Postgraduate Medical Journal最新文献

{"title":"Combined regional anesthetic techniques enhance postoperative recovery after cardiac surgery: a randomized controlled trial.","authors":"Dou Dou, Lu Wang, Su Yuan, Yuan Jia, Fuxia Yan","doi":"10.1093/postmj/qgaf113","DOIUrl":"https://doi.org/10.1093/postmj/qgaf113","url":null,"abstract":"<p><strong>Background: </strong>Regional anesthetic techniques are applied in cardiac surgery to improve postoperative pain and accelerate recovery. Pecto-intercostal fascial block (PIFB) combined with rectus sheath block (RSB) has been proved to provide ideal analgesia for cardiac surgery, but the effects of combing regional anesthetic techniques on postoperative recovery are uncertain.</p><p><strong>Methods: </strong>This is a prospective and randomized controlled trial at Fuwai Hospital from 1 June 2024 to 3 July 2024. Eighty patients undergoing elective cardiac surgery via cardiopulmonary bypass were randomized at a 1:1 ratio to be allocated in the intervention group (PIFB combined with RSB) or control group (without regional blocks). The primary outcome was the global score of the 15-item quality of recovery (QoR-15) questionnaire at 24 h after surgery. Secondary outcomes included QoR-15 at 72 h, postoperative pain scores, time to extubation, length of stay, medical expenses in hospital and postoperative morbidities.</p><p><strong>Results: </strong>The QoR-15 global score at 24 h after cardiac surgery was 122.35 ± 6.71 in the intervention group vs 115.30 ± 5.90 in the control group (P < .001). The proportion of patients experiencing better quality of recovery (Qor-15 ≥ 118) was higher in the intervention group (77.5% vs 55%, P = .033). Postoperative pain scores were 1.90 ± 0.18 in the intervention group compared to 2.95 ± 0.99 in the control group (P = .027) at 24 h. Time to extubation was earlier in the intervention group (274.40 ± 98.36 vs 741.28 ± 93.82 min, P < .001). There were no statistically differences in Qor-15 at 72 h and other recovery outcomes.</p><p><strong>Conclusion: </strong>The administration of PIFB combined with RSB could improve quality of recovery and relieve postoperative pain for patients following cardiac surgery. Key message What is already known on this topic Previous studies have demonstrated that ultrasound-guided nerve blocks effectively reduce postoperative pain in cardiac surgery patients. However, whether these techniques further enhance overall postoperative recovery remained unclear. What this study adds This trial revealed that ultrasound-guided nerve blocks improved postoperative QoR-15 scores, and combined regional techniques further improved recovery without compromising analgesia. How this study might affect research, practice, or policy The findings support applying combined nerve blocks into enhanced recovery protocols for cardiac surgery, offering evidence to optimize postoperative analgesia strategies.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859548","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":"Back to basics: why open groin hernia repair still deserves center stage?","authors":"Kaushik Bhattacharya, Dhananjaya Sharma","doi":"10.1093/postmj/qgaf128","DOIUrl":"https://doi.org/10.1093/postmj/qgaf128","url":null,"abstract":"<p><p>In an age of surgical innovation, the shift toward minimally invasive inguinal hernia repair demands critical reappraisal. Large-scale data and registry analyses reveal no consistent superiority of laparoscopic or robotic techniques over the traditional open repair, particularly regarding recurrence, complications, chronic pain, or patient satisfaction. The open Lichtenstein approach, often undervalued, remains a pragmatic, cost-effective, and evidence-based option, especially in high-risk or resource-limited settings. The enduring appeal of minimally invasive techniques appears increasingly driven by industry, training hierarchies, perceived prestige, and surgical showmanship rather than clear patient benefit.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859547","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":"Choosing the right title, keywords and crafting an effective abstract in scientific writing.","authors":"Atanu Chandra, Manali Bera Chandra","doi":"10.1093/postmj/qgaf126","DOIUrl":"https://doi.org/10.1093/postmj/qgaf126","url":null,"abstract":"<p><p>The title and abstract are the most visible and frequently accessed components of a scientific article, often determining whether a manuscript is read, cited or even considered for peer review. Alongside title and abstract, the inclusion of well-chosen keywords significantly enhances searchability and visibility in academic databases. A well-crafted title encapsulates the essence of the study, ensuring clarity, conciseness and searchability, while an effective abstract provides a succinct yet comprehensive summary of the research. Despite their critical role in scientific communication, many authors struggle with optimizing these elements. This article reviews best practices in scientific communication, with a practical orientation. We discuss how structured frameworks (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Consolidated Standards of Reporting Trials, Strengthening the Reporting of Observational Studies in Epidemiology) enhance rigor and visibility. New authors often overlook the importance of journal-readership alignment, targeting appropriate scopes or the \"So what?\" test for relevance: critical questions all researchers should pose before submission. Despite being grounded in conventional best practices, this work aims to bridge persistent gaps in real-world manuscript preparation. By addressing common pitfalls and integrating examples and models, this article helps researchers improve both the impact and acceptance potential of their manuscripts through more strategic use of titles, keywords and abstracts.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837431","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":"Climate change and public health in low- and middle-income countries: the critical role of health professionals.","authors":"Umaima Mir, Muhammad Salar Khan, Shandana Kifayat, Shanlina Kifayat","doi":"10.1093/postmj/qgaf123","DOIUrl":"https://doi.org/10.1093/postmj/qgaf123","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837432","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 relationship between sleep patterns and the risk of edentulism: evidence from the CHARLS.","authors":"Hong-Yu Zhao, Peng-Lu Jia, Ping Ma, Wu-Long Jin, Hua-Jiao Yu","doi":"10.1093/postmj/qgaf115","DOIUrl":"https://doi.org/10.1093/postmj/qgaf115","url":null,"abstract":"<p><strong>Background: </strong>Edentulism is a common disease among the elderly. The relationship between sleep patterns and edentulism has not been fully explored.</p><p><strong>Methods: </strong>This study utilized baseline and follow-up data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015-participants aged 45 or above. The outcome variable was self-reported edentulism. Independent variables included nap duration, nighttime sleep duration, and sleep quality. The association between edentulism and sleep patterns was evaluated using multivariable logistic regression analysis. To further explore the potential non-linear relationship between nighttime sleep duration and the risk of edentulism, restricted cubic spline (RCS) regression was performed with nighttime sleep duration treated as a continuous variable. Subgroup analysis by gender and age, and introduce interaction terms into the Multivariable logistic regression analysis.</p><p><strong>Results: </strong>466 of the 9732 participants were edentulous. After adjusting for potential confounders, participants with short nighttime sleep duration had a 34.5% higher risk of edentulism than those with normal nighttime sleep duration (OR: 1.345; 95% CI:1.097-1.653). RCS regression demonstrates dose-response relationship. Subgroup analyses revealed a significant association between short nighttime sleep duration and edentulism in both men (OR: 3.89; 95% CI: 2.75-6.24) and women (OR: 4.25; 95% CI: 2.99-6.86), as well as in individuals aged ≥65 years (OR: 5.26; 95% CI: 3.25-10.72). Interaction analyses showed no significant interaction between nighttime sleep duration and gender or age.</p><p><strong>Conclusion: </strong>Short nightly sleep duration may be closely connected to the prevalence of edentulism in people of middle age and older age.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837434","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":"Adverse drug reaction to contrast medium after anti-PD-1 therapy.","authors":"Suiting Ao, Bowen Liu, Monday Ogaba Ogese, Dean Naisbitt, Yonghu Sun","doi":"10.1093/postmj/qgaf122","DOIUrl":"https://doi.org/10.1093/postmj/qgaf122","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837430","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":"Early pregnancy maternal hemoglobin and the risk of neonatal congenital heart disease: insights from a case-control study, Guangdong, China.","authors":"Shuqi Chen, Guo Wei, Shufen Chen, Xiang Zhou","doi":"10.1093/postmj/qgaf112","DOIUrl":"https://doi.org/10.1093/postmj/qgaf112","url":null,"abstract":"<p><strong>Introduction: </strong>The association between maternal hemoglobin in the first trimester (1st TRI) and the risk of neonatal congenital heart disease (CHD) remains unclear.</p><p><strong>Methods: </strong>A case-control study was conducted involving 102 CHD neonates and 408 controls. Iron-deficiency anemia in the first trimester (1st TRI) was characterized by a hemoglobin level below 110 mg/L, in the absence of hemoglobinopathies such as thalassemias and sickle cell anemia like thalassemia or sickle cell anemia. We utilized logistic regression models to assess the association between maternal hemoglobin/iron-deficiency anemia in 1st TRI and the risk of neonatal CHD.</p><p><strong>Results: </strong>Neonate born to mothers with iron-deficiency anemia in 1st TRI increased risks of CHD and patent ductus arteriosus compared to those in neonates born to mothers without anemia in 1st TRI (OR = 3.544, 95%CI = 1.428, 8.795; OR = 6.990, 95%CI = 1.248, 39.157, respectively). Pregnant women in the lowest hemoglobin quartile (Q1) in 1st TRI had a significantly higher risk compared to Q4 (OR = 5.365, 95% CI: 2.232-12.896). There was a dose-response relationship between lower maternal hemoglobin in 1st TRI and the increased risk of neonate CHD (P for trend < .001). The probabilities of neonates developing CHD increased as the maternal hemoglobin concentrations in 1st TRI decreased (rs = -0.614, 95% CI: -0.673, -0.555, P < .05).</p><p><strong>Conclusion: </strong>Maternal iron-deficiency anemia in 1st TRI increased the risk of CHD in neonates. Maternal hemoglobin in 1st TRI may be a practical risk marker of neonatal CHD. Key message What is already known on this topic-Previous studies have suggested that maternal anemia may influence fetal development, but the association between first-trimester maternal hemoglobin levels and the risk of neonatal CHD has remained unclear. What this study adds-This study demonstrates that maternal iron-deficiency anemia in the first trimester is significantly associated with an increased risk of neonatal CHD, particularly PDA, and that lower maternal hemoglobin levels are positively associated with higher CHD risk. How this study might affect research, practice or policy-These findings highlight the importance of early screening and management of maternal iron-deficiency anemia, suggesting that maternal hemoglobin in the first trimester could serve as a potential risk marker for neonatal CHD, informing prenatal care strategies and public health policies.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837433","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":"Women in surgery: addressing inequality in the surgical workforce and improving training for all.","authors":"Caitlin Brennan, Vishwani Chauhan, Rahee Mapara, Philippa Rust","doi":"10.1093/postmj/qgaf120","DOIUrl":"https://doi.org/10.1093/postmj/qgaf120","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837435","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 impact of inhaler on the environment and climate change: past, present, and future.","authors":"Elizabeth Man Chin Ng, Wang Chun Kwok","doi":"10.1093/postmj/qgaf121","DOIUrl":"https://doi.org/10.1093/postmj/qgaf121","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775993","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":"Impact of thyroid nodule location on the risk of papillary thyroid carcinoma.","authors":"Yumeng Liu, Shijie Yang, Meijuan Tan, Xiequn Xu","doi":"10.1093/postmj/qgaf119","DOIUrl":"https://doi.org/10.1093/postmj/qgaf119","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are a widespread disease in endocrine system. While ultrasound is the preferred non-invasive examination, it still has some limitations. The study aims to evaluate the correlation between the location of thyroid nodules and pathological diagnosis of thyroid cancer (TC).</p><p><strong>Methods: </strong>We retrospectively reviewed data from medical records of patients with thyroid nodules who underwent thyroidectomy from 2018 to 2024. A total of 1307 patients with confirmed benign or malignant thyroid nodules were included.</p><p><strong>Results: </strong>Nodules located in the lower part of left/right thyroid lobe had a higher frequency of malignancy (41.2%) compared to the isthmus (5.4%). A logistic regression model uncovered that the location of thyroid nodules was a significant risk factor for the diagnosis of TC (P = .044), both the upper [P = .040, odds ratio (OR) = 2.009] and the middle (P = .020, OR = 1.702) nodules in left/right lobe were distinctly malignant compared those in the lower. Adjusted by age, maximum nodule size, and aspect ratio, nodules in the middle part still had higher malignancy than the lower lobe (P = .046, OR = 1.630). We also evaluated the correlation between the location and capsular invasion. Compared with nodules in the lower part, non-lower nodules had a greater likelihood of invading the capsule, indicating a poorer prognosis for TC patients.</p><p><strong>Conclusions: </strong>Our study showed that the location of thyroid nodules is an independent risk factor in determining TC. Nodules located in the lower part of the left/right lobe are considered as having the lower risk of malignancy and capsular invasion.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775992","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}