BMJ talk medicine

In this month's podcast, Editor-in-Chief of Injury Prevention, Dr Rod McClure​, talks with Professor Fred Rivara, Professor of Pediatrics, University of Washington, School of Medicine. They explore what is unique about Injury Prevention as a field, and where this field integrates with the more general world of public health. They also discuss leadership in injury prevention and the major challenges ahead.

Some of Professor Fred Rivara's latest papers:

- A Qualitative study on diverse perspectives and identities of firearm owners - https://injuryprevention.bmj.com/content/28/5/434

- Concussion education for youth athletes using Pre-Game Safety Huddles: a cluster-randomised controlled trial - https://injuryprevention.bmj.com/content/early/2022/09/16/ip-2022-044665

- Predictors of health-related quality of life following injury in childhood and adolescence: a pooled analysis - https://injuryprevention.bmj.com/content/28/4/301

- Association of state-level intoxicated driving laws with firearm homicide and suicide - https://injuryprevention.bmj.com/content/28/1/32

- Age, period and cohort effects in firearm homicide and suicide in the USA, 1983–2017 - https://injuryprevention.bmj.com/content/27/4/344

Please subscribe to the Injury Prevention Podcast via 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 Injury Prevention Podcast iTunes page (https://podcasts.apple.com/gb/podcast/injury-prevention-podcast/id942473946). Thank you for listening!

In this month's Talk Evidence, Helen Macdonald, The BMJ's research integrity editor, is joined again by Juan Franco, editor in chief of BMJ EBM, and Joe Ross, US research editor.

They're straying beyond the pages of The BMJ, and discussing an NEJM paper about colonoscopy for colorectal cancer screening.

We have a listener request, asking about evidence for England's " NHS Diabetes Prevention Programme" - what do we know about how lifestyle interventions work at a population level? Juan puts on his Cochrane hat to answer the query.

We stay with diabetes, and Joe tells us about his research trying to see if routinely collected observational data could be used to match the outcomes of an RCT into drug treatments.

Finally, Helen updates us about what she's been doing about a case of plagiarism in one of BMJ's journals - and what that means for researchers who are writing in multiple journals about their work.

Reading list

Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death

https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

Emulating the GRADE trial using real world data: retrospective comparative effectiveness study

https://www.bmj.com/content/379/bmj-2022-070717

Expression of concern about content of which Dr Paul McCrory is a single author

https://bjsm.bmj.com/content/early/2022/10/11/bjsports-2022-106408eoc

Endoscopic pyloromyotomy (G-POEM) is a minimally invasive treatment option with promising uncontrolled outcome results in patients with gastroparesis.

Dr Philip Smith, Digital and Education Editor of Gut, interviews Professor Jan Martinek, from the Department of Hepatogastroenterology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic, about his paper on this topic. The article titled 'Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial' is published in paper copy in Gut in November 2022 and available online at: https://gut.bmj.com/content/71/11/2170

Please subscribe to the Gut Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Gut Podcast iTunes page (https://podcasts.apple.com/gb/podcast/gut-podcast/id330976727).

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Dimitrios Nasioudis to discuss ovarian preservation in grade 2 or 3 endometrial cancer. Dr. Nasioudis is a Gynecologic Oncology Fellow at the University of Pennsylvania. His current research focuses on translational therapeutics and population-based research.

Highlights:

- For premenopausal patients with endometrial cancer, ovarian preservation is not associated with worse oncologic outcomes for those with grade 1 tumors. However, safety of ovarian preservation for grade 2 or 3 tumors is not established.

- Ovarian preservation was not associated with worse overall survival for patients with grade 2 or 3 endometrioid tumors.

-Ovarian preservation may be considered for carefully selected patients with grade 2 tumors.

Dr Kevin Monahan(1) explains what the general gastroenterologist needs to know about the diagnosis and management of patients with Lynch syndrome, including considerations for endoscopy surveillance and changes to the BCS programme.

Read the article in Frontline Gastroenterology here: https://fg.bmj.com/content/13/e1/e80

(1) Consultant Gastroenterologist, Family Cancer Clinic and Wolfson Endoscopy Unit, St Mark's Hospital

Listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify. If you enjoy our podcast, please rate us on your chosen platform, and leave us a review on the Frontline Gastroenterology Podcast page on iTunes: https://podcasts.apple.com/gb/podcast/fg-podcast/id942944229

In this episode of the podcast, Andrew Perry chats with Dr. Amanda Eng to discuss the paper “Long working hours, sedentary work, noise, night shifts and risk of ischaemic heart disease.”

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: https://heart.bmj.com/content/early/2022/08/24/heartjnl-2022-320999

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Jonathan Ledermann to discuss ICON8-Overall Survival. Jonathan Ledermann is a professor of medical oncology and Clinical Director at UCL Cancer Institute specializing in the treatment and research of gynaecological malignancies. He has led several national and international trials on the treatment of ovarian cancer and has played a key role in developing trials of PARP inhibitors in ovarian cancer. He is the ESMO Gynaecological Cancer Practice Guidelines Editor and past Vice President of ESGO. He is a Fellow of the Academy of Medical Sciences and a Senior Investigator for the National Institute of Health Research in the UK.

Highlights:

- Weekly first-line chemotherapy for ovarian cancer does not improve progression-free or overall survival.

- ICON8 was the largest randomized trial exploring weekly paclitaxel or weekly carboplatin and paclitaxel compared to tri-weekly chemotherapy.

- There is no evidence to suggest that weekly first-line chemotherapy should be used as part of multimodal treatment of newly diagnosed ovarian cancer.

- The results in a predominately European population differ from a similar Japanese trial, raising the possibility that genetic or pharmacogenomic differences need to be considered when comparing the results of trials in ovarian cancer.

In this conversation with Journal of Investigative Medicine Social Media Editor John Dickinson, MD, PhD, University of Nebraska Medical Center, Gregory Vercellotti, MD, from the University of Minnesota provides an overview of the symptoms, diagnosis and management of sickle cell disease. Dr. Vercellotti is a national leader in the field of vascular biology and cares for adult patients with sickle cell disease. This podcast is especially relevant for primary care physicians, hospitalists, ER physicians, and other subspecialists who may not frequently encounter patients with sickle cell disease.

We discuss many of the common features for symptoms, including pain crises, and complications including stroke, pulmonary hypertension, and avascular necrosis. We also discuss some of the social, economic, and racial factors that are often barriers to effective care. Finally, we discuss some of the promising new options including stem cell transplantation and CRISPR-based cures.

Establishing new clinical pathways and accomplishing change often takes a super-human effort in a complex health system. In terms of systemic lidocaine, the analgesic effects of systemic lidocaine are well recognized, but what is novel is the application of this therapy in an environment once thought to be inappropriate, that is, in the general inpatient units. In this month’s RAPM Focus, Editor-in-Chief Brian Sites, MD, joins Meagan Miller, APRN, MSN, AGACNP-BC, and Brian Allen, MD, to discuss their university-based study, “Safety of postoperative lidocaine infusions on general care wards without continuous cardiac monitoring in an established enhanced recovery program,” first published in January 2022 (https://rapm.bmj.com/content/47/5/320).

Meagan Miller graduated from the University of Alabama with her bachelor’s in nursing in 2012. She was then accepted into Vanderbilt University Medical Center Nurse Residency Program and joined the colorectal and general surgery floor, which sparked her interest in enhanced recovery after surgery, as it was the first floor to initiate lidocaine infusions outside of the ICU. She has her master’s in nursing science in adult gerontology acute care nurse practitioner and first assist.

Dr. Brian Allen is an associate professor at Vanderbilt University Medical Center, where he directs the fellowship in regional anesthesiology and acute pain medicine. He completed undergraduate in medical school at Washington University. He was a resident at Vanderbilt and did his regional fellowship at Oregon Health & Science University (OHSU) before returning to join the Vanderbilt faculty. His clinical focus is on regional and multimodal analgesia in ERAS pathways. His research interests include educational assessment, evaluating ERAS efficiency, efficacy and compliance, and opioid minimization.

*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.

Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.

Today we talk with the principal investigators of the DoxyPEP trial which was prematurely terminated due to its amazing success: participants receiving a stat dose of Doxycycline 200mg in less than 72 hours after condom-less sex were 63% less likely to develop a bacterial STI compared to participants in the control arm.

Prof Annie Leutkemeyer based in San Francisco (UCSF) and Prof Connie Celum, based in Seattle (WA)join Dr Fabiola Martin, STI's Podcast editor, in this short interview.

Please listen to a recent podcast on the wider subject of Bacterial STIs: https://soundcloud.com/bmjpodcasts/management-of-bacterial-stis?in=bmjpodcasts/sets/sti

Related links:

https://www.aidsmap.com/news/jul-2022/taking-antibiotic-after-sex-cuts-stis-two-thirds-doxypep-study-finds

academic.oup.com/cid/article/70/6/1247/5557867

www.ncbi.nlm.nih.gov/pmc/articles/PMC8360665/

To hear more episodes of the STI Podcast, please subscribe: https://podcasts.apple.com/gb/podcast/sti-podcast/id356342980