Scottish Medical Journal最新文献

{"title":"ST ANDREW'S DAY PAEDIATRIC SYMPOSIUM Friday 25th November 2022 Royal College of Physicians and Surgeons of Glasgow.","authors":"","doi":"10.1177/00369330231187720","DOIUrl":"10.1177/00369330231187720","url":null,"abstract":"Background: High-fl ow nasal cannula oxygen (HFNCO) therapy is a well-recognised therapy to provide respiratory support to infants with bronchiolitis. It has been provided on the general paediatric receiving ward in the Royal Hospital for Children (RHC), Glasgow for 3 years, having previously been delivered only in Paediatric Intensive Care Unit (PICU). Due to COVID-19 the requirement for PICUsto have a contingency plan to increase critical care capacity and initiate changes in critical care practice high-lighted the importance of providing ward-based HFNC. Aims: To ascertain the effectiveness and safety of using HFNC within the ward setting and establish the number of PICU days saved. Methodology:","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"NP17-NP20"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10587597","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":"Can peritumoral edema evaluated by Magnetic Resonance Imaging before neoadjuvant chemotherapy predict complete pathological response in breast cancer?","authors":"Burcak Cakir Pekoz,&nbsp;Okan Dilek,&nbsp;Tolga Koseci,&nbsp;Zeynel Abidin Tas,&nbsp;Oktay Irkorucu,&nbsp;Bozkurt Gulek","doi":"10.1177/00369330231174230","DOIUrl":"https://doi.org/10.1177/00369330231174230","url":null,"abstract":"<p><strong>Background and aims: </strong>The complete pathological response (pCR) following neoadjuvant chemotherapy (NAC) in breast cancer is essential for the accurate prediction of prognosis. We aimed to evaluate the efficacy of the presence and type of peritumoral edema detected by magnetic resonance imaging (MRI) in predicting pCR to NAC in breast cancer patients.</p><p><strong>Methods and results: </strong>One hundred five patients with the diagnosis of invasive carcinoma were evaluated by MRI before NAC. Edema was evaluated in fat-suppressed T2-weighted images. The patients were categorized into three groups: patients with no peritumoral edema, patients with peritumoral edema, and patients demonstrating subcutaneous edema. The cases were categorized as being pCR and non-pCR. Molecular subtypes, lymphovascular invasion (LVI), tumor size, and apparent diffusion coefficient (ADC) were evaluated. A positive relationship was found between the presence of edema and tumor size. Subcutaneous edema was found to be statistically higher in non-pCR patients. While the number of pCR patients with subcutaneous edema was 17 (30.4%), the number of non-pCR patients with subcutaneous edema was 26 (53.1%) (<i>p</i>  =  0.018). LVI was found to be statistically higher in patients with edema. The number of edema-negative and LVI (+) patients was 4 (15.4%), while the number of edema-positive and LVI (+) patients was 28 (35.4%) (<i>p</i> = 0.042). Intratumoral and peritumoral ADC values were significantly higher in tumors with edema.</p><p><strong>Conclusion: </strong>The presence of subcutaneous edema and LVI may be utilized for the prediction of pCR outcomes in breast cancer patients scheduled for NAC treatment.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"121-128"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10178456","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":"Effectiveness of educational and training intervention for improving hand hygiene compliance amongst nurses: a systematic review and meta-analysis of randomised controlled trials.","authors":"Ping Liu, Fang Cao, Qian Yao, Lin Xu, Hao Dai","doi":"10.1177/00369330231178909","DOIUrl":"10.1177/00369330231178909","url":null,"abstract":"<p><strong>Background and aims: </strong>Developing and implementing an educational and training programmes for improving hand hygiene compliance of the nursing personnel might help in increasing their knowledge, promoting positive attitude and follow adequate practice measures.</p><p><strong>Material and methods: </strong>Systematic search was done in PubMed, SCOPUS, CENTRAL, EMBASE, ScienceDirect, Clinicaltrials.gov and Google Scholar databases for articles published between 1964 and December 2022. Meta-analysis was carried out using a random-effects model, and the results were reported as pooled risk ratio (RR) with 95% confidence intervals (CIs), pooled standardised mean differences (SMD) or risk ratios (RR).</p><p><strong>Results: </strong>Eight studies were included in the analysis. Most studies had higher risk of bias. Nurses receiving educational and training programmes had significantly higher compliance to hand hygiene practices (pooled RR of 1.69 [95% CI: 1.23-2.31; I²  =  99.1%], p  =  0.001). The pooled analysis based on studies reporting the compliance to hand hygiene as continuous outcome has reported the pooled SMD as 1.28 with 95% CI: 0.62 to 1.95 and I²  =  74.5%. There were no single-study effects with respect to this outcome, since the sensitivity analysis showed no difference in either direction or strength of effect estimate.</p><p><strong>Conclusion: </strong>Educational and training programmes are effective in improving the hand hygiene compliance amongst the nursing professionals.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"72-79"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176068","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":"Platelet-lymphocyte ratio and lymphocyte-monocyte ratio in inflammatory bowel disease and disease activity: A systematic review and meta-analysis.","authors":"Lanqin Gao, Yazhen Zhan, Xingping Hu, Shuli Liao","doi":"10.1177/00369330231188962","DOIUrl":"10.1177/00369330231188962","url":null,"abstract":"<p><strong>Objective: </strong>This review aimed to examine if the platelet-lymphocyte ratio and lymphocyte-monocyte ratio can be useful in determining disease activity in patients with inflammatory bowel disease.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched for studies published up to 9 January 2023. Platelet-lymphocyte ratio and lymphocyte-monocyte ratio values from active and remission inflammatory bowel disease cases were compared to generate a mean difference (MD).</p><p><strong>Results: </strong>Nine studies were included. Meta-analysis showed that inflammatory bowel disease patients with active disease had significantly higher values of platelet-lymphocyte ratio as compared to those in remission (MD: 63.46 95% CI: 35.74, 91.17, <i>I</i>²= 89%). The values of platelet-lymphocyte ratio were significantly higher in both active ulcerative colitis and Crohn's disease patients. Meta-analysis also showed that lymphocyte-monocyte ratio values were significantly lower in active inflammatory bowel disease patients as compared to those under remission (MD: -1.28 95% CI: -1.42, -1.14, <i>I</i>²= 4%). Lymphocyte-monocyte ratio values were significantly lower in both ulcerative colitis and Crohn's disease patients with active disease.</p><p><strong>Conclusion: </strong>Platelet-lymphocyte ratio and lymphocyte-monocyte ratio can be useful blood-based markers in differentiating active disease in inflammatory bowel disease patients. Active cases of ulcerative colitis and Crohn's disease have high platelet-lymphocyte ratio and low lymphocyte-monocyte ratio as compared to those in remission. Further studies with a larger sample size are needed to strengthen conclusions.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"101-109"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10178494","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 and data analyses: Guide to clinical practice and research.","authors":"Qiushuo Wu,&nbsp;Ghulam Nabi","doi":"10.1177/00369330231193888","DOIUrl":"10.1177/00369330231193888","url":null,"abstract":"This issue of the Scottish Medical Journal has a few systematic reviews and critical analysis of literature in many areas. We feel that for clinical practice, evidence is essential and systematic reviews summarize evidence for us through a scientific synthesis. The range of topics of systematic reviews.1–8 in this issue has been wide and not focusing on a particular problem, however, publications should generate awareness, some glimpse into methodology and associated discussions around evidence-based medicine. Evidence-based medicine is a combination of individual clinical knowledge and the results of clinical trials. And as a doctor, there is a great need for some strong evidence to support his diagnosis and treatment and all aspects of it. Due to the proliferation of medical literature and the limited time available to clinicians and researchers, systematic evaluation was born. The systematic evaluation aims to obtain stronger clinical evidence for clinical decisionmaking by systematically searching medical databases. So high-quality systematic reviews are needed. The quality of a systematic review depends on the number and quality of the studies included and the presence of heterogeneity. Choosing a good topic is the beginning of preparing a systematic review. Once you have chosen a topic, you can start with the Protocol. At this stage, most journals recommend that we use The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) to assist in the writing of our articles. PROSPERO (http://www.crd.york.ac.uk/prospero/) is a well-known platform for registration of system overviews, so it is best to make a registration on such a platform. And check if anyone has done any relevant research to avoid duplication. In particular, for clinical questions, authors should use the “Participants, Interventions, Comparisons and Outcomes (PICO)” to analyze the question before starting the process of conducting a systematic review. The search strategy is mainly to link some keywords by means of ‘and’ and ‘or’ to achieve a search of the relevant literature. Then it is a matter of selecting the appropriate database for the search, e.g. PubMed, Web of Science, Embase, Cochrane Library, CENTRAL, Cinahl, and LiLacs., etc. Searches can be conducted within them using keywords and appropriate filters such as time frame, language, type of literature, etc. It is recommended to search using multiple databases to increase the coverage of the literature. Before literature screening, screening criteria should be determined, including inclusion criteria and exclusion criteria. The selection of literature is divided into 2 parts, firstly by determining the type of literature and reading the abstract to determine whether the literature meets the search requirements to exclude some literature, and secondly by reading the full text of the article to determine whether the selected literature meets the requirements and whether there is a lack of data to determi","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"69-71"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549119","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":"Scottish Paediatric Society Summer Meeting, Stirling Court Hotel, University of Stirling, Friday 10th June 2022.","authors":"","doi":"10.1177/00369330231187719","DOIUrl":"10.1177/00369330231187719","url":null,"abstract":"Objectives: Determine the association between socio-economic status and features of Paediatric Emergency","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"NP11-NP16"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196937","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":"Scottish Paediatric Society Summer meeting Friday 9th June 2023 Suttie Centre for Teaching and Learning in Healthcare Foresthill Site, University of Aberdeen.","authors":"","doi":"10.1177/00369330231187718","DOIUrl":"10.1177/00369330231187718","url":null,"abstract":"Background: Clinical decision scores are used to target antibiotic use for acute sore throat (AST) but are not well validated in children under 5 years old. NICE guidance recommends antibiotics in AST where FeverPAIN score is >4. Following an increase in Group A streptococcal (GAS) transmission in December 2022, Public Health Scotland (PHS) interim guidance lowered this prescribing threshold to a FeverPAIN score >3. Objectives: To audit antibiotic prescribing for upper respiratory tract infection (URTI)/AST in the PED in the context of the GAS public health alert in December 2022 with NICE and interim PHS guidance as reference standards. To determine the diagnostic accuracy of the FeverPAIN score in predicting con fi rmed GAS infection. Population: All children aged 3 to 16 years who presented to the PED between 3 and 16 December 2022, who had a throat swab for bacterial culture. Methods: Cases were identi fi ed from laboratory sample data. FeverPAIN scores retrospectively assigned from clinical records. Descriptive statistics were calculated in excel. Received operator characteristic (ROC)curves were created using XLSTAT. Only children with a diagnosis of URTI/AST and calculable FeverPAIN score were included.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"NP6-NP10"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196941","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 prehospital intubation on mortality rates in patients with traumatic brain injury: A systematic review and meta-analysis.","authors":"Fang Ji, Xiaohui Zhou","doi":"10.1177/00369330231189886","DOIUrl":"10.1177/00369330231189886","url":null,"abstract":"<p><strong>Objective: </strong>It is unclear if prehospital intubation improves survival in patients with traumatic brain injury. We performed a systematic review and meta-analysis to assess the impact of prehospital intubation on mortality rates of traumatic brain injury.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Web of Science, and Embase databases were searched without any language restriction up to 20 June 2022 for all types of comparative studies reporting survival of traumatic brain injury patients based on prehospital intubation.</p><p><strong>Results: </strong>In total, 18 studies with 41,185 patients were eligible for inclusion. Meta-analysis showed that traumatic brain injury patients receiving prehospital intubation had higher odds of mortality as compared to those not receiving prehospital intubation. Meta-analysis of adjusted data also indicated that prehospital intubation was associated with increased odds of mortality in traumatic brain injury patients. The results did not change on sensitivity analysis. Subgroup analysis based on study type, the severity of traumatic brain injury, inclusion of isolated traumatic brain injury, emergency department intubation in the control group, and prehospital intubation group sample size demonstrated variable results.</p><p><strong>Conclusion: </strong>Heterogeneous data from mostly observational studies demonstrates higher mortality rates among traumatic brain injury patients receiving prehospital intubation. The efficacy of prehospital intubation is difficult to judge without taking into account multiple confounding factors.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"80-90"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168449","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 weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis.","authors":"Haiyan Xiong, Linlin Shi","doi":"10.1177/00369330231189887","DOIUrl":"10.1177/00369330231189887","url":null,"abstract":"<p><strong>Background: </strong>There is an ongoing debate if weekend admissions of critically ill patients are associated with higher mortality rates. The current review aimed to specifically assess this effect in sepsis and septic shock patients by comparing mortality rates with weekend versus weekday admissions.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 20th February 2023 with an additional search of Google Scholar for gray literature.</p><p><strong>Results: </strong>Nine studies were eligible. Meta-analysis of all nine studies with data from 1,134,417 patients demonstrated that sepsis or septic shock patients admitted on weekends don't have higher mortality as compared to those admitted on weekdays (OR: 1.04; 95% CI: 1.00, 1.09; p = 0.05; I²= 93%). On subgroup analysis based on sample size (>2000 or <2000 patients) and timing of mortality, we noted no difference in the significance of the results. However, there was a small significant increased risk of mortality with weekend admission noted in studies on the Asian population and including septic shock patients.</p><p><strong>Conclusion: </strong>Weekend admission does not have an adverse impact on mortality rates of sepsis and septic shock patients. Results must be interpreted with caution owing to high interstudy heterogeneity and variation in confounders adjusted by individual studies.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"91-100"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174576","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":"Burnout and patient safety perceptions among surgeons in the United Kingdom during the early phases of the coronavirus disease 2019 pandemic: A two-wave survey.","authors":"Tmam Al-Ghunaim,&nbsp;Judith Johnson,&nbsp;Chandra S Biyani,&nbsp;Marina Yiasemidou,&nbsp;Daryl B O'Connor","doi":"10.1177/00369330231163378","DOIUrl":"https://doi.org/10.1177/00369330231163378","url":null,"abstract":"<p><strong>Background: </strong>Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time.</p><p><strong>Purpose: </strong>The main aim was to examine the relationships between surgeon burnout and surgeons' perceptions of patient safety cross-sectionally and longitudinally. The secondary aim was to test whether surgeons' burnout levels varied over the first six months of the coronavirus disease 2019 pandemic.</p><p><strong>Methods: </strong>This paper reports data from a two-wave survey (first wave from 5 May and 30 June 2020, the second wave 5 January to 30 February 2021). The dataset was divided into a longitudinal group (for surgeons who responded at both the time points) and two cross-sectional groups (for surgeons who responded at a one-time point, but not the other).</p><p><strong>Results: </strong>The first key finding was that burnout was associated with patient safety outcomes measured at the same time point (Group 1 = 108, <i>r =</i> 0.309<i>,</i> <i>p</i> < 0.05 and Group 2 = 84, <i>r = </i>0.238, <i>p</i> < 0.05). Second, burnout predicted poor patients' safety perceptions over time, and poor patient safety predicted burnout over time (Group 3 = 39, <i>p</i> < 0.05). Third, burnout increased between the first and second surveys (<i>t</i> = -4.034, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Burnout in surgeons may have serious implications for patient safety. Interventions to support surgeons should be prioritised, and healthcare organisations, surgeons and psychological specialists should collaborate on their development.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"41-48"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}