Clinical Medicine最新文献_第9页

The prevalence and associated risk factors of osteoporosis in hiv positive postmenopausal women on combined antiretroviral therapy. 接受联合抗逆转录病毒疗法的艾滋病毒阳性绝经后妇女骨质疏松症的患病率和相关风险因素。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.23-6-s53

Chinwada Pasca, Chiratidzo Ellen Ndhlovu, Alan Mcgregor, Cynthia Mukwasi-Kahari

引用次数: 0

The rapid progression of Creutzfeldt-Jakob disease with concomitant COVID-19 infection: a case report. 克雅氏病快速进展并伴有 COVID-19 感染：一份病例报告。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.23-6-s21

Adrian McGrath, Hari Pai, Aidan Clack

引用次数: 0

Are we missing pancreatic exocrine insufficiency in 'at-risk' groups? Prospective assessment of the current practice and yield of faecal elastase testing in patients with diabetes mellitus, HIV and/or high alcohol intake. 我们是否遗漏了 "高危 "人群的胰腺外分泌功能不全？对糖尿病、艾滋病和/或酒精摄入量高的患者粪便弹性蛋白酶检测的现行做法和结果进行前瞻性评估。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.2023-0185

Mustafa Jalal, John S Leeds, Hey-Long Ching, Andrei Oprescu, Ann Tunbridge, Julia Greig, Solomon Tesfaye, Andrew D Hopper

{"title":"Are we missing pancreatic exocrine insufficiency in 'at-risk' groups? Prospective assessment of the current practice and yield of faecal elastase testing in patients with diabetes mellitus, HIV and/or high alcohol intake.","authors":"Mustafa Jalal, John S Leeds, Hey-Long Ching, Andrei Oprescu, Ann Tunbridge, Julia Greig, Solomon Tesfaye, Andrew D Hopper","doi":"10.7861/clinmed.2023-0185","DOIUrl":"10.7861/clinmed.2023-0185","url":null,"abstract":"There is cumulative evidence that pancreatic exocrine insufficiency (PEI) is under-recognised and can occur in patients with 'at-risk' conditions. Thus, we aimed to assess the current practice and yield of requesting faecal elastase (FEL-1), an indicator of PEI, in patients with 'at-risk' conditions. We prospectively recruited patients attending secondary care clinics with diabetes mellitus (DM), people living with HIV (PLHIV) and inpatients admitted to hospital with high alcohol intake (HAI). All patients underwent testing with FEL-1. Those patients with PEI (FEL-1 <200 μg/g) were contacted and offered a follow-up review in gastroenterology clinic. In total, 188 patients were recruited (HAI, n=78; DM, n=64; and PLHIV, n=46). Previous FEL-1 testing had not been performed in any of the patients. The return rate of samples was 67.9% for patients with HAI, 76.6% for those with DM and 56.5% for those with PLHIV. The presence of PEI was shown in 20.4% of patients with DM, 15.4% of patients with PLHIV and 22.6% in those with HAI. Diarrhoea and bloating were the most reported symptoms in followed-up patients with low FEL-1 (31.8% and 22.7% of patients, respectively). Follow-up computed tomography (CT) scans in those patients with PEI identified chronic pancreatitis changes in 13.6% and pancreatic atrophy in 31.8% of patients. These results suggest that there is a lack of testing for PEI in 'at-risk' groups. Our findings also suggest that using FEL-1 to test for PEI in patients with DM, PLHIV and HAI has a significant impact, although further studies are required to validate these findings.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"588-593"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142857","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

Evidence-based appraisal of the role of SJTs in selection. 以证据为基础评估 SJT 在选拔中的作用。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.2023-0295

Gurvinder Sahota, John McLachlan, Fiona Patterson, Paul Tiffin

{"title":"Evidence-based appraisal of the role of SJTs in selection.","authors":"Gurvinder Sahota, John McLachlan, Fiona Patterson, Paul Tiffin","doi":"10.7861/clinmed.2023-0295","DOIUrl":"10.7861/clinmed.2023-0295","url":null,"abstract":"A recent opinion article in Clinical Medicine promoted a new preference-based algorithm to allocate training places for the UK Foundation Programme Office (UKFPO). This replaced the previous process, which ranked candidates based on medical school academic achievement (the educational performance measure; EPM) and the score on a situational judgement test (SJT). Although not without risks, we believe that the new system has positive potential. In presenting their case, Sam et al summarised evidence relating to the UKFPO in an unbalanced way, leading to what we believe are erroneous inferences, particularly with regard to differential attainment. Here, we provide an example of how the general evidence base and conceptual understanding of the validity of SJTs for medical selection is poorly understood. We highlight important research findings that were not cited by Sam et al and provide what we believe is a more balanced and accurate interpretation of the evidence base relating the UKFPO SJT, and SJTs used in medical selection in general. We do this with particular reference to the validity of such tools in this context, as well as their potential impact on under-represented groups in medicine, compared with other selection assessments.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"641-642"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142859","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

Lactic acidosis in a patient with cancer. 癌症患者出现乳酸酸中毒。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.2023-0391

Mayra Oseguera, Amy A Yau

引用次数: 0

Research activity among physicians in the United Kingdom: results from the Royal College of Physicians Census 2022. 英国医生的研究活动：英国皇家内科学院 2022 年普查结果。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.2023-0388

Subashini Chandrapalan, Chris Phillips, Nina Newbery, Sarah Logan, Ramesh Arasaradnam

引用次数: 0

Supervision, scheduling, satisfaction and shared working: how experiences of junior doctors relate to excess mortality within the NHS. 监督、日程安排、满意度和共同工作：初级医生的经历与国家医疗服务系统内死亡率过高的关系。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.2023-0129

Jack Charles Barton, Daniel Richardson, Amber Elyse Corrigan, Matthew R Solomons, Ashvin Kuri, Jonathan Round

{"title":"Supervision, scheduling, satisfaction and shared working: how experiences of junior doctors relate to excess mortality within the NHS.","authors":"Jack Charles Barton, Daniel Richardson, Amber Elyse Corrigan, Matthew R Solomons, Ashvin Kuri, Jonathan Round","doi":"10.7861/clinmed.2023-0129","DOIUrl":"10.7861/clinmed.2023-0129","url":null,"abstract":"Background: We sought to explore associations between trainee doctor perception and excess patient mortality.Methods: Data from two publicly available databases reflecting mortality and components of trainee satisfaction within 81 NHS healthcare institutions between the years 2012 and 2019 were analysed. Pearson's correlation coefficients were calculated.Results: All domains of trainee perception were correlated with excess mortality. Clinical supervision out of hours (R=-0.44; p<0.0001), teamwork (R=-0.36; p<0.0001) and clinical supervision at any time (R=-0.35; p<0.0001) were most strongly correlated. Most associations remained consistent year on year.Conclusion: Trainee doctor perceptions of clinical supervision, rota design and teamwork within the NHS are consistently correlated with excess patient mortality. Further exploration of these associations could identify opportunities for interventions to reduce excess patient mortality. Given the clinical significance of our findings, organisations should consider rapid implementation of evidence-based interventions where they exist.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":"23 6","pages":"582-587"},"PeriodicalIF":4.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142870","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

A 'catastrophic' fall! 灾难性 "的坠落

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.23-6-s25

Farishta Khan, Rona Applewaite, Anthony Abdullah

引用次数: 0

A case of ANCA-associated vasculitis presenting as a chronic cough with night sweats in an adult male. 一例表现为慢性咳嗽伴盗汗的 ANCA 相关性血管炎成年男性病例。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.23-6-s50

Jacob Corum Williams, Ryan Malcolm Hum, Silke Brix, Pauline Ho

引用次数: 0

A case of HSV2 vasculitis causing multi-territory ischaemic stroke in an immunocompetent man. 一例由 HSV2 型血管炎引起的免疫功能正常男子多区缺血性中风。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2023-11-01 DOI: 10.7861/clinmed.23-6-s33

Okkar Kyaw, Gagira Mudalige

引用次数: 0