BMJ talk medicine

A rundown of some of the best papers we published in the January 2023 edition of the journal. We cover an excellent practice review on the management of pulmonary embolism, going through some of the great pearls of wisdom relevant to our practice. How do you risk stratify patients with PE? What do you treat them with and how do you decide, especially when there are special considerations? When should you use thrombolysis? We cover a national survey of practice for prophyalxis of venous thromboembolism in patients who need lower limb immobilisation, we look at ambulance service configuration (should we have more rapid response vehicles?), we look at the outcomes of children who received 999 ambulance responses but weren't transported to hospital, and we look at whether vitamin D deficiency predicts outcome for patients with severe sepsis.

Read the highlights: https://emj.bmj.com/content/40/1/1.

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In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Jason Wright to discuss hormone replacement therapy after cervical cancer. Dr. Wright is the Sol Goldman Associate Professor and Chief of the Division of Gynecologic Oncology at Columbia University.

Highlights:

- Among cervical cancer patients <50 years of age who underwent surgery including oophorectomy or primary radiation, only 39% received estrogen replacement therapy.

- In patients who did receive estrogen replacement therapy the duration of use was short, with a median of only 60 days.

- Black patients were significantly less likely to receive estrogen replacement therapy than White patients.

We release episodes fortnightly. Stroke is the fourth and fifth leading cause of death in the UK and US, respectively. There are more than 100,000 strokes in the UK every year. And approximately 10% to 15% of all ischaemic strokes are associated with carotid artery stenosis. So it is important that we get the diagnosis and management of this condition right. In this BMJ Best Practice podcast on carotid artery stenosis, Kieran Walsh talks to Brajesh Lal, Professor of Vascular Surgery, University of Maryland School of Medicine and Professor of Neurology, Mayo Clinic.

Competing interests: None

In a series of podcasts to mark the 60th anniversary of DTB, we talk to some of DTB's Editorial Board members and other colleagues about their work and their involvement with DTB.

In this podcast, David Phizackerley (DTB's deputy editor) talks to Dr John Dowden, the editor of Australian Prescriber since 1990. Australian Prescriber (https://www.nps.org.au/australian-prescriber) is an independent peer-reviewed journal providing critical commentary on drugs and therapeutics for health professionals, and like DTB, Australian Prescriber was a founder member of the International Society of Drug Bulletins. At the time of recording, John highlighted that public funding for NPS Medicinewise (https://www.nps.org.au/), the organisation that publishes Australian Prescriber, was under threat and unfortunately the Australian Government withdrew funding and the organisation closed at the end of December. John and his team were made redundant, and the future of Australian Prescriber is uncertain.

We wrote an editorial that criticises the decision to remove funding from NPS Medicinewise and you can find this in the January 2023 issue of DTB (https://dtb.bmj.com/content/61/1/2).

This special series of the DTB Podcast is produced by Letícia Amorim and edited by Brian O'Toole.

Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

Autoantibodies against post-translationally modified proteins (PTM) are described in various rheumatic diseases and facilitate diagnosis and patient stratification. Researchers from the Leiden University Medical Center analysed the presence of autoantibodies against six different post-translational modifications in a cohort of patients with neuropsychiatric lupus. In this podcast, Leendert Trouw, Rory Monahan and Michelle van den Beukel discuss the results of their study with the ARD/RMDopen social media advisor Caroline Ospelt.

Read the Open Access related paper: https://rmdopen.bmj.com/content/8/1/e002079

Listen to more episodes of RMD Open: https://podcasts.apple.com/gb/podcast/rmd-open-rheumatic-and-musculoskeletal-diseases/id1237127864

In this podcast, Dr Brooke Patterson hosts ACL injury and post-traumatic osteoarthritis leading experts Ass. Prof Jackie Whittaker and Dr Stephanie Filbay in part 2 of an ACL myth busting series. Jackie and Steph provide tips about how you can integrate new evidence into daily practice that may challenge existing beliefs and practices. In today’s episode you will find out if the following statements are TRUE or FALSE….

• ACL tears can heal

• ACL tears only heal if patients are braced immediately

• Open chain knee extension exercises are safe to perform in the first 4 weeks after ACLR

• Returning to high impact sports increases the risk of PTOA after ACL injury

• Having an early ACL reconstruction will reduce the risk of future structural OA

Whittaker et al 2022 OPTIKNEE consensus statement https://www.ncbi.nlm.nih.gov/pubmed/36379676

Whittaker et al 2022 OPTIKNEE review of risk factors http://bjsm.bmj.com/content/early/2022/10/05/bjsports-2022-105496.abstract

Filbay et al 2022 ACL healing paper http://dx.doi.org/10.1136/bjsports-2022-105473

OPTIKNEE website OPTIKNEE bit.ly https://bit.ly/OPTIKNEE

Editor's in Chief of Medical Humanities, Brandy Schillace, interviews Amelia DeFalco, University of Leeds and Steve Byrne Director/Chief exec of the Interplay Theatre about the Interplay Theatre's work with disabled students and the role of immersive experience for the LivingBodiedObjects project.

Related blog including the transcription of the podcast:

https://blogs.bmj.com/medical-humanities/2023/01/12/immersive-and-interactive-accessibility-theatre-and-livingbodiesobjects

Subscribe to the Medical Humanities Podcast in all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify. If you enjoy our podcast, please consider leaving us a review and a 5-star rating on the Medical Humanities Podcast iTunes page (https://podcasts.apple.com/gb/podcast/medical-humanities-podcast/id961667204). Thank you for listening!

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Dr. Anil K. Sood to discuss novel high-grade serous ovarian morphologic classification. Dr. Sood is a Professor in the Department of Gynecologic Oncology and Reproductive Medicine at the UT MD Anderson Cancer Center. He is Co-Director of the multi-disciplinary Blanton-Davis Ovarian Cancer Research Program and co-leads the Ovarian Cancer Moonshot Program. He is an elected member of the American Society for Clinical Investigation (ASCI), the Association of American Physicians (AAP), and the National Academy of Medicine (NAM).

Highlights:

- High grade serous ovarian cancer (HGSOC) could be classified into two gross morphologic subtypes.

- Type I and type II morphologic subtypes differed with respect to clinical outcomes.

- The two morphologic subtypes also differed with regard to transcriptomic, proteomic, and metabolomic profiles.

One size doesn’t fit all - so what are the alternative career paths of doctors in the NHS? The treadmill of medical school, to foundation training, to specialist training, to a consultant position takes years and is not very trainee-centric in it’s design.

So are there other ways for doctors to be able to work in the NHS, still progress their career, but also tailor the job to themselves? And what are the drawbacks of trying to do that?

In this podcast, Clara Munro is joined by Flo Wedmore and new panelist Jason Ramsingh, a surgical trainee in Newcastle. They speak to Rob Fleming an SAS (speciality and associate specialist) doctor in anaesthetics.

In this podcast, JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, speaks with Dr. Amanda Baker(1) and Dr. Sandra Narayanan(2) about their recently published standard "Society of NeuroInterventional Surgery: position statement on pregnancy and parental leave for physicians practicing neurointerventional surgery" - https://jnis.bmj.com/content/15/1/5.

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 edited by Brian O'Toole.

(1) Radiology and Biomedical Imaging, UCSF, San Francisco

(2) Neurointerventional Program and Comprehensive Stroke Program, Pacific Neuroscience Institute, Santa Monica