Postgraduate Medical Journal最新文献

{"title":"Think like a surgeon: the T-DODAR tool for problem solving in oral examinations and clinical practice.","authors":"Petrut Gogalniceanu, Stefano Artusa, Cameron Ruckley","doi":"10.1093/postmj/qgaf146","DOIUrl":"10.1093/postmj/qgaf146","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"970-974"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased food prices and changes in food consumption behavior: an early precursor to malnutrition, and widespread food insecurity among the Egyptian population.","authors":"Nadira Mansour Hassan, Shimaa Mohamed Koabar","doi":"10.1093/postmj/qgag078","DOIUrl":"10.1093/postmj/qgag078","url":null,"abstract":"<p><strong>Background: </strong>Recent increases in food prices in Egypt have raised concerns about their impact on dietary patterns and household food security (FS), particularly among economically vulnerable groups, forcing families to reduce dietary diversity and nutrient intake. This may indirectly contribute to an increased risk of malnutrition and chronic diseases.</p><p><strong>Aim: </strong>To identify changes in food consumption behavior (food choices and dietary patterns) among Egyptian households following food inflation and determine the levels and predictors of food insecurity (FI).</p><p><strong>Methods: </strong>An online cross-sectional survey of 723 Egyptian households from June to December 2024. Data was collected using a pretested structured questionnaire targeting household heads. The tool assessed sociodemographic characteristics, food consumption changes, and FS status.</p><p><strong>Results: </strong>Most participants reported increased food expenditure (58.2%) with dietary shift toward cheaper carbohydrate-rich staple foods (55.2%). Reduced consumption of animal protein and dairy products was also observed. Overall, 64.6% of households experienced FI: 15.8% mild, 27.5% moderate, and 20.3% severe levels. Significant predictors of FI included female respondents (OR = 2.425, P < .001), maternal unemployment [odds ratio (OR) = 1.597, P = .018], low household income (OR = 1.774, P = .001), maternal financial responsibility (OR = 3.432, P < .001), the presence of a family member with chronic disease (OR = 1.748, P = .002), and a current smoking father (OR = 1.711, P = .004).</p><p><strong>Conclusion: </strong>Increased food prices lead to changes in food consumption patterns with shifts toward less nutritionally valuable foods and deprive most households of FS. Therefore, there is an urgent need for national nutrition health education programs to help households optimize the use of limited household budgets to achieve a balanced diet.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"925-934"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building global learning networks: a practical guide for medical educators.","authors":"Jun Jie Lim, Amani Mansour Mohmad Alnimr, Iveren Winifred Nyinoh, Elsa Sanatombi Devi, Joanna Matthan, Paul Stephen Hubbard, Thomas Quinn, Dara Stanescu, Vrinda Nayak","doi":"10.1093/postmj/qgaf213","DOIUrl":"10.1093/postmj/qgaf213","url":null,"abstract":"<p><p>As healthcare becomes increasingly globalized, postgraduate medical education must evolve to prepare clinicians for an increasingly interconnected, diverse, and intercultural healthcare landscape. This article offers nine practical tips for designing and sustaining global learning networks-virtual, collaborative frameworks that connect trainees, educators, and institutions across borders. The recommendations are organized under four themes: (1) designing equitable curricula, (2) facilitating global collaboration, (3) developing culturally competent educators and learners, and (4) sustaining and evaluating learning networks. These recommendations are grounded in the theoretical frameworks of systems thinking and communities of practice. We emphasize co-created curricula, digital platforms for international engagement, culturally responsive pedagogy, inclusive assessment strategies, and decentralized leadership models. Each tip is grounded in peer-reviewed literature, international case studies, and lessons from our collaborative experiences. We address barriers such as time zones, resource inequities, and quality assurance. By embedding global perspectives into postgraduate programmes, global learning networks strengthen intercultural competence, enhance professional identity formation, expand access to medical education in low-resource settings, and foster mutual learning across diverse health systems. This guide supports postgraduate medical educators in cultivating culturally competent clinicians and advancing a more equitable, collaborative, and resilient global healthcare workforce.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"953-959"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of randomized controlled trials comparing outcomes of artificial intelligence-based teaching versus traditional-based teaching in medical education.","authors":"Pratyush Pillai, Shayan Saadat, Imogen Ward, Shahab Hajibandeh, Shahin Hajibandeh","doi":"10.1093/postmj/qgag077","DOIUrl":"10.1093/postmj/qgag077","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate comparative outcomes of artificial Intelligence (AI)-based and traditional-based teaching in medical education.</p><p><strong>Methods: </strong>The literature search was carried out in CENTRAL, CINAHL, Web of Science, MEDLINE, and EMBASE to identify randomized controlled trials (RCTs) comparing AI-based versus traditional-based teachings in medical education. Estimate of effect size was determined for knowledge score, skills score, and teaching satisfaction score via fixed-effect modelling.</p><p><strong>Results: </strong>Fourteen RCTs enrolling 1116 students who received AI-based teaching (n = 558) or traditional-based teaching (n = 558) were included. The use of AI-based teaching was associated with significantly higher knowledge score (standardized mean difference (SMD): 0.36, 95% CI, 0.24-0.49, P < .00001), skills score (SMD: 0.78, 95% CI, 0.57-0.99, P < .00001), and teaching satisfaction score (SMD: 0.97, 95% CI, 0.66-1.29, P < .00001) compared to the traditional-based teaching. Subgroup analyses with respect to the practical course, theoretical course, duration of course shorter or longer than 1 week were consistent with the main analyses. Meta-regression analysis demonstrated that practical course significantly increased estimate effect for knowledge score (P = .002) and skills score (P = .0001).</p><p><strong>Conclusions: </strong>Meta-analysis of best available evidence (level 1a) indicates that AI-based teaching significantly improves student's knowledge, skills, and satisfactions compared to traditional teaching. However, the available evidence may be subject to publication and reporting bias with high between-study heterogeneity. Future studies should evaluate AI-based teaching in postgraduate settings including speciality and even subspecialties trainings. Key messages What is already known on this topic: Growing evidence from randomized controlled trials demonstrated positive impact of artificial intelligence (AI) in medical education when compared to the traditional approaches. What this study adds: Meta-analysis of best available evidence (level 1a) indicates that AI-based teaching significantly improves student's knowledge, skills, and satisfactions compared to traditional teaching. How this study might affect research, practice, or policy: This study suggests that Future studies should evaluate AI-based teaching in postgraduate settings including speciality and even subspecialties trainings.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"916-924"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deucravacitinib-induced cutaneous hypersensitivity reactions.","authors":"Qirui Wang, Peng Qu, Xitong Zhao, Xiaoqi Yang, Suiting Ao, Pingping Song, Xiaofeng Shan, Baoqi Yang","doi":"10.1093/postmj/qgag028","DOIUrl":"10.1093/postmj/qgag028","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"960-961"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating UK cardiology higher specialty training applications: a practical guide.","authors":"Connor Matthews, Oliver I Brown, Lucy Lawson, Sara Khalid, Holly Morgan, Sam Straw, Anshuman Sengupta, Jivendra Gosai, Richard Cubbon, Michael Drozd","doi":"10.1093/postmj/qgaf210","DOIUrl":"10.1093/postmj/qgaf210","url":null,"abstract":"<p><p>Cardiology remains one of the most competitive medical specialties in the UK. This article provides practical guidance for aspiring cardiologists preparing for Higher Specialty Training applications. It outlines strategies to maximize portfolio scores, prepare effectively for interviews and adapt to recent changes in the scoring framework. The guidance also simultaneously supports the development of core skills essential for a successful career in cardiology.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"948-952"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The reconstruction of young physicians' professional roles in the era of artificial intelligence.","authors":"Hongnan Ye","doi":"10.1093/postmj/qgaf162","DOIUrl":"10.1093/postmj/qgaf162","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"966-967"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction of: Volrustomig/Rilvegostomig related \"triple M\"-myasthenia gravis and overlap syndrome.","authors":"","doi":"10.1093/postmj/qgaf118","DOIUrl":"10.1093/postmj/qgaf118","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"975"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic dysfunction and diabetes: the DIADAD study-a retrospective cohort study from Liverpool.","authors":"Laila Wali, Mohammad Adeeb Abbara, Sowmya Ekhelikar, Jennifer Pilling, Khaled Albouaini, Scott W Murray","doi":"10.1093/postmj/qgag079","DOIUrl":"10.1093/postmj/qgag079","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diastolic dysfunction is an important early indicator of heart failure (HF) with preserved ejection fraction (HFpEF). Type 2 diabetes mellitus (T2DM) may contribute to HFpEF, as it is associated with an increased risk of hospitalization and mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the association between diastolic dysfunction and T2DM in an adult population from Liverpool, accounting for age and sex.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of 493 patient records was conducted, extracting data on diastolic function status, diabetes status, age, and sex. Echocardiographic parameters were used to assess and grade diastolic function according to the 2016 ASE/EACVI recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Diastolic dysfunction was more prevalent in type 2 diabetics (71.42%) than non-diabetic patients (43.98%) (P &lt; .05). The odds ratio of developing diastolic dysfunction was 2.636 times higher in diabetics, with 2.56 times greater odds of a higher dysfunction grade (P &lt; .001). Age ≥65 years was associated with 4.65 times higher odds of having diastolic dysfunction, with no significant difference between genders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This retrospective cohort study demonstrates a clear and statistically significant association between T2DM, advancing age and diastolic dysfunction. This association, however, should be interpreted within the context of a clinically selected population undergoing echocardiography. Due to the metabolic alterations that are associated with diabetes and the pathophysiology of HFpEF, there is a great potential for the use antidiabetic therapies as cardioprotective agents aimed at reducing HF morbidity and mortality. Considering these results, we propose incorporating diabetes into the H2FpEF score. Key messages What is already known on this topic - the development of heart failure with preserved ejection fraction (HFpEF) has long been associated with type 2 diabetes mellitus (T2DM), with the recognition of diastolic dysfunction as an early marker of disease progression. However, data describing the relationship between diabetes and diastolic dysfunction in specific local populations remains limited. What this study adds - this study provides data from a Liverpool tertiary centre showcasing significantly higher prevalence and severity of diastolic dysfunction in patients with type 2 diabetes. These findings produce locally relevant epidemiological evidence that supports the association between diabetes and diastolic dysfunction. How this study might affect research, practice or policy - the findings of this study highlight the importance of cardiovascular assessment in patients with type 2 diabetes in certain populations with a high burden of diabetes, such as Liverpool, and may support earlier identification of individuals at risk of developing HFpEF. Future research might consider incorporating T2DM into the H₂FPEF score, to improve early risk ","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"935-941"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of social deprivation on quality indicators for the acute medical take.","authors":"Christian P Subbe, Matthew S Watson, Noura Al Moubayed, Mark Holland, Catherine Atkin","doi":"10.1093/postmj/qgag094","DOIUrl":"10.1093/postmj/qgag094","url":null,"abstract":"<p><strong>Purpose: </strong>Social deprivation is a predictor of delivered care and clinical outcomes in many areas of medicine. It is not known whether social deprivation affects quality of care received by patients admitted as medical emergencies to hospitals in the United Kingdom (UK).</p><p><strong>Methods: </strong>The Society for Acute Medicine's Benchmarking Audit (SAMBA) measures performance of Acute Medical Units in the UK during a 24-hour period. SAMBA23 took place on Thursday, 22 June 2023. Social deprivation was measured by matching the first half of patient postcodes with publicly available data about the Index of Multiple Deprivation for that geographic area.</p><p><strong>Results: </strong>SAMBA23 included 161 UK hospitals and 9612 patients. Data on social deprivation were available for 7855 patients. Patients from areas with the highest social deprivation were more frail and more likely to be admitted via the emergency department, as opposed to being referred by a General Practitioner. Patients from areas with the highest and lowest levels of deprivation received a similar standard of care as measured by three quality indicators; there were no statistically significant differences in the proportion of patients who received timely measurements of the National Early Warning Score, were seen within 4 hours by a clinician, and were reviewed in a timely manner by a consultant.</p><p><strong>Conclusions: </strong>In this single 24-hour snapshot we were unable to identify differences in the delivery of the Acute Medical take in relation to the residential area index of multiple deprivation. Further research is required using patient level data. Key messages What is already known on this topic: Social deprivation is a co-factor for poor outcomes in most areas of medicine. It is unclear whether social deprivation influences the process of care and outcomes of patients admitted as medical emergencies. What this study adds: We found no evidence for an effect of the residential area index of multiple social deprivation on quality indicators for medical emergencies in data a single 24-hour snapshot as part of a national audit in Acute Medicine. How this study might affect research, practice or policy: This is the first published data from acute medical care in the UK looking at social deprivation, but more data is needed at individual patient level.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"978-983"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}