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Journal of the Royal College of Physicians of Edinburgh最新文献

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Successful management of refractory Cushing's disease with severe hypercortisolemia using etomidate and temozolomide in post-surgical failure. 在手术失败后使用依托咪酯和替莫唑胺成功治疗伴有严重高皮质醇血症的难治性库欣病。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-30 DOI: 10.1177/14782715241293817
Neeti Agrawal, Debalina Sarkar, Subhankar Chatterjee, Pallab Sinha, Ranita Bhattacharya, Prabhat Ranjan, Partha Pratim Chakraborty, Rana Bhattacharjee
{"title":"Successful management of refractory Cushing's disease with severe hypercortisolemia using etomidate and temozolomide in post-surgical failure.","authors":"Neeti Agrawal, Debalina Sarkar, Subhankar Chatterjee, Pallab Sinha, Ranita Bhattacharya, Prabhat Ranjan, Partha Pratim Chakraborty, Rana Bhattacharjee","doi":"10.1177/14782715241293817","DOIUrl":"https://doi.org/10.1177/14782715241293817","url":null,"abstract":"<p><p>Corticotropinomas account for 20% of all aggressive pituitary tumors and pituitary carcinomas and are associated with high mortality. These tumors not only cause neurovascular compromise but can also be fatal due to severe hypercortisolemia itself. Although surgery is considered the primary treatment modality, it is often partially successful or unsuccessful. Moreover, these tumors frequently recur and may be resistant to conventional treatments, including surgery and radiotherapy. Therefore, early multimodal treatment and regular follow-up are necessary. We present a case of aggressive Cushing's disease managed with combined temozolomide therapy and radiotherapy following an unsuccessful transsphenoidal surgery, resulting in significant long-term radiological and biochemical remission. In addition, etomidate infusion was administered to achieve rapid cortisol reduction, highlighting its role as a bridging therapy to other modalities in treating life-threatening and severe hypercortisolemia outside an intensive care setting.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revisiting the conceptualisation and implications of medicine's 'hidden curriculum'. 重新审视医学 "隐性课程 "的概念和影响。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-27 DOI: 10.1177/14782715241293814
Isaac Ks Ng, Li Feng Tan, Wilson Gw Goh, Christopher Thong, Kevin Sh Teo, Desmond B Teo
{"title":"Revisiting the conceptualisation and implications of medicine's 'hidden curriculum'.","authors":"Isaac Ks Ng, Li Feng Tan, Wilson Gw Goh, Christopher Thong, Kevin Sh Teo, Desmond B Teo","doi":"10.1177/14782715241293814","DOIUrl":"https://doi.org/10.1177/14782715241293814","url":null,"abstract":"<p><p>In medical training and practice, our professional attributes, attitudes, perceptions, character traits and identities are fundamentally shaped by our lived experiences and observations in clinical and para-clinical settings instead of being inculcated through formal curriculum or classroom teaching. For instance, clinical acumen, communication skills and bedside manners are learnt through role modelling and experiential learning in the course of clinical rotations. Likewise, one's attitudes, professional behaviours and inclinations are often also influenced by direct/indirect observations of the actions of others in the medical fraternity in various clinical and non-clinical settings. This is also what is often termed as the 'hidden curriculum' of medicine. In this article, we sought to provide a practical conceptualisation of the hidden curriculum in medical training, which we describe as lived experiences and personal observations of medical trainees and residents in clinical and para-clinical spaces, which shape their perceptions of the medical profession (vocational identity and purpose), patients (patient-physician relationship) and colleagues (intra- and inter-professional relationships), with downstream implications on physician well-being and clinical decision-making. Although this idea of a 'hidden curriculum' has conventionally carried predominantly negative connotations in medical literature, we suggest that it is an inevitable part of medical education and practice, which, through deliberate regulation, can potentially be shaped to create more positive and meaningful effects in the professional development of medical trainees.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
'No one has ever told us it will be fun'. Achieving fulfilment in medical practice. 从来没有人告诉我们这会很有趣"。在医疗实践中获得成就感。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-23 DOI: 10.1177/14782715241293185
Clive Weston
{"title":"'No one has ever told us it will be fun'. Achieving fulfilment in medical practice.","authors":"Clive Weston","doi":"10.1177/14782715241293185","DOIUrl":"https://doi.org/10.1177/14782715241293185","url":null,"abstract":"<p><p>Facilitating a tutorial with medical students who appeared unusually tentative and apathetic prompted me to reflect upon the intergenerational character of Medicine and consider how we might counter the pervasive pessimism that leads to demoralisation and disillusionment. Engaging in local Communities of Practice may allow clinicians, old and new, to maintain enjoyment and fulfilment in Medicine.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Renaming 'junior doctors' and beyond: Learning from international dialogue. 重新命名 "初级医生 "及其他：从国际对话中学习。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-21 DOI: 10.1177/14782715241287435
Clare Bostock
{"title":"Renaming 'junior doctors' and beyond: Learning from international dialogue.","authors":"Clare Bostock","doi":"10.1177/14782715241287435","DOIUrl":"https://doi.org/10.1177/14782715241287435","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cough-induced vertebral artery dissection: A case report and literature review. 咳嗽诱发椎动脉夹层：病例报告和文献综述。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-10 DOI: 10.1177/14782715241290309
A Khalid, A Summerbell, P Jha, A H Abdelhafiz
{"title":"Cough-induced vertebral artery dissection: A case report and literature review.","authors":"A Khalid, A Summerbell, P Jha, A H Abdelhafiz","doi":"10.1177/14782715241290309","DOIUrl":"https://doi.org/10.1177/14782715241290309","url":null,"abstract":"<p><p>Spontaneous vertebral artery dissection (VAD) is common after minor neck trauma or abrupt neck manipulation, which may result in stroke. However, violent cough is a less recognised cause of VAD. Only a few cases are reported in the literature. We review the literature and report a case of a 62-year-old man who presented with a headache and neck pain following a period of intermittent coughing, which led to VAD and a cerebellar ischaemic stroke. He responded well to medical treatment and made a full recovery. Therefore, VAD should be considered in the differential diagnosis for patients presenting with neck pain and headache after episodes of violent coughing.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proactive frailty in primary care: A primary care system fit for frailty. 在初级保健中积极预防虚弱：适合体弱病症的初级保健系统。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-10-06 DOI: 10.1177/14782715241286918
Lloyd D Hughes, Tara Verity, Liz Lawn, Deb Gompertz
{"title":"Proactive frailty in primary care: A primary care system fit for frailty.","authors":"Lloyd D Hughes, Tara Verity, Liz Lawn, Deb Gompertz","doi":"10.1177/14782715241286918","DOIUrl":"10.1177/14782715241286918","url":null,"abstract":"<p><p>Older adults with frailty are at increased risk of premature death, and numerous negative sequalae including falls, disability, and dementia alongside increased healthcare costs. Most healthcare interactions for older people with frailty take place in primary care, and there is increasing interface working between primary and secondary care to manage this patient group including virtual wards, frailty management programmes and Hospital @ Home. This commentary aims to place proactive frailty into recent policy perspective, alongside highlighting some of the current challenges around the implementation of proactive frailty programmes.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unlocking the diagnostic riddle: Beyond arthritis in DIP joint deception. 揭开诊断之谜：超越关节炎的 DIP 关节欺骗。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-30 DOI: 10.1177/14782715241288903
Saranya Chinnadurai, Sabarinath Mahadevan, PadamKumar Bhawarlal
{"title":"Unlocking the diagnostic riddle: Beyond arthritis in DIP joint deception.","authors":"Saranya Chinnadurai, Sabarinath Mahadevan, PadamKumar Bhawarlal","doi":"10.1177/14782715241288903","DOIUrl":"https://doi.org/10.1177/14782715241288903","url":null,"abstract":"<p><p>Glomus tumour is a rare benign neoplasm arising from specialized neuromyoarterial plexus situated in the subungual region. Here, we present a 36-year-old male who had severe pain in the distal part of left third finger mimicking distal interphalangeal joint arthritis (DIP). On evaluation, he was found to have severe tenderness just distal to the DIP joint line. Also, he had positive cold sensitivity test. MRI showed high-signal intensity lesion in the dorsal aspect of left third digit. Glomus tumour was suspected based on these findings. Surgical excision was done followed by histopathological examination, confirmed the diagnosis. We present this case to raise awareness about this rare condition and the possibility of misinterpreting distal pain as DIP arthritis.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wild & Tame: Animals in history. 野性与驯服历史上的动物
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-23 DOI: 10.1177/14782715241288363
{"title":"Wild & Tame: Animals in history.","authors":"","doi":"10.1177/14782715241288363","DOIUrl":"10.1177/14782715241288363","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Ayurveda medicine supplement modern medical treatments in chronic disease management? 阿育吠陀医学能否辅助现代医学治疗慢性病？
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1177/14782715241273738
Vyshna Ravindran, Kanta Kumar, Sunil Bhandari, Kaushik Chattopadhyay, Unnikrishnan Payyappallimana, Antonio Morandi, Rajeev Gupta
{"title":"Can Ayurveda medicine supplement modern medical treatments in chronic disease management?","authors":"Vyshna Ravindran, Kanta Kumar, Sunil Bhandari, Kaushik Chattopadhyay, Unnikrishnan Payyappallimana, Antonio Morandi, Rajeev Gupta","doi":"10.1177/14782715241273738","DOIUrl":"10.1177/14782715241273738","url":null,"abstract":"<p><p>The editorial highlights the fact that there is limited communication between healthcare providers and patients about complementary and integrative medicine (TCI) like Ayurveda. To address this, healthcare professionals need better education on Ayurveda. Additionally, international collaborations can enhance research and credible information, ensuring safe and effective patient care.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rapidly progressive pulmonary actinomycosis. 快速进展的肺放线菌病。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-19 DOI: 10.1177/14782715241281805
Scott Hainey, Phil Reid, Andrew Wood
{"title":"Rapidly progressive pulmonary actinomycosis.","authors":"Scott Hainey, Phil Reid, Andrew Wood","doi":"10.1177/14782715241281805","DOIUrl":"10.1177/14782715241281805","url":null,"abstract":"<p><p>This clinical image documents a rare case of rapidly progressive pulmonary actinomycosis in a patient initially seen in lung cancer clinic. Despite radiological findings suggestive of malignancy, biopsy was consistent with a diagnosis of actinomycosis. The patient responded well to prolonged antibiotics with significant clinical improvement. This case highlights the importance of considering actinomycosis even in rapidly progressive cases and emphasises the need for tissue diagnosis in patients with suspected lung cancer.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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