Journal of the Royal College of Physicians of Edinburgh最新文献_第4页

Nail and distal interphalangeal joint involvement parallel each other in psoriatic arthritis. 在银屑病关节炎中，指甲和远端指间关节的受累情况是并行的。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-07-28 DOI: 10.1177/14782715241267328

Ashish Sharma, Ankita Sheoran

引用次数: 0

The rise of medical influencers: The pros and the cons. 医疗影响者的崛起：利与弊。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-06-12 DOI: 10.1177/14782715241261736

Isaac Ks Ng, Christopher Thong, Li Feng Tan, Desmond B Teo

{"title":"The rise of medical influencers: The pros and the cons.","authors":"Isaac Ks Ng, Christopher Thong, Li Feng Tan, Desmond B Teo","doi":"10.1177/14782715241261736","DOIUrl":"10.1177/14782715241261736","url":null,"abstract":"In the past few years, the online influencer industry has exponentially expanded, fuelled by the COVID pandemic lockdown, increased social media platforms and lifestyle appeal of influencership. This phenomenon has likewise infiltrated the medical field, where many healthcare practitioners have taken to social media platforms for content creation and influencer marketing. There are many reasons that underlie medical influencership - some may use it to improve public health literacy and correct medical misinformation, engage in medical advocacy or use the platform simply as a means of humanistic expression of the medical career, while others may seek to advertise private practice/medical products, boost personal reputation, and gain popularity and monetary benefits. Regardless of the underlying motivations of the medical influencers, some have fallen afoul of professionally accepted practices and ethical boundaries in their use of social media platforms, leading to serious consequences such as professional sanctioning or termination of employment. In this article, we hope to provide a comprehensive review of the 'good' (positive practices), the 'bad' (practices with possible unintended negative consequences) and the outright unprofessional or unethical behaviours aspects of social media use by medical influencers and offer practical strategies to ensure responsible and meaningful use of influencer platforms at both the physician and health systems level.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"231-235"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311990","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

Alfred Labinjoh: Edinburgh doctor, Nigerian Pan-Africanist. 阿尔弗雷德-拉宾约爱丁堡医生，尼日利亚泛非主义者。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-23 DOI: 10.1177/14782715241283136

Henry Dee

引用次数: 0

Dietary behaviour, attitude and food perceptions of patients with ulcerative colitis - An observational study. 溃疡性结肠炎患者的饮食行为、态度和食物认知--一项观察性研究。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-14 DOI: 10.1177/14782715241281682

Nancy Sahni, Urvashi Rana, Sindhuja Rajan, Anuraag Jena, Anupam K Singh, Usha Dutta, Vishal Sharma

{"title":"Dietary behaviour, attitude and food perceptions of patients with ulcerative colitis - An observational study.","authors":"Nancy Sahni, Urvashi Rana, Sindhuja Rajan, Anuraag Jena, Anupam K Singh, Usha Dutta, Vishal Sharma","doi":"10.1177/14782715241281682","DOIUrl":"10.1177/14782715241281682","url":null,"abstract":"Background: Dietary knowledge, perception and practices may have a role in determining the nutritional status of patients with inflammatory bowel disease (IBD). However, the assessment of these patterns has infrequently been done in developing countries. We aimed to evaluate patients with ulcerative colitis (UC) about their dietary beliefs, practices and changes after the diagnosis.Methods: We conducted a cross-sectional survey among patients with UC at a tertiary care centre in North India. Apart from clinical details, we collected information about dietary beliefs, sources of information, dietary practices and changes after the diagnosis of UC. The information was collected using a designed and pretested survey questionnaire.Results: We included 93 patients with a mean age of 40.6 ± 13.3 years and 49 (52.7%) were men. A majority of patients felt that diet had an important role in the causation of IBD (86%, n = 80) and triggering relapses (86%, n = 80). A total of 94.6% of patients (n = 88) felt that certain foods (especially spicy and fatty food and milk) items increased the symptoms of IBD. Patients felt that some food items (yogurt and buttermilk) improved the symptoms. A total of 96.8% of patients (n = 90) changed their diet in some form (commonly, restriction of milk products and outside food), 64% of patients (n = 60) deprived themselves of their favourite food after diagnosis, 80.6% of patients (n = 75) felt a need for additional dietary advice. Regular milk intake was seen more often by patients in remission than those with active disease in IBD (36/47 (76.6%) vs 7/15(46.6%), p = 0.03).Conclusion: Most patients believe that diet has an important role in the causation, relapses and treatment of UC. Patients also felt the need for more information regarding diet in IBD.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"212-220"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298385","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

Looking beyond duty hours: Offering a balanced quantitative-qualitative approach to resident burnout. 超越值班时间：为住院医师职业倦怠提供一种定量与定性兼顾的方法。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.1177/14782715241273739

Isaac Ks Ng, Sarah Zl Tham, Kar Mun Chong, Desmond B Teo

{"title":"Looking beyond duty hours: Offering a balanced quantitative-qualitative approach to resident burnout.","authors":"Isaac Ks Ng, Sarah Zl Tham, Kar Mun Chong, Desmond B Teo","doi":"10.1177/14782715241273739","DOIUrl":"10.1177/14782715241273739","url":null,"abstract":"Burnout, stress and overwork are highly prevalent amongst junior training physicians worldwide, which explains the widespread phenomenon of physicians leaving the field and organised protests/strikes for better working conditions. Back in 2003, the mandatory duty hour restriction was a landmark intervention rolled out by the Accreditation Council for Graduate Medical Education that formally mandated limiting working hours of trainee residents to no more than 80 h per week, and not exceeding 24-h shifts with 6 added hours for education and handover. Nonetheless, 20 years later, this measure continues to be subject to multiple debates on its purported efficacy in achieving its intended objectives and fails to adequately prevent physician burnout and exodus. In our view, the current duty hour restriction model is, in and of itself, inadequate for combating burnout amongst medical residents for several reasons, including insignificant reduction in duty hours with suboptimal adherence/reporting, failure to account for off-site clinical and non-clinical duties, as well as nature of clinical work which typically involves high work intensity in less-than-optimal/unconducive work environments and significant psychoemotional stress. In this article, we offer our perspectives on pursuing a balanced approach towards both meaningful quantitative reduction in working hours as well as practical qualitative improvement in nature of clinical and non-clinical work that could collectively address resident burnout and improve work and training outcomes.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"236-240"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972059","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

Cardiogenic shock secondary to immune checkpoint inhibitor associated myocarditis. 继发于免疫检查点抑制剂相关心肌炎的心源性休克。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1177/14782715241276900

Kuan Ken Lee, Tanith Bain, Andrew Flapan

{"title":"Cardiogenic shock secondary to immune checkpoint inhibitor associated myocarditis.","authors":"Kuan Ken Lee, Tanith Bain, Andrew Flapan","doi":"10.1177/14782715241276900","DOIUrl":"10.1177/14782715241276900","url":null,"abstract":"Immune checkpoint inhibitors have transformed the treatment for multiple cancers and are increasingly used in recent years, but they can cause potentially life-threatening cardiac toxicity. We report a case of a 64-year-old gentleman who presented to the Emergency Department with symptoms of fatigue and breathlessness whilst receiving treatment with an immune checkpoint inhibitor, pembrolizumab, for cholangiocarcinoma. He was found to be in cardiogenic shock with an abnormal electrocardiogram and elevated cardiac troponin at presentation. Echocardiogram demonstrated severely impaired right and left ventricular function. Computed tomography pulmonary angiography and invasive coronary angiography excluded pulmonary embolism and acute myocardial infarction, respectively, and he was diagnosed with immune checkpoint inhibitor associated myocarditis. He was treated with high-dose methylprednisolone and a dobutamine infusion. Within days, his troponin and C-reactive protein levels decreased, and his left ventricular function improved. He was established on heart failure therapies and discharged from hospital 12 days later.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"225-230"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037266","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

Mr W Martin Nichols (1910-1979): From prisoner of war to first Aberdeen neurosurgeon. W Martin Nichols 先生（1910-1979 年）：从战俘到首位阿伯丁神经外科医生。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-23 DOI: 10.1177/14782715241282360

Mark Pecover, David Nichols, Peter Alwyn Bodkin

引用次数: 0

Features in this issue. 本期专题

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-10-06 DOI: 10.1177/14782715241290278

Graeme Currie

引用次数: 0

Caught in the act - pancreatic actinomycosis masquerading as malignancy. 猝不及防--伪装成恶性肿瘤的胰腺放线菌病。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-07-28 DOI: 10.1177/14782715241265144

Nikhil Kenny Thomas, John P Thomas, Mukundan Swaminathan

{"title":"Caught in the act - pancreatic actinomycosis masquerading as malignancy.","authors":"Nikhil Kenny Thomas, John P Thomas, Mukundan Swaminathan","doi":"10.1177/14782715241265144","DOIUrl":"10.1177/14782715241265144","url":null,"abstract":"A 57-year-old male with a background of chronic pancreatitis presented with acutely worsening abdominal pain and vomiting. He previously had a pancreatic duct stent in situ which had been removed 1 year prior to presentation. Initially suspected to be acute-on-chronic pancreatitis, a computed tomography (CT) scan of the abdomen and pelvis revealed an atrophic pancreas and a new mass in the pancreatic head, raising the suspicion of pancreatic malignancy. An urgent endoscopic ultrasound (EUS)-guided fine needle biopsy of the pancreatic head mass surprisingly revealed the presence of actinomyces colonies on histological evaluation. Prompt initiation of a prolonged antibiotic course led to significant clinical and radiological improvement. This case highlights the rare presentation of pancreatic actinomycosis which can often masquerade as malignancy. Although a gut commensal, actinomyces can elicit pathogenic effects if allowed to enter tissues through a breach in the mucosal lining such as following abdominal surgery or pancreatic duct intervention as observed in this case. Early recognition and appropriate treatment with antibiotics can lead to clinical recovery and complete resolution of the infection.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"257-259"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789362","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

Less than full-time training, barriers and future needs. A UK-wide online survey of doctors in training. 非全职培训、障碍和未来需求。英国范围内对受训医生的在线调查。

IF 1.1

Journal of the Royal College of Physicians of Edinburgh Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.1177/14782715241273741

Hannah Preston, Emma Spencer, Robert Ker, Jonathan Guckian, Marilena Giannoudi

{"title":"Less than full-time training, barriers and future needs. A UK-wide online survey of doctors in training.","authors":"Hannah Preston, Emma Spencer, Robert Ker, Jonathan Guckian, Marilena Giannoudi","doi":"10.1177/14782715241273741","DOIUrl":"10.1177/14782715241273741","url":null,"abstract":"Background: The the current views of less-than full-time (LTFT) training by both LTFT and full-time (FT) doctors in training, with regards to health and well-being, clinical and non-clinical opportunities, in addition to associated future workforce implications and challenges, are uncertain.Methods: We performed a cross-sectional study of UK-based doctors in training via an online questionnaire, designed and piloted by the Royal College of Physicians Edinburgh (RCPE) Trainees and Members Committee. Design was informed by prior investigation into LTFT training undertaken amongst similar populations by RCPE in 2019. The survey was distributed from May to September 2023 via email to trainees across the United Kingdom and was open to all specialties and training grades. The survey focused on lived experience of both LTFT and FT training, as well as perceived challenges for the future workforce.Results: There were 648 responses from doctors in training across the United Kingdom, with an even spread of LTFT and FT trainees. Most responses (53%) were from trainees in medical specialties. Most LTFT trainees plan to train at this pace for more than 5 years. LTFT was commonly linked to improved work-life balance and well-being, with FT training perceived to feature high stress and burnout. Concerns around LTFT relate to administrative errors, reduced training opportunities and colleague prejudice. Trainees are concerned about LTFT leading to rota gaps and incoherent workforce planning around training numbers.Conclusion: With ever-increasing popularity in LTFT training, flexible and robust long-term workforce planning is necessary for the system to adapt to a new normal and improve retention of doctors in training.","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"204-211"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298386","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