor of

medicine, with a courtesy appointment to psychiatry and behavioral sciences at Stanford University. She is board-certified in internal medicine and has developed a perioperative specialization over the past 6 years in her clinical role as surgical co-management hospitalist, primarily for orthopedic surgery.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this

podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical

treatment or for the medical treatment of others.

Halitosis is common and can affect people of all ages. Severe halitosis is less common but it can affect confidence and quality of life. It can even result in social isolation. So it is important that we get the diagnosis and management of this condition right.

In this BMJ Best Practice podcast on halitosis, Kieran Walsh talks with Professor Stephen Porter, Director of the UCL Eastman Dental Institute in London.

Competing interests: none declared

Dr. Kate Diomede, social media editor at Thorax, speaks with Dr. Anna Podolanczuk(1) and Dr. John Kim(2) about their article, "MUC5B, telomere length and longitudinal quantitative interstitial lung changes: the MESA Lung Study", published in Thorax:

https://thorax.bmj.com/content/early/2022/08/04/thorax-2021-218139

Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - @Thorax.BMJ · Pulmonologist) and subscribe on your preferred platform, to get the latest episodes directly on your device each month.

(1) Division of Pulmonary and Critical Care, Weill Cornell Medical College, New York, New York, USA

(2) Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA

Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA

This episode was produced by Letícia Amorim and edited by Brian O'Toole.

If you enjoy the Thorax Podcast, please leave us a rating and a review on the Thorax Podcast page on iTunes - https://podcasts.apple.com/gb/podcast/thorax-podcast/id343304910.

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Professor Paul Kalra from Portsmouth, UK, the CI of the Ironman study. They discuss the trial in depth and the implications for future management of heart failure patients.

This episode is sponsored by an educational grant from the Boehringer Ingelheim-Lilly Alliance. The sponsor has no influence over podcast content, the selection of speakers or any associated educational material. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02083-9/fulltext

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Jenny Mueller and Bill Zammarrelli to discuss molecular classification and risk stratification in endometrial cancer. Jenny Mueller, MD, is a gynecologic oncologist and assistant attending in the department of surgery at Memorial Sloan Kettering Cancer Center. She leads the endometrial cancer research team at MSKCC with an emphasis on prospective, translational, and collaborative efforts within and across institutions. Bill Zammarrelli, MD, currently works as a gynecologic oncology fellow at Memorial Sloan Kettering Cancer Center. He is a commissioned officer in the US Army and completed his residency at Walter Reed National Military Medical Center. His current research focuses on the genetics of endometrial cancer.

Highlights:

- PORTEC-1 and GOG-99 risk classifications are discordant for stage I grade 3 endometrioid endometrial carcinoma (EEC).

- Stage I grade 3 EECs of CN-high molecular subtype have a worse 3-year progression-free survival compared to non-CN-high molecular subtypes.

- Molecular classification in combination with clinicopathologic factors may provide improved prognostic information.

Grit is one of those concepts (like the dreaded resilience) that has a specific meaning, but has become a buzzword in healthcare.

It’s the ability to persevere in the pursuit of a goal, in the face of obstacles - and it’s something all doctors have.

However that trait has benefits and drawbacks. It’s not necessarily fixed, but will depend on context, and it is measurable but not a very helpful measure in isolation.

In this episode, Clara Munro is joined by Declan Murphy and Ayisha Ashmore - and they sit down with neurourgeon and researcher Simone Betchen, who has measured grit in women surgeons, and helps them understand their grit scores.

Reading list

Grit in surgeons

https://pubmed.ncbi.nlm.nih.gov/34218313/

In this podcast, we host Dr Chloë Williamson (Twitter @Chlobobs). Chloë is a Postdoctoral Fellow in Physical Activity for Health based in the Physical Activity for Health Research Centre at the University of Edinburgh. Her research (including PhD) over the past 4 years or so has focused on physical activity communication and messaging. We all know that physical activity is important but it is equally important to consider how PA messaging is delivered. Chloë provides a great overview on the findings of her research to date and her work on the development of a translational tool to bring PA messaging research into practice. In this podcast, we discuss on:

The framework of PA messaging and how to use it

Key points to focus on and consider when delivering PA messages

How we can use the framework findings to engage different partners and organisations

How we can make PA attractive to our target audience

Get the Message? A scoping review of physical activity messaging. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00954-3

A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01182-z

Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): International consensus statement and user guide. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01230-8

How can we better promote physical activity to the public through messaging? https://blogs.bmj.com/bjsm/2020/11/10/how-can-we-better-promote-physical-activity-to-the-public-through-messaging/

Infographic: Walking on sunshine: scoping review of the evidence for walking and mental health: https://bjsm.bmj.com/content/53/14/903

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Kyle Fargen(1) about the recently published study "Mechanical thrombectomy decision making and prognostication: Stroke treatment Assessments prior to Thrombectomy In Neurointervention (SATIN) study" - https://jnis.bmj.com/content/early/2023/01/05/jnis-2022-019741.long

Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767

Thank you for listening!

This episode was produced and edited by Brian O'Toole.

(1) Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Professor Giovanni Scambia and Dr. Carmine Conte to discuss mildly invasive surgery in ovarian cancer. Prof. Scambia is the Director of the Gynecologic Oncology Unit and the Scientific Director of Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy. He is Full Professor of Obstetrics and Gynaecology, at Catholic University in Rome, and Member of Consiglio Superiore di Sanità, Ministry of Health Italy and Vice President 1st Section of Consiglio Superiore di Sanità. He is President Elect of E.S.G.E. (European Society for Gynaecological Endoscopy), and Past President of the Italian Society of Obstetrics and Gynecology (S.I.G.O.). Prof. Scambia is specialized in gynaecological cancer treatment and research. He has studied and developed innovative surgical approaches for the cure of gynecological cancers and has been invited professor in several academic hospitals both in Europe and outside Europe, and he is considered an opinion leader in the field of gynecologic oncology. Dr. Carmine Conte works at the Gynecologic Oncology Unit at Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome, Italy. He got the ESGO Fellowship diploma and is recognized as a certified European Gynaecological Oncologist. Dr. Conte is a surgeon and researcher with special interest in minimally invasive surgery (laparoscopy and robotic) to treat cancerous and noncancerous diseases of the female reproductive system.

Highlights:

- The patients with oligometastatic recurrent disease had a higher likelihood of minimally invasive secondary cytoreductive surgery.

- Lymphnodal recurrences can be easily approached by MIS.

- Propensity-matched analysis showed no differences in survival between the MIS and open groups, with a higher rate of overall and severe early complications in the open group.

- Diagnostic laparoscopy and PET/CT scan should be considered complementary because of the potential of each one to identify a different disease setting.

- A diagnostic laparoscopy before secondary cytoreductive surgery may prevent unnecessary laparotomies.