QJM: An International Journal of Medicine最新文献

{"title":"Joint Clues to a Silent Killer: Hypertrophic Osteoarthropathy and Lung Cancer.","authors":"Bodhibrata Banerjee, Gsrsnk Naidu, Aman Sharma","doi":"10.1093/qjmed/hcaf105","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf105","url":null,"abstract":"<p><p>54-year-old male presented with dyspnea on mild exertion of mMRC grade II, chronic cough, pandigital clubbing (figure 1A) along with painful swelling involving distal part of both forearms for past 1 year. He is a chronic smoker since past 30 years with a smoking index of 680. Investigations revealed anemia of chronic disease with slight A/G reversal. X ray of forearm showed distal periosteal new bone formation along the shafts of radius and ulna with surrounding soft tissue swelling (figure 1B). A computer enhanced tomography of chest showed a heterogeneously enhancing mass along pleural surface on left hemithorax (figure 1C). FDG-PET showed hypermetabolic uptake in that mass with an SUVmax of 26.2 (figure 1D). He was diagnosed as hypertrophic osteoarthropathy secondary to lung carcinoma. A PET guided biopsy from the lung mass confirmed the histological type to be adenocarcinoma of lung. He was started on combination chemotherapy with Pemetrexed and Paclitaxel and is currently under medical oncology follow up.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529420","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":"Testosterone and suicidal behavior in women.","authors":"Leo Sher","doi":"10.1093/qjmed/hcaf140","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf140","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529421","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":"Crumpled posterior subcapsular cataract.","authors":"Manu Sharma, Chintan Malhotra, Deeksha Katoch","doi":"10.1093/qjmed/hcaf112","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf112","url":null,"abstract":"<p><p>Posterior subcapsular cataract(PSC) is a type of cataract that forms at the back of lens, just in front of the posterior capsule. It is commonly tends to affect younger patients. PSC with crumpled posterior capsule is an unusual finding that can result from trauma, surgery or developmental issues.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529419","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":"Time Allocation in Clinical Training (TACT): National Study Reveals Resident Doctors Spend Four Hours on Admin for Every Hour With Patients.","authors":"Sammy Arab, Karanjot Chhatwal, Thomas Hargreaves, Michela Sorbini, Sara El-Toukhy, Chiara J Vedi, Yusuf Alghabra, Jude Merzah, Stuart D Rosen","doi":"10.1093/qjmed/hcaf141","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf141","url":null,"abstract":"<p><strong>Background: </strong>Resident Doctors (RDs) in the UK must balance clinical training with non-clinical administrative tasks. Concerns increase over how these tasks impact their professional development, job satisfaction, and patient care. The shift toward consultant-delivered care has led to a redistribution of responsibilities, increasing administrative burden on RDs. This study aims to quantify how RDs allocate time between patient-facing and non-patient-facing tasks and assess impact on job satisfaction.</p><p><strong>Methods: </strong>The Time Allocation in Clinical Training (TACT) study is a multicentre, observational cohort study conducted over seven months (January-July 2024) at secondary NHS centres. 137 RDs, from Foundation Year 1 to Specialty Training Year 8, were observed for four-hour periods, with time tracked using stopwatches for five task categories. An optional survey assessed job satisfaction, rated on a five-point Likert scale.</p><p><strong>Results: </strong>RDs spent 73.0% of their time on non-patient-facing tasks, and 17.9% on patient-facing activities. Women spent more time on non-patient-facing tasks compared to men (75.0% vs. 69.9%, p = 0.03). Junior RDs (Foundation years and Core trainees) spent significantly less time on patient-facing tasks compared to senior RDs (ST6-8) (38.4% vs 17.8%; p = 0.004). Most RDs (62%) reported dissatisfaction with the administrative burden. Electronic health record users spent significantly more time on administrative tasks than paper-based record users (44.1% vs 37.3%; p = 0.02).</p><p><strong>Conclusions: </strong>The study reveals a significant imbalance between clinical and administrative tasks, with excessive administrative workload contributing to RD dissatisfaction. Streamlining administrative duties and integrating digital solutions is crucial for improving job satisfaction, clinical development, and healthcare delivery in the NHS.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529388","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":"Spatial Genomic Heterogeneity in IDH-wildtype Glioblastoma Uncovered by Multiregional Analysis.","authors":"Kazuhiro Miwa, Yuki Kato, Shigenobu Sawada, Hirohito Yano","doi":"10.1093/qjmed/hcaf138","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf138","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512441","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":"A severe case of Hantavirus Cardiopulmonary Syndrome in a Young Adult-a case report.","authors":"Ajeetha Priya Gajendiran, Sep Zichawo, Penny Williams, Kulothungan Gunasekaran","doi":"10.1093/qjmed/hcaf109","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf109","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512439","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":"Bear's paw sign in xanthogranulomatous pyelonephritis.","authors":"Hien-Che Mon, Ying-Lun Ou, Hua-Tung Fan, Hung-Kai Lo, Po-Jen Hsiao","doi":"10.1093/qjmed/hcaf126","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf126","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512440","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":"Pumice stone sign in emphysematous vertebral osteomyelitis.","authors":"Shu-Hua Li, Yi Yang, Hang Sun, Xiao-Feng Shi","doi":"10.1093/qjmed/hcaf137","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf137","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507963","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":"Invasive liver abscess syndrome.","authors":"Bangtao Yao, Ting Yu, Xuefeng Bu, Yirui Ge","doi":"10.1093/qjmed/hcaf136","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf136","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507962","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":"Response to Association of healthy sleep patterns with risk of mortality and life expectancy.","authors":"Haibin Li, Frank Qian","doi":"10.1093/qjmed/hcaf129","DOIUrl":"https://doi.org/10.1093/qjmed/hcaf129","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294842","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}