Journal of the Royal Society of Medicine最新文献

{"title":"For more events and to book online, please visit www.rsm.ac.uk/events.","authors":"","doi":"10.1177/01410768241240364","DOIUrl":"10.1177/01410768241240364","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"117 2","pages":"88-89"},"PeriodicalIF":17.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The difference in all-cause mortality between COVID-19 patients treated with standard of care plus placebo and those treated with standard of care alone: a network meta-analysis of randomised controlled trials of immunomodulatory kinase inhibitors.","authors":"Ping-Tao Tseng, Bing-Syuan Zeng, Chih-Wei Hsu, Trevor Thompson, Brendon Stubbs, Po-Ren Hsueh, Kuan-Pin Su, Yen-Wen Chen, Tien-Yu Chen, Yi-Cheng Wu, Pao-Yen Lin, Andre F Carvalho, Dian-Jeng Li, Ta-Chuan Yeh, Cheuk-Kwan Sun, Yu-Shian Cheng, Yow-Ling Shiue, Chih-Sung Liang, Yu-Kang Tu","doi":"10.1177/01410768231202657","DOIUrl":"10.1177/01410768231202657","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this network meta-analysis (NMA) was to assess whether participants assigned to a placebo and standard of care (SoC) group had different major coronavirus disease 2019 (COVID-19)-related outcomes than those assigned to SoC alone.</p><p><strong>Design: </strong>Frequentist model-based NMA.</p><p><strong>Setting: </strong>We searched for randomised controlled trials (RCTs) of Janus kinase/Bruton tyrosine kinase inhibitors for the management of COVID-19.</p><p><strong>Participants: </strong>Patients with COVID-19 infection.</p><p><strong>Main outcome measures: </strong>The primary outcome was the 28-day all-cause mortality, and secondary outcomes were: (1) use of mechanical ventilation; (2) secondary bacterial infection; (3) acceptability (i.e. drop-out rate); and (4) safety (i.e. serious adverse events). We conducted an NMA using the frequentist model. Effect sizes were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>We identified 14 eligible RCTs enrolling a total of 13,568 participants with COVID-19. Participants assigned to placebo plus SoC had a significantly higher risk of 28-day all-cause mortality than those receiving SoC alone (OR = 1.39, 95% CI = 1.07-1.79). This finding did not change substantially by subgroup analysis stratified by epidemiology factor, pandemic history progression and statistical methodologic consideration. In addition, none of the treatments investigated were associated with a significantly different risk of secondary bacterial infection, acceptability or safety compared with the SoC group.</p><p><strong>Conclusions: </strong>This NMA suggested a higher all-cause mortality in patients treated with placebo plus SoC compared with those treated with SoC alone. However, caution is advised in interpreting these results due to the absence of a direct head-to-head comparison. Future research should critically evaluate the necessity of placebo administration in COVID-19 RCTs and consider alternative study designs to minimise potential biases.<b>Trial registration:</b> The current study was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (TSGHIRB No. B-109-29) and registered in PROSPERO (CRD42022376217).</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"57-68"},"PeriodicalIF":8.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136397965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicine: the pursuit of understanding.","authors":"Kamran Abbasi","doi":"10.1177/01410768241239803","DOIUrl":"10.1177/01410768241239803","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"117 2","pages":"51"},"PeriodicalIF":8.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paul Owren, Christopher Bjerkelund and the dawn of controlled trials in Norway.","authors":"Magne Nylenna","doi":"10.1177/01410768231207292","DOIUrl":"10.1177/01410768231207292","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"77-84"},"PeriodicalIF":8.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European international medical graduates (IMGs): are we ignoring their needs and under-representing the scale of IMG issues in the UK?","authors":"Mo Al-Haddad","doi":"10.1177/01410768241230804","DOIUrl":"10.1177/01410768241230804","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"52-54"},"PeriodicalIF":8.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABO blood group associated with cerebral venous thrombosis after Oxford-AstraZeneca COVID-19 vaccination: a case-control study.","authors":"Gie Ken-Dror, Pankaj Sharma","doi":"10.1177/01410768231214341","DOIUrl":"10.1177/01410768231214341","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether blood group influences development of cerebral venous thrombosis (CVT) after administration of the coronavirus disease 2019 (COVID-19) AstraZeneca ChAdOx1-S vaccine.</p><p><strong>Design: </strong>A case-control study. Univariate and multivariate logistic regression was used to determine the association between blood type and COVID-19 vaccination status.</p><p><strong>Setting: </strong>Vaccinated and unvaccinated patients recruited from the international Bio-Repository to Establish the Aetiology of Sinovenous Thrombosis study and the Cerebral Venous Sinus Thrombosis With Thrombocytopenia Syndrome Study Group.</p><p><strong>Participants: </strong>All patients were of European descent and age and sex matched. Cases (<i>n</i> = 82) were patients ≥18 years old who suffered a CVT within 28 days of a first dose of ChAdOx1-S vaccine. Controls (<i>n</i> = 441) were unvaccinated CVT patients ≥18 years old. All patients were of European descent.</p><p><strong>Main outcome measures: </strong>Frequency of blood type and ABO allele distribution by vaccination status.</p><p><strong>Results: </strong>Blood group O was found to be more prevalent among CVT patients with vaccine-induced thrombotic thrombocytopenia (VITT-CVT) after ChAdOx1-S vaccination compared with unvaccinated CVT cases (43% vs. 17%, respectively, <i>p</i> < 0.001). Blood group A was less prevalent, though still high, in the vaccinated group compared with the unvaccinated group (47% vs. 71%, respectively, <i>p</i> < 0.001). No significant differences were observed in the VITT-CVT non-ChAdOx1-S vaccine group and unvaccinated pre-COVID-19 CVT group for blood group.</p><p><strong>Conclusions: </strong>Blood group O is more prevalent among patients with VITT-CVT after ChAdOx1-S vaccination compared with unvaccinated cases, independent of well-established CVT risk factors. A larger dataset may be able to determine whether those of blood groups B and/or AB may be safely vaccinated with the low cost, readily available and easily transported ChAdOx1-S rather than adopting a complete ban.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"69-76"},"PeriodicalIF":8.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectoral primary care-based approaches to reducing suicides in England.","authors":"Faraz Mughal, Aziz Sheikh","doi":"10.1177/01410768231220306","DOIUrl":"10.1177/01410768231220306","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"4-5"},"PeriodicalIF":8.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arts, literature, and witchcraft: medicine's many personalities.","authors":"Kamran Abbasi","doi":"10.1177/01410768241231196","DOIUrl":"10.1177/01410768241231196","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"117 1","pages":"3"},"PeriodicalIF":8.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139712401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Once a doctor, always a doctor.","authors":"Connor S Qiu, Hutan Ashrafian","doi":"10.1177/01410768231220312","DOIUrl":"10.1177/01410768231220312","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"42-44"},"PeriodicalIF":8.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region.","authors":"Girvan Burnside, Christopher P Cheyne, Gary Leeming, Michael Humann, Alistair Darby, Mark A Green, Alexander Crozier, Simon Maskell, Kay O'Halloran, Elena Musi, Elinor Carmi, Naila Khan, Debra Fisher, Rhiannon Corcoran, Jake Dunning, W John Edmunds, Kukatharmini Tharmaratnam, David M Hughes, Liora Malki-Epshtein, Malcolm Cook, Ben M Roberts, Eileen Gallagher, Kate Howell, Meera Chand, Robin Kemp, Matthew Boulter, Tom Fowler, Malcolm G Semple, Emer Coffey, Matt Ashton, Marta García-Fiñana, Iain E Buchan","doi":"10.1177/01410768231182389","DOIUrl":"10.1177/01410768231182389","url":null,"abstract":"<p><strong>Objectives: </strong>To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted.</p><p><strong>Design: </strong>Prospective, population-wide observational study.</p><p><strong>Setting: </strong>Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings.</p><p><strong>Participants: </strong>A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021.</p><p><strong>Main outcome measures: </strong>SARS-CoV-2 infections detected using audience self-swabbed (5-7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO₂ concentrations were monitored.</p><p><strong>Results: </strong>A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO₂ concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high.</p><p><strong>Conclusions: </strong>We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"11-23"},"PeriodicalIF":8.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9751653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}