Editorial

2011 ◽  
Vol 10 (1) ◽  
pp. 2-2
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Case Reports ◽  
Editorial Team ◽  
General Interest ◽  
Editorial Committee ◽  
Acute Medicine ◽  
The Past ◽  
Medicine Journal ◽  
The Press ◽  
Excellent Work ◽  
Areas Of Interest

Welcome to this special 10th anniversary edition of the Acute Medicine journal. Yes – there really have been 30 editions since Vol 1 issue 1, then the ‘CPD Journal of Acute Medicine’ rolled off the press. The journal has clearly evolved and expanded since then – both in terms of circulation and page count; submissions continue to rise in number and quality, ref lecting increased readership and developing interest in acute medicine as a speciality. We are marking the anniversary with a series of guest editorials, from inf luential figures in the development of the speciality over the past decade. I am delighted that Sir George Alberti agreed to write the first of these. George was the President of the Royal College of Physicians of London at the time of this journal’s first edition, and was instrumental in the developments leading up to the creation of the speciality of Acute Internal Medicine. After describing the challenges which the speciality has faced in its ‘gestation and birth’, he concludes that Acute Medicine has now reached its ‘rumbustious’ infancy with a bright future. ‘Overly exuberant or uncontrollably boisterous’, its definition, according to my Google dictionary are terms reminiscent of the past few weeks on our AMU. Hopefully, by the time this reaches printing, spring will be in the air and the dark days of winter, f lu and norovirus will be a distant memory. Optimism is as important as exuberance when working at the front line! As I mentioned in my last editorial, this year will see an increase from three to four issues, with the addition of a ‘trainee section’ containing a variety of new features. I hope that these will be of general interest, not just for the trainees. We have included a number of research-based articles this time, ref lecting some of the excellent work being done on acute medical units around the country. We still need to attract more research submissions if we are going to maintain the quality of the journal and develop into the high impact publication which the speciality so badly needs. Case reports continue to f lood in to the publishers and I am pleased that we are able to include a selection of these. The correspondence section is empty this time, after none was received in time for the publication deadline, but I hope this will return in the next edition. Finally, a word of thanks to the editorial committee, our external referees and, of course, the readers, for all the support over the past decade. The editorial team have worked tirelessly filtering, refereeing and selecting suitable articles for publication. Additional offers of help are always welcomed – please email me with details of any special areas of interest or expertise which you may be able to offer. In the meantime, I hope you enjoy reading this edition, and look forward to meeting some of you at the SAM meeting in May.

Editorial

2016 ◽  
Vol 15 (1) ◽  
pp. 2-2
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
The Netherlands ◽  
Editorial Team ◽  
Patient Specific ◽  
Service Improvement ◽  
Single Individual ◽  
National Goal ◽  
Acute Medicine ◽  
North West ◽  
The Past

Clinicians working in acute medicine will be familiar with change. The speciality and the environment we work in has changed continually over the past 15 years – I often reflect that no two years have been the same since I started working in the field back in 1999. Change is important, in order to achieve best practice, but sustaining such improvements can be an enormous challenge. The regular turnover of medical staff, local management restructuring and the constantly shifting National goal posts often conspire against us. It is easy for ‘changefatigue’ to set in. Submissions to this journal often describe local audits and service improvement projects which have raised standards: a low baseline may result in a statistically significant improvement from a relatively small intervention – often an education programme or poster campaign to raise awareness of the problem. However, what happens next is far more important: can the improvement be sustained when the key driver behind the project – the enthusiast – moves on, after their 4 month block of acute medicine comes to an end? One year on, we are often back where we started. Two articles in this edition appear to have achieved the Holy Grail of sustainability. In the paper by Joanne Botten from Musgrove Park, door to antibiotic time was improved for patients with neutopaenic sepsis by introducing a system whereby the antibiotics could be administered without waiting for a prescription to be written. The combination of a neutropaenic sepsis alert card and a patient-specific direction empowered the nurses and patients to ensure administration within an hour of arrival in over 90% of cases, a figure which has been sustained for over a year. Sustainable change is often facilitated by modifications in paperwork, but crucially the project’s success was not reliant on a single individual. The value of engaging with the wider team is also shown in Gary Misselbook’s paper describing sustained improvement in the layout and utility of an AMU procedure room. The authors describe how repeated attempts by different registrars had failed to achieve more than temporary reorganisation; the change was only sustained when nursing, infection control and administrative staff became involved in the process. The multiprofessional nature of the AMU is one of its greatest assets – we would all do well to remember this when instigating change. On a similar note, observant readers may have noticed some changes to the editorial board of this journal – I am delighted to welcome Dr Tim Cooksley, acute physician from Manchester and Dr Prabath Nanayakkara from the VUMC in the Netherlands. Tim came through the acute medicine training programme in the North West and his role in the acute oncology service at the Christie Hospital as well as his active involvement in the SAMBA project over recent years brings an important perspective to the editorial team. Prabath has been heavily involved with the development of acute medicine in the Netherlands and co-hosted the successful SAMSTERDAM meeting in 2014. His international perspective will be welcome as we attempt to extend the reach of Acute Medicine to our European neighbours over the coming years. I am very grateful to Nik Patel, Mark Jackson and Ashwin Pinto for their help and support during the past decade and wish them well for the future.

Editorial

2002 ◽  
Vol 1 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Case Reports ◽  
Gastrointestinal Haemorrhage ◽  
Medical Emergency ◽  
Editorial Team ◽  
Original Research ◽  
Acute Medicine ◽  
Previous Edition ◽  
Interesting Paper ◽  
Medical Emergencies ◽  
A Minor

So the brief ‘respite’ of summer is over, and we find ourselves plunging, once more towards the abyss of winter bed pressures. Hopefully those of you working at the coalface will find time to browse through the following pages. The production of a third issue in this ‘shortened’ year, following the launch of the Journal in July, is a credit to the hard work of the editorial and publishing teams. I am, as ever, grateful for their support. Next year will see a return to the planned 4-monthly cycle, with issues anticipated in March, July and November. One casualty of the tight schedule has been a minor adjustment to the cycle of reviews – COPD will now appear next Spring. In its place we have included an interesting paper reviewing the management of Neuroleptic Malignant Syndrome and Serotonin Syndrome, submitted by Consultant Psychiatrist David McNamara. Gastrointestinal haemorrhage and atrial fibrillation will be more familiar to readers, while Dr Joanna Girling’s review of the management of medical emergencies in pregnancy is essential reading for any physician working close to a maternity unit. Myasthenia gravis may not be the commonest medical emergency; nonetheless it is important that physicians are able to suspect, diagnose and initiate treatment for this condition. As I mentioned in my last editorial, I am keen to encourage submissions of case reports, audits, and pieces of original research provided they would appeal to a general medical readership. Cases need not be rare conditions, but must contain a clear teaching message for the reader. In future editions case reports will be categorised as ‘Tales of the Unexpected’, and ‘A Case to Remember’ (a memorable case or one with a message that readers should remember in future). The report on page 106 is an example of the latter – an important reminder that a radiological diagnosis of ‘pneumonia’ does not always imply an infective cause. Finally, I would like to thank those of you who have written with feedback following the previous edition of CPD Acute Medicine. We are clearly attempting to appeal to physicians from a broad range of backgrounds, and I hope that all readers find something which appeals to them in the pages which follow. Please feel free to write with your comments on any issue which you would like to share with the editorial team – depending on the response we may consider including a correspondence section in future editions of the journal.

Editorial Volume 1 Issue 1

2002 ◽  
Vol 1 (1) ◽  
Author(s):  
Paul F Jenkins ◽  
Keyword(s):  
Case Reports ◽  
General Medicine ◽  
Work Load ◽  
Original Research ◽  
Acute Medicine ◽  
The Past ◽  
Review Articles ◽  
Medical Emergencies

As you can see, the title of the Journal has changed and this is intended to emphasize its educational direction. It will continue to commission articles covering general medical topics with a particular emphasis on the management of acute medical emergencies, aiming to reflect the challenges that face those physicians responsible for supporting the acute medical intake. The CME component will continue,so helping to facilitate the accumulation of CPD points in General Medicine. As always we welcome submissions for publication and these can take the form of original research in areas of relevance to Acute Medicine or case-reports. We will continue to commission review articles as otherwise it proves impossible to maintain the cycle and the combination of articles we have planned. I am particularly enthused by the combination of topics covered in this Edition and I do hope that you enjoy reading them as much as I have enjoyed my editing duties. Profound thanks as always to those who have so kindly contributed;we do appreciate the extra commitment, especially in these days of inexorably heavier work-load for clinicians. This is my last Journal as Editor and I must extend my gratitude to those who have written articles over the past four years, to the member of the Editorial Board and of course to the Staff at RILA who have self lessly supported the Editor’s task. Unfailingly efficient they have been a complete pleasure to work with and very under tanding of the occasional memory lapse of this particular Editor! Chris Roseveare, Consultant in Acute Medicine in Southampton, takes over and the new editorial board will be announced in the next issue. Chris has some brilliant ideas and will lead this Journal to renewed success I am sure. I wish him the best of luck.

Editorial

2008 ◽  
Vol 7 (2) ◽  
pp. 62-62
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
British Society ◽  
Editorial Team ◽  
Clinical Activity ◽  
Acute Medicine ◽  
Acute Medical Unit ◽  
The Future ◽  
The Subject ◽  
Level Of Training ◽  
Areas Of Interest ◽  
To Receive

Whether acute medicine registrars should have the opportunity to acquire a procedural skill during their training has been the subject of considerable debate over recent years. The issue often dominates discussion amongst trainees and trainers alike at national meetings; exchanges are frequently heated and prolonged, highlighting the strength of feeling on all sides regarding the challenges which this creates. So the inclusion of three articles relating to this subject within this edition of Acute Medicine is not in any way disproportionate. In the past, much of the debate has centred on the concept of the ‘Sanity Session’ – the idea being that specialist acute physicians might need some clinical activity outside the acute arena to help prevent ‘burnout’. The three articles in this edition focus more specifi – cally on the issue of bedside investigation in the clinical setting. Many of us will recognise the scenario of the acutely unwell, hypotensive patient, for whom an urgent echocardiogram or ultrasound would enable great strides towards a diagnosis. Extracting a radiologist or cardiologist from their respective departments often requires a talent for negotiation of which a member of the Diplomatic Corps would be proud. Access to the equipment and possession of the necessary skills to undertake such procedures at the bedside would be a great asset for any Acute Medical Unit. While some units are undoubtedly already making great strides in this direction, this often results from the enthusiasm of individuals, many of whom have been trained in other specialities before moving to Acute Medicine. The statement from the British Society of Echocardiography on p95 should be viewed as an important step in identifying a level of training in which is feasible for trainees in acute medicine. The Royal College of Radiologists has also recently produced recommendations for training in ultrasound, which is described in detail by John Lorains; Mark Mallet also highlights some of the practical challenges which may arise in establishing an acute medical ultrasound service. Readers of this journal may note a slight change in the format, with fewer ‘commissioned’ review articles than in previous editions. The editorial team has been pleased to receive an increased number of unsolicited articles over recent months, which has facilitated this change. As the speciality continues to develop, a larger number of research-orientated papers are also beginning to fi lter through, which will be included over future editions. This increased number of submissions requires that a more rigorous review process is introduced. This will require an expanded team of editorial referees in the future. If any reader is interested in volunteering to help in this way, I would be grateful if you could email me at the address on this page, indicating your areas of interest and expertise. In addition any feedback from readers regarding the future format of the journal would be most welcome. I am also keen to establish a ‘correspondence’ section for future editions, so if any of the articles in this edition have raised your heckles, or reminded you of similar experiences which you wish to share, I would be delighted to receive these.

Editorial

2006 ◽  
Vol 5 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Medical Training ◽  
Case Reports ◽  
Junior Doctors ◽  
Acute Medicine ◽  
The Past ◽  
Acute Medical Unit ◽  
Application Service ◽  
Public House ◽  
The Uk

They say time flies when you’re having fun – and the 5 years since Paul Jenkins convinced me to take over as editor of this journal have certainly flown by. This period has seen a dramatic expansion in the numbers of physicians specialising in Acute Medicine, the confirmation of subspeciality status and development of a training curriculum. Addressing over 300 delegates at the recent Society for Acute Medicine meeting at the Royal College of Physicians, President Mike Jones reminded us that only seven years earlier the Society’s entire membership had sat around a small table in a public house just a few hundred yards from that spot. At that time many were predicting that recruitment to the speciality would be a major challenge. ‘Why would anyone choose to specialise in acute medicine?’ was a question, sometimes whispered in the corridors of St Andrew’s Place. And yet many have made this choice, and many more continue to do so. The Society for Acute Medicine now has upwards of 400 members, a figure which has doubled in the past 12 months. Even more encouraging was the large number of trainees who visited the Acute Medicine stand at the recent BMJ careers fair. Many junior doctors clearly view Acute Medicine as a positive career choice, not the ‘last resort’ which some predicted it may become. However, challenges remain. By the time this edition hits the press the Medical Training Application Service (MTAS) will be swinging into action to produce the first applicants for ‘post MMC’ training positions across the UK. For those of us who are involved in the shortlisting and interview process, the enormity of the task is rapidly becoming apparent. In Wessex, the Deanery has suggested that Acute Medicine shortlisting may take as much as a week, with a further week set aside for interviews of the hopeful candidates. Then comes ‘round two’, later in the year, when potentially we do it all over again. Suddenly the prospect of annual leave in the months of March or April looks like a forlorn hope. But before I break this news to my wife and family, I should spare a thought for those readers who find themselves on the opposite side of the process. To be part of the first cohort of trainees to be involved in this must be a daunting prospect. Many of those enthusiastic potential recruits to the speciality are clearly struggling to know where to turn to for advice on the process, confused by often contradictory messages and unanswered questions. Hopefully all will become clearer as the deadlines approach. A smaller ‘Reviews’ section in this edition reflects a dramatic increase in the number of articles submitted for consideration of publication in this journal over the past 6 months. As a result we have accommodated more case reports than normal, along with two papers in our new section for research and audit. I would encourage similar submissions in the future; case reports need not be rare or esoteric, provided they contain a clear teaching message clinicians involved in the acute ‘take’. Completed audits will be considered if they demonstrate clear evidence of how to improve practice in an acute medical unit. Owing to some software problems, Rila has temporarily suspended their submissions website which, until recently, had been the mechanism for submission of articles to this journal. Until these problems are resolved, I would be grateful if any articles could be e-mailed directly to me at the address shown on this page, so that I can arrange for peer review. Finally, a reminder that this edition concludes the cycle of reviews which started in 2002 and has now covered the majority of conditions presenting as emergencies on the acute medical ‘take’. The new cycle, starting in 2007 with volume 6 issue 1 will follow a modified pattern, with different authors hopefully providing a fresh perspective in their updated reviews. My thanks go to all of the authors who have produced material over the past 5 years as well as to the editorial board for their ongoing hard work in commissioning articles for the past and future cycles.

Editorial Volume 16 Issue 4

2017 ◽  
Vol 16 (4) ◽  
pp. 155-155
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Internal Medicine ◽  
Case Reports ◽  
Editorial Team ◽  
Research Committee ◽  
Acute Medicine ◽  
The Future ◽  
New Vision ◽  
The Uk

My time has come. After 15 years and over 50 editions it is time for me to hang up my metaphorical red biro, and hand over the role of Editor. It has been an interesting job, and I am extremely grateful to everyone who has contributed and supported the journal over this period. When I took on the position in 2002, this journal was very different to how it is today. Some readers may recall its original incarnation as the CPD journal of Internal Medicine, part of a series of publications produced at that time by Rila. Initially this was comprised predominantly of commissioned review articles, running over a 5 year cycle which was designed to cover the common conditions managed by ‘general’ physicians. As time progressed, the number of unsolicited submissions grew steadily – initially (and continually) dominated by case reports, but with a slowly increasing number of research-based articles as the readership expanded. The quality of these submissions improved further when we finally attained indexing in PubMed, which also attracted more international submissions. I am delighted that the current edition features research papers from the Netherlands and Singapore, both of which have a growing community of Acute Physicians. I remain hopeful that the number of acute medicine-related research submissions from the UK will rise as the speciality grows. The number of high quality abstracts presented at the Society for Acute Medicine (SAM) meetings is indicative of the amount of work that is going on, but it is disappointing that so few of these turn into publications in peerreviewed journals. Acute Physicians are busy people with constant and year-round operational pressures, which may mean that writing up research is continually pushed down the list of priorities. Perhaps also the fact that the number of consultant posts across the continues to exceed the number of Acute Internal Medicine trainees removes some of the ‘pressure to publish’ which is felt by trainees in other hospital specialities. My hopes for the future of this journal have been boosted by the appointment of Tim Cooksley as my replacement ‘Editor in Chief’, who will take over from the Spring 2018 edition onwards. Tim has been a hard working member of the editorial team over recent years, and prior to this was a regular contributor to the journal. He has a strong research background and is a leading member of the SAMBA academy and SAM research committee. I would also like to thank the other members of the editorial board without whose support and contributions this job would have been completely untenable. I understand that Tim plans to keep many of these colleagues in post, as well as bringing in some ‘new blood’ to create a fresh new vision for the future. I wish them all well, and will look forward to reading (as opposed to writing) these editorials. Thanks, finally, to all of the loyal readers who have stuck with the journal over the past 2 decades. I hope that we have managed to keep you entertained and educated on those occasional moments of respite during the acute medical on-call. I wish you all well for the future.

Editorial Volume 1 Issue 2

2002 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Case Reports ◽  
Editorial Team ◽  
Original Research ◽  
Self Assessment ◽  
Acute Medicine ◽  
Questions And Answers ◽  
Medical Emergencies ◽  
Near Future

When I was invited to take over as Editor of this journal, I had little idea of the amount of work which went into its production. I am indebted to Paul Jenkins for staying on in the role of sub-editor, and for helping me up a very steep learning curve over the past few months. I am certain that regular readers will wish to join me in thanking Paul and his editorial team for all their hard work during the last three years. The new editorial board has been expanded to include physicians with a broad range of specialty interests. We will be making use of their expertise and their contacts within their fields to commission reviews on a range of topics relevant to Physicians involved in the Acute Medical take. The intention is to cover all of the common (and some less common) conditions presenting as medical emergencies over a four yearly cycle. Ultimately this will mean that regular subscribers will have access to a comprehensive ‘textbook’ of acute medicine, with ongoing regular updates. The cycle schedule has already been determined, and a provisional plan is listed on page 71. The second section of the journal will include some new features. Some of these will be commissioned, but we would also like to encourage submissions from the readership. Case reports of a ‘General Medical’ nature, pieces of original research and audits relevant to Acute Medicine would be most welcome for this section. ‘Viewpoint’ is intended as a soapbox for anyone with a strong opinion which they would like to air in around 1000 words. This edition contains reviews of the management of suspected pulmonary embolism, diabetic ketoacidosis, anaphylaxis and cellulitis, all relatively common presentations on an Acute Medical take. In addition, we have a detailed review of the management of severe asthma, written from an intensivist’s perspective. This should provide an insight into the management of this complex group of patients, for those of you who are unfamiliar with what goes on beyond the ITU doors. Our ‘How to do it’ feature for this edition is an ophthalmologists’ view of fundoscopy, and some key abnormalities of the optic disc. Self assessment questions and answers are included at the back of this edition. Unfortunately, external CPD credits cannot currently be accrued by completion of these, although we hope to remedy this in the near future. I am sure this will not detract from the enjoyment of reading the journal, which I hope you find as educational an experience as I have had in editing it.

Partial Adrenal Suppression with Prolonged Use of Depo-Provera

2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani
Keyword(s):  
Weight Gain ◽  
Medroxyprogesterone Acetate ◽  
Side Effect ◽  
Case Reports ◽  
Adrenal Incidentaloma ◽  
Adrenal Suppression ◽  
Private Pharmacy ◽  
Significant Weight Gain ◽  
The Past ◽  
Depo Provera

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.

scholarly journals Acknowledgement to Reviewers of Logistics in 2019

Logistics ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 2
Author(s):  
Keyword(s):  
Editorial Team ◽  
Editorial Process ◽  
Considerable Time ◽  
The Past

The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal’s rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not [...]

scholarly journals Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

2021 ◽  
Vol 49 (01) ◽  
pp. 046-055
Author(s):  
Victoria Hernández ◽  
Tania Lena ◽  
Eliana Camacho ◽  
Matías Craviotto
Keyword(s):  
Glomus Tumor ◽  
Case Reports ◽  
Low Frequency ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Soft Tissue Tumors ◽  
Glomus Tumors ◽  
The Past ◽  
Pubmed Search ◽  
Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

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