British journal of hospital medicine最新文献

{"title":"Association Between Liver and Muscle Fat Fractions: A Study Using the Proton Density Fat Fraction MRI.","authors":"Gülsüm Kilickap, Mehmet Cem Kolsuz","doi":"10.12968/hmed.2025.0169","DOIUrl":"https://doi.org/10.12968/hmed.2025.0169","url":null,"abstract":"<p><p><b>Aims/Background</b> Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common condition linked to insulin resistance and metabolic syndrome, potentially leading to liver fibrosis. Myosteatosis shares common pathophysiological pathways with MASLD. This study aims to evaluate the relationship between psoas and paraspinal muscle fat content and liver fat content, and compare the muscle fat content in patients with and without fatty liver. <b>Methods</b> Patients who underwent T2* Magnetic Resonance Imaging (T2*MRI) between January 2023 and November 2024 in the Bilkent City Hospital, Ankara, Turkey, were included in the study (n = 280). Fat fractions were determined using the Proton Density Fat Fraction (PDFF). The relationship between liver fat fraction and psoas and paraspinal muscle fat fractions was analysed using age- and sex-adjusted regression models. <b>Results</b> Fatty liver was observed more in men than in women (68% vs. 50%, <i>p</i> = 0.003). Psoas and paraspinal muscle fat fractions were significantly higher in patients with versus without fatty liver (<i>p</i> < 0.001). The regression analysis revealed that both psoas (<i>p</i> = 0.002) and paraspinal muscle (<i>p</i> < 0.001) fat fractions had significant non-linear associations with liver fat fraction. The area under the receiver operating characteristic (ROC) curves demonstrated that the discriminative value of psoas and paraspinal muscle fat fractions for fatty liver were comparable (0.715 vs. 0.678, respectively; <i>p</i> = 0.249). Psoas muscle fat fraction of ≥4.5% and paraspinal muscle fat fraction of ≥7% had a sensitivity of 69.3% and 62.0%; specificity of 65.8% and 72.8%; positive predictive value of 74.7% and 76.9%; and negative predictive value of 59.5% and 56.8% for the diagnosis of fatty liver, respectively. <b>Conclusion</b> There is a non-linear and significant relationship between liver fat fraction and psoas and paraspinal muscle fat fractions. The fat fractions of the psoas and paraspinal muscles were significantly higher in patients with fatty liver, and the diagnostic efficacy level for fatty liver was moderate, and the discriminant values of the two were comparable.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136566","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":"Recombinant Human Thrombopoietin Combined With Avatrombopag for Chemoradiotherapy-Induced Thrombocytopenia in Nasopharyngeal Carcinoma: A Prospective, Randomized Controlled Trial.","authors":"Ting Jin, Qifeng Jin, Yonghong Hua, Shuang Huang, Xiaozhong Chen","doi":"10.12968/hmed.2025.0641","DOIUrl":"10.12968/hmed.2025.0641","url":null,"abstract":"<p><p><b>Aims/Background</b> Chemoradiotherapy-induced thrombocytopenia is a frequent dose-limiting toxicity in nasopharyngeal carcinoma (NPC). Thrombopoietin receptor agonists have shown potential in accelerating platelet recovery. This study aimed to evaluate the clinical efficacy of recombinant human thrombopoietin (rhTPO) combined with avatrombopag in treating chemoradiotherapy-induced thrombocytopenia in NPC patients. <b>Methods</b> A total of 42 NPC patients receiving chemoradiotherapy at Zhejiang Cancer Hospital between May 2023 and June 2024 were randomly allocated into an experimental group (n = 21) and a control group (n = 21) using the envelope method. The control group received avatrombopag alone, whereas the experimental group was administered rhTPO plus avatrombopag. Clinical efficacy, platelet parameters, serological indicators, and adverse events were assessed and compared. <b>Results</b> No significant difference was observed between groups in the overall response rate (95.24% vs. 71.43%) (χ² = 2.743, <i>p</i> = 0.098). Before treatment, platelet parameters and serological indicators did not differ significantly between groups (<i>p</i> > 0.05). Following treatment, platelet distribution width (PDW) and mean platelet volume (MPV) were significantly reduced, while plateletcrit (PCT) was significantly elevated in the experimental group compared to the control group (<i>p</i> < 0.05). Additionally, serum levels of thrombopoietin (TPO), signal transducer and activator of transcription 3 (STAT3), and mitogen-activated protein kinase (MAPK) were markedly elevated in the experimental group (<i>p</i> < 0.05). The incidence of adverse events did not differ significantly between groups (47.62% vs. 52.38%, χ² = 0.095, <i>p</i> = 0.758). <b>Conclusion</b> The combination of rhTPO and avatrombopag demonstrates potential clinical efficacy with a favorable safety profile. However, larger randomized controlled trials are warranted to validate these findings. <b>Clinical Trial Registration</b> Chinese Clinical Trial Registry (ChiCTR2400081992).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136562","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":"Evolution of Modern Acute Pathways to Evaluate Key Performance Indicators and Outcomes in Femoral Fragility Trauma.","authors":"Panagiotis Konstantinou, Ashraf Amin Ariff, Charmaine Riley Nelson, Ahmed Hamed, Panteleimon Tsantanis, Niraj Vetharajan, Anastasios P Nikolaides","doi":"10.12968/hmed.2024.0681","DOIUrl":"https://doi.org/10.12968/hmed.2024.0681","url":null,"abstract":"<p><p><b>Aims/Background</b> The prevalence of fragility neck of femur (NOF) fractures among the elderly poses significant healthcare challenges. The Best Practice Tariff (BPT) was introduced to improve care standardization and outcomes for these high-risk patients. This study evaluates the effectiveness of transferring NOF fracture management to a specialized facility, focusing on BPT adherence, efficiency, and patient outcomes. <b>Methods</b> Employing a mixed-method cohort design, the study contrasted retrospective data pre-transition with prospective data post-transfer from Queen Elizabeth Hospital Birmingham (QEHB) to Birmingham Heartlands Hospital (BHH). A pivotal change was the introduction of a standardized electronic NOF Fracture Proforma. Comparison of demographic data, BPT adherence, 30-day mortality and postoperative care was made. <b>Results</b> The move to BHH resulted in a significant rise in BPT compliance rising from 40.5% at QEHB to 59.9% at BHH (<i>p</i> < 0.001), as well as a higher percentage of patients reaching operating theatres within 36 hours (<i>p</i> < 0.001). Despite improved adherence and operational efficiencies, no statistically significant reduction in 30-day mortality was observed. <b>Conclusion</b> NOF fracture management relocation to BHH yielded higher BPT compliance and greater operational efficiency. The lack of significant mortality reduction underlines the multifaceted nature of influencing patient outcomes. Specialized, multidisciplinary care has the potential to elevate the standard of patient care for NOF fractures, but continuous service optimization is critical for significant outcome improvements.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136522","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":"What's New in Operative Gynaecology? An Introduction to Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES).","authors":"Hashviniya Sekar, Kirsty Hartshorn, Liam Nicholson, Helienke Yoong, Joachim Ho, Priyanka Prakash, Wai Yoong","doi":"10.12968/hmed.2024.0775","DOIUrl":"https://doi.org/10.12968/hmed.2024.0775","url":null,"abstract":"<p><p>Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is a novel minimal invasive technique which uses the vagina for operative entry, after which fibreoptic and endoscopic instruments are introduced to perform surgery. This approach avoids external skin incisions and has attracted the attention of both clinicians and patients. Further, compared to conventional laparoscopic surgery, patients undergoing vNOTES have lower morbidity, better cosmesis and reduced length of postoperative stay. Initially limited to hysterectomy and adnexectomy, its role has now expanded to include indications such as urogynaecology, oncology and fertility. The aim of this review is to narrate to a general medical readership what the vNOTES approach means and how this can be adopted to hysterectomy, adnexectomy and other gynaecological indications. We also assess some of the reported outcomes and highlight that further randomised control trials will help decide if this indeed becomes the preferred surgical approach. Lastly, it is crucial to stress that clinicians wishing to implement vNOTES need to undergo appropriate training and appreciate judicious governance.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136553","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":"Thymosin α1 Combined With 2HRZE/4HR Regimen as a Potential Treatment of Pulmonary Tuberculosis: An Analysis of Immune Function, Pulmonary Function and Inflammatory Response.","authors":"Guofeng Wu, Xuelian Sun","doi":"10.12968/hmed.2025.0235","DOIUrl":"https://doi.org/10.12968/hmed.2025.0235","url":null,"abstract":"<p><p><b>Aims/Background</b> Immunotherapy plays a critical role in the clinical treatment of tuberculosis, an infectious disease caused by <i>Mycobacterium tuberculosis</i>, in which immune damage promotes the occurrence and development of the disease. This study aimed to investigate the efficacy of thymosin α1 combined with the 2HRZE/4HR (2 months of isoniazid, rifampin, pyrazinamide, and ethambutol followed by 4 months of isoniazid and rifampin) in the treatment of pulmonary tuberculosis and its effect on immune function and inflammatory factors. <b>Methods</b> A retrospective analysis was conducted on 106 pulmonary tuberculosis patients treated between October 2022 and June 2024. The patients were divided into two groups based on their treatment regimens: the control group (<i>n</i> = 47) received the 2HRZE/4HR treatment, while the observation group (<i>n</i> = 59) received thymosin α1 in addition to the 2HRZE/4HR treatment. All patients underwent a 6-month treatment course. Clinical efficacy was evaluated 6 months after treatment based on clinical symptoms and sputum smear results. The study compared foci resorption rates, cavity closure rates, and changes in pulmonary function indices, immune function indices, and inflammatory factor levels before and after treatment between the two groups. Adverse reactions were also recorded and analyzed. <b>Results</b> The total effective rate and the rate of foci resorption and cavity closure of the observation group were higher than the control group (<i>p</i> < 0.05). After 6 months of treatment, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, and peak expiratory flow (PEF) of the observation group were higher compared to the control group (<i>p</i> < 0.05). Compared with the control group, the observation group exhibited lower mRNA expression of T-cell immunoglobulin mucin-1 (<i>TIM-1</i>) and <i>TIM-3</i>; reduced levels of immunoglobulin E (IgE), sputum supernatant, serum interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α); but higher interferon-gamma (IFN-γ) levels (<i>p</i> < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> Thymosin α1 combined with the 2HRZE/4HR regimen holds promise as an effective treatment of pulmonary tuberculosis by improving immune function and pulmonary function of patients while attenuating the inflammatory response.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136575","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 Systematic Review Investigates the Safety and Efficacy of Intravenous Iron Dosing in Peritoneal Dialysis.","authors":"Sebastian Spencer, Rosa Maeve McGing, Samantha Hunter, Sunil Bhandari","doi":"10.12968/hmed.2024.0874","DOIUrl":"https://doi.org/10.12968/hmed.2024.0874","url":null,"abstract":"<p><p><b>Aims/Background</b> Anaemia is a common complication in chronic kidney disease, particularly in people with advanced kidney failure, contributing to increased morbidity and mortality. Iron repletion and erythropoietin-stimulating agents are widely used to manage anaemia, reducing the need for blood transfusions. However, these treatments carry risks, including thrombosis and cardiovascular issues. While intravenous iron is an established therapy for people receiving haemodialysis, its safety and efficacy in people undergoing peritoneal dialysis remain uncertain, partly due to limited data. This review assesses the current evidence on intravenous iron for managing anaemia in peritoneal dialysis, focusing on its impact on iron status, safety, and clinical outcomes. <b>Methods</b> Systematic searches of MEDLINE, Embase, Cochrane Library, HMIC, AMED and CINAHL were conducted. All eligible studies investigating intravenous iron therapy in adults with end-stage kidney failure undergoing peritoneal dialysis were included. The risk of bias was assessed using the Joanna Briggs Institute checklists for randomised, quasi-randomised and cohort studies. Sensitivity analysis was performed by comparing fixed and random effects models, removing outliers and performing a leave-one-out analysis. Studies had considerable heterogeneity when tested with Cochran's Q Test and the I² statistic. Where meta-analyses were not possible, narrative syntheses were conducted due to expected variations in iron dosing and monitoring practices, allowing for a more contextualised analysis of the data across heterogeneous study designs. <b>Results</b> 9 studies were included (3 studies compared intravenous to oral iron). The mean ferritin increase was 153.07 ng/mL (95% confidence interval (CI): 107.30-198.84; <i>p</i> < 0.0001) after sensitivity analysis. The mean transferrin saturation increase was 9.29% (95% CI: 2.98-15.61; <i>p</i> = 0.0039). <b>Conclusion</b> Despite the variability, the included studies consistently show that intravenous (IV) iron improves ferritin, transferrin saturation, haemoglobin, and haematocrit levels, while reporting few adverse events. Future research should focus on optimal dosing, safety, and outcomes beyond anaemia, such as cardiovascular health and quality of life, to maximise patient benefits. <b>Systematic Review Registration</b> PROSPERO (CRD42022363043).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-28"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136537","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":"Investigating Potential Causal Relationships Between Plasma Protein Ratios and Alopecia Areata: A Bidirectional Mendelian Randomization Study.","authors":"Xiaoqi Tan, Zhen Yin, Shiyu Zhu, Liehua Deng","doi":"10.12968/hmed.2025.0405","DOIUrl":"https://doi.org/10.12968/hmed.2025.0405","url":null,"abstract":"<p><p><b>Aims/Background</b> Several types of plasma protein ratios (PPRs) have been shown to have significant associations with alopecia areata (AA); however, their causal relationships remain to be elucidated. This study aimed to identify causal relationships of 2821 PPRs with AA. <b>Methods</b> Data from the United Kingdom Biobank Pharma Proteomics Project (n > 54,000) and FinnGen R11 data (862 cases/432,686 controls) were used for a bidirectional Mendelian randomization (MR) analysis. Inverse-variance weighting (IVW), weighted median, simple mode, weighted mode and MR-Egger regression tests were used to estimate the causality between PPRs and AA. Sensitivity analyses were performed to ensure the robustness of our findings. <b>Results</b> Our analysis showed that the agrin (AGRN)/heparan sulfate proteoglycan 2 (HSPG2) and 2,4-dienoyl-CoA reductase 1 (DECR1)/FK506-binding protein 1B (FKBP1B) ratios were significantly elevated in AA patients (<i>p</i> < 0.05). The IVW method revealed that for every one standard deviation (SD) increase in the AGRN/HSPG2 ratio, the risk of AA increased by 44.8% (odds ratio [OR] = 1.448, 95% confidence interval [CI]: 1.200-1.745, <i>p</i> < 0.001). Similarly, for every one SD increase in the DECR1/FKBP1B ratio, the risk of AA increased by 65.8% (OR = 1.658, 95% CI: 1.273-2.159, <i>p</i> < 0.001). In contrast, reverse MR analysis did not detect any significant causal effects of AA on these two PPRs (<i>p</i> > 0.05). Sensitivity analyses confirmed the robustness of our results and ruled out horizontal pleiotropy (MR-Egger intercept <i>p</i> > 0.05). <b>Conclusion</b> This study uncovered the causal relationships between two types of PPRs and AA, offering new insights into the diagnosis, treatment, and underlying mechanisms of AA.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136564","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 Time-Cost Analysis of Operating Room Utilization and Efficiency in Cardiac Surgery.","authors":"Suvitesh Luthra, Gabriel Hunduma, Ahmed Eissa, Laura Viola, Szabolcs Miskolczi, Theodore Velissaris","doi":"10.12968/hmed.2024.0836","DOIUrl":"https://doi.org/10.12968/hmed.2024.0836","url":null,"abstract":"<p><p><b>Aims/Background</b> The aim of this analysis was to determine Operating Room (OR) utilization efficiencies and costs in cardiac surgery. <b>Methods</b> A retrospective cohort of 1987 cardiac surgeries were analyzed over a 2-year period for surgeon idling time, knife-to-skin time, procedure time, total operation time and transfer times in a two-case/block model. Predefined indices of operational efficiency (Index of Operational Efficiency [InOE], Surgical Index of Operational Efficiency [sInOE]) were calculated for various procedures and teams. The goodness of fit of regression curves were performed for InOE for various times on the operational pathway. <b>Results</b> The mean 'procedure time' was 246 ± 73 minutes (78% of total OR time). OR utilization efficiencies were highest for aortic valve replacement (AVR) and coronary artery bypass surgery (CABG) and least for complex aortic procedures. Significant differences existed for procedure-specific and team-specific OR times and operational efficiency. Procedure times correlated strongest with InOE (r = -0.940, <i>p</i> < 0.001). They had a closer linear fit to regression curve analysis thus indicating greater efficiency. <b>Conclusion</b> There were significant variations between OR times and efficiencies for procedures and teams. Significant cost savings are possible by increasing efficiency along the operational pathways in cardiac surgery theatres.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136526","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":"Imaging Features of Primary Clear Cell Carcinoma of the Liver: A Case Series and Literature Review.","authors":"Lifeng Xu, Jingru Dai, Guifen Wei, Bifeng Zhang, Ping Zhu","doi":"10.12968/hmed.2025.0642","DOIUrl":"https://doi.org/10.12968/hmed.2025.0642","url":null,"abstract":"<p><p>To analyse the computed tomography (CT) and magnetic resonance imaging (MRI) features of primary clear cell carcinoma of the liver (PCCCL), and to provide a diagnostic basis for its identification and differentiation from other lesions. Clinical and imaging data of five patients with surgically and pathologically confirmed PCCCL were retrospectively collected and analysed. All patients underwent non-contrast and dynamic contrast-enhanced CT and MRI scans. On non-contrast CT, all five lesions appeared hypodense, with the lowest CT attenuation values measured in the lesions within the negative range, suggestive of intralesional fat components. On MRI, T1-weighted imaging showed hypointensity in three cases, isointensity in one case, and mild hyperintensity in one case. T2-weighted fat-suppressed sequences revealed heterogeneous-both high and low-signals in four cases and mild hypointensity in one case. Dual-echo sequences demonstrated signal drop on opposed-phase images in all five cases. Diffusion-weighted imaging showed predominantly hypointense signals in one case and heterogeneous hyperintensity (predominantly hyperintense) in four cases. The apparent diffusion coefficient values were preserved in two cases but reduced in three cases. Dynamic contrast-enhanced imaging showed arterial phase enhancement in all five lesions, with washout to hypodense or hypointense patterns in the portal venous and delayed phases. Nodular enhancement was observed in one lesion, prominent intratumoral vessels in one case, and delayed capsular enhancement in two cases. Neither CT nor MRI revealed portal vein tumour thrombus, intrahepatic metastases, lymphadenopathy in the hepatic hilum or retroperitoneum, or ascites. PCCCL is a rare subtype of hepatocellular carcinoma. Identifying its distinct imaging findings, such as peripheral solitary lesions, intratumoral fat, and a high incidence of pseudocapsule formation, may enhance diagnostic accuracy.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136547","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":"Patient-Centred Preoperative Assessment.","authors":"Ben Chisnall, Joanna Simpson","doi":"10.12968/hmed.2024.0717","DOIUrl":"https://doi.org/10.12968/hmed.2024.0717","url":null,"abstract":"<p><p>Patient-centred preoperative assessment describes an approach to preoperative assessment based on early screening and triage, optimisation of comorbidities and lifestyle, shared decision-making and multidisciplinary working. This approach tailors preoperative assessment to the individual circumstances of the patient, taking into account their comorbidities, functional status, health needs and lifestyle, and also their wishes and desired outcomes from surgical interventions (or, in some cases, the avoidance of surgery). This review outlines the components of patient-centred preoperative assessment, the relevant evidence, and practical approaches that can be used to facilitate patient-centred services.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136579","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}