Talk Medical English

Welcome to episode 53. The final. Here is the link to the article: https://www.nejm.org/doi/full/10.1056/NEJMp2114695?query=featured_home  

Hello and welcome to episode 52. This episode uses the Christmas themed BMJ as its source of medical interest. https://www.bmj.com/content/bmj/375/bmj-2021-068001.full.pdf

Hello and welcome to episode 51. This episode mixes health and politics in the UK. The article can be found using the link below: https://www.bmj.com/content/375/bmj.n3056?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text  

Hello and welcome to episode 50. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2784458

Hello and welcome to episode 49. This episode considers chronic renal failure and its treatment with different forms of peritoneal dialysis. The article used is taken from the New England Journal of Medicine and is a clinical education article. Sections  of the article are read for you to enjoy and follow in the text. Areas covered include the physiology of dialysis, the anatomy of the peritoneum I am well as the outcomes of this form of treatment.   The link to  the article is in the notes: https://www.nejm.org/doi/full/10.1056/NEJMra2100152

Hello and welcome to episode 48. This time we return to the subject of the Covid pandemic and the role of vaccination, but this time there is an ethical component which is presented an opinion article published in the BMJ. It argues from ethical standpoint healthcare workers of different types have an obligation to be vaccinated to protect their patients. The article is available freely for a BMJ website and the link to the article is in the notes. https://www.bmj.com/content/bmj/375/bmj.n2670.full.pdf

Hello and welcome to episode 47. This episode is rather different and more genteel than usual, as it is talks of the experience of a doctor outside of work and is not technical. The article taken from the BMJ and explores the benefits of having an allotment, an area of land like a garden that allows you to grow fruit and vegetables. As you can see from the commentary, it is beneficial for people's mental health, giving them an opportunity to connect with nature, finding something to do that is totally different from their work, and is a form of relaxation as well as providing food. The link is in the notes. https://www.bmj.com/content/375/bmj.n2370?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text

Hello and welcome to episode 46.   This episode uses an article that considers  the important issue of prevention of cardiovascular disease with dietary intervention.  That is, the benefits of  lower dietary animal fat in particular and the increase in intake of fats derived from plants. The selected article is a systematic review of cohort studies that analyses the benefits of alpha linolenic acid with respect to all-cause, cardiovascular and cancer mortality. The article is freely available and the link is in the notes. https://www.bmj.com/content/375/bmj.n2213  

Hello and welcome to episode 45.   The article used this time continues on the theme of climate change and the actions that are required to reduce our output of carbon. It  remains topical in the light of its importance and the up-and-coming COP26 conference in Glasgow later this year.   The article considers actions that will be required for sectors that are the dominate sources of  carbon production and the benefits of change. There are different routes to achieve change but we cannot rely upon education alone. We need to change the physical and economic environments to make change sustainable but also make sure that actions are fair. Extracts of the article are read and as it is is freely available, the other sections can be accessed at your leisure. https://www.bmj.com/content/375/bmj.n2293  

Hello and welcome to episode 44. In view of the well recognised climate and biodiversity crisis, medical journals around the world have published a joint editorial calling for real action. In this episode the editorial is read and a link to it is in the notes. However it is widely available elsewhere.   https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00204-8/fulltext

This episode is based on an article that discusses general practice in the UK setting. It considers the stresses the system is under, its overall delivery and the fact that is the bedrock of the NHS. It proposes that questions need to asked in order to decide on future funding investment needed to provide the service that is required and desired. Additionally it considers the political backdrop to the way the service functions and is viewed by those who do not necessarily believe in it.   The article is available through the BMJ website and the link is in the notes: https://blogs.bmj.com/bmj/2021/09/28/will-the-nhs-survive-without-gps/?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text  

Hello and welcome to episode 42. These two brief entries summarise  and discuss the same paper which is a cohort study that looked at the effect of anti-psychotic medication during pregnancy and the subsequent development of complications in the child. The first is a brief summary that he is available on the BMJ site and the second is part of an editorial that is available in the original journal of JAMA. The links to both are provided in the text. https://blogs.bmj.com/bmj/2021/09/03/ann-robinsons-research-reviews-3-september-2021/ https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2782822  

Hello and welcome to episode 41.   The article this time considers continuity of care in the primary care setting and its importance in terms of hard health outcomes. The way in which health care systems are organised varies between countries and a strong relationship between the practitioner and patient exists more clearly in some systems than others. The article notes that this is the case in the UK, Denmark, Netherlands as well as Norway, the setting for this research and article. As well as providing satisfaction in terms of having a regular relationship the research indicates, as does previous research, that  there are clear health benefits of an ongoing professional relationship. The article is freely available and the link is in the notes.   https://bjgp.org/content/bjgp/early/2021/08/26/BJGP.2021.0340.full.pdf

Hello and welcome to episode 40. This article written by an educationalist touches on the reality of general practice that you cannot know everything. Therefore, you have to be realistic during your working time to deal with gaps in knowledge: be willing to learn, search for answers and verify your understanding.  Of course the application of this article goes beyond general practice. All specialities or areas of medical practice throw up new scenarios where you may lack knowledge. There is a recognition that we need to learn as we go along in our career. I hope you find the article interesting and the link  to it is found in the notes so that you can read and listen. https://www.bmj.com/content/374/bmj.n2025  

Hello and welcome to episode 39.   This time we consider a public health intervention that had a positive effect on the reduction in  childhood obesity and the subsequent negative impact of withdrawing the funding for this service. The  health consequences are felt in childhood and in later years. As the article points out childhood obesity is important both in childhood and has long-term effects into adult health. From the paper the background information is read in addition to the abstract which points out the results of the change in the policy. The link to the article is in the notes. Happy listening https://jech.bmj.com/content/75/9/860    

Hello and welcome to episode 38.   This episode again considers the importance of head injury in sport and the development of future neurodegenerative disease. This particular cohort study analyses the risk of development of neurodegenerative disease in Scottish football players.   In the article the game is referred to as soccer, I assume as the journal is American, while the game is predominantly referred to as football around the world bar the United States. The topic of head injury in sport has been considered before in the podcast in episode 4; link provided :(https://talk-medical-english.uk/2020/12/18/neurological-damage-and-rugby-union/) This is a cohort study that retrospectively identifies the exposed group of interest through historical records of professional players. Exposure is quantified through the proxy of position played on the pitch as it is not possible to identify exposure directly for individuals. Exposure has also been quantified through the length of career. Control for confounding has been attempted by utilising  matched population-based controls by age and area socioeconomic status.   The link to the article is found in the notes: https://jamanetwork.com/journals/jamaneurology/fullarticle/2782750?resultClick=1

Hello and welcome to episode 37. This episode is taken from the Lancet an is a commentary extolling the virtues of physical exercise for its public health benefits.These health benefits arrive in many forms. The commentary introduces a new series of articles on the benefits to health broadly of physical activity. The article on the Lancet website contains links to further articles in the series itself.   The link to the commentary is in the notes.   https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01652-4/fulltext

Hello and welcome to episode 36. This week's item is taken from the BMJ and is a short article that provides clinical advice for a rarely occurring side-effect of Covid-19 vaccination. It is interesting however, as it provides the symptoms of the clinical presentation to help with the identification of this rare side-effect. Additionally it advises the management steps and so is of clinical value. The link to the article is in the notes. https://www.bmj.com/content/374/bmj.n1914?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text ----more----  

Hello again. The podcast has had to change hosting arrangements  and so the RSS links with the previous site have been broken. So please research for Talk Medical English through your favourite podcasting app.   Episodes will still be available at https://talk-medical-english.uk

Hello and welcome to episode 35. This week takes us away from infectious disease to something with a long-term public health impact. The article, taken from the Lancet, is a systematic review and meta-analysis that considers the benefits of paternal education on child well-being as defined by mortality are different ages. The introduction and abstract are read but there is a lot more detail in the article to read if the subject matter takes you interest. The link to the article on the Lancet website is in the notes. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00534-1/fulltext

Hello and welcome to episode 34. This episode again returns to the topic of Covid 19 but this time with a different perspective: the genetic aspects that determine the of risk of developing disease and its subsequent severity. The article presented is from Nature, the prestigious science journal. A section of the introduction is read along with the abstract to give a taster of a complex and technical subject, but with enough to impart some key messages. The link to the article is in the text. https://www.nature.com/articles/s41586-021-03767-x

Hello and welcome to episode 33. This week's episode is based on an educational article that appears in the BMJ . It provides an insight into the interpretation of lateral flow tests used in COVID-19 detection. However, additionally it provides a useful overview of how to assess test results by considering test function, the epidemiology of the disease as well as the limitation of so called ‘gold standard' tests. The article provides a useful diagram which helps to explain the concept of pre-test and post-test probability and how the latter is derived from knowledge of test sensitivity and specificity, plus how a post-test probability is used and informs the necessary next steps. Certain parts of the article are read which you can follow in the text which is available on the BMJ website. The link to the article is in the notes. https://www.bmj.com/content/373/bmj.n1411

Hello and welcome to episode 32. This week's episode is somewhat briefer than usual as I've just come back from my holidays. The article chosen this week is shorter but still of interest to listen to and to read. It comments on the United States' FDA decision regarding the approval in a specific way of a new drug to treat Alzheimer's disease and touches on the use of interim outcome measures to indicate effectiveness and how to press forward with treatments for conditions that otherwise have limited care options. The article is published by The Lancet and the link is included in the notes for you to access. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01455-0/fulltext

Hello and welcome to episode 31 This week's article is taken from the Lancet journal and provides evidence regarding screening for ovarian cancer. It is important and interesting to note that this trial actually shows negative results. There is a recognised tendency for negative results not to be published leading to bias in the production of clinical evidence. The link the article is shown in the text and is freely available to download. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00731-5/fulltext

Hello and welcome to episode 30 This episode presents the personal views of a GP working in the UK regarding the working style and potential ways of improving working methods for the future. It is a short and more lighthearted episode than usual but equally an important way to consider how general practice works and could work differently. The link to the article is included in the notes and is freely available to read. https://www.bmj.com/content/373/bmj.n1496

Hello and welcome to episode 29. The dermatological effects of mask wearing have increased as a result of the Covid pandemic with the increased use of protection by healthcare workers and others. This podcast is based on an article from the BMJ which is openly accessible. There is a lot of detail regarding the skin conditions that can develop or be exacerbated by mask wearing. Additionally, the article includes a useful diagram to aid diagnosis of skin conditions, taking into account the distribution on the face of the dermatosis and the other areas of the body affected. Some of the passages are read and you will be able to follow the written word at the same time as listening. The link to the text is below.

Hello and welcome to episode 28. This week's chosen article has American focus but some of the messages I think can be applied universally. The article published in the New England Journal of Medicine considers the use of financial incentives to increase vaccination rates for the current Covid-19 pandemic. However the ideas are applicable to other areas of health improvement and so the concepts are worth noting. Parts of the article are read and the full article is available on the NEJM website to allow you read while you listen and if you wish read further for fuller details. The link to the article is in the notes. https://www.nejm.org/doi/full/10.1056/NEJMp2107719?query=featured_home

Hello and welcome to episode 27. This week's topic is taken from an open source BMJ article on the commonly considered subject of the use of night sedation medication to help people with sleep. I cannot give exact data but sleep disturbance in a common problem to deal with in primary care and one that has a significant impact on people and their quality of life. As such, there is often a pressure to use medication to help sleep, although it is well recognised that these medications have an addictive quality and so short-term use is usually recommended. However, these medications may be initiated for all the best intentions but some people use them in the longer term possibly with little benefit. The following article considers the long-term use of medication and the possible benefits, or not, for sleep quality. The introduction and abstract are read for your listening practice and the full article is openly available and the link is included in the notes below. https://bmjopen.bmj.com/content/11/5/e045074

Hello and welcome to episode 26 and a special welcome to those who have started listening recently. This week's subject is taken from an editorial that appears in the New England Journal of Medicine regarding the role of ‘grommets' or tympanostomy tubes in the management of recurrent acute otitis media in children. The article references a study published in the same edition which reports a randomised controlled trial comparing the insertion of grommets with medical treatment for recurrent infections. However the experience in the trial is a demonstration of the difficulties of producing valuable results and providing clinical evidence when there is significant crossover within the two arms of the trial. As a result of the crossover the effects of the intervention are diluted and the ‘intention-to-treat' analysis shows a non-significant effect. Most sections of the editorial are read for you to listen and the links to both articles are shown in the notes. Additionally, I would be very grateful if you would visit the website of the podcast and leave a comment on the blog entry to indicate where you are listening from and say what, if any, your connection is with healthcare. Thanks and keep well. https://www.nejm.org/doi/full/10.1056/NEJMe2104952?query=recirc_curatedRelated_article https://www.nejm.org/doi/full/10.1056/NEJMoa2027278?_ga=2.209131026.1410344250.1621347011-502440880.1621347011