Main Residency Match for Applicants With Disability
This cohort study assesses match rates of US applicants with and without disability into specialty residence programs. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 17, 2024 Category: General Medicine Source Type: research
A Patient with Diabetes Mellitus and Acute Rhinosinusitis
A 41-year-old with type 1 diabetes had generalized weakness, muffled voice, and slurred speech. Neck computed tomography showed soft-tissue gas in the nasopharynx and prevertebral fascia; examination of sinus mucosal samples identified numerous broad, nonseptate right-angled hyphae and fruiting bodies. What is the diagnosis and what would you do next? (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 17, 2024 Category: General Medicine Source Type: research
Understatement in Poetry (Quieter Than an MRI)
Understatement, or “showing without telling,” makes writing in prose and especially in poetry pleasing to read. Medical training, in contrast, is rife with exhaustive explanation. “Open MRI” demonstrates the effect of understatement. The poem brims with implied yet revealing comparisons: the massive, coldly im personal MRI scanner that swallows the speaker’s mother and the small, oddly intimate denture case kept warm in the hands of the daughter; the eerily soothing, mentally replayed Bowie song lyrics vs the overtly loud magnetic clanging of the machine; the precise processing of details of the mother’ s inter...
Source: JAMA - Journal of the American Medical Association - April 17, 2024 Category: General Medicine Source Type: research
Open MRI
I keep my mother ’s dentures warm; they fog the plastic case on my lap. Lips pursed, arms raised above her head, she lies on a table about to slide through the doughnut of an apparatus that looks like a spaceship. I hear David Bowie’s voice: This is Ground Control to Major Tom as the contraption begins its magne tic music— an opus of hammers, a staccato hum. What a brave astronaut my mother is, fitted into a coil helmet, going in alone. She waves off my hand to hold, refuses earbuds the technician offers. I’d give anything if we were anywhere else. Strange, the way I now drift above her, the technician and the mach...
Source: JAMA - Journal of the American Medical Association - April 17, 2024 Category: General Medicine Source Type: research
Aspirin versus metformin in pregnancies at high risk of preterm pre-eclampsia in China (AVERT): protocol for a multicentre, double-blind, 3-arm randomised controlled trial
This study will compare the incidence of preterm-PE with delivery at <37 weeks’ gestation, as the primary outcome, of three different interventional groups: (1) aspirin 75 mg daily, (2) aspirin 150 mg daily and (3) aspirin 75 mg with metformin 1.5 g daily. 957 participants per treatment group are required to detect a significant difference of 59% in the reduction of the incidence of preterm-PE with 80% power and type I error of 5%. Pregnancy and neonatal outcomes will be collected and analysed.
Ethics and dissemination
Ethical approval for the study was obtained from the Joint Chinese University of Hong Kong&ndas...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Liu, J., Shen, L., Nguyen-Hoang, L., Zhou, Q., Wang, C. C., Lu, X., Sahota, D., Chong, K. C., Ying, H., Gu, W., Zhou, R., Yang, H., Jiang, Y., Chen, D., Li, X., Poon, L. Tags: Open access, Obstetrics & Gynaecology Obstetrics and gynaecology Source Type: research
Effect of metacognitive therapy on depression in patients with chronic disease: a protocol for a systematic review and meta-analysis
This article is a literature review that does not include patients’ identifiable information. Therefore, ethical approval is not required in this protocol. The findings of this systematic review and meta-analysis will be published in a peer-reviewed journal as well as presentations at relevant conferences.
PROSPERO registration number
CRD42023411105. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Zhang, Z., Wang, P., Gu, J., Zhang, Q., Sun, C., Wang, P. Tags: Open access, Mental health Source Type: research
De-imFAR phase II project: a study protocol for a cluster randomised implementation trial to evaluate the effectiveness of de-implementation strategies to reduce low-value statin prescribing in the primary prevention of cardiovascular disease
This study aims to reduce potentially inappropriate prescribing (PIP) of statins and foster healthy lifestyle promotion in cardiovascular disease (CVD) primary prevention in low-risk patients. To this end, we will compare the effectiveness and feasibility of several de-implementation strategies developed following the structured design process of the Behaviour Change Wheel targeting key determinants of the clinical decision-making process in CVD prevention.
Methods and analysis
A cluster randomised implementation trial, with an additional control group, will be launched, involving family physicians (FPs) from 13 Integrate...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Sanchez, A., Pijoan, J. I., Sainz de Rozas, R., Lekue, I., San Vicente, R., Quindimil, J. A., Rotaeche, R., Etxeberria, A., Mozo, C., Martinez-Cengotitabengoa, M., Monge, M., Gomez-Ramirez, C., Samper, R., Ogueta Lana, M., Celorrio, S., Merino-Inda, N., L Tags: Open access, Evidence based practice Source Type: research
Prevalence of work-related musculoskeletal disorders and associated factors affecting emergency medical services professionals in Jordan: a cross-sectional study
Conclusions
There is a high prevalence of musculoskeletal complaints among EMS personnel. Multiple variables may be incorporated into a national prevention campaign and professional development programme to educate EMS personnel on avoiding WMSDs. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Nazzal, M. S., Oteir, A. O., Alrawashdeh, A., Alwidyan, M. T., Obiedat, Q., Almhdawi, K. A., Ismael, N. T., Williams, B. Tags: Open access, Occupational and environmental medicine Source Type: research
Cost of SARS-CoV-2 self-test distribution programmes by different modalities: a micro-costing study in five countries (Brazil, Georgia, Malaysia, Ethiopia and the Philippines)
Conclusions
Our results indicate that it is likely to cost between $2.44 and $12.78 per test to distribute COVID-19 self-tests across common settings in five heterogeneous countries. Cost-effectiveness analyses using these results will allow policymakers to make informed decisions on optimally scaling up COVID-19 self-test distribution programmes across diverse settings and evolving needs. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Hansen, M. A., Lekodeba, N. A., Chevalier, J. M., Ockhuisen, T., del Rey-Puech, P., Marban-Castro, E., Martinez-Perez, G. Z., Shilton, S., Radzi Abu Hassan, M., Getia, V., Weinert-Mizuschima, C., Tenorio Bezerra, M. I., Chala, L., Leong, R., Peregino, R., Tags: Open access, Health economics, COVID-19 Source Type: research
Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings
Conclusion
Many varied interventions to de-implement potentially harmful NSAIDs have been applied in healthcare settings worldwide. Based on these findings and identified knowledge gaps, further efforts to comprehensively evaluate the effectiveness of interventions and the combination of intervention characteristics associated with effective de-implementation are needed. In addition, future work should be guided by de-implementation theory, focus on OTC NSAIDs and incorporate patient-focused strategies and outcomes, including the evaluation of unintended consequences of the intervention. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Rockwell, M. S., Oyese, E. G., Singh, E., Vinson, M., Yim, I., Turner, J. K., Epling, J. W. Tags: Open access, Health services research Source Type: research
Randomised controlled, patient-blinded, multicentre, superiority trial to evaluate the efficacy of the line-attached sheath-type traction device for endoscopic submucosal dissection in patients with superficial gastric neoplasms
Introduction
EndoTrac is a line-attached sheath-type traction device that enables us to control the direction and the force of traction during endoscopic submucosal dissection (ESD). The efficacy of EndoTrac for gastric ESD has not been fully verified.
Methods and analysis
The G-Trac study is a multicentre (nine general hospitals and two university hospitals in Japan) collaborative trial assessing the efficacy of EndoTrac for gastric ESDs. Patients with superficial gastric neoplasms will be enrolled and randomly assigned to undergo either conventional ESD or EndoTrac ESD. Allocation will be stratified according to tumour ...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Abe, H., Sako, T., Yamamoto, Y., Ikeda, A., Kawara, F., Ose, T., Takao, T., Kitamura, Y., Ariyoshi, R., Morita, Y., Ishida, T., Ikegawa, T., Ishida, R., Yoshizaki, T., Sakaguchi, H., Toyonaga, T., Kodama, Y. Tags: Open access, Gastroenterology and hepatology Source Type: research
Effects of different exercise interventions on chemotherapy-related cognitive impairment in patients with breast cancer: a study protocol for systematic review and network meta-analysis
Introduction
Breast cancer stands as the most prevalent type of cancer affecting women globally, and chemotherapy plays a pivotal role in its treatment by diminishing tumour recurrence and enhancing the survival rates of patients. However, chemotherapy-related cognitive impairment (CRCI) often occurs in patients undergoing treatment. Although multiple clinical trials have indicated that exercise therapy can improve CRCI in patients with breast cancer, there are variations in the types of exercise interventions and their effectiveness. We aim to perform a pioneering network meta-analysis (NMA) to assess and prioritise the e...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Dong, Y., Huang, H., Wang, A. Tags: Open access, Rehabilitation medicine Source Type: research
Evaluation of a manualised neurofeedback training in psychosomatic-psychotherapeutic outpatient treatment (Neuro-pp-out): study protocol for a clinical mixed-methods pilot study
Introduction
Electroencephalographic neurofeedback (NFB), as a non-invasive form of brainwave training, has been shown to be effective in the treatment of various mental health disorders. However, only few results regarding manualised and standardised NFB trainings exist. This makes comparison as well as replication of studies difficult. Therefore, we developed a standard manual for NFB training in patients with mental health disorders attending a psychosomatic outpatient clinic. The current study aims at investigating the conduction of a standardised manual for NFB training in patients with mental health disorders. If suc...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Schmidt, K. L., Kowalski, A., Schweda, A., Dörrie, N., Skoda, E. M., Bäuerle, A., Teufel, M. Tags: Open access, Mental health Source Type: research
Outcomes after cancer diagnosis in children and adult patients with congenital heart disease in Sweden: a registry-based cohort study
Conclusions
Cancer-related deaths constituted 1.8% of all mortalities across all CHD patients. Among CHD patients with cancer, 18.3% died, with cancer being the cause in 71.9% of cases. Although CHD patients have an increased cancer risk, their mortality risk post-diagnosis does not significantly differ from non-CHD patients after adjustements and exclusion of patients with genetic syndromes and transplant recipients. However, CHD patients with genetic syndromes and concurrent cancer appear to be a vulnerable group. (Source: BMJ Open)
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Karazisi, C., Dellborg, M., Mellgren, K., Giang, K. W., Skoglund, K., Eriksson, P., Mandalenakis, Z. Tags: Open access, Cardiovascular medicine Source Type: research
Short-duration aerobic high-intensity intervals versus moderate exercise training intensity in patients with peripheral artery disease: study protocol for a randomised controlled trial (the Angiof-HIIT Study)
This study aims to compare the effects of 12-week-long supervised walking exercise training (high-intensity interval training (HIIT) vs moderate-intensity exercise (MOD)) in patients with chronic symptomatic PAD.
Methods and analysis
This study is a monocentric, interventional, non-blinded randomised controlled trial. 60 patients (30 in each group) will be randomly allocated (by using the random permuted blocks) to 12 weeks (three times a week) of HIIT or MOD. For HIIT, exercise sessions will consist of alternating brief high-intensity (≥85% of the peak heart rate (HRpeak)) periods (≤60 s) of work with periods of pa...
Source: BMJ Open - April 17, 2024 Category: General Medicine Authors: Lanzi, S., Pousaz, A., Fresa, M., Besson, C., Desgraz, B., Gremeaux-Bader, V., Mazzolai, L. Tags: Open access, Sports and exercise medicine Source Type: research
