British journal of hospital medicine最新文献

{"title":"Impact of Obstructive Sleep Apnea on Fetal Heart Rate: A Systematic Review.","authors":"Marco La Verde, Maria Maddalena Marrapodi, Rosella Molitierno, Antonietta Petillo, Hande Uzunçıbuk, Marco Di Blasio, Marco Cicciù, Giuseppe Minervini","doi":"10.31083/BJHM53217","DOIUrl":"https://doi.org/10.31083/BJHM53217","url":null,"abstract":"<p><strong>Aims/background: </strong>Obstructive sleep apnea (OSA) and intermittent maternal hypoxia during pregnancy have been hypothesised to impact fetal heart rate (FHR). To evidence this possible link, we performed a systematic review of the current evidence about maternal OSA and FHR alteration.</p><p><strong>Methods: </strong>The following databases were analysed from the inception to June 2024: Cochrane Library, PubMed-Medline, EMBASE, Web of Science, and Google Scholar. We included studies with pregnant women affected by OSA, and FHR assessed via cardiotocography or fetal electrocardiography. Studies without polysomnography or home sleep testing, cross-over designs, or non-English publications were excluded.</p><p><strong>Results: </strong>168 studies were screened, and six were included. Five were prospective observational studies, and one was a case report. Maternal age showed a value from 26.6 ± 7.1 to 34.8 ± 3.3 years, and gestational age ranged from 32.1 ± 3.4 to 39.4 ± 1.0 weeks. The body mass index (BMI) values ranged between 27.5 ± 7.2 and 55 kg/m². Polysomnography was the primary diagnostic tool for OSA in most studies; one study utilised a home sleep test. Apnea/hypopnea episodes frequency varied from 8.4 to 159 events per hour. Findings about the FHR alterations were discordant: three studies did not report an association, other three observed FHR changes linked to maternal respiratory events.</p><p><strong>Conclusion: </strong>Our systematic review evidenced a significant variability about the maternal OSA impact on fetal heart rate. The study's results were contradictory. These inconsistencies also derive from different study designs, sample sizes, and outcomes analysed. Further studies are necessary to evidence the real impact of the OSA on the fetal cardiac response.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD42024533801).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53217"},"PeriodicalIF":1.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763047","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":"LDL-Cholesterol Lowering Therapies: An Update.","authors":"Robert Humphrey, Louise Bowman","doi":"10.31083/BJHM53219","DOIUrl":"https://doi.org/10.31083/BJHM53219","url":null,"abstract":"<p><p>Low-density lipoprotein-cholesterol (LDL-C) is a causal factor in atherosclerotic cardiovascular disease (ASCVD). Decades of genetic, epidemiological and randomised evidence support LDL-C reduction as a central strategy for cardiovascular risk reduction. Statins remain the first choice of LDL-C-lowering therapy due to their proven efficacy and favourable safety profile. However, therapeutic options have now expanded with widespread availability of other agents including ezetimibe, bempedoic acid and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. These can be prescribed alone or in combination with statins to help achieve optimal LDL-C targets. More recently, RNA-based therapies, oral small molecule inhibitors, and gene-editing strategies have emerged, which may offer even greater LDL-C reduction. As evidence increasingly supports a \"lower is better\" approach, combining established and novel therapies offers opportunities to optimise ASCVD prevention. This review summarises the evolving landscape of LDL-C-lowering therapies, highlighting their mechanisms, evidence base, and implications for clinical practice.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53219"},"PeriodicalIF":1.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762978","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 Levels and Significance of Serum Sex Hormones, BMP-7, and RBP in Adult Male Patients With Primary Nephrotic Syndrome.","authors":"Ying Zhou, Lai Zhang","doi":"10.31083/BJHM53218","DOIUrl":"https://doi.org/10.31083/BJHM53218","url":null,"abstract":"<p><strong>Aims/background: </strong>There remain significant challenges in assessing the risk of primary nephrotic syndrome (PNS) and concomitant acute kidney injury (AKI) in adult males. AKI is characterized by decreased glomerular filtration rate. This study investigates the levels of serum sex hormones, bone morphogenetic protein-7 (BMP-7), and retinol-binding protein (RBP) and their significance in adult male patients with PNS and concomitant AKI.</p><p><strong>Methods: </strong>This retrospective analysis enrolled 86 adult male PNS patients admitted to Wuxi No.2 People's Hospital between January 2020 and November 2023 as the PNS group, and 80 healthy adult males as the healthy group. Serum levels of sex hormones-estradiol (E2), testosterone (T), follicle-stimulating hormone (FSH), and luteinizing hormone (LH)-as well as bone morphogenetic protein-7 (BMP-7) and RBP were compared between the two groups. Furthermore, PNS patients were stratified into PNS groups with or without AKI cohorts based on glomerular filtration rate. Additionally, the levels of these parameters were compared between the subgroups.</p><p><strong>Results: </strong>In the PNS group, the levels of E2 and RBP were 66.67 ± 18.87 pg/mL and 56.65 ± 17.23 mg/L, respectively, both significantly higher than those in the healthy group (<i>p</i> < 0.05). Conversely, FSH and BMP-7 levels were 3.84 ± 1.02 IU/L and 1.83 ± 0.44 ng/mL, respectively, both significantly lower than those in the healthy group (<i>p</i> < 0.05). Within the PNS group, patients with AKI demonstrated significantly higher E2 levels of 69.93 ± 9.95 pg/mL than non-AKI patients (<i>p</i> < 0.05). FSH and BMP-7 levels were substantially lower (3.45 ± 0.96 IU/L and 1.57 ± 0.35 ng/mL) than in non-AKI patients (<i>p</i> < 0.05). However, RBP level was considerably higher (62.23 ± 12.01 mg/L) in those with AKI (<i>p</i> < 0.05). Furthermore, serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (Cys C) levels were 167.23 ± 34.43 μmol/L, 11.14 ± 2.23 mmol/L, and 2.02 ± 0.72 mg/L, respectively, all significantly higher in patients with AKI than in non-AKI (<i>p</i> < 0.05). Regression analysis identified E2, BMP-7, and RBP as independent predictors for assessing AKI risk in PNS patients, with corresponding odds ratios (ORs) (95% confidence interval (CI)) values of 1.092 (1.016-1.175), 0.021 (0.002-0.184), and 1.095 (1.032-1.162), respectively (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Male patients with PNS exhibit abnormal serum sex hormone, BMP-7, and RBP levels, which are associated with AKI. E2, BMP-7, and RBP levels demonstrate significant predictive potential in assessing AKI risk in PNS.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53218"},"PeriodicalIF":1.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763131","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":"New Insights Into Delaying Renal Progression: Cardiovascular, Renal & Metabolic Medicine.","authors":"Rabbani M Daoud, Sebastian Spencer, Robert Desborough, Sunil Bhandari","doi":"10.31083/BJHM53144","DOIUrl":"https://doi.org/10.31083/BJHM53144","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53144"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763037","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":"Prevention in Hospitals: From Rhetoric to Reality.","authors":"Judith Stanton, Aalaa Jawad, Gillian Smith","doi":"10.31083/BJHM53143","DOIUrl":"https://doi.org/10.31083/BJHM53143","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53143"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762973","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":"How to Translate Quality Standards Into Good Lung Cancer Screening Programmes: The UK Experience.","authors":"Amna Burzić, Emma L O'Dowd, David R Baldwin","doi":"10.31083/BJHM53142","DOIUrl":"https://doi.org/10.31083/BJHM53142","url":null,"abstract":"<p><p>Randomised controlled trials have shown that early detection of lung cancer by low-dose computed tomography (LDCT) reduces lung cancer and all-cause mortality. This, and a detailed health economics evaluation, led to a recommendation in September 2022 by the UK National Screening Committee (UKNSC) that all four UK nations move towards implementation of a targeted lung cancer screening programme. The National Health Service England (NHSE) Targeted Lung Health Check (TLHC) programme launched in 2019 and has been adopted as the national screening programme in England with national rollout expected to be complete in 2030. Given the complexities of lung cancer screening, a comprehensive protocol and linked quality assurance standard were developed to provide a mechanism to ensure uniform and regulated implementation of a high-quality programme. This review will describe the importance of quality assurance and show how this works in a national programme.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53142"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762909","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":"Maternal-Fetal Antibiotic Dynamics in Suspected Chorioamnionitis: A Data Mining Study Using VOSviewer and R Package.","authors":"Ali Hassan Khormi","doi":"10.31083/BJHM53141","DOIUrl":"https://doi.org/10.31083/BJHM53141","url":null,"abstract":"<p><strong>Aims/background: </strong>Chorioamnionitis is the main contributor to prenatal morbidity and mortality. This study aimed to investigate maternal-fetal antibiotic dynamics in suspected chorioamnionitis (<i>MFADESC</i>) using bibliometric data mining tools to determine key research themes and trends.</p><p><strong>Methods: </strong>This cross-sectional study, based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, was conducted using the Scopus data. A multistep data-mining protocol was employed to identify 1606 relevant articles from 2448 initial records, refined by filtering for language, document type, and publication year. VOSviewer (version 1.6.19) was utilised to map the co-authorship and co-citation networks, and the total link strength (TLS) was calculated. To analyse the knowledge structure, thematic maps, and trends, Bibliometrix (version 4.1.4) was used. Bibliometric indices (g-, m-, and h-indices) were utilised to evaluate researcher productivity and impact, providing insights into research contributions and influence.</p><p><strong>Results: </strong>The analysis identified an 8.16% annual growth rate. The TLS values identified prominent scholars in <i>MFADESC</i> research. Romero, R. stands out with the highest h-index (28), g-index (42), and total citations (TC = 3726), reflecting a significant influence since 1991. Thematic evolution has underscored emerging trends in antibiotic efficacy and neonatal outcomes, thereby reflecting evolving research priorities. <i>MFADESC</i> research themes focus on chorioamnionitis, antibiotic efficacy, preterm birth, neonatal outcomes, maternal morbidity, diagnostic innovations, and emerging trends.</p><p><strong>Conclusion: </strong>The current findings recommend advancing diagnostic tools, enhancing antibiotic efficacy, fostering collaboration, and addressing emerging trends in <i>MFADESC</i> research.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53141"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763010","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":"Is Appendicectomy Outdated in the Management of Paediatric Appendicitis?","authors":"Katherine Lehovsky, Nigel J Hall","doi":"10.31083/BJHM53108","DOIUrl":"https://doi.org/10.31083/BJHM53108","url":null,"abstract":"<p><p>Appendicitis is the most common emergency surgical presentation and is particularly prevalent in the paediatric population. At present, the majority of children are managed with surgical removal of the inflamed appendix, a procedure that was established centuries ago, before the widespread availability of antibiotics. There are anecdotal historical cases of non-operative management of appendicitis, particularly in geographically remote areas. In recent decades, there has been increasing interest in the potential to manage appendicitis non-operatively. This review explores the relative merits of non-operative and surgical management of appendicitis and their current role across the spectrum of disease in clinical practice in the UK. It concludes that both operative and non-operative management are safe and effective treatments in appropriately selected patients. However, the results of further large-scale studies are needed to help refine our application of these treatments in clinical practice. The current evidence supports discussion of both operative and non-operative management as part of informed consent and the shared decision-making process.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53108"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763026","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":"Effects of Therapeutic Play Combined With Emotional Soothing Care on Clinical Outcomes, Nutritional Status, and Sleep Quality in Children With Acute Diarrhea.","authors":"Ying He","doi":"10.31083/BJHM53107","DOIUrl":"https://doi.org/10.31083/BJHM53107","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims/background: &lt;/strong&gt;Providing effective nursing interventions alongside pharmacological treatment is essential for enhancing children's cooperation, alleviating clinical symptoms, and promoting recovery. This study aims to investigate the effects of therapeutic play combined with emotional soothing care on clinical outcomes, nutritional status, and sleep quality in children with acute diarrhea, and to inform a comprehensive nursing strategy for clinical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 148 children with acute diarrhea admitted to the Women and Children's Hospital of Ningbo University between June 2023 and May 2025. Participants were grouped according to the nursing intervention received: children receiving emotional soothing care were assigned to the control group (&lt;i&gt;n&lt;/i&gt; = 78), whereas those receiving therapeutic play combined with emotional soothing care were assigned to the observation group (&lt;i&gt;n&lt;/i&gt; = 70). Baseline characteristics and clinical data were extracted from the medical record system and comparatively analyzed between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The observation group demonstrated significantly shorter diarrhea cessation time, abdominal pain cessation time, and length of hospital stay compared with the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). No statistically significant difference in fever resolution time was observed between the groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). In the viral etiology subgroup, the observation group showed significantly shorter diarrhea cessation time, shorter abdominal pain cessation time, and a shorter length of hospital stay compared to the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the bacterial etiology subgroup, diarrhea cessation time and abdominal pain cessation time were also significantly shorter in the observation group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), whereas the difference in length of hospital stay between groups was not statistically significant (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Following the intervention, serum albumin (Alb), prealbumin (PA), and hemoglobin (Hb) levels in the observation group were significantly higher than those in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Post-intervention scores for sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, daytime dysfunction, and the total Chinese version of the Pittsburgh Sleep Quality Index (PSQI) score were significantly lower in the observation group than those in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Although the incidence rates of dehydration, electrolyte imbalance, diaper rash, perianal breakdown, and dyspnea were lower in the observation group than those in the control group, these differences did not reach statistical significance (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). The proportion of children experiencing at least one adverse clinical outcome was compared between the observation group and the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Therapeutic play combined with emotional soothing c","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53107"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762880","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":"Epidemiology and Disease Burden of Hospitalised Children With Invasive Fungal Infection in China, 2016-2022.","authors":"Wenya Feng, Xinyu Wang, Guoshuang Feng, Gang Liu","doi":"10.31083/BJHM53104","DOIUrl":"https://doi.org/10.31083/BJHM53104","url":null,"abstract":"<p><strong>Aims/background: </strong>Invasive fungal infection (IFI) represents a significant global health challenge, particularly in paediatric populations, due to high mortality and severe long-term sequelae. This study aimed to characterize the epidemiological patterns and quantify the disease burden of IFI among hospitalised children in China.</p><p><strong>Methods: </strong>Data were obtained from the face sheets of discharge medical records collected between 2016 and 2022 from 30 tertiary children's hospitals, aggregated into the FUTang Updating medical REcords (FUTURE) database. Sociodemographic variables, disease spectrum, pathogen distribution, potential risk factors, length of stay (LOS), and overall disease burden among children with IFI were systematically analysed.</p><p><strong>Results: </strong>A total of 1250 IFI cases were identified, revealing an upward trend in incidence since 2019. The pathogen distribution among the 485 episodes with available microbiological data included <i>Candida</i> (25.36%; 123/485), <i>Aspergillus</i> (23.71%; 115/485), <i>Cryptococcus</i> (22.06%; 107/485), <i>Pneumocystis</i> (21.44%; 104/485), <i>Mucor</i> (4.12%; 20/485), <i>Talaromyces</i> (1.24%; 6/485), <i>Histoplasma</i> (0.82%; 4/485), <i>Blastomyces</i> (0.62%; 3/485), and <i>Sporotrichum</i> (0.62%; 3/485). Disseminated infections accounted for 5.76% (72/1250) of all IFI. Among the 1178 non-disseminated IFI cases, pneumonia (73.34%, 864/1178), central nervous system (CNS) infections (15.53%, 183/1178), and bloodstream infections (8.66%, 102/1178) were the predominant disease types. The most prevalent risk factors were haematological malignancies and myelosuppression. Overall, 181 patients died during their hospitalisation, representing a mortality rate of 14.48%.</p><p><strong>Conclusion: </strong>The incidence of IFI among hospitalised children in tertiary centres in China has risen since 2019, with <i>Candida</i>, <i>Aspergillus</i>, and <i>Cryptococcus</i> identified as the predominant pathogens. These infections are associated with considerable mortality (14.48%). The findings highlight the urgent need for enhanced surveillance, earlier diagnosis, and targeted therapeutic strategies to reduce morbidity and mortality in this high-risk population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 4","pages":"53104"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762900","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}