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QJM. 2016 August; 109(8): 503.
Published online 2016 July 27. doi:  10.1093/qjmed/hcw103
PMCID: PMC4986444

Elements: in this month’s issue

QJM now ranked in the top 25 of medical journals

With the recent publication of the current journal impact factors, the QJM is now ranked in the top 25 of general medical journals. The journals impact factor increased by 15% compared to the previous year. Another marker of our success is the 25% increase in article downloads whereby 1.5 million articles are downloaded annually from our website ( One of the keys to this success is the quality of the manuscripts submitted by researchers from around the world. On behalf of the editorial team I would like to thank authors for their continuing strong support.

The right inhaler for the right patient

The QJM has been conscious of publishing state-of-the-art reviews on specific diseases which are clinically focused for the practicing clinician.1–3 Continuing this tradition, we welcome the timely, and authoritative review by Currie & Lipworth published in this issue of the journal in which they provide a practical overview of inhaler therapy in chronic obstructive pulmonary disease (COPD).

There are now an expanding and oftentimes confusing array of inhalers available to patients with airways disease. The authors provide an evidence based overview of the drugs available, describe the evidence supporting their use and highlights practical steps for clinicians with the aim of getting the right inhaler to the right patient.

Overdosing, new psychoactive substances (NPS) and recreational drug use

In analysing the epidemiology of novel psychoactive substance (NPS) use, it is apparent that newer structural modifications of compounds are being introduced into our community on a regular basis. Indeed, in 2014 over ×100 new additional substances were identified in Europe.4,5 For those of us working in acute medicine and dealing with patients overdosing on these substances this raises the question: what is our current knowledge in relation to the most appropriate treatment for these patients?.

Woods and colleagues provide an overview of our sometimes limited knowledge on these newer compounds. Historically, treating overdoses has been very much focused on the specific compound. The authors emphasize that rather than focusing on the specific agent, one should treat which ever of the three broad groups of compounds the drugs belong: (i. stimulant; ii. hallucinogenic or iii. depressant) and the associated symptoms.


1. McGwire BS, Satoskar AR. Leishmaniasis: clinical syndromes and treatment. QJM 2014; 107:7–14. [PMC free article] [PubMed]
2. Lobo LJ, Zariwala MA, Noone PG. Primary ciliary dyskinesia. QJM 2014; 107:691–9. [PubMed]
3. Klepfish A, Zuckermann B, Schattner A. Primary effusion lymphoma in the absence of HIV infection—clinical presentation and management. QJM 2015; 108:481–8. [PubMed]
4. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report 2015: Trends and Developments. [PubMed]
5. Archer JRH, Hudson S, Jackson O, Yamamoto T, Lovett C, Lee HM., et al. Analysis of anonymized pooled urine in nine UK cities: variation in classical recreational drug, novel psychoactive substance and anabolic steroid use. QJM 2015; 108:929–33. [PubMed]
6. Wood DM, Dargan PI. Novel psychoactive substances: how to understand the toxicity (harm) associated with the use of these substances. Ther Drug Monit 2012; 34:363–7. [PubMed]

Articles from QJM: An International Journal of Medicine are provided here courtesy of Oxford University Press