Postgraduate Medical Journal最新文献

{"title":"Transforming the NHS through AI-driven solutions: a new era of digital health.","authors":"Mohamed A Imam, Ahmed Elgebaly, Adam Zumla, Shyam Kolvekar, Rizwan Ahmed, Alimuddin Zumla","doi":"10.1093/postmj/qgaf023","DOIUrl":"https://doi.org/10.1093/postmj/qgaf023","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425964","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}

{"title":"Correction to: Contribution of nebulized budesonide before bronchoscopy, a prospective clinical study.","authors":"","doi":"10.1093/postmj/qgaf035","DOIUrl":"https://doi.org/10.1093/postmj/qgaf035","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425958","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}

{"title":"Dobutamine and severe eosinophilia.","authors":"Ami Schattner, Ina Dubin","doi":"10.1093/postmj/qgaf021","DOIUrl":"https://doi.org/10.1093/postmj/qgaf021","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415039","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}

{"title":"Effect of non-invasive brain stimulation on cancer-related pain: evidence from meta-analyses of randomized controlled trials.","authors":"Yaqi Zhang, Xiuyun He, Chen Gong, Yafei Wang, Longfei You, Yangyang Lin, Yuling Wang, Beibei Feng","doi":"10.1093/postmj/qgaf027","DOIUrl":"https://doi.org/10.1093/postmj/qgaf027","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer-related pain (CRP) is one of the most challenging disorders among cancer survivors. Non-invasive brain stimulation (NIBS) is an emerging technique for alleviating pain. Although there is evidence suggesting that NIBS can alleviate CRP, higher level evidence is still required to further substantiate its efficacy and safety. This study aimed to evaluate the efficacy of NIBS interventions for CRP via a meta-analysis.</p><p><strong>Methods: </strong>Databases such as MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure were systematically searched using key terms related to pain, cancer, and NIBS. The primary outcome was pain intensity and the secondary outcome was depression. After extracting and assessing data from the included literature, we performed Meta-analysis using RevMan 5.4.1 software.</p><p><strong>Results: </strong>The results encompassed 11 randomized controlled trials papers, involving 714 patients. The Meta-analysis findings indicated that NIBS demonstrated a significant reduction in pain intensity scores {SMD -0.72 [95% confidence interval (CI), -1.00 to -0.43], P < 0.00001}. NIBS also had a notable effect on depression [SMD -0.62 (95% CI, -0.93 to -0.31), P = 0.0004]. However, subgroup analysis revealed that one single session of NIBS did not show statistical significance in analgesic effect. Furthermore, no matter targeting the M1 and DLPFC areas, as well as using either rTMS or tDCS, resulted in significant reductions in pain intensity.</p><p><strong>Conclusion: </strong>NIBS exhibited a promising trend in alleviating CRP and enhancing treatment effectiveness. Nonetheless, due to limitations in the quantity and quality of the included studies, these findings warrant further validation through additional research.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415040","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}

{"title":"Diabetes and obesity susceptibility genes: a cross-sectional analysis of methylation patterns from Karachi, Pakistan.","authors":"Syeda Sadia Fatima, Asad Saulat Fatimi, Manzar Abbas, Unab I Khan","doi":"10.1093/postmj/qgaf016","DOIUrl":"https://doi.org/10.1093/postmj/qgaf016","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of study: &lt;/strong&gt;Environmental factors are pivotal in shaping disease outcomes for obesity, diabetes, and metabolic syndrome (MetS), especially in the Pakistani population. This study aimed to determine whether promoter methylation levels of 12 diabetes and obesity susceptibility genes are associated with MetS phenotypes and risk of T2DM in Pakistani individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A cross-sectional study was undertaken whereby methylation-specific PCR assays were conducted on 203 adult subjects recruited from the community in Karachi, Pakistan. Participants were stratified into four groups based on their metabolic health and BMI (MOU n = 39, MHO n = 43, MUHNW n = 51, MHNW n = 70). Biochemical and biophysical data were statistically analyzed to determine the association of methylation levels with MetS phenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Low chemerin promoter methylation was observed in metabolically unhealthy participants, irrespective of BMI, while higher methylation levels were observed for POMC and PCSK1. Unsupervised machine learning showed that the methylation status of Chemerin, IGF2, POMC, PCSK1 (P &lt; .001), and FNDC (P &lt; .05) was independently linked with the risk of developing MetS. Hierarchical clustering analysis revealed distinct genetic clusters that partially aligned with the original MetS and BMI categories, indicating the presence of unique genetic profiles and the potential misdiagnosis of high-risk individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Chemerin, IGF2, POMC, PCSK1, and FNDC's methylation status shows independently linked trends with the risk of developing MetS and obesity. Distinct genetic clusters for MUHNW and MHO exhibit similar phenotypic profiles, implying misdiagnosis risks and comparable risks of developing cardiometabolic disorders in the future. Large-scale methylation studies are needed to confirm the association. Key message What is already known on this topic:  Genetic susceptibility contributes significantly to complex disorders like obesity, diabetes, and MetS. Prior research has highlighted the role of genetic polymorphisms but hasn't extensively explored the influence of promoter methylation in Pakistani populations. Understanding genetic and epigenetic factors in disease etiology is crucial for tailored interventions, particularly in populations with diverse genetic backgrounds and environmental exposures. What this study adds:  Distinct trends of methylation patterns were observed in genes like Chemerin, IGF2, POMC, PCSK1, and FNDC, independently linked with MetS and obesity risk. Potential misdiagnosis risks and comparable risks of developing cardiometabolic disorders in individuals with metabolically unhealthy normal weight individuals and metabolically healthy phenotypes were observed. How this study might affect research, practice, or policy:  Incorporating epigenetic biomarkers into risk assessment algorithms could enhance disease prediction accuracy a","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390385","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}

{"title":"The Kafkaesque odyssey of securing study leave: a trainee's satirical take.","authors":"Ibraheem Alghamdi","doi":"10.1093/postmj/qgaf011","DOIUrl":"https://doi.org/10.1093/postmj/qgaf011","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391515","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}

{"title":"A more precise interpretation of the potential value of artificial intelligence tools in medical education is needed.","authors":"Hongnan Ye","doi":"10.1093/postmj/qgaf024","DOIUrl":"https://doi.org/10.1093/postmj/qgaf024","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383269","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}

{"title":"Association of fibrinogen-to-albumin ratio with all-cause and cardiovascular mortality in patients on dialysis with acute coronary syndrome.","authors":"Enmin Xie, Yaxin Wu, Zixiang Ye, Xuecheng Zhao, Yike Li, Nan Shen, FanFan Wang, Yanxiang Gao, Jingang Zheng","doi":"10.1093/postmj/qgaf015","DOIUrl":"https://doi.org/10.1093/postmj/qgaf015","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association of the fibrinogen-to-albumin ratio (FAR) and all-cause mortality as well as cardiovascular mortality in patients on dialysis with acute coronary syndrome (ACS). Furthermore, we explored the incremental prognostic value of incorporating the FAR into the Global Registry of Acute Coronary Events (GRACE) score.</p><p><strong>Methods: </strong>We retrospectively enrolled 1035 patients on dialysis with ACS between January 2015 and June 2021. The primary outcome was all-cause mortality, and the secondary outcome was cardiovascular mortality. Multivariate Cox regression model, restricted cubic spline analysis, and C-statistic were performed to evaluate the prognostic value of FAR on outcomes.</p><p><strong>Results: </strong>After a median follow-up of 21.8 months, 369 (35.7%) patients died, including 250 cardiovascular deaths. Patients with the highest FAR tertile had significantly increased risks of all-cause mortality (46.1% vs 27.8%; adjusted hazard ratio [HR], 1.790; 95% confidence interval [CI], 1.372-2.336) and cardiovascular mortality (33.0% vs 16.5%; adjusted HR, 2.086; 95% CI, 1.496-2.908) compared to those in the lowest tertile. Restricted cubic spline analysis revealed a J-shaped association between the FAR and all-cause mortality and cardiovascular mortality, with HRs increasing significantly when the FAR exceeded 94.15. Furthermore, integrating the FAR into the GRACE score significantly improved its predictive accuracy for all-cause mortality and cardiovascular mortality, as measured by C-statistic, continuous net reclassification index, and integrated discriminatory index.</p><p><strong>Conclusions: </strong>In patients on dialysis with ACS, the FAR was independently associated with increased risks of all-cause mortality and cardiovascular mortality. Incorporating the FAR might improve the predictive accuracy of the GRACE score in patients on dialysis with ACS.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374661","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}

{"title":"Comparison of one-handed face mask ventilation techniques on the simulation model: EO technique and EC technique.","authors":"Lan Xiao, Weijun Fang, Cheng Jiang, Hang Ke, Zongze Zhang, Hao Zou","doi":"10.1093/postmj/qgaf019","DOIUrl":"https://doi.org/10.1093/postmj/qgaf019","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of two one-handed face mask ventilation techniques. Secondarily, we also assessed the effect of hand size on the performance of both these techniques.</p><p><strong>Methods: </strong>Eighty subjects were randomized into the EO group and the EC group. After receiving face mask ventilation training, they carried out one-handed mask ventilation on a simulation model according to the order of EO technique-EC technique or EC technique-EO technique, and they performed each face mask ventilation technique for five consecutive ventilations. The primary outcomes were the time of the first chest undulation and the total number of chest undulations in the five operations. A questionnaire evaluated the subjects' feelings of simplicity and comfort regarding the two techniques.</p><p><strong>Results: </strong>Compared with the EC technique, the first success time was significantly shorter with the EO technique (17.69 ± 11.32 seconds vs 8.39 ± 8.08 seconds, P < 0.001), and the EO technique produced an improved successful ventilation rate (50.00% ± 33.89% vs 77.00% ± 28.84%, P < 0.001). For the EC technique, the first success time and successful ventilation rate of male subjects were better than those of female subjects (P < 0.05), whereas the first success time and successful ventilation rate in males and females did not significantly differ from each other for the EO technique (P > 0.5). Most subjects reported that the EO technique was simpler and more comfortable than the EC technique.</p><p><strong>Conclusion: </strong>On the simulation model, compared to the one-handed EC face mask ventilation technique, the EO technique is more conducive to the learning and mastery of novices and small-handed operators.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374003","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}

{"title":"Association between sleep duration and depression in adolescents and young adults: a system review of observational studies and a genetic research of Mendelian randomization analysis.","authors":"Qiu-Qiang Zheng, Wei-Wei Yang, Shan-Shu He, Yi-Ran Li","doi":"10.1093/postmj/qgaf013","DOIUrl":"https://doi.org/10.1093/postmj/qgaf013","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the causal association between sleep duration and depression in adolescents and young adults.</p><p><strong>Methods: </strong>We conducted a systematic review and Mendelian randomization (MR) to research the causal relationship between short sleep duration and adolescent depression risk from an observational and genetic perspective. In the systematic review, we searched observational studies from the PubMed, Embase, and Cochrane Library databases. In the MR analysis part, we screened Single Nucleotide Polymorphism (SNP) significantly relative to short sleep and conforming MR concept to investigate the genetic causality.</p><p><strong>Results: </strong>All research evidence shows that adolescents who sleep <6 h have the highest rates of depression. According to the MR result, short sleep duration significantly affected the depression risk (odds ratio, 1.034; 95% confidence interval, 1.012-1.058, P = .003). Sleep duration of 7-8 h has the lowest depression incidence. Insufficient sleep (≤6 h) and excessive sleep (≥8 h) also elevates adolescent depression risk. Genetic evidence shows that short sleep duration (<6 h) has significant causal effects on depression risk.</p><p><strong>Conclusions: </strong>Sleep duration was causally associated with depression in adolescents and young adults. Sleep duration of <6 h or >8 h daily increases the depression risk in adolescents and young adults.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190279","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}