BMJ talk medicine

In this episode of the Heart podcast, Andrew Perry visits Dr. Bairey Merz to discuss the diagnosis and management of INOCA and MINOCA. Dr. Bairey Merz spoke on this topic at the American College of Cardiology Scientific Sessions in March 2023. 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/104/4/284

The theory that depression is caused by serotonin deficiency has become embedded in our practice over the years, and can be a persuasive explanation of the condition for patients considering starting antidepressants. We talk to Tony Kendrick about the evidence (or lack thereof) to support this hypothesis, and what that means for the efficacy of antidepressants, particularly SSRIs. Later on, we speak to Mark Horowitz to discuss how to come off antidepressants safely, and manage withdrawal symptoms, and how to advise and support our patients as they gradually reduce, then stop, their medication.

Our guests:

Tony Kendrick is a retired GP, and NICE committee member for the 2022 guideline update on depression in adults. He is also a professor of Primary Medical Care at the University of Southampton.

Mark Horowitz is a training psychiatrist, working as a clinical research fellow at North East NHS Trust, and as an honorary clinical research fellow at UCL, he is also the co-founder of outro.com.

Further reading:

‘Antidepressants and the serotonin hypothesis of depression’. BMJ 2022;378:o1993 https://www.bmj.com/content/378/bmj.o1993

‘Stopping antidepressants’. Royal College of Psychiatrists. 2020. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Benoit You to discuss KELIM validation. Dr. You is a French medical oncologist at Lyon University Hospital, specialized in gynecological cancers, and the head of the drug development program of his institution (CITOHL-EPSILYON). Morever, he is the Director of a university research team involved in pharmacokinetics, and modeling analyses of the kinetics of serum tumor markers (EA 3738 CICLY). He is an active member of the French GINECO group, of the European ENGOT group, and of the international GCIG group.

Highlights:

- KELIM is the modeled CA-125 decline rate during the first 3 cycles of adjuvant or neo-adjuvant chemotherapy in first-line setting

- It is a pragmatic indicator of the tumor intrinsic chemosensitivity, easily calculable online on https://www.biomarker-kinetics.org

- KELIM is helpful to surgeons to anticipate the feasibility/complexity of complete interval debulking surgery after neo-adjuvant chemotherapy

- The analyses of ICON-7 and GOG-0218 trial datasets reproducibly showed that only the patients with unfavorable KELIM score < 1.0 had a survival benefit from bevacizumab among those with a high-risk disease

- KELIM may be a complementary tool to HRD status to select the best maintenance treatment in first-line setting, especially in patients with HRP cancer : PARP inhibitor expected to be effective in the case of favorable KELIM score ≥ 1.0 ; bevacizumab expected to be effective in the case of unfavorable KELIM score < 1.0

Editor-in-Chief of the Archives of Disease in Childhood, Dr. Nick Brown, and Senior Editor of ADC, Dr. Rachel Agbeko, bring you the monthly Atoms - the highlights of the April 2023 issue.

Read it on the Archives of Disease in Childhood website: https://adc.bmj.com/content/108/4/i

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

For interventional procedures that involve implanting devices or ablating tissues, it is common for patients to undergo prognostic tests to determine if they are responders prior to moving on to permanent procedures. However, definitions of responders and the number of prognostic tests necessary has caused some confusion. In this month’s RAPM Focus, Editor-in-Chief Brian Sites, MD, joins David Provenzano, MD, and Jozef Leech, to discuss their study “Evaluation of lumbar medial branch blocks: how does the second block influence progression to radiofrequency ablation?,” first published in July 2022 (https://rapm.bmj.com/content/47/12/719). In a single-center retrospective review, 224 patients with two consecutive local anesthetic-only blocks were examined for pain relief.

Dr. David Provenzano is president-elect of the American Society of Regional Anesthesia and Pain Medicine. He is currently an adjunct associate professor at the University of Pittsburgh, is on the executive committee of the Western PA Surgery Center, and is a critical member of the editorial board at Regional Anesthesia & Pain Medicine.

Jozef Leech is a native of Johnstown, PA, and graduated from Washington & Jefferson College in 2020 with his Bachelor of Arts in biology. He completed 2 years of internship work with Dr. Provenzano at Pain Diagnostics and Interventional Care located in Pennsylvania. In August of 2022, Jozef started Kent State University College of Podiatric Medicine in Independence, OH. He is an active member with the American College of Foot and Ankle Surgeons.

*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.

Fatigue can have as much of an affect in your ability to function as alcohol, and yet while you would be chastised for drinking before appearing on the ward, hospitals have systematically removed the spaces where tired clinicians can rest and recover.

The Royal College of Anaesthetists have been campaigning to raise awareness of the dangers of fatigue, and it seems that anaesthetic trainees have benefitted from that, with sleep pods and flexible schedules - but other specialties are lagging behind.

In this podcast, Roo McCrossan, a consultant anaesthetist joins our host Clara Munro, a surgical trainee, and Ayesha Ashmore, obstetric trainee, to talk about how to fight fatigue. They discuss circadian rhythms, what to eat, nappuccinos, and why trusts should make more sleeping spaces.

For more information about fighting fatigue;

https://anaesthetists.org/Home/Wellbeing-support/Fatigue/-Fight-Fatigue-download-our-information-packs

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the April 2023 issue of the journal (https://pn.bmj.com/content/23/2/103).

Please subscribe to the Practical Neurology 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 Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).

The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole.

Thank you for listening.

In this episode of the IJGC podcast, Editor-in-Chief, Dr. Pedro Ramirez, is joined by Drs. Vandré Carneiro and Glauco Baiocchi to discuss the LESSER trial. Dr. Carneiro is the head of the Department of Gynecologic Oncology at the Instituto de Medicina Integral Professor Fernando Figueira (IMIP). He is also Director of the Department of the Hereditary Cancer Program of Hospital de Cancer de Pernambuco. Dr. Baiocchi is the head of the Department of Gynecologic Oncology at the AC Camargo Cancer Center. He is also the president of the Brazilian Gynecologic Oncology Group – EVA Group.

Highlights:

- Hysterectomy is safe and potentially non-inferior to modified radical hysterectomy in early-stage cervical cancer.

- The LESSER supports simple hysterectomy as a substitute for radical hysterectomy in patients with cervical cancer ≤2 cm.

- The SHAPE trial will provide more concrete data on the role of simple hysterectomy for early-stage cervical cancer.

In this episode Dr. Kate Diomede, social media editor at Thorax, speaks with Prof. Andrew Bush(1) about the state of paediatric treatment for thoracic issues, including discussion of cystic fibrosis and asthma.

Hear the previous discussion with Prof. Ian Hall on the future of respiratory medicine: https://on.soundcloud.com/yb7pJ

(1) Consultant paediatric chest physician at Royal Brompton Hospital;

Professor of paediatric respirology, National Heart and Lung Institute, Imperial College London.

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.

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.

From the lingering effects of the pandemic to ongoing industrial action, it is a turbulent time to be working in healthcare. As medical students about to start working in this profession, it can feel really overwhelming and daunting to think about our future careers in the NHS.

Today we’re going to be talking about all the things we’re worried about when it comes to the current NHS crisis. Our expert guest, Elisabeth, will pull in evidence from interviews with junior doctors and healthcare leaders to get a broader sense of the current situation. We also reached out to the rest of the panel, and other medical students on social media, to hear more about their concerns too.

Expert guests:

Elisabeth Mahase is the clinical news reporter for the journalism team at The BMJ. She previously worked at GP magazine Pulse and has a background in Science Communication and Biomedical Science.

Check us out on social media:

Twitter: https://twitter.com/BMJStudent

Instagram: https://www.instagram.com/bmj_student/

Facebook: https://www.facebook.com/BMJStudent/

This podcast is produced and edited by Dom Byrne and Duncan Jarvies.