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 July 2022 issue of Frontline Gastroenterology: https://fg.bmj.com/content/13/4/271

The full issue is now online: https://fg.bmj.com/content/13/4

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

In this week’s episode, we share our experiences of attending the recent RCGP Annual Conference, and our thoughts on the topics that were covered in the talks at this year’s event. We talk to RCGP Chair, Martin Marshall, about continuity of care, which he states is one of the defining features of general practice. Evidence has shown that continuity of care is associated with better health outcomes for patients, but how can doctors convince politicians and policymakers of the benefits of it? We also speak to Emma Gladwinfield, a GP in Rossendale, about how connecting with schools, churches and community centres is helping to build relationships with patients and deliver care in her local community.

Our guests:

Martin Marshall is the Chair of the RCGP, a GP in Newham, East London, and Professor of Healthcare Improvement at UCL.

Emma Gladwinfield is a GP in Rossendale, East Lancashire.

Further reading:

‘Tackling the crisis in primary care’. doi:10.1136/bmj.o1485. https://www.bmj.com/content/377/bmj.o1485

COPD or chronic obstructive pulmonary disease is common. The pooled global prevalence is 15% in men and 9% in women. The expanding epidemic of smoking and the ageing of the population means that its prevalence is increasing. And COPD is a serious disease. It is associated with recurrent pneumonia, cor pulmonale, and respiratory failure. In this BMJ Best Practice podcast, Kieran Walsh talks to Dr. Hanna Sandelowsky, GP, Head of Unit at the Academic Primary Healthcare Centre, and Senior Researcher at Karolinska Institutet in Sweden.

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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.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor Alejandra Martinez to discuss the Chemotherapy Response Score (CRS) in ovarian cancer. Prof. Martinez has been the Deputy Head of the Surgical Oncology Department at Toulouse University Cancer Center (Institut Universitaire du Cancer de Toulouse) since 2016. She has served as the Director of the ESGO fellowship program of the IUCTO since 2017 and as a professor in oncology since 2021.

Highlights:

- CRS is an easy and reproductible biomarker that can help to stratify a patient's treatment.

- CRS 1-2 is associated with higher tumor load, more extensive surgical procedures, residual tumor after cytoreduction, and early relapse.

- Pathology response measured by the CRS is associated with disease-free and overall survival in patients with stage IIIC/IV treated with neoadjuvant chemotherapy irrespective of the number of cycles.

In this episode, Juan Franco, editor in chief of BMJ EBM, and Helen Macdonald, The BMJ's research integrity editor, sit down to discuss what's new in the world of evidence.

Firstly, last week they went to the first EBM Live conference for two years - and report back on what happened when the evidence community got back together.

We have two research papers looking at knees and shoulders, and finding out about the balance of risks and benefits.

In covid news, we're still finding new symptoms associated with infection, 2.5 years after the pandemic started. We'll also hear how complex it is to research vaccine efficacy now.

Reading list:

Smell and taste dysfunction after covid-19 https://www.bmj.com/content/378/bmj.o1653

Serious adverse event rates and reoperation after arthroscopic shoulder surgery

https://www.bmj.com/content/378/bmj-2021-069901

Viscosupplementation for knee osteoarthritis

https://www.bmj.com/content/378/bmj-2022-069722

Waning effectiveness of BNT162b2 and ChAdOx1 covid-19 vaccines over six months since second dose

https://www.bmj.com/content/378/bmj-2022-071249

Dr Philip Smith, Associate and Social Media Editor of FG and Consultant Gastroenterologist at the Royal Liverpool Hospital, Liverpool, UK interviews Dr Bel Kok who is a Consultant Gastroenterologist in the Department of Gastroenterology, Royal London Hospital, Barts and The London NHS Trust, London, UK on the paper 'Understanding and managing psychological disorders in patients with inflammatory bowel disease: a practical guide' published in paper copy in Frontline Gastroenterology in May 2022 and on the website: https://fg.bmj.com/content/early/2022/05/23/flgastro-2022-102094.

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 podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the August 2022 issue of DTB. They discuss progress in reducing use of psychotropic medications in adults and children with a learning disability, autism or both (https://dtb.bmj.com/content/60/8/114). They also provide an overview of a study that assessed the effect of deprescribing antihypertensive medication in older people (https://dtb.bmj.com/content/60/8/118) and talk about a national safety alert relating to amiodarone (https://dtb.bmj.com/content/60/8/116). They end the podcast with a discussion on the evidence for the lipid-lowering drug bempedoic acid and its effect on reducing low-density lipoprotein-cholesterol and the lack of evidence on clinical outcomes (https://dtb.bmj.com/content/60/8/120).

The contact address for the DTB team is [email protected].

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.

Last month we gave you a sneaky audio advanced peek into traumatic cardiac arrest - https://adc.bmj.com/content/107/7/695.1 - and so this month we are encouraging you to take a step back and think about why on earth we are doing this difficult, demanding, and intellectually brain stretching stuff of critically appraising clinical research studies - https://adc.bmj.com/content/107/8/772.1 - and beyond that, getting involved and creating some Archi’s yourself - adc.bmj.com/pages/authors/#archimedes.

Please listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify to get episodes automatically downloaded to your phone and computer. And if you enjoy the podcast, please leave us a review at https://podcasts.apple.com/gb/podcast/adc-podcast/id333278832

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Ramesh Nadarajah from the University of Leeds. They discuss their recent paper on Covid-bloated waiting lists and whether modelling can help to improve the situation for patients with aortic stenosis. 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://bmjopen.bmj.com/content/12/6/e059309

Buprenorphine is an incredibly safe and effective drug as both an analgesic as well as a front-line therapy for the treatment of an opioid use disorder (OUD). However, decisions around the management of this drug in the perioperative period have generated substantial confusion and anxiety amongst patients, policymakers, and healthcare providers. In this month’s “RAPM Focus,” Editor-in-Chief Brian Sites, MD, interviews Lynn Kohan, MD, the senior author of “Buprenorphine management in the perioperative period: educational review and recommendations from a multisociety expert panel,” first published in August 2021 (https://rapm.bmj.com/content/46/10/840). This multi-center and multi-disciplinary project establishes expert recommendations for the perioperative management of patients with OUD and brings clarity to many of these questions.

Dr. Kohan is an associate professor of anesthesiology and pain medicine at the University of Virginia (UVA) Pain Management Center. She did her anesthesiology residency at Georgetown University and her pain fellowship at UVA. She has served as the chronic pain fellowship director for the past several years and was recently appointed division chief of pan medicine. She is actively involved with ASRA Pain Medicine, serving as the chair of the membership committee. In addition, she holds leadership positions in the area of education, serving as the president-elect of the Association of Pain Program Directors, council member of the Society of Academic Associations of Anesthesiology and Perioperative Medicine, and the chair of the fellowship committee at the American Academy of Pain Medicine.

*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.