{"title":"Features in this issue.","authors":"Graeme P Currie","doi":"10.1177/14782715251325577","DOIUrl":"10.1177/14782715251325577","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"3"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524652","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}
{"title":"Dementia after stroke-risk prediction and management.","authors":"Marni James, Emily Ball, Eugene Yee Hing Tang, Gillian Mead","doi":"10.1177/14782715241308365","DOIUrl":"10.1177/14782715241308365","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"4-5"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899062","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}
{"title":"Less than full-time training and future needs.","authors":"Noor Jawad, Ali Jawad","doi":"10.1177/14782715251314568","DOIUrl":"10.1177/14782715251314568","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"75"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041615","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}
Wen Xin Rachel Chua, Shyer Wern Goh, Wen Hon Darren Wee, Hanna Osawa, Sharavan Sadasiv Mucheli, Bingwen Eugene Fan
{"title":"The historical evolution of smallpox treatment in Japan visualised through Japanese artwork and woodblock prints.","authors":"Wen Xin Rachel Chua, Shyer Wern Goh, Wen Hon Darren Wee, Hanna Osawa, Sharavan Sadasiv Mucheli, Bingwen Eugene Fan","doi":"10.1177/14782715241307997","DOIUrl":"10.1177/14782715241307997","url":null,"abstract":"<p><p>Art reveals core human emotions during catastrophes like epidemics, allowing people to narrate their coping stories. This review examines smallpox's historical evolution and treatment in Japan, integrating visual art with medical history. It provides chronological insights from smallpox's arrival and traditional remedies to the era of vaccination and public health measures leading to eventual eradication. Art played a vital role in Japan's smallpox eradication, helping to galvanise societal engagement and public trust. Efforts included utilising political and administrative systems for vaccination initiatives and effective public health methods for outbreak surveillance and containment. Japan's smallpox eradication story, depicted in art, offers valuable lessons on the power of robust public health policy and societal cooperation, providing a framework for managing current and future infectious diseases and pandemics.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"38-58"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899144","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}
{"title":"Low-dose methotrexate in Rheumatology: A reinvented drug.","authors":"Kushagra Gupta, Vinod Ravindran","doi":"10.1177/14782715241312256","DOIUrl":"10.1177/14782715241312256","url":null,"abstract":"<p><p>Low-dose methotrexate (LD-MTX) is the anchor drug used in the treatment of various rheumatological illnesses. There are a lot of misconceptions associated with the long-term use of MTX in the minds of practitioners. The origin of most of these myths stems from the ill effects associated with high-dose MTX used in cancer chemotherapy. In this review, we have summarised and discussed the latest data regarding the safety of LD-MTX. The current evidence underscores the safety of LD-MTX. It is not associated with liver and lung fibrosis as previously thought. Other major concerns such as bone marrow suppression and increased risk of infection are rare with chronic LD-MTX therapy. Hypersensitivity pneumonitis is a rare acute lung toxicity associated with MTX intake, it does not cause interstitial lung disease and in fact, may be protective against it. There is a slight concern about the increased risk of skin malignancy associated with MTX intake; however, association with no other malignancy has been found. It has taken many decades for researchers to clear the various preconceptions associated with MTX. It is time for the academic community to embrace LD-MTX as a new, separate and reinvented drug.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"59-68"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956674","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}
{"title":"Esophagitis dissecans superficialis: Often underdiagnosed entity.","authors":"Fazil Mohammed, Shiran Shetty, Megha Murali, Geetha Vasudevan, Balaji Musunuri","doi":"10.1177/14782715251322854","DOIUrl":"https://doi.org/10.1177/14782715251322854","url":null,"abstract":"<p><p>Esophagitis dissecans superficialis (EDS) is a rare and benign innocuous esophageal condition characterised by inflammation and epithelial changes. Here, we present the case of an 87-year-old male with multiple comorbidities, including diabetes and coronary artery disease, who had severe iron deficiency anaemia and who required upper gastrointestinal endoscopy for evaluation. Endoscopy revealed whitish slough-like membranes in the midesophagus, along with a hiatus hernia. Histopathological examination confirmed EDS. EDS is often missed during endoscopy and is linked to mucosal irritants such as medications, smoking, alcohol and bullous skin conditions. We present this case to raise awareness about this rare condition and the possibility of misinterpreting endoscopic findings.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251322854"},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494200","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}
{"title":"Cauda equina syndrome due to extramedullary hematopoiesis.","authors":"Uddalak Chakraborty, Amlan Kusum Datta, Adreesh Mukherjee, Sudeshna Malakar","doi":"10.1177/14782715251318873","DOIUrl":"https://doi.org/10.1177/14782715251318873","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251318873"},"PeriodicalIF":1.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383738","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}
{"title":"Thanks to Reviewer.","authors":"","doi":"10.1177/14782715251316448","DOIUrl":"https://doi.org/10.1177/14782715251316448","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251316448"},"PeriodicalIF":1.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061057","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}
{"title":"Medical emergencies in hospital: The role of treatment escalation plans in out-of-hours decision-making.","authors":"Tze Yi Gan, Roy Harris, D Robin Taylor","doi":"10.1177/14782715241298525","DOIUrl":"10.1177/14782715241298525","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hours medical emergencies are common in acute hospitals, and are often attended by staff who are unfamiliar with the patient's clinical background. Information in the hospital notes may or may not include guidance about how best to deal with clinical deterioration. The use of Treatment Escalation Plans (TEPs) attempts to address these deficiencies.</p><p><strong>Methods: </strong>This was an observational, questionnaire-based evaluation of the experience of trainee hospital doctors who attended out-of-hours medical emergencies.</p><p><strong>Results: </strong>Sixty-five medical emergencies were evaluated by a total of 38 doctors. Thirty patients had a TEP, attended by 20 doctors, and 35 without a TEP were attended by 27 doctors. Information from medical notes to facilitate decision-making was deemed sufficient by the attending doctor in 77% of patients with a TEP, compared to 54% of patients with no TEP. Only 10% of patients with a TEP had their treatment escalated at the time of the call, whereas this occurred in 20% of patients without a TEP (NS). A TEP was deemed 'somewhat' or 'very' helpful by trainees in 21/30 of the cases who had one. In 27/35 cases who did <i>not</i> have a TEP, trainees deemed that it would have been helpful to have had one. Twelve of 38 participants (32%) considered that there was a discrepancy between what was 'expected' and what they considered to be 'right' when managing out-of-hours emergencies.</p><p><strong>Conclusion: </strong>TEPs have an important role in delivering key information that shapes out-of-hours decision-making in deteriorating patients. Both objective outcomes and the subjective quality of medical decision-making are enhanced when a TEP is available.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"284-289"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773634","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}
{"title":"A physical directory.","authors":"","doi":"10.1177/14782715241307790","DOIUrl":"10.1177/14782715241307790","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"348"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808178","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}