BMJ talk medicine

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Katherine Hicks-Courant, MD, MSHP. Dr. Hicks-Courant is a fellow in the Division of Gynecologic Oncology at the University of Pennsylvania. She studies the intersection of gynecologic oncology, palliative care and oncology care delivery systems.

Highlights:

Having a gynecologic rather than a medical oncologist was associated with lower rates of high-intensity end-of-life care.

Having a gynecologic oncologist rather than a medical oncologist was associated with higher rates of invasive procedures.

Having a gynecologic oncologist rather than a medical oncologist was associated with higher Medicare spending.

In this podcast, RMD Open's Social Media Advisor, Dr. Paul Studenic, speaks to Dr. Giovanni Adami, from Universita degli Studi di Verona, Italy, about his population-based cohort study evaluating air pollution-associated risk of developing an immune-mediated disease. By using an Italian-wide patient-dataset, initially designed for fracture risk assessment in women in combination with data for air-quality control stations across Italy, he presents results indicating that long-term exposure to air pollution coincides with a higher risk of developing autoimmune diseases.

Read it on the RMD Open website: https://rmdopen.bmj.com/content/8/1/e002055

This is the first in a new series of BMJ Open Gastroenterology interviews, in which we will be covering high-profile publications in conjunction with the lead authors of the papers.

In this quarter’s podcast, we will be discussing a review article entitled ‘Enteropathies with villous atrophy but negative coeliac serology in adults: current issues’ published online in November 2021 (https://bmjopengastro.bmj.com/content/8/1/e000630).

Dr James Ashton (Social Media Editor of BMJOG) interviews Dr. Annalisa Schiepatti, researcher at the University of Pavia, Italy, and a junior consultant at the Gastroenterology Unit of Maugeri Insitute in Pavia.

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Duane Peters from the Lupus Foundation of America interviews Professor Ronald van Vollenhoven from the Amsterdam University Medical Centers in the Netherlands and Dr Cynthia Aranow from the Feinstein Institute for Medical Research in New York, USA.

They discuss the efforts of the DORIS international task force to agree on a single definition of remission in systemic lupus erythematosus, which they hope will ensure that clinicians, patients and researchers in the field are all working towards the same outcome.

Access the article: https://lupus.bmj.com/content/8/1/e000538

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) provide an overview of the June 2022 issue of DTB. They discuss the impact that the cessation of spirometry services in primary care has had on diagnosing obstructive lung disease (https://dtb.bmj.com/content/60/6/82). They highlight two separate patient safety incident reports from the Healthcare Safety Investigation Branch - confusion over the prescribed dose of oral morphine solution and the harm caused by a standard therapeutic dose of paracetamol in a frail older person (https://dtb.bmj.com/content/60/6/84). The editors also talk about an article on serotonin syndrome (https://dtb.bmj.com/content/60/6/88).

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.

Read the June issue: https://dtb.bmj.com/content/60/6

In this episode of the Heart podcast, Dr Andrew Perry is joined by Dr. Stephanie Curtis, a physician at the Bristol Royal Infirmary who specializes in caring for women who are pregnant and have co-morbid aortopathy. 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://heart.bmj.com/content/early/2022/02/09/heartjnl-2021-319828

In Doctor Informed, we've been hearing a lot about the problems of healthcare, but we also want to talk about solutions. Whatever we're going to do to fix healthcare, whether that's bullying, or burnout, or patient safety - it's going to require change. And change is hard.

In this episode Clara Munro is joined by Graham Martin, director of research at THIS Institute. They discuss the dreaded phrase "But it's always been done this way", and why failing is the path to success, and the true importance of listening.

Our guests;

Penny Pereira, Q managing director at the Health Foundation. Q helps promote improvement within the health and care system, encouraging and supporting a wide range of people to effectively lead improvement. https://www.health.org.uk/about-the-health-foundation/our-people/q-and-q-labs-team

Moira Durbridge, director of safety and risk at University Hospitals of Leicester NHS Trust. Moira trained as a nurse, and continues to work clinically, as well as her role in leading her Trust's change.

Consultations about suspected cow’s milk protein allergies are quite common in primary care, but these allergies can be a challenge to diagnose, particularly as symptoms can manifest in many different ways, and testing can be complicated. We talk to Dr. Nicola Brathwaite about the diagnosis and management of cow’s milk protein allergies in infants, and our discussion includes how to navigate consultations with parents who may be distressed and fraught with anxiety over their baby’s symptoms, and how best to manage the reintroduction of milk back into the diet.

Our guest:

Nicola Brathwaite is a paediatric allergy consultant at King's College Hospital, London. She completed her specialist training in Paediatrics and Paediatric Allergy in Cape Town, South Africa.

This month’s “RAPM Focus” highlights a small study conducted by a team out of the University of California San Diego, designed to determine if percutaneous cryoneurolysis of the lateral femoral cutaneous nerve is feasible and shows potential for future study in management of burn patients. Dr. John J. Finneran is the first author of “Percutaneous cryoneurolysis of the lateral femoral cutaneous nerve for analgesia following skin grafting: a randomized, controlled pilot study,” published first in August 2021 and subsequently in the January 2022 print edition (https://rapm.bmj.com/content/47/1/60).

As Dr. Finneran reported in the paper, peripheral nerve blocks may be used for postoperative analgesia following split thickness skin graft, and the lateral femoral cutaneous nerve is “an

optimal target, since it innervates the lateral thigh and has no motor component.” However, because local anesthetic nerve blocks are limited in their duration, this study looked at the use of ultrasound-guided percutaneous cyroneurolysis for extended analgesic effect. The results were promising, with the patients who were randomized to the cryoneurolysis group having lower average and maximum pain scores, less need for opioid analgesics, and fewer reports of sleep disturbances during the first two nights after surgery. Listen in as Dr. Finneran describes the study, the procedure, and future research objectives.

Dr. Finneran is a Health Sciences clinical associate professor and associate residency program director in the Department of Anesthesiology at the University of California San Diego, as well as clinical director for Regional Anesthesiology at UC San Diego Medical Center – Hillcrest.

*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.

@RAPM_Online

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Rene Pareja to discuss conservative management of cervical cancer. Dr. Pareja is a gynecologist-oncologist at Astorga Oncology Clinic in Medellín and the National Cancer Institute in Bogotá, Colombia. He is a reviewer for more than 20 specialty journals, an Associate Editor for IJGC, a member of the Editorial Board of Gynecology Oncology, and a member of the board of directors of the International Gynecological Cancer Society (IGCS). Additionally, he is a member of FIGO committee on Women's Cancer. Dr. Pareja is the author of nine book chapters and more than 70 publications in peer-reviewed journals, and at IGCS 2021 he received an award for Community Advancement in Resource-Limited Settings.

Highlights:

1. Fertility preserving options have to be offered to all women wishing to preserve their fertility potential, that fulfil the ECOG status, histological, and imaging criteria.

2. It is recommended to have an evaluation by human reproduction specialized teams in order to rule out any potential impairment before the surgery.

3. The relapse rate for vaginal radical trachelectomy, abdominal radical trachelectomy and simple trachelectomy/conization are around 4-5%.

4. The highest live birth rates are seen in patients undergoing conization + lymph node assessment (over 88%).

5. Vaginal radical trachelectomy and minimally invasive radical trachelectomy, with preservation of ascendent branch of uterine artery, are contraindicated in women with tumors > 2 cm, due to the high rate of relapse (over 20%).