Postgraduate Medical Journal最新文献

{"title":"Genetically predicted basal metabolic rate and infectious diseases: a Mendelian randomization study.","authors":"Zhanbin Li, Yicheng Ma, Qiuhui Xuan, Zhenyu Yao, Qiaoran Liu","doi":"10.1093/postmj/qgaf018","DOIUrl":"https://doi.org/10.1093/postmj/qgaf018","url":null,"abstract":"<p><strong>Background: </strong>The causal relationship between basal metabolic rate (BMR) and infectious diseases remains elusive. This study aims to clarify this association.</p><p><strong>Methods: </strong>This study analyzed genome-wide association studies (GWASs) data from the UK Biobank and FinnGen cohorts to investigate the association between BMR and infectious diseases in European populations. Mendelian randomization (MR) analysis was initially employed, followed by multivariable Mendelian randomization (MVMR) to account for potential confounders. Mediation analysis further confirmed significant relationships. Sensitivity analyses were conducted to validate the study findings.</p><p><strong>Results: </strong>Using two sample MR, genetically predicted BMR was positively linked to skin and soft tissue infections (SSTIs) (OR: 1.31, 95% CI: 1.18-1.47, P < .001), osteomyelitis (OR: 1.95, 95% CI: 1.36-2.80, P < .001) (1.36 ± 2.80), all-cause infections (OR: 1.36, 95% CI: 1.26-1.48, P < .001) and sepsis (OR: 1.36, 95% CI: 1.23-1.51, P < .001). MVMR analysis confirmed BMR's direct causal effect on SSTIs, osteomyelitis, all-cause infections, and sepsis, except for BMI and other factors affecting osteomyelitis. Mediation analysis revealed VAT as a mediator in the linkage between BMR and SSTIs and all-cause infections. HbA1c mediated the path from BMR to osteomyelitis, while CRP and BMI exhibited mediation effects in the BMR-all-cause infections relationship.</p><p><strong>Conclusion: </strong>The study revealed a significant link between increased BMR and elevated risks of SSTIs, osteomyelitis, and bacterial infections, highlighting the intricate BMR-immune connection and its implications for disease control. Key message What is already known on this topic:  High BMR is positively correlated with COVID-19 and associated with proinflammatory and immunological activation, but the relationship between BMR and other infectious diseases remains largely unexplored. What this study adds:  Higher BMR significantly raises the risk of SSTIs, osteomyelitis, all-cause infections, and sepsis. VAT, HbA1c, CRP, and BMI may mediate the BMR-infection relationship. How this study might affect research, practice, or policy:  A higher BMR may be a valuable indicator associated with an increased risk for SSTIs, osteomyelitis, and sepsis. Modulating BMR might hold promise as a clinically relevant intervention to prevent specific infectious diseases.</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":"143190282","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 reduction of medical resident duty hours for the benefit of patient safety.","authors":"Alison Hager","doi":"10.1093/postmj/qgaf014","DOIUrl":"https://doi.org/10.1093/postmj/qgaf014","url":null,"abstract":"<p><p>Since the case of Libby Zion spurred the first duty hour restrictions placed upon medical residents, the impact of fatigue and the importance of duty hour restrictions have been hotly debated. This paper discusses the history of duty hour restrictions as well as the documented impact of fatigue both on the medical profession and other industries upon which the federal government has imposed hours restrictions due to the danger fatigue has been found to pose. It then takes this information and applies it to the American Medical Association's 'Code of Medical Ethics' to determine if residents can truly adhere to these principles and prioritize patient safety while working hours shaped by current duty hour limits.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190284","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":"Insights into drug adverse reactions prediction through Mendelian randomization: a review.","authors":"Zhuanqing Huang, Hui Gong, Xuemin Sun, Wenqi Yi, Shiyang Liang, Sen Yang, Qi Sun, Xiaochuan Yan","doi":"10.1093/postmj/qgae203","DOIUrl":"https://doi.org/10.1093/postmj/qgae203","url":null,"abstract":"<p><p>Adverse drug reactions pose a significant threat to patient safety and public health and often become apparent only after widespread clinical use. Mendelian randomization (MR) analysis is a valuable tool that can be used to infer causality by using genetic variants as instrumental variables, which can predict the occurrence of adverse drug reactions before they occur. Compared with traditional observational studies, MR Analysis can reduce the potential bias of confounding factors. This article reviews the principles of MR Analysis and its application in the prediction of adverse drug reactions, the challenges and future directions, and summarizes how to harness the power of this innovative epidemiological method to put us at the forefront of improving drug safety assessment and personalized medicine.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067640","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 laparoscopic cholecystectomy on plasma levels of EETs, arachidonic acids derived lipid mediators.","authors":"İsmail Sarı, Hacı Bolat, Esma Özmen, Burcu Köse, Durmuş Ayan","doi":"10.1093/postmj/qgae175","DOIUrl":"https://doi.org/10.1093/postmj/qgae175","url":null,"abstract":"<p><strong>Background: </strong>Epoxyeicosatrienoic acids (EETs) are closely associated with lipoprotein metabolism, and changes in lipid profiles potentially affect their levels and functions. Given the alterations in lipid metabolism after cholecystectomy, this study aimed to investigate the levels of four EET regioisomers (free and esterified) and lipid profiles in patients with cholelithiasis after laparoscopic cholecystectomy (LC) and explore correlations between these parameters.</p><p><strong>Methods: </strong>This prospective study involved 40 patients with symptomatic cholelithiasis who underwent LC. Plasma EETs and serum total cholesterol, triglyceride, high-density lipoprotein (HDL), very low-density lipoprotein, low-density lipoprotein, and body mass index (BMI) values were determined preoperatively and after 6 months of LC.</p><p><strong>Results: </strong>After LC, triglyceride and very low-density lipoprotein levels increased while TC decreased. BMI values increased significantly after the operation. Despite plasma EET levels decreasing remarkably after surgery, this change did not reach statistical significance. A significant correlation was observed between preoperative levels of 8,9- and 11,12-EET and pre-and post-operative HDL. There was a significant negative correlation between the EET levels measured before and after surgery and the change in BMI values.</p><p><strong>Conclusions: </strong>In this study, we observed significant changes in lipid profile 6 months after LC. While HDL, low-density lipoprotein, and EET levels showed a decreasing trend post-surgery, this change was not statistically significant. This trend and their significant correlations may indicate a complex relationship between HDL and EET metabolism. In addition, the negative correlation between EET levels and BMI changes highlights the need for further research to elucidate the metabolic impact and weight regulation of EETs after LC.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067638","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 association between arachidonic acid and gallstone risk: cross-sectional study and Mendelian randomization analysis.","authors":"Zhanhua Gao, Jie Han, Di Chen, Quan Zhang, Weiqin Wang","doi":"10.1093/postmj/qgaf009","DOIUrl":"https://doi.org/10.1093/postmj/qgaf009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The formation of gallstones is a multifactorial process involving lifestyle habits, lipid metabolism disorders, and genetic factors. This study aims to explore the association between 19 types of dietary fatty acids and gallstone disease using large-scale population data, assess the correlation between dietary fatty acids and serum fatty acids, and investigate the causal relationship between plasma lipids and gallstone disease from a genetic perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We employed a cross-sectional study design, combined with logistic regression analysis to evaluate the association between dietary fatty acids and gallstone disease. Pearson correlation analysis was used to assess the correlation between dietary fatty acids and serum fatty acids. Additionally, we utilized Mendelian randomization analysis to explore the causal relationship between plasma lipids and cholelithiasis and performed collocation analysis to identify genetic loci associated with cholelithiasis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study demonstrated a significant association between the intake of eicosatetraenoic acid (20:4) and a reduced risk of gallstone disease. The correlation between dietary fatty acids and serum fatty acids was weak, but the intake of eicosatetraenoic acid (20:4) showed a positive correlation with serum levels of arachidonic acid (ARA). Mendelian randomization analysis revealed a protective relationship between plasma lipids containing ARA (20:4) and gallstone disease and identified two SNPs in the FADS1 gene(rs174533 and rs174537)associated with gallstone disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study identifies a significant association between ARA intake and reduced gallstone risk, underscoring its potential in gallstone prevention. The weak correlation between dietary and serum fatty acids suggests complex physiological regulation mechanisms. Mendelian randomization analysis establishes a protective causal link between specific plasma lipids containing ARA and gallstone disease, highlighting the genetic underpinnings of gallstone formation. This research provides a foundation for dietary interventions and underscores the importance of genetic factors in lipid metabolism for future gallstone research and clinical management. Key message What is already known on this topic?  Gallstone formation is a multifactorial process, and PUFAs may have a preventive effect, but the specific relationships between dietary fatty acids, serum fatty acids, plasma lipids, and gallstone disease are not well-established. What this study adds?  This study finds a significant association between eicosatetraenoic acid (20:4) intake and reduced gallstone risk, and establishes a protective causal link between plasma lipids containing arachidonic acid (20:4) and gallstone disease through Mendelian randomization analysis. How this study might affect research, practice, or policy?  The results highlight the potential of d","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047636","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":"Measures to prevent esophageal stenosis are necessary after endoscopic submucosal dissection for early esophageal cancer lesions with a circumferential ratio of 75%-99%: a retrospective case analysis.","authors":"Yong Gao, Jiao Zhu, Jianjun Li, Xue Peng, Xubiao Nie, Haiyan Zhao, Lifu Sheng, Chaoqiang Fan, Jianying Bai","doi":"10.1093/postmj/qgaf005","DOIUrl":"https://doi.org/10.1093/postmj/qgaf005","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic submucosal dissection (ESD) is currently one of the most curative treatments for early esophageal cancer. We conducted a retrospective case analysis to identify the characteristics of early esophageal cancer that indicate esophageal stenosis prevention measures. Our aim was to provide a reference for clinical decision-making.</p><p><strong>Methods: </strong>Six hundred and fifty-four patients with early esophageal cancer treated with ESD were admitted to our hospital between January 2011 and December 2018.Clinical information such as patients' demographic characteristics, lesion features, preventive measures if any, and complications of esophageal stenosis after ESD were collected from the hospital information system. The data were statistically analysed by SPSS software (version 23.0).</p><p><strong>Results: </strong>1. Seventy-nine patients with early esophageal cancer suffered from esophageal stenosis after ESD. The median time from undergoing ESD to the first occurrence of stenosis was 27 (17-43) days. Specifically, among the 79 cases, 47 of them experienced stenosis within one month after ESD, and 23 cases experienced stenosis between 1 and 2 months after ESD, and 9 cases experienced stenosis more than 2 months after the operation.2. Taking preventive measures significantly reduced overall esophageal stenosis incidence in patients with early esophageal cancer with lesion circumferential ratio of 75%-99% (P < 0.05).3. Among patients with early esophageal cancer with 75%-99% circumferential proportion of lesions, the risk of esophageal stenosis within 2 months without prevention measures was 2.617(95% CI, 1.057-6.479) times higher than that with prevention measures.</p><p><strong>Conclusion: </strong>It is necessary to take measures to prevent esophageal stenosis after ESD for early esophageal cancer lesions with a circumferential ratio of 75%-99%.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029434","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":"Seductive emails, dangerous consequences: how predatory journals, conferences, and publishers target early-career researchers.","authors":"Hamrish Kumar Rajakumar","doi":"10.1093/postmj/qgae167","DOIUrl":"10.1093/postmj/qgae167","url":null,"abstract":"<p><strong>Background: </strong>In recent years, early-career researchers and medical students have become targets of predatory publishers and conference organizers. These groups exploit the pressure to publish and gain recognition. They often offer tempting opportunities, such as fast publication, free travel, and prestigious positions. However, these offers often hide a profit-driven agenda. They lack academic integrity. Many of these events have little or no peer review. The impact metrics they claim are often inflated, and event details are vague.</p><p><strong>Objective: </strong>This paper aims to highlight the rise of predatory journals and conferences. It focuses on the harmful effects these organizations have on young researchers. We will identify the tactics they use. We will also point out key red flags. The goal is to help researchers, particularly medical students, understand how to navigate academic publishing and protect their careers.</p><p><strong>Conclusion: </strong>Predatory publishers and conferences pose a growing threat to academic integrity. Young researchers are especially vulnerable to these deceptive practices. It is important for academics to recognize warning signs. They should focus on quality over quantity when publishing. Educating the next generation of researchers is essential for preserving academic credibility.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"177-179"},"PeriodicalIF":3.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710786","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":"Developing comprehensive reporting guidelines for machine learning models using tabular data in medical research.","authors":"Omid K Gargari","doi":"10.1093/postmj/qgae080","DOIUrl":"10.1093/postmj/qgae080","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"174-176"},"PeriodicalIF":3.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535121","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":"Neurodiversity in the healthcare profession.","authors":"Jo-Anne Johnson, Sanjiv Ahluwalia","doi":"10.1093/postmj/qgae108","DOIUrl":"10.1093/postmj/qgae108","url":null,"abstract":"<p><p>The term neurodiversity was coined in the 1990s to describe a diversity in thinking, learning, and processing the world around us, and is associated with strengths as well as challenges. Rates of diagnosis of neurodivergent conditions are rising rapidly amongst patients and healthcare professionals, largely due to a recent surge in awareness and understanding of neurodiverse conditions and more inclusive diagnostic criteria. Societal adaptation, however, has lagged, and likely explains some of the psychosocial comorbidities of neurodiversity, as individuals are forced to adapt their personality and how they display their emotions to fit societal norms. There remains a lack of awareness and understanding of neurodiversity amongst the healthcare professions. There is also very limited published literature on the challenges and strengths of this group in the clinical environment. Here, we use a case study, focusing on attention deficit hyperactivity disorder to explore the relationship between neurodiversity and work from the perspective of a neurodiverse health care professional. We challenge the notion that neurodiversity itself is a disability, but more likely a result of lack of societal awareness and adaption. We suggest accommodations and training in the clinical environment to raise awareness and support neurodiverse healthcare professionals in order that they flourish rather than struggle in the workplace.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"167-171"},"PeriodicalIF":3.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111227","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":"Implications of the shift from GP-centred to multidisciplinary models on postgraduate GP training in the UK.","authors":"Waseem Jerjes","doi":"10.1093/postmj/qgae091","DOIUrl":"10.1093/postmj/qgae091","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"172-173"},"PeriodicalIF":3.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627425","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}