Postgraduate Medical Journal最新文献

{"title":"A Mendelian analysis of the causality between inflammatory cytokines and digestive tract cancers.","authors":"Xing Ren, Rong Hu, Hui Zhang","doi":"10.1093/postmj/qgae132","DOIUrl":"10.1093/postmj/qgae132","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we performed a two-sample Mendelian randomization (MR) analysis to assess the causality between inflammatory cytokines and the risk of digestive tract cancers (DTCs). Furthermore, we conducted a molecular docking study to predict the therapeutic mechanisms of traditional Chinese medicine (TCM) compounds in the treatment of DTCs.</p><p><strong>Methods: </strong>In our MR analysis, genetic variations associated with eight types of DTCs were utilized, which were sourced from a large publicly available genome-wide association study dataset (7929 cases and 1 742 407 controls of European ancestry) and inflammatory cytokines data from a genome-wide association study summary of 8293 European participants. Inverse-variance weighted method, MR-Egger, and weighted median were performed to analyze and strengthen the final results. We investigated the effects of 41 inflammatory molecules on 8 types of DTCs. Subsequently, the effect of DTCs on positive inflammatory factors was analyzed by means of inverse MR. Molecular docking was exploited to predict therapeutic targets with TCM compounds.</p><p><strong>Results: </strong>Interleukin-7, interleukin-16, macrophage colony-stimulating factor, monokine induced by interferon-gamma, and vascular endothelial growth factor may be significantly associated with various types of DTCs. Five TCM compounds (baicalin, berberine, curcumin, emodin, and salidroside) demonstrated better binding energies to both interleukin-7 and vascular endothelial growth factor than carboplatin.</p><p><strong>Conclusion: </strong>This study provides strong evidence to support the potential causality of some inflammatory cytokines on DTCs and indicates the potential molecular mechanism of TCM compounds in the treatment of DTCs. Key message What is already known on this topic  The increasing evidence indicates that inflammatory cytokines are implicated in the pathogenesis of digestive tract cancers (DTCs). Nevertheless, the causal relationship between inflammatory cytokines and DTCs remains indistinct. Additionally, certain traditional Chinese medicine compounds have been demonstrated to treat DTCs by influencing inflammatory factors, yet their underlying potential mechanisms remain ambiguous. What this study adds  In this study, Mendelian randomization analysis was performed for the first time regarding the causality between human inflammatory cytokines and eight types of DTCs, which revealed that inflammatory factors may play different roles in different types of DTCs. Moreover, molecular docking of key inflammatory factors was implemented, indicating the targets for drug actions. How this study might affect research, practice, or policy  This research has the potential to reveal the causality between 41 inflammatory factors and 8 DTCs, offering novel perspectives for the prevention and management strategies of DTCs. Additionally, it indicates the targets for the actions of traditional Chinese medici","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"704-715"},"PeriodicalIF":3.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372668","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: Revisiting the diagnostic and prognostic significance of high-frequency QRS analysis in cardiovascular diseases: a comprehensive review.","authors":"","doi":"10.1093/postmj/qgaf092","DOIUrl":"10.1093/postmj/qgaf092","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"754"},"PeriodicalIF":3.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249286","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":"Valproate induced obsessive-compulsive symptoms: unique side effect of a commonly used drug.","authors":"Pallavi Priyam, Payel Talukdar","doi":"10.1093/postmj/qgaf066","DOIUrl":"10.1093/postmj/qgaf066","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"773-774"},"PeriodicalIF":3.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045222","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":"Revisiting Ronald Ross: inspiration for pioneering research in resource-limited settings.","authors":"Rupak Chatterjee, Atanu Chandra, Sugata Dasgupta","doi":"10.1093/postmj/qgae199","DOIUrl":"10.1093/postmj/qgae199","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"752-753"},"PeriodicalIF":3.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953784","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":"Systematic reviews-an effective tool for academic motivation of advanced trainees.","authors":"Aabha P Yewale, Shripada Rao, Sanjay Patole","doi":"10.1093/postmj/qgaf107","DOIUrl":"https://doi.org/10.1093/postmj/qgaf107","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668200","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":"Reasons for and perceived barriers to applying for cardiology training: the 2024 British Junior Cardiologists' Association starter survey.","authors":"Ankit Gupta, Lucy Lawson, Jonathan J H Bray, Oliver I Brown, Michael Drozd, Sam Straw, Holly Morgan","doi":"10.1093/postmj/qgaf111","DOIUrl":"https://doi.org/10.1093/postmj/qgaf111","url":null,"abstract":"<p><strong>Background and aims: </strong>Understanding the reasons for, and perceived barriers to, applying for cardiology training is vital to interpret current application trends and address modifiable barriers to entry. A cross-sectional survey was conducted on behalf of the British Junior Cardiologists' Association (BJCA) to assess the opinions of resident doctors interested in pursuing a career in cardiology.</p><p><strong>Methods: </strong>Data were collected on six domains: demographic information, intention to pursue a career in cardiology, prior clinical and academic experiences, reasons for and perceived barriers to applying for cardiology training (assessed using a Likert scale from one to five), and the impact of the transition from core medical training to internal medicine training.</p><p><strong>Results: </strong>Responses were received from 171 of 307 (56%) eligible BJCA members. Of 171 participants, 109 (63.7%) stated they would definitely, and 29 (17.0%) would probably, apply for cardiology training. Formal research training was limited; of those who had published research, 77 (45.0%) had published fewer than five articles. The primary motivating factor for applying was the opportunity to perform invasive procedures [mean 4.2 ± standard deviation (SD) 1.0]; competition was identified as the most significant barrier, on average (3.8 ± SD 1.2). The transition to internal medicine training was viewed by 111 respondents (64.9%) as primarily serving the purpose of service provision.</p><p><strong>Conclusions: </strong>These data should allow potential applicants to make an informed decision as to their specialty of choice. Addressing modifiable barriers to entry may encourage a more diverse range of resident doctors to apply for cardiology training.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668199","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 coronary revascularization on electrocardiographic parameters in patients with chronic total occlusion.","authors":"Burak Ayca, Yasin Yüksel, Cennet Yıldız, Ahmet Öz, Fahrettin Katkat, Çağatay Önal, Mehmet Sait Altıntaş","doi":"10.1093/postmj/qgaf108","DOIUrl":"https://doi.org/10.1093/postmj/qgaf108","url":null,"abstract":"<p><strong>Purpose: </strong>Substantial evidence suggests that revascularization of chronic total occlusion (CTO) leads to improvement of quality of life and ventricular function. We studied the effect of revascularization on electrocardiographic parameters in patients with CTO.</p><p><strong>Study design: </strong>The data of patients who underwent CTO percutaneous intervention (PCI) were collected. QT dispersion (QTD), P-wave dispersion (PWD), T-wave peak-to-end (Tp - Te) interval, and Tp - Te/QT ratio were calculated for each patient before and 7 days after the intervention. Patients were divided into two groups according to their Rentrop grades.</p><p><strong>Results: </strong>One hundred and thirty three patients underwent successful CTO intervention. Their mean age was 61.88 ± 10.53 years, the median left ventricular ejection fraction (LVEF) was 55 (43.00-60.00). After revascularization, P-wave maximum, minimum duration, and PWD were significantly reduced. We found no difference in QRS duration between the pre- and post-PCI periods (P = .522). Corrected QT interval, QTc maximum, minimum time, and QTDc were all reduced after PCI. Tp - Te interval and Tp - Te/QT ratio were also found to decrease after successful revascularization (P < .001 for both). LVEF increased from 52.00 (42.75-60.00) to 55.00 (45.00-60.00) (P = .001). Compared to patients in Rentrop Group 2, patients in Group 1 had increased values for PWD before the procedure and for QTDc before and after the procedure. Multivariable linear regression analysis revealed that age and the SYNTAX score were predictors of the QTDc difference.</p><p><strong>Conclusions: </strong>Our findings supported the evidence that successful revascularization of CTO could lead to favorable effect on arrhythmia generation and LVEF.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668198","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":"Risk of gastrointestinal rebleeding in direct oral anticoagulant-treated population.","authors":"Bianca Codrina Morarasu, Victorita Sorodoc, Constantin Simiras, Stefan Morarasu, Catalina Lionte, Raluca Ecaterina Haliga, Cristina Bologa, Mihai Constantin, Alexandr Ceasovschih, Alexandra-Diana Diaconu, Raluca Elena Alexa, Andreea Asaftei, Emilia Adriana Marciuc, Mohammed Elsiddig, Laurentiu Sorodoc","doi":"10.1093/postmj/qgaf090","DOIUrl":"https://doi.org/10.1093/postmj/qgaf090","url":null,"abstract":"<p><strong>Introduction: </strong>We performed a retrospective analysis of rebleeding events and their association with direct oral anticoagulant (DOAC) discontinuation versus resumption in patients admitted with an index episode of gastrointestinal bleeding (GIB) while on oral anticoagulants.</p><p><strong>Materials and methods: </strong>We included patients ≥18 years between January 2018 and December 2022. The cohort was divided into two groups, initially based on anticoagulant management at discharge, subsequently, according to bleeding events during follow-up, which ended at the time of death, last clinical contact, time of the event, or within 6 months since last patient was included.</p><p><strong>Results: </strong>A total of 120 patients were included. Those with HAS-BLED score > 3 were more likely discontinue DOAC (P = 0.0009). Significantly more patients with previous GIB had a rebleeding episode (29.6% vs. 6.4%, P = 0.002) and a 4-fold higher risk of rebleeding in the first 15.2 months (HR 4.070, CI [1.771-9.354], P = 0.001). A history of diabetes mellitus, malignancy, CHA2DS2-VASc, and HAS-BLED score > 3 was associated with an increased rebleeding risk, but without statistical significance.</p><p><strong>Conclusion: </strong>Previous episode of GIB is the most significant risk factor for recurrent bleeding in DOAC-treated patients. It leads to a four times higher risk of bleeding, particularly in the first 15 months. Patients aged ≥75, with a history of diabetes mellitus, malignancy, and HAS-BLED score > 3 should be closely followed-up. Timing of anticoagulation resumption and specific DOAC agent did not influence the rate of rebleeding, supporting their proven benefit.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609190","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 single-centre audit of early warning scores and medical emergency team activation in medical and surgical admissions at Wellington Regional Hospital.","authors":"Julie K Cook, Rowan Biggs, Allie Eathorne, Tanira Kingi, Nick Shortt, Neakiry Kivi, Christina Elder, Alex Psirides, Richard Beasley, Louis Kirton","doi":"10.1093/postmj/qgaf106","DOIUrl":"https://doi.org/10.1093/postmj/qgaf106","url":null,"abstract":"<p><strong>Purpose: </strong>This single-centre retrospective audit evaluates the accuracy of nurse-documented vital signs and aggregated New Zealand's early warning scores (NZEWS) in high-acuity inpatients, and the proportion who appropriately received medical emergency team (MET) callouts.</p><p><strong>Methods: </strong>Eligible patients admitted to general medicine and surgery services in the first 2 days of each month starting January 2022 and ending August 2022 and February 2023, respectively, had every documented vital sign and NZEWS entered into a database until 100 patients with an NZEWS of 6 or greater in the first 24 hours of the admission, or 10 patients with MET callouts per service were identified. We examined NZEWS calculations and their association with MET callout activation. An agreement analysis examined discrepancies between nurse-calculated and audit-calculated NZEWS.</p><p><strong>Results: </strong>Of 491 screened admissions, 63 (12.8%) fulfilled criteria for inclusion and a total of 20 (4.1%) patients had at least 1 MET callout, of 23 who fulfilled MET criteria. Correct calculation and documentation occurred in three quarters (75.8%) of all NZEWS audited. Approximately half (46.8%) of the 47 individual NZEWS instances mandating MET activation resulted in a MET callout and only one in eight (12.8%) had a documented and accurately calculated NZEWS. The mean difference between nurse and audit-calculated NZEWS was -0.19 (nurse minus audit-calculated, with 95% confidence intervals of -0.28 to -0.09) with limits of agreement -3.64 to 3.26.</p><p><strong>Conclusions: </strong>When dependent on manual processes, NZEWS documentation, calculation, and MET activation is suboptimal. Automation of NZEWS and MET callouts requires prioritization.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609189","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":"Does work-family conflict predict allostatic load? A 4-year longitudinal study.","authors":"Mayumi Saiki, Adrian Loerbroks, Jian Li","doi":"10.1093/postmj/qgaf101","DOIUrl":"https://doi.org/10.1093/postmj/qgaf101","url":null,"abstract":"<p><strong>Objective: </strong>A growing number of studies have reported that occupational psychosocial factors increase the risk of cardiovascular disease. Allostatic load (AL) is a main biological mechanism that explains the pathway from stress to disease. This study examined whether work-to-family conflict (WFC) and family-to-work conflict (FWC) at baseline would be associated with changes in the AL index (ALI) across four years.</p><p><strong>Methods: </strong>We used the Midlife in Japan survey, Wave I, and the biomarker projects, Waves I and II. This study included 152 participants with paid jobs and variables of interest at baseline and target biomarkers at baseline and follow-up. We examined the four-year longitudinal changes in the ALI using two methods: comparing ALI scores at baseline and follow-up, named \"Two ALI approach,\" and creating one ALI score considering changes at baseline and follow-up, named \"One ALI approach.\" Negative binomial regression analysis and generalized estimating equations were used for analyses. The results were reported by count ratios (CRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>In the final model, our results demonstrated that WFC at baseline was significantly associated with increased ALI using the \"Two ALI approach\" (CR 1.15, 95% CIs: 1.03, 1.28) and \"One ALI approach\" (CR 1.15, 95% CIs: 1.01, 1.32), whereas FWC did not show statistical significance in both methods.</p><p><strong>Conclusions: </strong>WFC was longitudinally associated with increased ALI. It is crucial to mitigate the effects of work-to-family conflict.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576039","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}