Pub Date : 2023-11-01DOI: 10.7861/clinmed.23-6-s28
Ching Cheng Daniel Hsieh, A Daniel Pearl, Emma Wesley
{"title":"High success, low 30-day mortality and prolonged survival following PEG insertion in motor neurone disease patients undergoing multidisciplinary clinic review.","authors":"Ching Cheng Daniel Hsieh, A Daniel Pearl, Emma Wesley","doi":"10.7861/clinmed.23-6-s28","DOIUrl":"https://doi.org/10.7861/clinmed.23-6-s28","url":null,"abstract":"","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 Suppl 6 ","pages":"28-29"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848493","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}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.23-6-s71
Oluwaseun Anyiam, Katie Quinn, Bethan Phillips, Daniel Wilkinson, Kenneth Smith, Philip Atherton, Iskandar Idris
{"title":"Addition of very low calorie diet (VLCD) during initiation of semaglutide in individuals with type 2 diabetes - interim results.","authors":"Oluwaseun Anyiam, Katie Quinn, Bethan Phillips, Daniel Wilkinson, Kenneth Smith, Philip Atherton, Iskandar Idris","doi":"10.7861/clinmed.23-6-s71","DOIUrl":"https://doi.org/10.7861/clinmed.23-6-s71","url":null,"abstract":"","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 Suppl 6 ","pages":"71"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864316","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}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.2023-0398
Hannah Cooke, Matthew Wells, Keith Miller, Andrew R L Medford, Sam Patel
Despite its recognition as an 'ANCA-associated vasculitis' (AAV), eosinophilic granulomatosis with polyangiitis (EGPA) is ANCA negative in up to 60% of cases. Herein, we report the case of a young man with a clinical syndrome highly suggestive of EGPA but with repeated negative ANCA serology, ultimately presenting with cardiac arrest before recognition of the primary systemic vasculitis, whereupon he received successful induction therapy with high dose glucocorticoids and cyclophosphamide. The case illustrates the importance of awareness of ANCA negative AAV among general physicians in order to minimise morbidity and mortality.
尽管嗜酸性粒细胞肉芽肿伴多血管炎（EGPA）被认为是一种 "ANCA相关性血管炎"（AAV），但高达60%的病例ANCA呈阴性。在此，我们报告了一例临床综合征高度提示 EGPA 但 ANCA 血清学反复阴性的年轻男性病例，他最终在被确认为原发性系统性血管炎之前出现心脏骤停，随后接受了大剂量糖皮质激素和环磷酰胺的诱导治疗，并获得成功。该病例说明了普通医生对ANCA阴性AAV认识的重要性，以便将发病率和死亡率降至最低。
{"title":"ANCA-negative ANCA-associated vasculitis: pitfalls of the 'vasculitis screen'.","authors":"Hannah Cooke, Matthew Wells, Keith Miller, Andrew R L Medford, Sam Patel","doi":"10.7861/clinmed.2023-0398","DOIUrl":"10.7861/clinmed.2023-0398","url":null,"abstract":"<p><p>Despite its recognition as an 'ANCA-associated vasculitis' (AAV), eosinophilic granulomatosis with polyangiitis (EGPA) is ANCA negative in up to 60% of cases. Herein, we report the case of a young man with a clinical syndrome highly suggestive of EGPA but with repeated negative ANCA serology, ultimately presenting with cardiac arrest before recognition of the primary systemic vasculitis, whereupon he received successful induction therapy with high dose glucocorticoids and cyclophosphamide. The case illustrates the importance of awareness of ANCA negative AAV among general physicians in order to minimise morbidity and mortality.</p>","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"630-632"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142856","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}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.2023-0389
Miles D Witham, Jackie Bridges, John Gladman, Adam L Gordon, Susan Kay, Jill Manthorpe, Helen C Roberts, Lynn Rochester, Oliver Todd, Adeela Usman, Avan A Sayer
High-quality care for older people is best delivered by multidisciplinary teams involving a range of professions. Similarly, if research evidence is to effectively inform practice, it needs to be designed and executed by teams that are both multidisciplinary and multiprofessional. Here, we summarise the discussions from a 1-day workshop convened by the National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre in Spring 2021, which focussed on multidisciplinary academic teams. Barriers to success include small numbers of clinical academic researchers across all professions focussing on older people, and lack of career pathways, role models and support for non-medical clinical researchers. The workshop identified strengths in the tradition of multidisciplinary working in the care of older people, research questions that lend themselves naturally to multidisciplinary working, increasing interest from funders in multidisciplinary research, and untapped opportunities for greater commercial engagement. Initiatives to improve engagement of students and trainees, mentorship, career pathways, networking across research centres and possibly developing a national School of Older People's Care Research are all ways that we can ensure the growth of multidisciplinary research to best serve older people's health and social care in the future.
{"title":"Spotlight on the academic multidisciplinary team: proposals from the 3rd NIHR Newcastle BRC Academic Geriatric Medicine Workshop.","authors":"Miles D Witham, Jackie Bridges, John Gladman, Adam L Gordon, Susan Kay, Jill Manthorpe, Helen C Roberts, Lynn Rochester, Oliver Todd, Adeela Usman, Avan A Sayer","doi":"10.7861/clinmed.2023-0389","DOIUrl":"10.7861/clinmed.2023-0389","url":null,"abstract":"<p><p>High-quality care for older people is best delivered by multidisciplinary teams involving a range of professions. Similarly, if research evidence is to effectively inform practice, it needs to be designed and executed by teams that are both multidisciplinary and multiprofessional. Here, we summarise the discussions from a 1-day workshop convened by the National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre in Spring 2021, which focussed on multidisciplinary academic teams. Barriers to success include small numbers of clinical academic researchers across all professions focussing on older people, and lack of career pathways, role models and support for non-medical clinical researchers. The workshop identified strengths in the tradition of multidisciplinary working in the care of older people, research questions that lend themselves naturally to multidisciplinary working, increasing interest from funders in multidisciplinary research, and untapped opportunities for greater commercial engagement. Initiatives to improve engagement of students and trainees, mentorship, career pathways, networking across research centres and possibly developing a national School of Older People's Care Research are all ways that we can ensure the growth of multidisciplinary research to best serve older people's health and social care in the future.</p>","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"611-614"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142868","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}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.2023-0129
Jack Charles Barton, Daniel Richardson, Amber Elyse Corrigan, Matthew R Solomons, Ashvin Kuri, Jonathan Round
Background: We sought to explore associations between trainee doctor perception and excess patient mortality.
Methods: Data from two publicly available databases reflecting mortality and components of trainee satisfaction within 81 NHS healthcare institutions between the years 2012 and 2019 were analysed. Pearson's correlation coefficients were calculated.
Results: All domains of trainee perception were correlated with excess mortality. Clinical supervision out of hours (R=-0.44; p<0.0001), teamwork (R=-0.36; p<0.0001) and clinical supervision at any time (R=-0.35; p<0.0001) were most strongly correlated. Most associations remained consistent year on year.
Conclusion: Trainee doctor perceptions of clinical supervision, rota design and teamwork within the NHS are consistently correlated with excess patient mortality. Further exploration of these associations could identify opportunities for interventions to reduce excess patient mortality. Given the clinical significance of our findings, organisations should consider rapid implementation of evidence-based interventions where they exist.
{"title":"Supervision, scheduling, satisfaction and shared working: how experiences of junior doctors relate to excess mortality within the NHS.","authors":"Jack Charles Barton, Daniel Richardson, Amber Elyse Corrigan, Matthew R Solomons, Ashvin Kuri, Jonathan Round","doi":"10.7861/clinmed.2023-0129","DOIUrl":"10.7861/clinmed.2023-0129","url":null,"abstract":"<p><strong>Background: </strong>We sought to explore associations between trainee doctor perception and excess patient mortality.</p><p><strong>Methods: </strong>Data from two publicly available databases reflecting mortality and components of trainee satisfaction within 81 NHS healthcare institutions between the years 2012 and 2019 were analysed. Pearson's correlation coefficients were calculated.</p><p><strong>Results: </strong>All domains of trainee perception were correlated with excess mortality. Clinical supervision out of hours (R=-0.44; p<0.0001), teamwork (R=-0.36; p<0.0001) and clinical supervision at any time (R=-0.35; p<0.0001) were most strongly correlated. Most associations remained consistent year on year.</p><p><strong>Conclusion: </strong>Trainee doctor perceptions of clinical supervision, rota design and teamwork within the NHS are consistently correlated with excess patient mortality. Further exploration of these associations could identify opportunities for interventions to reduce excess patient mortality. Given the clinical significance of our findings, organisations should consider rapid implementation of evidence-based interventions where they exist.</p>","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"582-587"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11046585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.23-6-s104
Annie Noor Gheasuddin
{"title":"Evaluation of patients' suitability for a treatment break from bisphosphonates.","authors":"Annie Noor Gheasuddin","doi":"10.7861/clinmed.23-6-s104","DOIUrl":"10.7861/clinmed.23-6-s104","url":null,"abstract":"","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 Suppl 6","pages":"104"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11046999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139105918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.7861/clinmed.23-6-s12
Laura Pugh, Kishan Dattani
{"title":"Hypothermic episodes during hospital admission and the correlation with clinical condition and mortality in different age groups.","authors":"Laura Pugh, Kishan Dattani","doi":"10.7861/clinmed.23-6-s12","DOIUrl":"10.7861/clinmed.23-6-s12","url":null,"abstract":"","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 Suppl 6","pages":"12"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11046654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139105924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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