JournalSpotting

The inspirational Dr. Sangita Agarwal (Rheumatologist) & Dr. Boris Lams (Respiratory), inflammatory lung specialists, take us through our emerging understanding of the complications of COVID-19: 

• Hyperinflammation
• ARDS
• Haemophagocytic lymphohistiocytosis (HLH)

Introduction
Background to the lung inflammation service (03:02)
The secret to the dynamic duo and navigating disagreement (05:15)

HLH: Haemophagocytic lymphohistiocytosis
HLH: what is it and why is it relevant in COVID-19 "The power of the immune system" (06:40)
Common triggers of HLH (08:40)
Screening for HLH and The H score (09:08)
Investigations for HLH and the return of ferritin (13:43)

ARDS
The basics of ARDS. Subtypes: "normal & atypical" (16:45)
HLH and ARDS (19:47)
COVID driving ARDS and the possible subtypes of "COVID ARDS" (20:40)

Hyperinflammatory COVID-19 & Therapies
Steroids and severe COVID-19 (28:05)
Potential therapies targeting the abnormal host response (32:01)
Lung fibrosis (38:54)

Conclusions
Take-home points (44:20)
TIME IS LUNG! (46:12)

Buzzwords
#Trialtastic
#Inflammologist
#TimeIsLung
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Get in touch!
 @JournalSpotting or [email protected]
We’d love to hear from you: what you thought of the show, what you would like to hear, and if you have any articles that you would like us to share with the general medicine world!
 A wise man at your ARCP once said: "It didn't happen unless you've filled in a feedback form". (But seriously, we'd love to hear what you think!)

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Welcome to the COVID-ZONE
--------------------------- 
Journalspotting is here to bring you important clinical updates on coronavirus.
Get in touch: [email protected]
Twitter @JournalSpotting
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In today's episode:

#Transmision models: out with the old and in with the new
- Turbulent gas clouds
- Barney's Jigglypuff work shelf
- Presymptomatic transmission
- Jogging with COVID-19


#Treatment update: Remdesivir, convalescent plasma, RECOVERY trial
- Remdesevir: NEJM paper, orphan status, STAT news

#Cover your face(mask)
- BMJ analysis
- How good are cotton masks?

#Coagulopathy & COVID-19
- Cui et al + D-Dimer pooled analysis
- ISTH Interim guidance
- The dutch anticoagulate

Covid rants
- Donald Trump cuts WHO funding
- 5G conspiracy + app ideas

Covert Covid Distractions
- Explicit lyric warning!!

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We welcome the incredibly enthusiastic and positive medical educator Dr. Anita Banerjee, consultant in obstetric medicine (and covidologist in training)

Anita takes us on a comprehensive tour of covid-19 and pregnancy based on both the latest literature and her own clinical practice.
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Pregnancy & Covid-19:

~How does pregnancy affect the clinical presentation of covid-19?

~Are there any risks to the baby?

~What are the key investigations for a pregnant woman with suspected covid-19? How do they differ from non-pregnant patients?

~What are the management considerations including thromboprophylaxis, oxygen therapies, and delivery of the baby?
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**Pregnancy and covid-19 resources**

RCOG guidelines: Coronavirus, pregnancy and women’s health.

Royal College of Physicians toolkit; Managing acute medical problems in pregnancy
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JournalSpotting wants to pay tribute to our NHS colleagues....

We know that at journal spotting sometimes we err on the lighter side of medicine...but we wanted to take this opportunity to express our condolences for the lives of NHS workers lost to coronavirus. 

It seems particularly pertinent to highlight Mary Agyapong, a 28-year-old nurse at Luton Hospital who passed away on the 12th of April. She was pregnant and her baby was delivered by C-section and is reportedly doing well.

Our thoughts are with her family and she has a gofundme page to support Mary, her newborn baby girl.

We are going to end this week's episode with the wonderful Lewisham and Greenwich NHS Choir who have sung a special rendition of their number one hit ‘A Bridge Over You’ paying tribute to those who have given their lives to save others.
https://youtu.be/horE5bH9SCg

Support the show

Visit the website on www.journalspotting.com.
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Email us on [email protected].
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Share us with all your colleagues!

Are you trying to keep up with the general medicine literature but you are saturated with Covid Coughs, Swabs, Oxygenation, Isolation, Ventilation, and the Mortality of the Nation? Your ears are in the right place as we bring you last months most relevant
(and sometimes less relevant) general medicine articles.
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In this month's episode...

...why we shouldn't leave all the cycling to work to the anaesthetists...
Association of injury-related hospital admissions with commuting by bicycle in the UK: a prospective population-based study. BMJ.
https://doi.org/10.1136/bmj.m336

...ACEI/ARBs shine through some difficult COVID related PR...
Qiao, Yao et al. “Association Between Renin-Angiotensin System Blockade Discontinuation and All-Cause Mortality Among Persons With Low Estimated Glomerular Filtration Rate.” JAMA internal medicine, e200193. 9 Mar. 2020, doi:10.1001/jamainternmed.2020.0193

...a new treatment regimen injects some life into HIV care...
Orkin, Chloe et al. “Long-Acting Cabotegravir and Rilpivirine after Oral Induction for HIV-1 Infection.” The New England journal of medicine vol. 382,12 (2020): 1124-1135. doi:10.1056/NEJMoa1909512

....the ISCHAEMIA trial, morbidly expensive but no extra mortality...
Maron, David J et al. “Initial Invasive or Conservative Strategy for Stable Coronary Disease.” The New England journal of medicine vol. 382,15 (2020): 1395-1407. doi:10.1056/NEJMoa1915922

...brush up on treatment options for CFS/ME...
Kim, Do-Young et al. “Systematic review of randomized controlled trials for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).” Journal of translational medicine vol. 18,1 7. 6 Jan. 2020, doi:10.1186/s12967-019-02196-9

...a few pearls to help with your ICU redeployment...
Lee, Robert Y et al. “Association of Physician Orders for Life-Sustaining Treatment With ICU Admission Among Patients Hospitalized Near the End of Life.” JAMA, vol. 323,10 950–960. 16 Feb. 2020, doi:10.1001/jama.2019.22523

Lamontagne, François et al. “Effect of Reduced Exposure to Vasopressors on 90-Day Mortality in Older Critically Ill Patients With Vasodilatory Hypotension: A Randomized Clinical Trial.” JAMA, vol. 323,10 938–949. 12 Feb. 2020, doi:10.1001/jama.2020.0930

...and finally, the great medical conundrum of our time...
Ukai, Tomohiko et al. “Habitual tub bathing and risks of incident coronary heart disease and stroke.” Heart (British Cardiac Society), heartjnl-2019-315752. 24 Mar. 2020, doi:10.1136/heartjnl-2019-315752
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Get in touch!
 @JournalSpotting or journalsp

Support the show

Visit the website on www.journalspotting.com.
Follow us on Twitter @JournalSpotting.
Email us on [email protected].
Get our JournalClub App on https://journalclub.messly.com
Share us with all your colleagues!

Welcome to the COVID-ZONE. 
Journalspotting is here to bring you important clinical updates on coronavirus.
Get in touch: [email protected]
Twitter @JournalSpotting

In today's episode:

#ACE inhibitors and angiotensin receptor blockers- do they worsen COVID-19? 
https://doi.org/10.1016/j.cell.2020.02.052 
ESC position statement 

#The NSAID controversy 
https://doi.org/10.1016/S2213-2600(20)30116-8 
EMA statement 
French pharmacovigilance of ibuprofen 
MHRA alert  
Indomethacin and SARS CoV-1 

#Lopinavir/Ritonavir falls at the first hurdle 
https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001282?articleTools=true 

#Chloroquine/Hydroxychloroquine get a big endorsement 
Systematic review on the efficacy and safety of chloroquine for treatment of COVID-19 
Letter in Bioscience trends 10.5582/bst.2020.01047 
In vitro study of chloroquine: https://www.nature.com/articles/s41422-020-0282-0 

#How good are the swabs? 
https://jamanetwork.com/journals/jama/fullarticle/2762997 

#Anosmia is the new normal: Will I ever smell again? 
https://www.entnet.org/content/coronavirus-disease-2019-resources 

#Coronavirus likes plastic, hates pennies: which surfaces should I be wiping down? 
https://pubmed.ncbi.nlm.nih.gov/32182409/ 

#Modelling studies that matter   
https://www.bmj.com/content/bmj/368/bmj.m1216.full.pdf 
https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/ 
Oxford modelling  

#Covert COVID Distractions 
Because isolation can bring out a sense of humour in us, and we all need a distraction!

Support the show

Visit the website on www.journalspotting.com.
Follow us on Twitter @JournalSpotting.
Email us on [email protected].
Get our JournalClub App on https://journalclub.messly.com
Share us with all your colleagues!

Did you spend that extra leap year day in February keeping up with the medical literature? No? No problem, we’ve got you covered with a fresh look at the month's most relevant and interesting Gen Med articles.
---------------------------
Get in touch!
 @JournalSpotting or [email protected]
We’d love to hear from you: what you thought of the show, what you would like to hear, and if you have any articles that you would like us to share with the general medicine world!
 A wise man at your ARCP once said: "It didn't happen unless you've filled in a feedback form". (But seriously, we'd love to hear what you think!)
---------------------------
 In this month’s episode:

 …NELSON sails the high seas of lung cancer screening…

de Koning, Harry J et al. “Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial.” The New England journal of medicine  https://pubmed.ncbi.nlm.nih.gov/31995683/

…the rise and rise of the NOAC…

 Inohara, Taku et al. “Decline in renal function and oral anticoagulation dose reduction among patients with atrial fibrillation.” https://pubmed.ncbi.nlm.nih.gov/31911503/

 Kuno, Toshiki et al. “Oral Anticoagulation for Patients With Atrial Fibrillation on Long-Term Hemodialysis.” Journal of the American College of Cardiology https://pubmed.ncbi.nlm.nih.gov/31976865/

 
…why we should all brush up on our drug side effect monitoring…

 Savage, Rachel D et al. “Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults With Hypertension.” JAMA internal medicine
https://pubmed.ncbi.nlm.nih.gov/32091538/ 

…Surely there’s more to it than just steroids?...

 Dobler, Claudia C et al. “Pharmacologic Therapies in Patients With Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-analysis.” Annals of internal medicine. https://pubmed.ncbi.nlm.nih.gov/32092762/

 …when the question is steroids, might metformin be the answer?...

Pernicova, Ida et al. “Metformin to reduce metabolic complications and inflammation in patients on systemic glucocorticoid therapy” The lancet. Diabetes & endocrinology
https://pubmed.ncbi.nlm.nih.gov/32109422/

…to scope or not to scope for dyspepsia…
Sonnenberg, Amnon et al. “Low Prevalence of Helicobacter pylori-Positive Peptic Ulcers in Private Outpatient Endoscopy Centers in the United States.” The American journal of gastroenterology 

https://pubmed.ncbi.nlm.nih.gov/31972622/ 

***Irrelevantly relatively relevant articles*** 

Urinary Auto-brewery Syndrome: A Case Report https://pubmed.ncbi.nlm.nih.gov/32092761/

Sex rations & societal stress
https://pubmed.ncbi.nlm.nih.g

Support the show

Visit the website on www.journalspotting.com.
Follow us on Twitter @JournalSpotting.
Email us on [email protected].
Get our JournalClub App on https://journalclub.messly.com
Share us with all your colleagues!

Welcome to our first ever podcast!
We’re excited to bring you a fresh look at the last month's most relevant and interesting general medicine articles.
---------------------------
Get in touch!
@JournalSpotting or [email protected]
We’d love to hear from you: what you thought of the show, what you would like to hear, and if you have any articles that you would like us to share with the general medicine world!
A wise man at your ARCP once said: "It didn't happen unless you've filled in a feedback form". (But seriously, we'd love to hear what you think!)
---------------------------

In this month's episodes we cover:

...Sepsis treatment adjuncts: what works and (still) doesn’t work...

#Vitamin C still doesn’t work

Fujii, Tomoko et al. “Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial.” JAMA 2020
https://pubmed.ncbi.nlm.nih.gov/31950979/

#Ringers lactate finally settles the score with saline

Brown, Ryan M et al. “Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial.” AJRCCM 2019
https://pubmed.ncbi.nlm.nih.gov/31454263/

...A few articles to up your AF game…

#Booze and Atrial Fibrillation don’t mix well.

Voskoboinik, Aleksandr et al. “Alcohol Abstinence in Drinkers with Atrial Fibrillation.” NEJM 2020
https://pubmed.ncbi.nlm.nih.gov/31893513/

#Think twice about combining Aspirin & DOACs

Santulli, Gaetano. “In AF and stable CAD, rivaroxaban reduced cardiovascular events and mortality more than rivaroxaban plus an antiplatelet.” Annals of internal medicine 2020
https://pubmed.ncbi.nlm.nih.gov/31958820/

...Why that 2 am pneumothorax might not be quite so scary...

#To drain or not drain in spontaneous pneumothorax treatment

Brown, Simon G A et al. “Conservative versus Interventional Treatment for Spontaneous Pneumothorax.” NEJM 2020
https://pubmed.ncbi.nlm.nih.gov/31995686/

BTS pneumothorax guidelines: https://thorax.bmj.com/content/65/Suppl_2/ii18

...A few Quickfire JournalSpots...

Ascitic taps in cirrhosis: https://pubmed.ncbi.nlm.nih.gov/31688022/
BSG Ascites Guidance: https://www.bsg.org.uk/clinical-resource/bsg-guidelines-on-the-management-of-ascites-in-cirrhosis/

Gram-negative bacteraemia: https://pubmed.ncbi.nlm.nih.gov/30535100/

N95 masks vs. surgical masks for flu: https://pubmed.ncbi.nlm.nih.gov/31958821/

...And at the end of the shift...

#Why coffee could get you home safely after a night shift

Support the show

Visit the website on www.journalspotting.com.
Follow us on Twitter @JournalSpotting.
Email us on [email protected].
Get our JournalClub App on https://journalclub.messly.com
Share us with all your colleagues!