Clinical Medicine最新文献_第8页

Strongyloides stercoralis infection in the UK: A systematic review and meta-analysis of published cases. 英国的盘尾丝虫感染：对已发表病例的系统回顾和荟萃分析。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-14 DOI: 10.1016/j.clinme.2024.100227

Ali M Alam, Cansu Ozdemir, Nada Reza

{"title":"Strongyloides stercoralis infection in the UK: A systematic review and meta-analysis of published cases.","authors":"Ali M Alam, Cansu Ozdemir, Nada Reza","doi":"10.1016/j.clinme.2024.100227","DOIUrl":"10.1016/j.clinme.2024.100227","url":null,"abstract":"Strongyloidiasis is a helminth infection where symptoms vary, and asymptomatic presentation is common. Chronic strongyloidiasis can cause a high mortality 'hyper-infection' in immunocompromised states. Understanding at risk populations and symptomology can guide screening and early treatment to reduce hyper-infection risk. A systematic review of studies describing patients in the UK with strongyloidiasis pooled a total of 1,308 patients. Weighted pooled prevalence (WPP) of asymptomatic cases was 27.7% (95% CI 17.1-39.5%, I2 = 92%, p < 0.01). At-risk populations included migrants, returning travellers and armed forces personnel. The most common symptoms reported were abdominal pain (WPP 32.1% (95% CI 20.5-44.8%), I2 = 93%, p < 0.01), rashes (WPP 38.4% (95% CI 13.1-67.7%), I2 = 99%, p < 0.01) and diarrhoea (WPP 12.6% (95% CI 6.7-19.9%), I2=70%, p = 0.03). Symptomatology varied with cohort characteristics. Although asymptomatic presentation is common, patients may present with abdominal pain, diarrhoea or rashes. A low threshold for screening symptomatic individuals in at-risk groups is required.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100227"},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619505","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

Mandibular movement monitor provides faster, yet accurate diagnosis for obstructive sleep apnoea: A randomised controlled study. 下颌运动监测仪为阻塞性睡眠呼吸暂停提供更快更准确的诊断：随机对照研究。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-22 DOI: 10.1016/j.clinme.2024.100231

Sulaiman S Alsaif, Wendy Douglas, Joerg Steier, Mary J Morrell, Michael I Polkey, Julia L Kelly

{"title":"Mandibular movement monitor provides faster, yet accurate diagnosis for obstructive sleep apnoea: A randomised controlled study.","authors":"Sulaiman S Alsaif, Wendy Douglas, Joerg Steier, Mary J Morrell, Michael I Polkey, Julia L Kelly","doi":"10.1016/j.clinme.2024.100231","DOIUrl":"10.1016/j.clinme.2024.100231","url":null,"abstract":"Many patients with obstructive sleep apnoea (OSA) remain undiagnosed and thus untreated, and in part this relates to delay in diagnosis. Novel diagnostic strategies may improve access to diagnosis. In a multicentre, randomised study, we evaluated time to treatment decision in patients referred for suspected OSA, comparing a mandibular movement (MM) monitor to respiratory polygraphy, the most commonly used OSA detection method in the UK. Adults with high pre-test probability OSA were recruited from both northern Scotland and London. 40 participants (70 % male, mean±SD age 46.8 ± 12.9 years, BMI 36.9 ± 7.5 kg/m2, ESS 14.9 ± 4.1) wore a MM monitor and respiratory polygraphy simultaneously overnight and were randomised (1:1) to receive their treatment decision based on results from either device. Compared to respiratory polygraphy, MM monitor reduced time to treatment decision by 6 days (median(IQR): 13.5 (7.0-21.5) vs. 19.5 (13.7-35.5) days, P = 0.017) and saved an estimated 29 min of staff time per patient.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100231"},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757589","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

The appropriateness of penicillin allergy de-labelling by non-allergist clinical ward teams. 非过敏学家临床病房团队对青霉素过敏进行去标签处理的适当性。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-27 DOI: 10.1016/j.clinme.2024.100225

Neil Powell, Shuayb Elkhalifa, Daniel Hearsey, Michael Wilcock, Jonathan Sandoe

{"title":"The appropriateness of penicillin allergy de-labelling by non-allergist clinical ward teams.","authors":"Neil Powell, Shuayb Elkhalifa, Daniel Hearsey, Michael Wilcock, Jonathan Sandoe","doi":"10.1016/j.clinme.2024.100225","DOIUrl":"10.1016/j.clinme.2024.100225","url":null,"abstract":"Objectives: We aimed to assess the appropriateness of penicillin allergy (PenA) assessment conducted by clinical teams and to review the safety of subsequent exposure of these patients to penicillin.Methods: Opportunistic, prospective observational study of usual clinical care, between 16 May 2023 and 14 August 2023, of inpatients with a PenA and requiring antibiotics, in a 750-bed hospital in England. To assess the appropriateness of management, PenA patients prescribed penicillins were grouped into risk categories using a validated antibiotic allergy assessment tool: eligible for de-label on history alone (direct de-label; DDL), eligible for direct oral challenge (DOC), high risk or unable to obtain history.Results: Of the 123 patients admitted with a PenA (or sensitivity record) and exposed to a penicillin, data were collected for 50. Their PenA records were grouped follows: eligible for DDL 34 (68%), eligible for DOC 11 (22%), high risk 4 (8%) and unable to obtain history 1 (2%). In 14/50 (28%) patients there was no evidence of a current PenA assessment in the medical notes.Conclusions: Using the allergy risk tool, most patients with PenA records were exposed to penicillin appropriately. However, patients meeting high-risk criteria were also exposed to penicillin when the tool excluded them. PenA assessment needs to be carried out with appropriate training and governance structures in place.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100225"},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466705","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

Letter to the Editor on Outpatient parenteral antibiotic treatment (OPAT) for infective endocarditis. 感染性心内膜炎的门诊肠外抗生素治疗（OPAT）。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-13 DOI: 10.1016/j.clinme.2024.100221

Marina Zafeiri, Temi Lampejo

引用次数: 0

Strategies to identify medical patients suitable for management through same-day emergency care services: A systematic review. 识别适合通过即日急诊服务管理的内科病人的策略：系统回顾。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-19 DOI: 10.1016/j.clinme.2024.100230

Catherine Atkin, Rhea Khosla, John Belsham, Hannah Hegarty, Cait Hennessy, Elizabeth Sapey

{"title":"Strategies to identify medical patients suitable for management through same-day emergency care services: A systematic review.","authors":"Catherine Atkin, Rhea Khosla, John Belsham, Hannah Hegarty, Cait Hennessy, Elizabeth Sapey","doi":"10.1016/j.clinme.2024.100230","DOIUrl":"10.1016/j.clinme.2024.100230","url":null,"abstract":"Same-day emergency care (SDEC) in unplanned and emergency care is an NHS England (NHSE) priority. Optimal use of these services requires rapid identification of suitable patients. NHSE suggests the use of one tool for this purpose. This systematic review compares studies that evaluate the performance of selection tools for SDEC pathways. Nine studies met the inclusion criteria. Three scores were evaluated: the Amb score (seven studies), Glasgow Admission Prediction Score (GAPS) (six studies) and Sydney Triage to Admission Risk Tool (START) (two studies). There was heterogeneity in the populations assessed, exclusion criteria used and definitions used for SDEC suitability, with proportions of patients deemed 'suitable' for SDEC ranging from 20 to 80%. Reported score sensitivity and specificity ranged between 18-99% and 10-89%. Score performance could not be compared due to heterogeneity between studies. No studies assessed clinical implementation. The current evidence to support the use of a specific tool for SDEC is limited and requires further evaluation.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100230"},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11359741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733718","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

Never forget the basics while seeking correct diagnosis and management. 在寻求正确诊断和治疗的同时，切勿忘记基本要素。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.clinme.2024.100232

Ponnusamy Saravanan

引用次数: 0

Determinants of 1-year mortality after acute myocardial infarction in patients with and without diabetes. 糖尿病患者和非糖尿病患者急性心肌梗死后 1 年死亡率的决定因素。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-12 DOI: 10.1016/j.clinme.2024.100223

Annalisa Montebello, Martina Agius, Martina Grech, Nicoletta Maniscalco, Ivana Kenkovski, Stephen Fava

引用次数: 0

Specialist referrals and diagnostic delays in motor neurone disease: Mapping patients' journey through hoops and hurdles in healthcare. 运动神经元疾病的专科转诊和诊断延误：绘制患者在医疗保健领域的 "圈套 "和 "障碍 "之旅。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-14 DOI: 10.1016/j.clinme.2024.100228

Samuel James Reynolds, Suresh Kumar Chhetri

{"title":"Specialist referrals and diagnostic delays in motor neurone disease: Mapping patients' journey through hoops and hurdles in healthcare.","authors":"Samuel James Reynolds, Suresh Kumar Chhetri","doi":"10.1016/j.clinme.2024.100228","DOIUrl":"10.1016/j.clinme.2024.100228","url":null,"abstract":"Motor neuron disease (MND) is an uncommon but invariably fatal condition, with a median survival of 24-48 months from symptom onset. Although there is no cure at the moment, early diagnosis is crucial to enable timely access to multidisciplinary care, and enrolment in clinical trials utilising investigational therapies. Unfortunately, diagnostic delays remain common, and the average delay between symptom onset and diagnosis is 12 months. Large numbers of specialist referrals have been suggested as a key contributor to diagnostic delays. We conducted a retrospective review of the medical records of patients diagnosed with MND in Lancashire and South Cumbria, to investigate whether large numbers of specialty referrals are a common occurrence in MND. Our review identified that 35% of patients with MND were seen by two or more specialties before being referred to neurology. This rose to 49% when patients with bulbar onset disease were considered. 9% of cases saw three or more specialists. There was a statistically significant correlation between the number of specialist referrals and delays in neurology referral. We hope our findings will increase awareness of the importance of early neurology referral in the diagnosis of MND and promote the use of the MND Red Flag tool as a means of identifying patients in need of prompt neurological evaluation.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100228"},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603341","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

Statin-induced, immune-mediated necrotising myopathy triggered by malignancy successfully treated with immunosuppression. 通过免疫抑制成功治疗恶性肿瘤诱发的他汀类药物免疫介导坏死性肌病

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-05-01 Epub Date: 2024-05-06 DOI: 10.1016/j.clinme.2024.100217

Ahmed Abouelazm, Kirollos Philops, Amr Amine, Yahia Golam

引用次数: 0

A case of spinal epidural abscess concealed by delirium in a young man. 每月一课一例被谵妄掩盖的年轻男子脊髓硬膜外脓肿病例。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-05-01 Epub Date: 2024-05-04 DOI: 10.1016/j.clinme.2024.100214

Benjamin Page, Sam Waddy

引用次数: 0