Clinical Medicine最新文献

Bilateral Adrenal Infarction and Secondary Haemorrhage in Pregnancy: Implications of Factor V Leiden Heterozygosity: A Review of the Literature and a Case Report.

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-24 DOI: 10.1016/j.clinme.2025.100288

Wiaam Elradi, Samreen Innayat, Ahmed Hanafy, Sharifah Naseem, Abuzar Awadelkareem, Deepika Meneni

引用次数: 0

A mixed method evaluation of a novel targeted health messaging intervention to promote COVID-19 protective behaviours and vaccination among Black and South Asian communities living in the UK (The COBHAM study).

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-23 DOI: 10.1016/j.clinme.2025.100285

Dr Katie Sutton, Professor Jo Armes, Professor Lindsay Forbes, Ms Amran Mohamed, Dr Shuja Shafi, Dr Reham Mustafa, Ms S Shah, Professor Andrew Hayward, Dr Tasneem Pirani, Professor Tushna Vandrevala, Professor Jane Hendy, Dr Osman Dar, Dr Miqdad Asaria, Professor Sir Alimuddin Zumla, Professor Aftab Ala

{"title":"A mixed method evaluation of a novel targeted health messaging intervention to promote COVID-19 protective behaviours and vaccination among Black and South Asian communities living in the UK (The COBHAM study).","authors":"Dr Katie Sutton, Professor Jo Armes, Professor Lindsay Forbes, Ms Amran Mohamed, Dr Shuja Shafi, Dr Reham Mustafa, Ms S Shah, Professor Andrew Hayward, Dr Tasneem Pirani, Professor Tushna Vandrevala, Professor Jane Hendy, Dr Osman Dar, Dr Miqdad Asaria, Professor Sir Alimuddin Zumla, Professor Aftab Ala","doi":"10.1016/j.clinme.2025.100285","DOIUrl":"https://doi.org/10.1016/j.clinme.2025.100285","url":null,"abstract":"Aim: To evaluate an intervention (a film and electronic leaflet) disseminated via text message by general practices to promote COVID-19 preventative behaviours in Black and South Asian communities.Methods: We carried out a before-and-after questionnaire study of attitudes to and implementation of COVID-19 preventative behaviours and qualitative interviews about the intervention with people registered with 26 general practices in England who identified as Black or South Asian.Results: In the 108 people who completed both questionnaires, we found no significant change in attitudes to and implementation of COVID-19 preventative behaviours, although power was too low to detect significant effects. A key qualitative finding was that participants felt they did not 'belong' to the group targeted by the intervention.Conclusion: Interventions targeting ethnic minorities in the UK need to acknowledge the heterogeneity of experience and circumstances of the target group so that people feel that the intervention is relevant to them.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100285"},"PeriodicalIF":3.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037387","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}

引用次数: 0

Training, experience and perceptions of point of care ultrasound amongst internal medicine trainees: implications for training, curriculum development and service delivery.

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-21 DOI: 10.1016/j.clinme.2025.100283

Ben Joseph Probyn, Cyrus Daneshvar

{"title":"Training, experience and perceptions of point of care ultrasound amongst internal medicine trainees: implications for training, curriculum development and service delivery.","authors":"Ben Joseph Probyn, Cyrus Daneshvar","doi":"10.1016/j.clinme.2025.100283","DOIUrl":"https://doi.org/10.1016/j.clinme.2025.100283","url":null,"abstract":"Point of care ultrasound (POCUS) has revolutionised modern day medicine and has widespread utilisation throughout healthcare settings. Despite the availability of ultrasounds, there are no requirements for internal medicine trainees (IMTs) to undergo any form of POCUS training. This study aimed to explore the perceptions and experience of IMTs of POCUS. A multicentre survey was distributed via mass email to all internal medicine trainees (IMT1-ST8) across two deaneries in Southwest England. A total of 42% (213/509) IMTs completed the survey. Of these 97% (207/213) contributed to the acute medical or general medical rota and 95% (202/213) of trainees reported performing invasive procedures on call. Training in ultrasound site selection was reported by 30% (63/213) of IMTs and 11% (23/213) worked in a trust with accessible POCUS training. Formal POCUS accreditation was reported by 16.0% (34/213) of trainees. Identifying sonographic findings of common medical conditions was considered useful by 86.9% of trainees. Identifying pleural effusions being the most useful (99%, 211/213), whilst identifying a deep vein thrombosis was the least (87%,185/213). Higher confidence scores were reported for ultrasound assisted as opposed to ultrasound guided ascitic or pleural procedures, although this was not significant. On a 10-point Likert scale most trainees highly rated POCUS training (Median = 10, interquartile range 8-10). Free text responses supported POCUS training in the IMT curriculum. We found IMTs perceive POCUS training as highly valuable. However, few IMT trainees are obtaining sufficient experience or training of POCUS. Opportunities for enhanced POCUS training should be embedded in training programmes.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100283"},"PeriodicalIF":3.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028146","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}

引用次数: 0

Controversies in thyroid disease management in pregnancy. 妊娠期甲状腺疾病管理的争议。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-17 DOI: 10.1016/j.clinme.2025.100287

Pushpa Singh, Kristien Boelaert

{"title":"Controversies in thyroid disease management in pregnancy.","authors":"Pushpa Singh, Kristien Boelaert","doi":"10.1016/j.clinme.2025.100287","DOIUrl":"10.1016/j.clinme.2025.100287","url":null,"abstract":"Adequate control of thyroid function is crucial for optimal pregnancy outcomes and neurodevelopment of the offspring, and testing for thyroid function is ideally performed using manufacturer- and gestation-specific reference ranges. While universal screening for thyroid dysfunction is not recommended, targeted case finding of women at risk of thyroid disease during pregnancy is advised. A number of controversies continue to fuel debate including: (i) the target range for thyroid stimulating hormone (TSH) in women with subfertility planning pregnancy, (ii) management of mild thyroid hypofunction before and during pregnancy, (iii) the treatment of thyroid peroxidase (TPO) antibody-positive euthyroid women with levothyroxine, (iv) the optimal choice of antithyroid treatment in women with hyperthyroidism. A significant body of evidence has accumulated in recent years, including large systematic reviews and meta-analyses of observational studies determining effects of thyroid dysfunction on pregnancy and fetal outcomes. In addition, outcomes from important randomised trials continue to inform current guidance on how to best care for women with thyroid dysfunction before and during pregnancy.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100287"},"PeriodicalIF":3.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001486","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}

引用次数: 0

Clinical inertia - It is imperative to avoid delays in managing common conditions in pregnancy. 临床惰性-这是当务之急，以避免延误管理常见的情况下，在怀孕。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-15 DOI: 10.1016/j.clinme.2025.100286

Anita Banerjee, Ponnusamy Saravanan

引用次数: 0

Letter to the editor: "Implementation of ultrasound-guided cannulation training for foundation doctors". 致编者信：实施超声引导下的基础医生插管培训。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2025-01-14 DOI: 10.1016/j.clinme.2025.100284

Kushal Krishna Banerjee, Rabia Batool Hussain

引用次数: 0

The management of severe eczema in pregnancy. 妊娠期严重湿疹的处理。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-12-27 DOI: 10.1016/j.clinme.2024.100282

E Keeling, C H Smith, R T Woolf

引用次数: 0

Approach to investigation and management of proteinuria in pregnancy. 妊娠期蛋白尿的调查与处理方法。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-12-26 DOI: 10.1016/j.clinme.2024.100281

Isabela Bertoni, Sion Williams

{"title":"Approach to investigation and management of proteinuria in pregnancy.","authors":"Isabela Bertoni, Sion Williams","doi":"10.1016/j.clinme.2024.100281","DOIUrl":"10.1016/j.clinme.2024.100281","url":null,"abstract":"Pregnancy leads to significant changes in renal physiology, which result in increases in glomerular filtration rate (GFR) and enhanced protein excretion. These changes may continue in the postnatal period and might be observed for 5-6 months after birth. Once confirmed, proteinuria warrants investigation and close surveillance. Clinicians should establish the level of excretory kidney function and the presence or absence of proteinuria at booking/diagnosis. A history of proteinuria, PET and anti-hypertensive requirements in previous pregnancies is a helpful guide to what to expect in the current pregnancy. Maternal physiological adaptations mean that yet-undiagnosed kidney disease is unmasked during pregnancy. New onset of proteinuria before 20 weeks' gestation (with or without kidney impairment) suggests known or previously undetected kidney disease. As pregnancy evolves, hyperfiltration may lead to increasing proteinuria, posing a diagnostic challenge in the diagnosis and recognition of pre-eclampsia. This article was written as a guide for the evaluation and management of proteinuria in pregnancy, as well as appreciating diagnostic dilemmas.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100281"},"PeriodicalIF":3.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892093","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}

引用次数: 0

Cerebrospinal fluid leak-associated ventriculitis - a case report. 本月经验：脑脊液漏相关脑室炎1例报告

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-12-18 DOI: 10.1016/j.clinme.2024.100279

Amir Waheed, Faryal Amir

引用次数: 0

The approach to a pregnancy after bariatric surgery. 减肥手术后怀孕的方法。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-12-17 DOI: 10.1016/j.clinme.2024.100275

Harriet D Morgan, Amy E Morrison, Malak Hamza, Cathy Jones, Caroline Borg Cassar, Claire L Meek

{"title":"The approach to a pregnancy after bariatric surgery.","authors":"Harriet D Morgan, Amy E Morrison, Malak Hamza, Cathy Jones, Caroline Borg Cassar, Claire L Meek","doi":"10.1016/j.clinme.2024.100275","DOIUrl":"10.1016/j.clinme.2024.100275","url":null,"abstract":"With a rising worldwide incidence of obesity, particularly in the young, bariatric surgery offers an effective method of meaningful and sustained weight loss. At present, most bariatric procedures are carried out in women and increasingly in younger age groups. In line with the fertility benefits associated with weight loss, pregnancy after bariatric surgery is now a very common scenario. Although there is limited evidence to support optimal care in this group, most women appear to have good pregnancy outcomes, with reduced rates of pre-eclampsia and gestational diabetes (GDM). However, rates of stillbirth and small-for-gestational-age (SGA) babies are increased, suggesting that screening and supplementation of micronutrients is likely to be very important in this cohort. The risks and benefits that bariatric surgery may pose to pregnancy outcomes, both maternal and fetal, are largely dependent upon the degree of weight loss, weight stability upon entering pregnancy, surgical complications and the time interval between bariatric surgery and pregnancy. Ideally, preconception care would be more widely available, helping to assess and address micronutrient deficiencies and support preparation for pregnancy.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100275"},"PeriodicalIF":3.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863583","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}

引用次数: 0