Are you well aware of the health risks to adults from air pollution, but want to know more about the risk to pregnant women and their unborn children?

Your ears are in the right place.

The wonderful Professor Cathy Thornton helps us pick apart:

The effects of air pollution on mothers, fetuses and pregnancy outcomes.
The long-term effects on children.
The evidence behind this.
What you can do to help.

We will be having a break from JournalSpotting for a few months! But don't unsubscribe. We may well be back in a few months, and better than ever. xx

Support the showVisit the website on www.journalspotting.com.
Follow us on Twitter @JournalSpotting.
Email us on journalspotting@gmail.com.
Get our JournalClub App on https://journalclub.messly.com
Share us with all your colleagues!

View Details

Wondering how we have reached 2023, you still are the only one in the hospital who can do an LP overnight, half your patients have dementia with no cure, and people are still researching vitamin C?

Your ears are in the right place

Dr Barney Hirons flies solo and covers:

The best dementia trials from the last few months:

Blood pressure reduction reduces risk.

Ultra-processed food worsens cognition.

Correcting hearing loss corrects the risk.

Ketones for Alzheimer’s. Really?

Lecanemab in Alzheimer's **- the blockbuster and why it IS important.

Others:**

Vitamin C in pregnant smokers. Save the baby's lungs!LP after -ve CT in SAH. No need?

View Details

Aware that microplastics are bad for the environment but want to better understand their effects on human health?

Your ears are in the right place.

We chat with the brilliant Professor Barbro Melgert from the University of Groningen, Netherlands.
Don't know her? She is an expert performing cutting-edge research on the effects of microplastics on humans and shares with us her fascinating, if not daunting, findings.

We cover:
What microplastics are.
How they form.
Where they are found (spoiler... EVERYWHERE).
Why what you wear matters.
Their effect on the environment.
What her research has shown and the consequences for human health.
What you should do to reduce risk and plastic.

And... Ventilate ventilate ventiliate!

View Details

Love a Christmas tune? Ever wondered if the lyrics are detrimental or beneficial to health?
Your ears are in the right place!

LJ and Barney, with help from Jon, performed a thematic analysis of the top 41 Christmas song lyrics from 2021, then completed a semi-systematic review analysing their risks and benefits to health!

The conclusion? A list of recommendations on which songs to listen to, and which to avoid based on their underlying health messages.

We cover the risks and benefits of:
Alcohol and sugar binging,
Cold exposure,
Kissing,
Chestnuts,
Indoor fires,
Giving vs consumerism,
Turkeys,
Loneliness,
Singing & dancing,
Inequality & war,
& MORE...!

All references are on this shared Google Doc.

Merry Christmas Journal Junkies!!

View Details

Worried that the ocean is dying, and your favourite dolphin may well become extinct?! Want to know what you can do to help?

Your ears are in the right place

Firstly LJ and Barney outline the good and bad of COP27.

Barney then interviews the inspiring Dr Richard Hixson, chair of Healthcare Ocean.

We cover:
Why the oceans are essential for the planet.
Why the oceans are at risk.
The biggest problem sources.
The role of healthcare.
The importance of NHS procurement, and what needs to change.
What YOU can do as a healthcare professional!

Interested in sunscreen which has been proven safe for the ocean reefs? Aethic is recommended by Richard (and as far as we know he has no investment in them)!

View Details

Barney, LJ, and Jon are back with all the most interesting and practice-changing articles published in the last month:

💉Should I exercise before my next COVID Jab?
Does magnesium work in COPD exacerbations and should we give fewer antibiotics?
📽Is a colonoscopy a good way to screen for cancer?
🧂Should we restrict salt in HFPEF?
Why does skin colour matter when it comes to CPR?

🕺Things you can do:

Support the show by buying us a coffee (or monetary equivalent)!
Visit the website
Follow us on Twitter @JournalSpotting.
Email us : journalspotting@gmail.com.
Get our JournalClub App

View Details

Want to understand the planetary impact of the medications you prescribe, whilst enjoying your high tea?

Your ears are in the right place.

ClimateZone host Dr LJ Smith discusses the role of pharmacy with the awesome Tracy Lyons and Minna Eii, co-founders of the excellent organisation Pharmacy Declares.

In the interview, we discuss:
Carbon lifecycles of medications.
How Carbon is not the whole problem.
How climate change is affecting procurement and storage of vital meds.
What healthcare professionals NEED to do.
Ideas for QIPs!

After:
The JournalSpotters chat about their latest Climate Challenge - making a Climate Haiku!

View Details

Wondering what to do with the post-op patient in front of you with new AF, who drinks buckets of tea, takes multivitamins for dinner, and is just getting over pneumonia?

Your ears are in the right place.

Jon and Barney tackle 2 topics of recent research: latest evidence in diet and 'secondary' AF.

Articles we digest for your spongey brains:

Diet etc:
Tea reduces mortality! MortaliTEA!
Flavanoids in CVD / cerebrovascular disease
Link with Ca and hot tea
Time-restricted eating vs not
Fasting in cancer
Bin the vitamins: paper and editorial

'Secondary' AF:
AF post pneumonia risk
AF peri-surgery risk

Follow us, rate us, share us... go on Journal Junkies, you know you want to!

Support the show by buying us a coffee (or monetary equivalent)!

Support the show

View Details

Want to get active fighting Climate Change, but need some inspiration on things to do, people to talk to and a large dose of Climate Joy?

Your ears are in the right place.

We talk to the incredible medical students:
MEHAJABEEN FARID,
MARINA POLITIS,
&
LIZZIE O'BRIEN.

They are fighting Climate Change. This wide-ranging discussion covers COP26, activism, medical education, Climate anxiety, Climate Joy, the pressure on the younger generation, and how YOU can get involved.

LJ and Barney also discuss tips on talking to work colleagues and the next climate challenge!

Follow on Twitter, share with you friends, rate us all over the place and keep active in fighting climate change by whatever means you can.

View Details

Were your school teachers right? Are psychedelics really dangerous tree hugging hippy drugs? Or are they safe medications that might play a crucial role in modern medicine?

Your ears are in the right place.

Fascinating discussion with psychedlic medicine expert Prof Allan Young on:

The history of Psychedlics.
How they work.
The evidence behind them.
The risks & the benefits.
What is currently being investgated.
What the future holds.

Get up to date.

Help us grow! Share us everywhere and rate us wherever you listen!
Follow us on Twitter @journalspotting.

View Details

Confused over which drink to offer your patients? Orange juice or Coffee? Is the sugar bad for them, or is caffeine worse? Which has more fibre? Don’t those septic people need vitamin C?

**Your ears are in the right place.

Dr Camille and Barnaby Hirons cover the latest and greatest in the medical literature including:**

4-hour ED targets - useless government orders or life savers?Choosing wisely - the most low-value care which we need to scrapThunderstorm Asthma - it exists! And it may pose a real issue for patientsYoga for Migraines - can it help?Magic mushroom safety and the Latest on Psychedelic medicationsVit C in sepsis. Forget it.Coffee reduces mortality, but what if you add sugar?
Pulse oximetry in patients of colour - still a problem: first and second studyPickle juice in leg cramps**... surely not?!

Check up our follow-up interview with psychedelic expert Prof Allan Young****... coming soon!

View Details

Feel even more anxious about the climate crisis after the termostat hit 40 degrees? Your ears are in the right place.

LJ interviews the inspiring Dr. Rosie Spooner

We cover:
How the climate crisis will affect children and their health
How to talk about the climate crisis with children
How to find hope while facing the climate crisis.

The CliamteZone team then discuss their latest challenge: try and cut out fast fashion!

Excellent links for you to browse, amuse and amaze:

Children, Cities and Climate LSHTM Report
RCPCH position statement on the impact of climate change on global child health
A coping review of climate change and child health

The good on you website

View Details

Warning the experiences and stories described may be disturbing for some listeners.
Are you trying to imagine what it might be like for a medic, maybe such as yourself, on the front line of a war? Do you want to understand how you can help?

Your ears are in the right place.

We speak with Taras, a doctor working in the closest hospital to the frontline in the South of Ukraine.
He takes us through his life, his daily routine, the cases he sees and the devastating impact this is having on the society around him.
We discuss the pressures he is experiencing, and his views on where money from charities should go.

His recommended charity for donations: United24

Subscribe / rate on Spotify / Apple.
Follow us on Twitter / Instagram.
Send us FEEDBACK JournalSpotting@gmail.com.
Share with your pals/colleagues/random groups on WhatsApp.

View Details

Wondering if you should get that X-ray on your pregnant lady who is suffering from hip pain whilst doing Tai Chi, which is associated with inpatient hypertensive spikes that might (just might) be related to your bad singing?

No?

Well, your ears are still in the right place.

Today you have Jon, Barney and Alvin delving into the latest and greatest of medical literature!

We cover:

Steroid injections for OA - sure?
Radiology in pregnancy - risky?
Pregnancy HTN - treat?
IP Hypertensive episodes - leave?
Radiofrequency denervation for HTN - maybe not when on call?
Aspirin cessation and use in primary prevention - stop?
Music for mental and physical health - sing!
Tai chi or Muscle strengthening - do!
Nasal Swab or rectal exam for cardioversion?! Hmmmm.....

As always:
Subscribe / rate on Spotify / Apple.
Follow us on Twitter / Instagram.
Send us FEEDBACK JournalSpotting@gmail.com.
Share with your pals/colleagues/random groups on WhatsApp.

View Details

Worried about the effect the awful war in Ukraine is having on their doctors and healthcare system? Want to hear their experiences first-hand and find out how you can help?

Your ears are in the right place.

A change from our usual Round-Ups and Climate shake-ups, today we talk candidly to two inspiring Ukrainian doctors.

Dr Andrei Semikhodskii: A geneticist living in England, who set up a wonderful charity which sends ambulances with bespoke medicine and equipment directly to Ukrainian hospitals that need it most.
Links:
JustGiving Page click here.
King's Health Partners Lifelines page.

Professor Uliana Pidvalna: Living in Lviv, she talks openly about life as a doctor in Ukraine, how medics are coping, and the cases they are seeing. We also discuss the incredible positive and determined attitude of Ukrainian people!
Links discussed:
Defend Ukraine site - a large number of verified and official charities.
Medical supplies charity sites, here and here

If you like this episode, let us know and we will make more! Twitter @JournalSpotting, or email journalspotting@gmail.com!

View Details

Want to hear key medical literature facts to help become that awesome doctor, whilst also being able to tell if people like beer by their facial expressions?

Your ears are in the right place.

Dr LJ Smith, Dr Camille Hirons, Dr Jonathan Hudson and Dr Barnaby Hirons scour and digest the latest and greatest medical literature out there... and some other fun stuff too:

Why pulse oximeters miss deadly hypoxia in people of colour.

How paracetamol and sodium can kill.

Are sweeteners a safe alternative to sugar?

Empagliflozin in acute heart failure - EPULSE trial.

Should we be banning tanning salons?

Metoprolol vs Diltiazem in AF with RVR?

How much exercise to save lives?

Drug induced liver injury causes.

Facial expressions drinking beer!

Tell us what you think! Twitter @JournalSpotting, journalspotting@gmail.com, www.journalspotting.com.
Rate us on apple podcasts or spotify.
Share us everywhere.

Want a free JS mug for your doctors’ mess? Just get in touch.

View Details

Want to do more to combat climate change but current events and your state of Weltshmerz is holding you back? Do you need some positive practice-changing, actionable advice?
Your ears are in the right place!

LJ and Katia interview the brilliant Dr Alex Wilkinson.

We cover:
The huge carbon cost of inhalers.
The key stats and evidence.
Why change is needed and how to make it.
Barriers to change and how to overcome them.

With Barney & Jon we discuss our latest climate challenge- contacting MPs about a Climate Issue- hear how we got on and get advice on how to proceed.

Excellent links for you to browse, amuse and amaze:
Alex's articles:

The environmental impact of inhalers for asthma; a green challenge and a golden opportunity.
Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England.

Clots & COVID-19 Vaccines # High flow Oxygen in suspected ACS

Delaying dialysis in severe AKI

Contrast-induced nephropathy****: fact or fiction?

Another Vitamin D study # Inhalers for COVID-19

Shortening antibiotic courses in CAP

When to restart a DOAC after bleeding

--------------**
Get in touch via Instagram, Facebook, Twitter, or journalspotting@gmail.com.

View Details

The JournalSpotters chat to the fist author of the ATTIRE trial, a big RCT looking at albumin use in cirrhosis patients.

Dr. Louise China is a senior clinical fellow at the Royal Free Hospital, London and has spent many years investigating the role of albumin in patients with liver cirrhosis.

We chat to Louise about:

An overview of decompensated cirrhosis
When to use Albumin in patients with cirrhosis
The design of the ATTIRE trial
What can we learn from the ATTIRE trial
Top tips for managing patients with cirrhosis
Advice for medics looking to get involved in research

A big thank you to Lousie for taking some time out of her busy job as a hepatologist (and her time dreaming of being back scuba diving)!

China L, Freemantle N, Forrest E, Kallis Y, Ryder SD, Wright G, Portal AJ, Becares Salles N, Gilroy DW, O'Brien A; ATTIRE Trial Investigators. A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis. N Engl J Med. 2021 Mar 4;384(9):808-817. doi: 10.1056/NEJMoa2022166. PMID: 33657293.

View Details

Have you been wondering how that busy congested main road you commute along every day is bad for your health and the health of your patients?

We chat with Professor Frank Kelly world expert on the impact of air pollution on health. This conversation will help us better understand how these pollutants are a dangerous exposure for many diseases and what is being done about it.

We discuss:

What are the different kinds of pollutants in the air?
How we established a causal link between air pollution and health outcomes?
What are the key organ systems affected by air pollutants?
What is the current status in London, the UK, and the world regarding our ability to mitigate the effects of air pollution?

Important links:
London air: a world-class air monitoring network
Breathe London: the app to help people navigate air pollution
The famous six city study
The Oxford Street study

For more episodes check out: journalspotting.com

View Details

For full show notes and more check out journalspotting.com

Trying to keep up with the medical literature but

SQUIRREL!! .... You keep getting distracted?

Your ears are in the right place.

Happy International Women's Day! Check out our chosen inspirational women:

Dr Marlies Ostermann
Dr Elizabeth Blackwell
Anna Jones
Mothers everywhere!

This month Jon and Barney are accompanied by Dr. Katia Florman and Dr. Camille Hirons as we cover a HUGE selection of impressive and practice-changing articles.

Journal Junkies, get your fill:

Our blockbuster: Semaglutide in obesity. A gamechanger.

The cost of liberal oxygen in COPD

Avacopan in ANCA associated vasculitis

Hb targets and transfusions in MIs

Rate of PEs in COPD

The risk of antibiotic UTI prophylaxis

Probiotics for Parkinson's constipation

NOACS vs Warfarin and Dementia risk

AF screening and deep learning AF / Stroke prediction

Fossil Fuels mortality

Why 5 fruit & veg is probably enough

Phew! That's a lot to cover... Thanks JounalSpotters!

Don't forget to review us on apple and get in touch on Twitter, FB and Instagram @JournalSpotting

View Details

This is part 2 of our BTS Winter 2021 special.

The JournalSpotters packed their virtual backpacks and headed to the British Thoracic Society’s Winter Conference 2021. This a huge international conference, covering all things lung.

We've brought together some of the best speakers along with some new JournalSpotters to bring you all the best update and pearls from the conference.

In part 2 we cover:

Air pollution and the havoc it is causing in the UK, in Africa and in the World. We discuss the cost of the NHS amongst all this, particularly focusing on inhalers. We talk about what we can all do about it and why there is reason to be hopeful!

Featuring:

Dr. Laura-Jane Smith, Respiratory Consultant.
Claire McBrien, Respiratory Registrar
Vicky Tayler, Respiratory Registrar
Emma Lombard, Respiratory trainee

A big thank you to all our speakers and contributors:

View Details

The JournalSpotters packed their virtual backpacks and headed to the British Thoracic Society’s Winter Conference 2021. This a huge international conference, covering all things lung.

We've brought together some of the best speakers along with some new JournalSpotters to bring you all the best update and pearls from the conference.

In part 1 we cover:

Discrimination in COVID times
The cost of COVID to our healthcare services,
D-dimers in COVID,
Post TB lung disease,
Why the circadian rhythm really is important clinically
Top pleural facts.

Featuring:

Dr. Jamilah Meghji- clinical academic respiratory medicine
Dr. Marina Soltan- NIHR Respiratory Registrar
Dr. Sam Bartlett-Pestell- Respiratory Registrar
Dr. Stefano Palazzo- Respiratory Registrar
Dr. Amy Downes- Respiratory Registrar

A big thank you to all our speakers and contributors!

View Details

Have you been trying to keep up with the medical literature, but you don’t have the time, don’t know where to start, and would like someone to do the legwork for you?

Your ears are in the right place.

We cover:

Alteplase and improved stroke outcomes
Tranexamic acid and SAH
Ablation trial AF
AAA and fluoroquinolones
Occult blood and risk of ischaemic stroke
Faecal transplant for melanoma
Gut microbiome and link to depression
Low socioeconomic status and cardiac arrest
Type 2 MI medications
Surgery and type 2 diabetes
Oxygen saturation and ethnicity
Topical steroids
Acute appendicitis and antibiotics

Get in touch:
Twitter, Facebook, Instagram, or journalspotting@gmail.com

View Details

Looking for the right gateway drug to help start up an insatiable medical literature habit?

JournalJunkies, your ears are in the right place!

Today we interview Dr James Galloway, rheumatologist, semi- ornithologist, clinical lecturer, and head of the TACTIC trial at King's Hospital.
He helps guide us through the mysteries of immunomodulation in COVID in understandable terms. What do the trials show us? Why? And, what is on the COVID horizon?

02:00 Introductions
02:45 Why the birds aren't coming to your garden
04:45 The Recovery Trial
08:00 Why Steroids?
09:35 REMAP CAP
13:45 The conflicting Tocilizumab data
17: 40 What is Tocilizumab and why might it work?
24:50 The value of CRP monitoring
27:00 Who to give Tocilizumab to
29:40 TACTIC trial
34:30 Why study SGLT2 inhibitors
37:00 The future Tx of Severe COVID
40:00 The JournalSpotting Gateway drug

View Details

Have you been trying to keep up with the COVID literature, but too shattered after work these days to read anything except the local take out menu?

Your ears are in the right place, we help you get up to date on what you need to know in COVID-19, including:

TOCILIZUMAB: Why it's been approved and when you might be using it.ICU DELIRIUM: Why you should put the benzos away and get the iPad out.ASYMPTOMATIC TRANSMISSION:What percentage of your family actually had COVID at Christmas?VENOUS THROMBOEMBOLISM: Wondering why everyone is messing around with the prophylaxis dose?OXYGEN: is it safe in the early 90's?PRONING: what's the point and do patients actually do it?ACE INHIBITORS: can we finally declare them safe in COVID?

View Details

Want to know how to be more green at work, but you can only sigh as you plop your 1 millionth item of pristine plastic PPE from that morning into the bin?

Your ears are in the right place.

Today we interview Ms Chantelle Rizan; mountain biker, ENT fellow and environment warrior... She has published numerous articles on the topic of what healthcare does to our environment and, crucially, what we can do to improve it.

Timeline:
0200 Introducing Chantelle Rizan
0630 The situation with our environment
1130 Contribution of the NHS on the situation
1535 Impact of COVID pandemic on this
2130 The issues with surgery / theatres
2800 The role of waste disposal and recycling
3140 What is needed from organisation / government point of view?
3420 What can individual doctor do?
3910 Planetary Health edition of the Bulletin - thoughts and conclusions
4130 Take home points

Articles discussed:

Plastics in healthcare: time for a re-evaluationThe carbon footprint of waste streams in a UK hospital
The Carbon Footprint of Surgical Operations
Using surgical sustainability principles to improve planetary health and optimise surgical services following the COVID-19 pandemic

View Details

💊 STATINS...everyone's on them and lots of people stop them!

In this JournalChat, we caught up cardiologist Dr. James Howard, one of the co-authors of the SAMSON trial published in last months New England Journal of Medicine and featured in last months Round-Up.

James is a cardiology registrar at Imperial College, London. He chats to us about statin side effects, how the Nocebo effect might play a role, and how the SAMSON trial might help us better counsel patients about side effects. He also takes us behind the scenes of the N-of-1 trial design and we explore how it could be used in further trials and clinical practice.

❤️ The SAMSON trial was funded by the British Heart Foundation.

View Details

Trying to keep up with the general medicine literature but, in an environmentally friendly frenzy, you’ve used up all your shiny BMJs as wrapping paper?

Your ears are in the right place.
In this episode, Jon and Barney are joined by Alvin and Camille, and together we wade through the murky medical literature so you don't have to.

1) Blockbuster trial of the month: Semaglutide - the saviour of NASH? (04:40)
2) Bereavement and stroke - what is the link? (08:05)
3) Combo pill may, or may not, save us all (10:40)
4) Topic of the month: Statins in the elderly. Maybe the elderly benefit more than we think, and those side effects aren't as significant as your patient thinks... (13:10)
5) Which crystalloid in DKA? There can only be one winner. (19:00)
6) What's the link between sarcopenia and orthostatic hypotension? (21:18)
7) Natural remedies which might actually work in UC (24:05)
8) Inotropic drugs which could save lives in HFrEF (27:22)
9) Why you should check Vit D in your asthmatics (30:25)
10) Anticholinergic drugs and dementia risk (33:15)
11) A Case Study of ST elevation in a young patient (36:16)

View Details

Have you been trying to keep up with the medical literature, but you’ve been too busy trying to keep track of vote counts for Biden in small counties in Arizona you’ve never heard of?

We have an awesome Round-Up of the key medical articles from September with Katia and Alvin! Enjoy!

Finerenone: FIDELIO-DKD trialKDIGO guidelinesNighttime BP and adverse cardiovascular eventsNSBB cirrhosis Iron - vitamin C and heart failureSC-ICD; UNTOUCHEDHyponatraemia- SALSA
Intermittent fasting trial: TREAT trialMicrobleeds and embolic stroke of unknown sourceNaps for improving your brain function!

Irrelevant chat:
Chicken Dippaaaaz
Butterfield Diet

Find us on JournalSpotting.com, on Twitter / Facebook / Instagram @JournalSpotting

Leave a review on apple podcasts or email us any thoughts on journalspotting@gmail.com!

View Details

Trying to keep up with COVID literature but there are more important things to consider, like, is your pumpkin carved as Trump even orange enough?

Your ears are in the right place.

COVID-19 is back (and never actually left)! After a blockbuster opening run in the first half of 2020 taking the world by storm, it’s back with a sequel that promises to be even bigger, even more gripping, and maybe even more deadly.

We’re back to bring you the latest key COVID literature updates you need to know as you head out the door in the morning to face COVID-19.

In this update we cover:

SOLIDARITY trial
RECOVERY trial
REACT working group
ACTT-1
Convalescent Plasma
4C Score
Case Fatality Rate
Face Masks in the population
At-risk patient groups: ILD, Asthama, Immunosuppression
Ventilation masterclass
Beards and FFP-3
COVID-19 and domestic Dogs

View Details

Trying to keep up with the literature but you’re too exited IT'S AUTUMN! Whoo-Hoo!Oh wait, it’s cold, wet, and Christmas is still months away.
At least we have conkers.

We have an awesome Round Up of the key medical articles from September with Annalan and Katia! Enjoy!

Here are the timestamps:

Introductions 01:00
Colchicine for the heart 04:50
SGLT2s for everyone! 08:30
Coffee in colorectal Ca 13:10
Tumeric for arthritis 15:50
Once weekly insulins 18:30
OOH Cardiac arrests 20:00
Giant Cell Arteritis 22:45
Pollution kills 25:05
Morphine for COPD 29:00
Prasugrel vs Ticagrelor 31:45
Candy Case Study 35:42

Find us on JournalSpotting.com, on Twitter / Facebook / Instagram @JournalSpotting

Leave a review on apple podcasts or email us any thoughts on journalspotting@gmail.com!

View Details

Trying to read up on Latent TB but the thought of wading through complicated literature about a dormant bug makes you wish you were, well, dormant?

Your ears are in the right place!

A comprehensive Interview on everything you need to know about Latent TB with the mystical TB Guru of South London, Dr Ronan Breen!

0200 : Introductions
0300: Why Robber rob banks
0415: What is Latent TB (LTB)?
0600: LTB prevalence and who we should test
1145: IGRAs and our immune response
1230: Healthcare staff risk
1730: The patients choice
2110: Testing, Mantoux - pros and cons
2645: Progression to TB
3110: Excluding active TB
3930: Options for Tx
4430: CDC direction
4650: S/Es to watch for
5620: Future of LTB
5945: Take Homes

Literature:
NICE TB 2016 (updated 2019)
Risk of untreated LTB, BMJ
CDC treatment regimes
WHO on LTB

View Details

Have you been trying to keep up with the medical literature, but its eat out to help out, and nothing is getting in the way of 50% your favourite pizza joint?

In this months episode:

..How to use D-dimers to diagnose cerebral venous thrombosis...(04:17)Heldner, Mirjam R et al. “Prediction of cerebral venous thrombosis with a new clinical score and D-dimer levels.” Neurology vol. 95,7 (2020): e898-e909. doi:10.1212/WNL.0000000000009998

...Do we still need metronidazole for pneumonia?...(07:13)Marin-Corral, Judith et al. “Aspiration risk factors, microbiology and empiric antibiotics for patients hospitalized with community-acquired pneumonia.” Chest, S0012-3692(20)31905-X. 17 Jul. 2020, doi:10.1016/j.chest.2020.06.079

...Ambulatory pneumothorax management...(09:45)Hallifax, Rob J et al. “Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial.” Lancet (London, England) vol. 396,10243 (2020): 39-49. doi:10.1016/S0140-6736(20)31043-6

...SIADH management: more to it than just fluid restriction?... (16:37)Krisanapan, Pajaree et al. “Efficacy of Furosemide, Oral Sodium Chloride, and Fluid Restriction for Treatment of Syndrome of Inappropriate Antidiuresis (SIAD): An Open-label Randomized Controlled Study (The EFFUSE-FLUID Trial).” American journal of kidney diseases : the official journal of the National Kidney Foundation vol. 76,2 (2020): 203-212. doi:10.1053/j.ajkd.2019.11.012

...How harmful are steroid bursts?... (22:15)Yao, Tsung-Chieh et al. “Association Between Oral Corticosteroid Bursts and Severe Adverse Events : A Nationwide Population-Based Cohort Study.” Annals of internal medicine vol. 173,5 (2020): 325-330. doi:10.7326/M20-0432

...Candesartan's role in cognitive decline... (25:11)Hajjar, Ihab et al. “Effects of Candesartan vs Lisinopril on Neurocognitive Function in Older Adults With Executive Mild Cognitive Impairment: A Randomized Clinical Trial.” JAMA network open vol. 3,8 e2012252. 3 Aug. 2020, doi:10.1001/jamanetworkopen.2020.12252

...Weight loss: when do you go hunting for cancer?... (29:16)Nicholson, Brian D et al. “Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study.” BMJ (Clinical research ed.) vol. 370 m2651. 13 Aug. 2020, doi:10.1136/bmj.m2651

...Baloxavir: the antiviral no ones talking about...yet...(33:15)Ikematsu, Hideyuki et al. “Baloxavir Marboxil for Prophylaxis against Influenza in Household Contacts.” The New England journal of medicine vol. 383,4 (2020): 309-320. doi:10.1056/NEJMoa1915341

...Is race/ethnicity a factor in physician burnout?... (29:16)Garcia, Luis C et al. “Burnout, Depression, Career Satisfaction, and Work-Life Integration by Physician Race/Ethnicity.” JAMA network open vol. 3,8 e2012762. 3 Aug. 2020, doi:10.1001/jamanetworkopen.2020.12762

View Details

Are you trying to keep up with the latest medical literature but your journals keep getting blown away by the industrial fan you’ve bought to try and survive this sweaty heat wave? Your ears are in the right place! In this months episode:

...Tranexamic acid in UGI bleeding: more harm than good?...(04:35)HALT-IT Trial Collaborators. “Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial.” Lancet (London, England) vol. 395,10241 (2020): 1927-1936. doi:10.1016/S0140-6736(20)30848-5

...Cocoa beans in acute ischaemic stroke?...(08:15)Modrau, Boris et al. “Theophylline as an Add-On to Thrombolytic Therapy in Acute Ischemic Stroke: A Randomized Placebo-Controlled Trial.” Stroke vol. 51,7 (2020): 1983-1990.

...Ticagrelor for stroke prevention?...(12:40)Johnston, S Claiborne et al. “Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA.” The New England journal of medicine vol. 383,3 (2020): 207-217.

...Probiotics for your mood?... (16:28)Noonan S, Zaveri M, Macaninch E, et al Food & mood: a review of supplementary prebiotic and probiotic interventions in the treatment of anxiety and depression in adults BMJ Nutrition, Prevention & Health 2020

...Probiotics in care homes... (22:15)Butler, Christopher C et al. “Effect of Probiotic Use on Antibiotic Administration Among Care Home Residents: A Randomized Clinical Trial.” JAMA vol. 324,1 (2020): 47-56.

...Tofu to reduce mortality?... (25:11)Cai, Xiaoyan et al. “Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis.” BMJ (Clinical research ed.) vol. 370 m2297. 15 Jul. 2020,

...Coffee time: the facts and myths... (29:16)van Dam, Rob M et al. “Coffee, Caffeine, and Health.” The New England journal of medicine vol. 383,4 (2020): 369-378.

...Does MTX actually cause ILD?...(33:15)Juge, Pierre-Antoine et al. “Methotrexate and rheumatoid arthritis associated interstitial lung disease.” The European respiratory journal, 2000337. 9 Jul. 2020,

JOURNALBITES (38:13)Vitamin D & diabetes preventionAn app for cardiac arrestNoradrenaline dysregulates the immune responseAI & Skin disease...Putting the Ash in hand wASH...(42:40)
-------------------------------------
Check out the awesome infographics on Twitter @JournalSpotting or our website

View Details

Do you keep hearing numerous statistics about the mortality risk in COVID but want to know what the most robust data shows? How much of it is media hype? Can we really put
it down to racism?..

And what should we be doing about it??

Your ears are in the right place.

We interview the inspiring Professor Ewen Harrison; HPB surgeon, Lead for the Centre for Medical Infomatics at Edinburgh University, and Lead author of the impressive and essential study:
“Ethnicity and outcomes from COVID-19: the ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) CCP-UK (Clinical characterisation Protocol) prospective observational cohort study of hospitalised patients” Introduction to the JournalSpotters (01:00) Introduction to Professor Ewen Harrison (06:00) Why this study was needed (09:45) Ewen's role in the study (13:45) Success in enrolling (16:55) Extra information collected and studies awaited (18:30) What the study found (20:25) Role of Obesity (23:00) Difficulty of data interpretation (24:48)ICNARC report comparison with study and difference in outcomes for sex (27:00) What are the other key factors in South Asians apart from diabetes? (32:45) Role of deprivation / socioeconomic status (35:15) Limitations of study (37:30) What this means for policy makers (39:00) How this should impact healthcare professionals (40:40) Risk assessment tools (44:20) Data sharing / linkage (46:38) The role of racism in the findings (48:00) Ewen's top take home points (50:30)

Don't forget to check out Kosta's awesome Podpoint graphics on www.JournalSpotting.com, Twitter @ JournalSpotting, Instagram or Facebook.

View Details

Are you trying to keep up with the latest medical literature but now you can go out for dinner, go to pubs, and send your kids to school...oh wait no...they're still stuck at home...nevermind...your ears are still in the right place!

In this months episode:

...Lung ultrasound scans for heart failure follow up... (06:30)D. Araiza-Garaygordobil, R. Gopar-Nieto, P. Martinez- Amezcua, et al., A randomized controlled trial of lung ultrasound guided therapy in heart failure (CLUSTER-HF study), American Heart Journal (2020), https://doi.org/10.1016/ j.ahj.2020.06.003

...Depression and the risk of cardiovascular disease... (09:40)Rajan, Selina et al. “Association of Symptoms of Depression With Cardiovascular Disease and Mortality in Low-, Middle-, and High-Income Countries.” JAMA psychiatry, e201351. 10 Jun. 2020, doi:10.1001/jamapsychiatry.2020.1351

...The link between mental health and the immune system... (14:45)Shields, Grant S et al. “Psychosocial Interventions and Immune System Function: A Systematic Review and Meta-analysis of Randomized Clinical Trials.” JAMA psychiatry, e200431. 3 Jun. 2020, doi:10.1001/jamapsychiatry.2020.0431

...When to look for primary hyperaldosteronism?... (18:00)Brown, Jenifer M et al. “The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study.” Annals of internal medicine vol. 173,1 (2020): 10-20. doi:10.7326/M20-0065

...Migraines are not as benign as we might think... (22:56)Kurth, Tobias et al. “Association of Migraine With Aura and Other Risk Factors With Incident Cardiovascular Disease in Women.” JAMA vol. 323,22 (2020): 2281-2289. doi:10.1001/jama.2020.7172

...Technology takeover of T1 Diabetes care... (31:22)Agarwal, Shivani, and Anne R Cappola. “Continuous Glucose Monitoring in Adolescent, Young Adult, and Older Patients With Type 1 Diabetes.” JAMA vol. 323,23 (2020): 2384-2385. doi:10.1001/jama.2020.7058

...ICU outcomes in the elderly, not all bad news... (36:30)Haas, Lenneke E M et al. “Outcomes of Intensive Care Patients Older Than 90 Years: An 11-Year National Observational Study.” Journal of the American Geriatrics Society, 10.1111/jgs.16624. 27 Jun. 2020, doi:10.1111/jgs.16624

JOURNALBITES (42:00)Ketamine for rapid tranquillisationDiscrimination and hypertensionDOACs in end-stage renal failureClarithromycin + DOACs= bleedingHaloperidol for headachesPutting Type 2 diabetes into remission: DIRECT style....Hookworm & Multiple Sclerosis...Tanasescu, Radu et al. “Hookworm Treatment for Relapsing Multiple Sclerosis: A Randomized Double-Blinded Placebo-Controlled Trial.” JAMA neurology, e201118. 15 Jun. 2020, doi:10.1001/jamaneurol.2020.1118

Check out the awesome infographics on Twitter @JournalSpotting or our website

View Details

Are you trying to keep up with the COVID literature but by the time you’ve read one article you realise it was from one month ago and therefore is currently irrelevant?

Here we have the Brilliant Professor Beverley Hunt to help us wade through the literature, learn from her experience and figure out how we should be treating our COVID-19 patients relating to their bloody sticky blood.

Don't forget to subscribe to the podcast, and get regular emails by signing up on our website. Also on our website are the awesome Podpoint Graphics by Kosta for this episode and others!

www.JournalSpotting.com

01:00 Introduction to hosts / what we are talking about
03:30 Professor Beverley explains her role in COVID crisis
05:00 Why the blood is so sticky
06:40 How we have come to understand this
08:50 Rates & Cause of thrombosis - immunothrombosis
11:10 Why Dexamethasone helps
12:50 What thromboses do we see in patients?
15:10 Which patients are most at risk
16:35 And in pregnancy?
18:45 Which blood tests are useful? And the D-Dimer?
24:25 Which dose of LMWH? Call for trials
27:50 Rates of bleeding with LMWH
29:45 Are the thrombosis rates higher than other conditions?
30:45 OP / discharge Tx
33:20 Key Take Home Points for Bloody COVID
- Thromboprophylaxis on D1 admission!
- Enter your patients into trials
- Don't over treat with LMWH
- Sometimes the best is what existed before and had good evidence
35:00 An OBE for COVID?
35:15 Thank yous and sign offs

Want more info on Professor Hunt? Just google her name or find her on Twitter @bhwords.

Subscribe to regular JournalSpotting emails on our website!

View Details

We welcome Mr. Mahmood Bhutta an ENT surgeon who is an experienced campaigner in the fight for the ethical procurement of medical supplies.

We discuss how many of our medical supplies including PPE are produced in conditions that amount to modern slavery and how COVID-19 has affected this situation.

Important sources for the show:

BMA fair medical trade
Time for a global response to labour rights violations in the manufacture of health-care goods, WHO bulletin by Mr. Mahmood Bhutta
Clean Gloves, Dirty Practices: Debt Bondage in Malaysia's Rubber Glove Industry- The Diplomat article
Guardian article on slave-like conditions of glove industry

Show Notes

Background to the link between PPE & modern slavery (1:50)
The secret to Mood's fascinating and diverse career (04:08)
What is meant by modern slavery (08:04)
Mood's personal story on how he became interested in ethical procurement (09:05)
How involved is the NHS & the complexity of supply chains (10:50)
Working conditions in which medical supplies are made (14:24)
The glove industry (17:00)
How do we get reliable data? (20:08)
The effect of COVID-19 (22:35)
How is the NHS responding (26:15)
What can clinicians do? (28:05)
Plugs (36:20)
Take-home points (37:27)

View Details

Here at Journalspotting headquarters we sacrificed our vitamin d levels and frisbee skills during the sunny month of May, and have compiled an episode that will get you up to scratch with what you missed while you were out sunbathing. In this months episode:

...Does a lower BP lower the risk of dementia?...(04:38)Hughes, Diarmaid et al. “Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis.” JAMA. doi:10.1001/jama.2020.4249

...When’s the right time to start dialysis in severe AKI?...(08:51)Gaudry, Stéphane et al. “Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials.” Lancet, doi:10.1016/S0140-
...Do I really need to find ice for an ammonia level?...(13:10)Haj, Mona, and Don C Rockey. “Ammonia Levels Do Not Guide Clinical Management of Patients With Hepatic Encephalopathy Caused by Cirrhosis.” The American journal of gastroenterology. doi:10.14309/ajg.0000000000000343

...Is there a safer antiplatelet for the elderly?...(19:18)Gimbel, Marieke et al. “Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome.” Lancet. doi:10.1016/S0140-6736(20)30325-1

...How can we better serve our patients in care homes?...(23:21)Alcorn, Gemma et al. “Care home residents who die in hospital: exploring factors, processes and experiences.” Age and ageing, doi:10.1093/ageing/afz174

...Are fancy lipid-lowering drugs all their cracked up to be?...(29:24)Gencer, Baris et al. “Efficacy of Evolocumab on Cardiovascular Outcomes in Patients With Recent Myocardial Infarction: A Prespecified Secondary Analysis From the FOURIER Trial.” JAMA cardiology, doi:10.1001/jamacardio.2020.0882

...How significant is the wrong diagnosis?...Newman-Toker, David E et al. “Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the "Big Three".” Diagnosis (Berlin, Germany), doi:10.1515/dx-2019-0104 ...Can you trust the EWS score?...Gerry, Stephen et al. “Early warning scores for detecting deterioration in adult hospital patients: systematic review and critical appraisal of methodology.” BMJ. doi:10.1136/bmj.m1501JOURNALBITESCanadian Syncope ScoreOpioids in dialysis patientVTE guideline updatePDE-4 inhibitors and COPD

...Cannabis & Fungal Infections...Benedict, Kaitlin et al. “Cannabis Use and Fungal Infections in a Commercially Insured Population.” Emerging infectious diseases. doi:10.3201/eid2606.191570

View Details

Introduction chat with Barney and Annalan:

Meet the hosts
Get you up to speed with what differential attainment (DA) is.
The stats behind DA and racial inequality in the UK.
Who is Sir Sam Everington anyway?

Interview with Sir Everington: (15:25)

Getting to know Sir Sam
What is racism?
Selection process for students and doctors
Mentoring
Views on ‘colourblind’
Celebrating diversity
Challenging behaviours
Microaggressions at work
Leadership / teamwork
Appointments commission
WRES / Observatory
Changing how we manage our workload

Post-interview chat with Annalan: (63:10)

Take home points and final words

Links as promised:
Websites / articles

BMJ on Racism
BMJ on DA
GMC on DA
Equality and Human rights website
Gov.uk Stats
Bromley by Bow

Books

Why I know longer talk to white people about race
Natives

Why I’m No Longer Talking to White People About Race

Natives: Race and Class in the Ruins of Empire - The Sunday Times Bestseller

View Details

We welcome the inspirational Dr. Joel Meyer, an adult intensivist and co-founder of LifeLines. Joel joins us to cover:

Communication in the ICU & virtual visiting during COVID-19
LifeLines: the inspiration and development for a novel virtual visiting platorm
The Post ICU syndrome and recovery

Introduction
- Joel tells us a bit about himself and his experience of COVID-19 (04:07)
- Something positive to come out of the pandemic (06:10)

Virtual Visiting & Lifelines- "The whole structure of visiting has been turned on its head" (08:35)
- How lifelines was developed (12:00)
- Applications of Lifelines beyond the ICU (18:10)

Post ICU syndrome- An overview of the syndrome (23:40)
- Physical manifestations (26:30)
- Post ICU syndrome and COVID-19 (28:30)
- Complications to look out for when patients are stepped down from the ICU (31:30)
- Psychological effects of a prolonged COVID ICU admission (37:15)
- Optimisation of the post ICU care (40:30)

Important Links

Critical care recovery: managing and supporting ICU recovery
ICM guidance on recovery from COVID-19
LifeLines
BTS guidance on follow up

View Details

Welcome back to the COVID-ZONE for another round-up of the latest COVID-19 literature.
---------------------------
In today's episode:

S(o)wab's the big deal? The trouble with false-negative swabs (05:29)

Proning in the A&E department: flipping around what we do in COVID respiratory failure (09:52)

Treatment Update

The Remdesevir saga continues: the Lancet trial, the NIH trial, and the controversy over ending it early. (13:39)
Hydroxychloroquine not living up to the hype: JAMA & NEJM papers (20:35)
Anakinra is promising in severe COVID-19 (24:17)

Cardiac arrest & COVID-19 (26:55)

Neurological manifestations of COVID-19 (34:03)

An overview of presentations
A case series of GBS
Summary of all the published literature

Man's best friend is called up to help fight the pandemic (38:38)

Covert COVID distractions:

The fantastic healthcare practitioners from 3 GP practices in the Brownlow Health Central, Liverpool with an amazing health promotion message!

Check out our website for the latest PodPoints
Get in touch: journalspotting@gmail.com
Twitter @JournalSpotting

View Details

Are you trying to keep up with the general medicine literature but after completing Love is Blind and Tiger King, you’ve spent your evenings cringing through episodes of Normal People with your family?

Check out the awesome infographics on Twitter @JournalSpotting or our website
In this month's episode...
(05:11)...Sepsis bundles, not greater than the sum of their parts?...Baghdadi, Jonathan D et al. “Association of a Care Bundle for Early Sepsis Management With Mortality Among Patients With Hospital-Onset or Community-Onset Sepsis.” *JAMA

(10:39)*...Aspirin might prevent HCC (and preserve flowers?)Simon, Tracey G et al. “Association of Aspirin with Hepatocellular Carcinoma and Liver-Related Mortality.” *NEJM

(17:30)*...CPAPathon: ACS/OSA/CO (there's a good anagram in there somewhere)...Sánchez-de-la-Torre, Manuel et al. “Effect of OSA and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial.” LancetWimms, Kelly et al. "CPAP versus standard care for the treatment of people with mild obstructive sleep apnoea (MERGE): a multicentre, randomised controlled trial" LancetTurgut & Yavuz. "Comparison of non-invasive CPAP with mask use in carbon monoxide poisoning" AJEM

(27:52)...Diets and cardiovascular disease...Ge, Long et al. “Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials.” BMJ

(37:17)...Does MRSA bacteremia need anything more than vancomycin ...
Tong, Steven Y C et al. “Effect of Vancomycin or Daptomycin With vs Without an Antistaphylococcal β-Lactam on Mortality, Bacteremia, Relapse, or Treatment Failure in Patients With MRSA Bacteremia: A Randomized Clinical Trial.” JAMA
(40:43)...is your stethoscope spreading the next pandemic?...Sukaina Ali Alali et. al "Community Hospital Stethoscope Cleaning Practices and Contamination Rates" AJIC

(44:24)...JOURNALBITES...Benzo-resistant status epilepticus
Penicillin allergy decision rule
New anaphylaxis guidelines
SGLT2 inhibitors and heart failure

(50:07)...Medieval strains of m. leprae in the red squirrel...Ploemacher, Thomas et al. “Reservoirs and transmission routes of leprosy; A systematic review.” PLoS neglected tropical diseases

Get in Touch! @JournalSpotting or journalspotting@gmail.comWe’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!

View Details

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

Get in touch!
@JournalSpotting or journalspotting@gmail.comWe’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!)

View Details

Welcome to the COVID-ZONE
---------------------------Journalspotting is here to bring you important clinical updates on coronavirus.
Get in touch: journalspotting@gmail.com
Twitter @JournalSpotting

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!!

View Details

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.

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?

*Pregnancy and covid-19 resources*

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

Royal College of Physicians toolkit; Managing acute medical problems in pregnancy

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

View Details

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.

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

View Details

Welcome to the COVID-ZONE.
Journalspotting is here to bring you important clinical updates on coronavirus.
Get in touch: journalspotting@gmail.com
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!

View Details

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 journalspotting@gmail.comWe’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 medicinehttps://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 & endocrinologyhttps://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.gov/32127345/

*Other bits***
Piers Morgan vs. Gregg’s https://www.youtube.com/watch?v=Jj2x_NE_TNQ

Bjork’s 4th album: https://www.youtube.com/watch?v=OnjWKA0JsJo&list=PL1BCBDDA394C775C

LSHTM Viral Podcast

View Details

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 journalspotting@gmail.comWe’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

Huffmyer, Julie L et al. “Impact of Caffeine Ingestion on the Driving Performance of Anesthesiology Residents After 6 Consecutive Overnight Work Shifts.” Anesthesia and analgesia 2020
https://www.ncbi.nlm.nih.gov/pubmed/31274603

JournalSpotting.: Recent Episodes

Journalspotting

Clots & COVID-19 Vaccines # High flow Oxygen in suspected ACS

Delaying dialysis in severe AKI

Contrast-induced nephropathy****: fact or fiction?

Another Vitamin D study # Inhalers for COVID-19

Shortening antibiotic courses in CAP

When to restart a DOAC after bleeding

For full show notes and more check out journalspotting.com

S(o)wab's the big deal? The trouble with false-negative swabs (05:29)

Proning in the A&E department: flipping around what we do in COVID respiratory failure (09:52)

Treatment Update

Cardiac arrest & COVID-19 (26:55)

Neurological manifestations of COVID-19 (34:03)

Man's best friend is called up to help fight the pandemic (38:38)

Covert COVID distractions:

Are you trying to keep up with the general medicine literature but after completing Love is Blind and Tiger King, you’ve spent your evenings cringing through episodes of Normal People with your family?

(50:07)...Medieval strains of m. leprae in the red squirrel...Ploemacher, Thomas et al. “Reservoirs and transmission routes of leprosy; A systematic review.” PLoS neglected tropical diseases

Trialtastic

Inflammologist

TimeIsLung

Transmision models: out with the old and in with the new

Treatment update: Remdesivir, convalescent plasma, RECOVERY trial

Cover your face(mask)

Coagulopathy & COVID-19

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

~What are the management considerations including thromboprophylaxis, oxygen therapies, and delivery of the baby?

Royal College of Physicians toolkit; Managing acute medical problems in pregnancy

ACE inhibitors and angiotensin receptor blockers- do they worsen COVID-19?

The NSAID controversy

Lopinavir/Ritonavir falls at the first hurdle

Chloroquine/Hydroxychloroquine get a big endorsement

How good are the swabs?

Anosmia is the new normal: Will I ever smell again?

Coronavirus likes plastic, hates pennies: which surfaces should I be wiping down?

Modelling studies that matter

Covert COVID Distractions