Clinical Medicine最新文献_第9页

Adenosine-sensitive ventricular tachycardia. 腺苷敏感性室性心动过速

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-05-01 Epub Date: 2024-05-06 DOI: 10.1016/j.clinme.2024.100216

Rahul K Mukherjee, Magdi M Saba

引用次数: 0

Design, implementation and evaluation of a spiral module combining data science, digital health and evidence-based medicine in the undergraduate medical curriculum: A mixed methods study. 在医学本科课程中结合数据科学、数字健康和循证医学的螺旋模块的设计、实施和评估：一项混合方法研究。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-05-01 Epub Date: 2024-04-20 DOI: 10.1016/j.clinme.2024.100207

Nader Al-Shakarchi, Jaya Upadhyay, Ivan Beckley, Faye Gishen, Anna Di Iorio, Robert Stephens, Sarah Clegg, Fiona C Lampe, Amitava Banerjee

{"title":"Design, implementation and evaluation of a spiral module combining data science, digital health and evidence-based medicine in the undergraduate medical curriculum: A mixed methods study.","authors":"Nader Al-Shakarchi, Jaya Upadhyay, Ivan Beckley, Faye Gishen, Anna Di Iorio, Robert Stephens, Sarah Clegg, Fiona C Lampe, Amitava Banerjee","doi":"10.1016/j.clinme.2024.100207","DOIUrl":"10.1016/j.clinme.2024.100207","url":null,"abstract":"Background: Digital health, data science and health informatics are increasingly important in health and healthcare, but largely ignored in undergraduate medical training.Methods: In a large UK medical school, with staff and students, we co-designed a new, 'spiral' module (with iterative revisiting of content), covering data science, digital health and evidence-based medicine, implementing in September 2019 in all year groups with continuous evaluation and improvement until 2022.Results: In 2018/19, a new module, 'Doctor as Data Scientist', was co-designed by academic staff (n = 14), students (n = 23), and doctors (n = 7). The module involves 22 staff, 120 h (43 sessions: 22 lectures, 15 group and six other) over a 5-year curriculum. Since September 2019, 5,200 students have been taught with good attendance. Module student satisfaction ratings were 92%, 84%, 84% and 81% in 2019, 2020, 2021 and 2022 respectively, compared to the overall course (81%).Conclusions: We designed, implemented and evaluated a new undergraduate medical curriculum that combined data science and digital health with high student satisfaction ratings.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100207"},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853958","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

Doing simple things well can achieve significant benefits. 把简单的事情做好，就能取得显著的效益。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-05-01 DOI: 10.1016/j.clinme.2024.100219

Ponnusamy Saravanan

引用次数: 0

Editorial: Learnings from all walks of medical practice. 社论：从各行各业的医疗实践中学习。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.clinme.2024.100201

Ponnusamy Saravanan

引用次数: 0

Pyroglutamate acidosis 2023. A review of 100 cases. 焦谷氨酸酸中毒 2023。100 例病例回顾。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-29 DOI: 10.1016/j.clinme.2024.100030

Gordon W Stewart

引用次数: 0

Optimising renal risk parameters in type 2 diabetes mellitus: Perspectives from a retinal viewpoint. 优化 2 型糖尿病肾脏风险参数：从视网膜角度看问题。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-16 DOI: 10.1016/j.clinme.2024.100031

Sarita Jacob, George I Varughese

{"title":"Optimising renal risk parameters in type 2 diabetes mellitus: Perspectives from a retinal viewpoint.","authors":"Sarita Jacob, George I Varughese","doi":"10.1016/j.clinme.2024.100031","DOIUrl":"10.1016/j.clinme.2024.100031","url":null,"abstract":"Diabetic retinopathy and nephropathy share pathophysiological mechanisms and there is a defined correlation between the severity of both these microvascular complications from suboptimal glycaemic control. The reno-protective properties offered by sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists should be applicable to diabetic retinopathy as well. However, in patients with pre-existing diabetic retinopathy, sudden improvement in glycaemic control is well documented to cause early worsening of the changes in the retina that is usually transient. This paradoxical phenomenon tends to occur with longer duration of diabetes, higher HbA1c at the outset, rapid improvement of glucose levels and the magnitude of HbA1c reduction with addition of more agents to tighten metabolic control. Interestingly, this progression of pre-existing diabetic retinopathy is not quite observed with newer sodium-glucose co-transporter-2 inhibitors. This article discusses potential further areas of future research where mechanisms of renal protection can be translated to the retina.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100031"},"PeriodicalIF":3.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899515","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

Predictive value and interrater reliability of mental status and mobility assessment in the emergency department. 急诊科精神状态和行动能力评估的预测价值和相互间可靠性。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-16 DOI: 10.1016/j.clinme.2024.100027

Tanguy Espejo, Henk B Riedel, Sebastian Messingschlager, Wolfram Sonnleitner, John Kellett, Mikkel Brabrand, Tim Cooksley, Roland Bingisser, Christian H Nickel

{"title":"Predictive value and interrater reliability of mental status and mobility assessment in the emergency department.","authors":"Tanguy Espejo, Henk B Riedel, Sebastian Messingschlager, Wolfram Sonnleitner, John Kellett, Mikkel Brabrand, Tim Cooksley, Roland Bingisser, Christian H Nickel","doi":"10.1016/j.clinme.2024.100027","DOIUrl":"10.1016/j.clinme.2024.100027","url":null,"abstract":"Aim: To investigate the predictive value of both mental status, assessed with the AVPUC (Alert, responds to Voice, responds to Pain, Unresponsive, and new Confusion) scale, and mobility assessments, and their interrater reliability (IRR) between triage clinicians and a research team.Method: Prospective study of consecutive patients who presented to an ED. Mental status and mobility were assessed by triage clinicians and by a dedicated research team.Results: 4,191 patients were included. After adjustment for age and sex, patients with altered mental status have an odds ratio of 6.55 [4.09-10.24] to be admitted in the ICU and an odds ratio of 21.16 [12.06-37.01] to die within 30 days; patients with impaired mobility have an odds ratio of 7.08 [4.60-11.12] to be admitted in the ICU and an odds ratio of 12.87 [5.93-32.30] to die within 30 days. The kappa coefficient between triage clinicians and the research team for mental status assessment was 0.75, and 0.80 for mobility.Conclusion: Assessment of mental status by the AVPUC scale, and mobility by a simple dichotomous scale are suitable for ED triage. Both altered mental status and impaired mobility are associated with adverse outcomes. Mental status and mobility assessment have good interrater reliability.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100027"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899516","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 future of clinical lipidology in the UK. 英国临床血脂学的未来。

IF 3.6 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-16 DOI: 10.1016/j.clinme.2024.100026

Jaimini Cegla, Dev Datta, Alan Rees, Handrean Soran, Gilbert Thompson

引用次数: 0

Tertiary centre study highlights low inpatient deintensification and risks associated with adverse outcomes in frail people with diabetes. 三级中心研究突显了虚弱糖尿病患者的低住院去势率和与不良后果相关的风险。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-20 DOI: 10.1016/j.clinme.2024.100029

Eka Melson, Mohamed Fazil, Hnin Lwin, Anu Thomas, Ting Fong Yeo, Kevin Thottungal, HayMar Tun, Faseeha Aftab, Meri Davitadze, Alison Gallagher, Samuel Seidu, Kath Higgins

{"title":"Tertiary centre study highlights low inpatient deintensification and risks associated with adverse outcomes in frail people with diabetes.","authors":"Eka Melson, Mohamed Fazil, Hnin Lwin, Anu Thomas, Ting Fong Yeo, Kevin Thottungal, HayMar Tun, Faseeha Aftab, Meri Davitadze, Alison Gallagher, Samuel Seidu, Kath Higgins","doi":"10.1016/j.clinme.2024.100029","DOIUrl":"10.1016/j.clinme.2024.100029","url":null,"abstract":"Introduction: The community deintensification rates in older people with diabetes are low and hospital admission presents an opportunity for medication review. We audited the inpatient assessment and deintensification rate in people with diabetes and frailty. We also identified factors associated with adverse inpatient outcomes.Methods: A retrospective review of electronic charts was conducted in all people with diabetes and clinical frailty score ≥6 who were discharged from the medical unit in 2022. Data on demographics, comorbidities and background glucose-lowering medications were collected.Results: Six-hundred-and-sixty-five people with diabetes and moderate/severe frailty were included in our analysis. For people with no HbA1c in the last six months preceding admission, only 9.0% had it assessed during inpatient. Deintensification rates were 19.1%. Factors that were associated with adverse inpatient outcomes included inpatient hypoglycaemia, non-White ethnicity, and being overtreated (HbA1c <7.0% [53 mmol/mol] with any glucose-lowering medication).Conclusion: The assessment and deintensification rate in secondary care for people with diabetes and frailty is low. Inpatient hypoglycaemia, non-White ethnicity, and overtreatment are important factors in determining inpatient outcomes highlighting the importance of deintensification and the need for an evidence-based risk stratification tool.","PeriodicalId":10492,"journal":{"name":"Clinical Medicine","volume":" ","pages":"100029"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930315","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

A novel mutation in the ABCC8 gene causing maturity-onset diabetes of the young: A case report. ABCC8基因突变导致青年成熟型糖尿病：病例报告。

IF 4.4 4区医学

Clinical Medicine Pub Date : 2024-03-01 Epub Date: 2024-03-20 DOI: 10.1016/j.clinme.2024.100033

Yifan Guo, Yangli Chen, Wen Liang, Lirong Zeng, Fang Hu, Yingjuan Zeng, Li Cong

引用次数: 0