British journal of hospital medicine最新文献

{"title":"A Causal Relationship Between Hypothyroidism and Gestational Hypertension: Results From a Two-Sample Mendelian Randomization Analysis.","authors":"Yizhen Chen, Shaoxing Guan, Wei Zhuang","doi":"10.12968/hmed.2024.0492","DOIUrl":"https://doi.org/10.12968/hmed.2024.0492","url":null,"abstract":"<p><p><b>Aims/Background</b> Although hypothyroidism induced thyroid hormone disorders affect cardiovascular system homeostasis, whether hypothyroidism has a causal effect on gestational hypertension remains unknown. Therefore, our research aims to explore the causal relationship between hypothyroidism and gestational hypertension using Mendelian randomization (MR) analysis. <b>Methods</b> Summary data genome-wide association study of hypothyroidism (30,155 cases and 379,986 controls in the discovery dataset; 26,342 cases and 59,827 controls in the replicated dataset) and gestational hypertension (14,727 cases and 196,143 controls) were used for analysis. Inverse-variance weighted (IVW), weighted median, weighted mode and MR-Egger methods were used to estimate the causality between hypothyroidism and gestational hypertension. <b>Results</b> Hypothyroidism significantly increased the risk of gestational hypertension, as indicated by IVW (odds ratio (OR) = 1.0433, 95% confidence interval (CI) = 1.0081-1.0798, <i>p</i> = 0.0155), MR Egger (OR = 1.1445, 95% CI = 1.0620-1.2334, <i>p</i> = 0.0008), weighted median (OR = 1.0802, 95% CI = 1.0204-1.1435, <i>p</i> = 0.0079) and weighted mode (OR = 1.0999, 95% CI = 1.0286-1.1761, <i>p</i> = 0.0071) in the discovery analysis, which was consistent with the results of the replicated analysis. There was no bidirectional causality for hypothyroidism or gestational hypertension in the reverse MR analysis. <b>Conclusion</b> Our findings highlight the importance of hypothyroidism induced thyroid hormone disorder in increasing the risk of gestational hypertension by affecting cardiovascular system homeostasis. Early intervention in patients with hypothyroidism might reduce the risk of gestational hypertension and maternal and neonatal morbidity and mortality. Further studies are needed to determine the relationship between these factors and the underlying mechanism in detail.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966410","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":"Knowledge, Attitude, and Practice of Chinese Medical Staff for Common Resident Emergencies in Elder Care Facilities: A Structural Equation Model-Based Survey.","authors":"Shenjing Yu, Hongyu Tang, Wenting Cao, Li Gui, Yixin Wang","doi":"10.12968/hmed.2024.0788","DOIUrl":"https://doi.org/10.12968/hmed.2024.0788","url":null,"abstract":"<p><p><b>Aims/Background</b> Increasing population longevity poses challenges to health care for the elderly. Facility-based care is a primary approach to elder care, and medical staff in these settings must be skilled in managing emergencies, as the elderly are more likely to experience emergencies than those living in the community. To aid in developing first aid training, procedures, and regulations for medical staff in elder care facilities, we evaluated the knowledge, attitude, and practice (KAP) levels concerning commonly reported emergencies, as well as the correlations between these factors. <b>Methods</b> The questionnaires were distributed among 1493 doctors and nurses within 258 residential facilities in Shanghai between 1 May 2023 and 31 October 2023. Of the 725 valid questionnaires, we obtained socio-demographic and KAP-related data. Structural equation modeling (SEM) was applied to determine associations between KAP elements. <b>Results</b> Chinese medical staff in elder care facilities had relatively suboptimal knowledge regarding first aid for common resident emergencies, with only 41.7% rated as good. Their levels of attitude and practice were optimistic. The proportion of medical staff demonstrating a positive attitude and appropriate practice in first aid was 79.31% and 68.00%, respectively. Age, gender, educational level, experience with witnessing and dealing with emergencies were identified as factors influencing knowledge, attitude, and practice. Structural equation modeling revealed that attitude and knowledge could directly or indirectly affect management approaches for common elderly emergencies, with a correlation coefficient of 0.11 between knowledge and attitude and 0.66 between attitude and practice. The \"first aid for nine preventions\" and \"cardiac arrest and cardiopulmonary resuscitation\" substantially influenced knowledge acquisition, with correlation coefficients of 0.66 and 0.48, respectively. \"Attitude toward emergency management\" had a significant impact on the attitude of the medical staff, with correlation coefficients of 0.90. <b>Conclusion</b> Knowledge, attitude, and practice are interconnected, with knowledge indirectly influencing behavior by shaping attitude. The medical staff in elder care facilities in Shanghai had a limited understanding of first aid for common resident emergencies. Targeted training and education are urgently required to enhance their knowledge and skills in managing common emergencies among elderly patients, while fostering a strong sense of responsibility. Such initiatives can ensure prompt and appropriate first aid actions, boosting their confidence and promoting a positive and harmonious environment for medical staff and elderly residents.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970173","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":"Impacts of PEG-IFN-α-2b Combination Therapy on Liver Function, Immune Factors and Risk Factors in Patients With HBV Infection: A Retrospective Study.","authors":"Jun Zhang, Jing Zhou","doi":"10.12968/hmed.2024.0850","DOIUrl":"https://doi.org/10.12968/hmed.2024.0850","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Hepatitis B virus (HBV) infection poses a challenge to global healthcare. Peginterferon alfa-2b (PEG-IFNα-2b) is an effective treatment for HBV infection. This study aimed to explore the efficacy of PEG-IFNα-2b combined with entecavir in the treatment of HBV infection, its effect on liver function and immune factors, and the risk factors affecting the prognosis of patients with HBV infection. &lt;b&gt;Methods&lt;/b&gt; The clinical data of 184 patients with HBV infection who were treated at Jinhua Central Hospital from January 2021 to January 2024 were collected for retrospective analysis. Patients were divided into a control group (not receiving antiviral treatment, &lt;i&gt;n&lt;/i&gt; = 34), a standard treatment group (receiving entecavir, &lt;i&gt;n&lt;/i&gt; = 85), and a combination treatment group (PEG-IFNα-2b and entecavir, &lt;i&gt;n&lt;/i&gt; = 65) according to the treatment approach. Treatment efficacy, liver function indicators (albumin [ALB], alanine aminotransferase [ALT], and aspartate aminotransferase [AST]), immune factor indexes (tumour necrosis factor alpha [TNF-α] and interferon gamma [IFN-γ]), hepatitis B surface antigen [HBsAg] and HBV DNA levels were compared among the three groups. All patients were followed up after treatment. According to their prognosis, the patients were divided into good prognosis group (&lt;i&gt;n&lt;/i&gt; = 118) and poor prognosis group (&lt;i&gt;n&lt;/i&gt; = 66). Logistic regression analysis was performed to explore the risk factors affecting the prognosis of HBV patients. &lt;b&gt;Results&lt;/b&gt; The efficacy in the combination treatment group was higher (92.31%) than that in the control group (8.82%) and the standard treatment group (78.82%) (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). After treatment, the HBsAg and HBV DNA levels were decreased in the standard treatment and combination treatment groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Compared with the control and standard treatment groups, the combination treatment group exhibited significantly lower HBsAg and HBV DNA levels after treatment (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Besides, the combination treatment group had lower ALT and AST levels (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), and higher ALB level (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), than the control and standard treatment groups after treatment. Compared with the control and standard treatment groups, the combination treatment group demonstrated decreased TNF-α level and higher IFN-γ level after treatment (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Multivariate logistic regression analysis identified family medical history as the risk factor affecting the prognosis of patients with HBV infection (&lt;i&gt;p&lt;/i&gt; = 0.001, odds ratio [OR] = 3.614, 95% confidence interval [CI]: 1.685-7.750) and therapy regimen as the protective factor (&lt;i&gt;p&lt;/i&gt; = 0.029, OR = 0.135, 95% CI: 0.022-0.815). &lt;b&gt;Conclusion&lt;/b&gt; The PEG-IFNα-2b combination therapy in patients with HBV infection significantly improves the clinical treatment efficacy, liver function, and immune factors. In addition, this study found that therapy regimen and family medical history are independent factors affec","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964912","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":"Efficacy of Sacubitril/Valsartan Combined With Metoprolol on Cardiac Function, Cardiac Remodeling, and Endothelial Function in Patients With Coronary Heart Disease and Heart Failure.","authors":"Tongyu Zhu, Yingjing Song","doi":"10.12968/hmed.2025.0120","DOIUrl":"https://doi.org/10.12968/hmed.2025.0120","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Coronary heart disease (CHD) combined with heart failure results in a rapidly progressing disease with an acute onset, posing a significant threat to a patient's survival. Metoprolol, a β-blocker, is effective in treating heart failure; however, due to its complex pathogenesis, the efficacy of monotherapy in managing disease progression remains suboptimal. Sacubitril/valsartan, an angiotensin II receptor antagonist, is another widely used drug for treating heart failure. The combination of the two drugs may play a synergistic role in effectively managing heart failure through different mechanisms. This study aims to investigate the effects of sacubitril/valsartan combined with metoprolol on cardiac function, cardiac remodeling, and endothelial function in patients with CHD and heart failure. &lt;b&gt;Methods&lt;/b&gt; This retrospective analysis included 138 CHD patients combined with heart failure who received care at Linhai Hospital of Traditional Chinese Medicine between January 2022 and January 2024. Based on the treatment regimen, patients were divided into two groups. Patients receiving metoprolol monotherapy were included in the Metoprolol group (n = 61), while those receiving a combination of sacubitril/valsartan and metoprolol were assigned to the Combination group (n = 77). The cardiac function [New York Heart Association (NYHA) cardiac function classification], myocardial injury markers [serum cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP)], cardiac remodeling function [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD)], endothelial function [serum endothelin-1 (ET-1), nitric oxide (NO)] were compared between these two groups before treatment and 3 months post-treatment. Additionally, the two groups were comparatively assessed for the incidence of adverse reactions during the treatment period. &lt;b&gt;Results&lt;/b&gt; Following treatment, the NYHA cardiac function grading was significantly improved in the Combination group than in the Metoprolol group (&lt;i&gt;p&lt;/i&gt; = 0.014). After treatment, the Combination group demonstrated significantly lower serum cTnI and NT-proBNP levels than the Metoprolol group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). After treatment, the Combination group had substantially higher LVEF and lower LVEDD and LVESD than the Metoprolol group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Furthermore, the Combination group showed a significant decrease in serum ET-1 levels and an increase in serum NO levels compared to the Metoprolol group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). During the treatment period, there was no significant difference in the incidence of adverse reactions between the two groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). &lt;b&gt;Conclusion&lt;/b&gt; Sacubitril/valsartan combined with metoprolol is a safe, effective, and viable treatment option for patients with CHD combined with heart failure. This combination therapy may further improve cardiac and endothelial function by r","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980887","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":"Primary Localised Endobronchial Amyloidosis Mimicking Aspiration Pneumonia.","authors":"Darren Borg Azzopardi, David Bilocca, Ian Said Huntingford, Joseph Galea","doi":"10.12968/hmed.2024.0387","DOIUrl":"https://doi.org/10.12968/hmed.2024.0387","url":null,"abstract":"<p><p>A female in her 70s originally presented with a mechanical fall and a consolidation on a chest x-ray, thought to be secondary to aspiration. Failure to response to medical treatment prompted further investigations which revealed a calcific lesion obstructing the left lower lobe bronchus, histologically confirmed as endobronchial amyloidosis. Amyloidosis is a rare condition characterized by insoluble fibril protein deposition in various organs. Pulmonary amyloidosis can be a manifestation of systemic amyloid disease, or otherwise being isolated in nature. Tracheobronchial amyloidosis is a subtype of lung-related amyloidosis, and in fact being mostly not linked to a systemic form of disease. Removal of the lesion with rigid bronchoscopy led to an excellent recovery. Given that the lesion was focal and endobronchial, the most common manifestations would be complications related to collapse of the airway, including symptoms such as dyspnea or chronic cough and also episodes of recurrent pneumonias. Bronchoscopy and resection of the lesion is the main management of localised endobronchial amyloidosis unless systemic involvement or other complications are present.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974113","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 Holistic Approach to Improving Outcomes in Atrial Fibrillation: The AF-CARE Pathway.","authors":"Michael Griffin, Mark T Mills","doi":"10.12968/hmed.2024.0929","DOIUrl":"https://doi.org/10.12968/hmed.2024.0929","url":null,"abstract":"<p><p>In 2024, the European Society of Cardiology (ESC) released an updated guideline for the comprehensive management of atrial fibrillation (AF). This editorial summarises the holistic AF-CARE approach (CARE comprising Comorbidity management, Avoidance of stroke, Reduction of symptoms, plus Evaluation and dynamic reassessment) which is advocated in the guidance.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973847","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 Effects of Recombinant Human Brain Natriuretic Peptide in Combination With Sacubitril Valsartan Sodium on Cardiac Function, Inflammatory Markers, and Oxidative Stress Indicators in Elderly Patients With Acute Left Heart Failure: A Retrospective Study.","authors":"Yibing Gao, Zhi Cheng","doi":"10.12968/hmed.2024.0706","DOIUrl":"https://doi.org/10.12968/hmed.2024.0706","url":null,"abstract":"<p><p><b>Aims/Background</b> Acute left ventricular failure (ALVF), a common cardiovascular emergency characterized by rapid occurring and progressing, poses a severe threat to the patient's life. The purpose of this study is to investigate the impact of combining recombinant human brain natriuretic peptide (rhBNP) with sacubitril valsartan sodium on cardiac function, inflammatory markers, and oxidative stress indicators in elderly ALVF patients. <b>Methods</b> This retrospective study included 167 elderly ALVF patients between June 2022 and June 2024. Based on the treatment regimen, the patients were divided into three groups: a control group (n = 49, who received traditional treatment), an observation group (n = 61, who received replacement treatment with sacubitril and valsartan sodium), and a combination group (n = 57, who administered with a combination of rhBNP and sacubitril and valsartan sodium). Clinical data of patients were accessed from the electronic medical record system in the Second Affiliated Hospital of Nanjing Medical University, and the pre- and post-treatment cardiac function, inflammatory marker levels, oxidative stress indicators, and incidence of adverse reactions were compared among the three groups of patients. <b>Results</b> Following treatment, the left ventricular ejection fraction (LVEF) and superoxide dismutase (SOD) levels were significantly higher in the combination group compared to the observation and control groups. Furthermore, the combination group exhibited a substantial decrease in the left ventricular end-diastolic diameter (LVEDD), creatine kinase isoenzyme MB (CK-MB), alpha hydroxybutyrate dehydrogenase (α-HBDH), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA) and tumor necrosis factor-alpha (TNF-α). Moreover, TNF-α, MDA and interleukin-6 (IL-6) levels were significantly lower in the observation group compared to the control group (<i>p <</i> 0.05). Additionally, no significant difference was observed in the incidence of adverse reactions between the two groups (<i>p ></i> 0.05). <b>Conclusion</b> Combining rhBNP with sacubitril and valsartan sodium can effectively improve the cardiac function among elderly ALVF patients, significantly reducing the levels of inflammatory factors and alleviating oxidative stress reactions. This approach provides superior efficacy and safety for managing elderly ALVF patients.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966990","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":"Anaesthetic Allies: The I-gel and Its Rivals-Are We Becoming Less Familiar With the Latter?","authors":"Arunita Jha, Gabriela Pettey, Yasser Mandour","doi":"10.12968/hmed.2024.0085","DOIUrl":"https://doi.org/10.12968/hmed.2024.0085","url":null,"abstract":"<p><p>The field of airway management has undergone significant evolution, particularly with the introduction of the i-gel, a second-generation airway device. Initially developed to provide a less invasive alternative to endotracheal intubation, the i-gel gained widespread popularity due to its ease of insertion, rapid deployment, and minimal complications. This editorial compares the i-gel, highlighting its pros and cons. The i-gel offers key advantages, such as the anatomical seal without the need for cuff inflation, and reducing the risk of airway trauma. Furthermore, its reliable performance has been documented across various patient groups, including paediatrics and obese populations. Despite its strengths, there are limitations, such as reduced applicability in difficult airway situations and its lack of compatibility with endotracheal tubes. The choice of airway device should be tailored to the specific needs of the patient and the surgical procedure, emphasising the importance of maintaining familiarity with a variety of devices rather than solely relying on the i-gel. The editorial focuses on the ongoing evaluation of the role of the i-gel in modern anaesthesia, including the need for enhanced training in alternative supraglottic airway devices to ensure optimal airway management.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959322","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 Efficacy of Hydrocortisone Combined With Norepinephrine in the Treatment of Severe Septic Shock and Its Effect on Immunoinflammatory Indexes.","authors":"Juanjuan Lin, Renfei Shan, Shasha Lin, Keke Wu","doi":"10.12968/hmed.2024.0814","DOIUrl":"https://doi.org/10.12968/hmed.2024.0814","url":null,"abstract":"<p><p><b>Aims/Background</b> Severe septic shock (SS) is a life-threatening condition characterized by systemic inflammation and organ dysfunction. Hydrocortisone is used to reduce inflammation, while norepinephrine raises blood pressure and supports vasoconstriction, helping to maintain organ perfusion. This study aims to investigate the efficacy of hydrocortisone combined with norepinephrine in the treatment of SS and its effect on immunoinflammatory indexes. <b>Methods</b> A total of 126 patients with severe SS admitted to Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University from December 2020 to December 2023 were retrospectively selected as the study subjects. Patients were divided into control group (<i>n</i> = 67) and observation group (<i>n</i> = 59) according to the treatment given. The control group was treated with norepinephrine, whereas the observation group was treated with hydrocortisone combined with norepinephrine. The clinical efficacy of the treatment given between the two groups was compared. The serum levels of interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) were compared between the two groups before and after treatment. The occurrence of adverse reactions was compared between the two groups. The clinical prognostic indexes of the two groups were analyzed. <b>Results</b> The total efficacy rate of observation group (93.22%) was significantly higher than that of control group (74.63%) (<i>p</i> = 0.005). After treatment, the levels of CRP, PCT, IL-6 and SAA in both groups were significantly decreased, with the observation group exhibiting significantly lower levels of these inflammatory indexes than the control group (<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). After 7 days of treatment, compared with the control group, the observation group showed significantly lower Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sepsis-related Organ Failure Assessment (SOFA) score, required shorter mechanical ventilation time and total emergency intensive care unit (EICU) treatment time, and had lower mortality within 4 weeks (<i>p</i> < 0.05). <b>Conclusion</b> Hydrocortisone combined with norepinephrine holds high degree of efficacy in the treatment of severe SS by alleviating inflammation, improving prognosis and reducing mortality, while maintaining a good safety profile.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959769","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":"Relationship Between Stress Hyperglycemia Ratio and In-Stent Restenosis in Patients Receiving Drug-Eluting Stents.","authors":"Ming Zhang, Yanchun Chen, Junxiang Sun, Chen Xu, Yunjie Yin, Liang Xu","doi":"10.12968/hmed.2024.0868","DOIUrl":"https://doi.org/10.12968/hmed.2024.0868","url":null,"abstract":"<p><p><b>Aims/Background</b> In-stent restenosis (ISR) is a major cause of long-term failure in coronary revascularization among patients undergoing percutaneous coronary intervention (PCI). Emerging evidence suggests that the stress hyperglycemia ratio (SHR) is a novel biomarker with potential predictive value for cardiovascular diseases. This study aimed to investigate the relationship between SHR and ISR in patients treated with drug-eluting stents (DES). <b>Methods</b> This retrospective study included 410 patients who underwent DES implantation at the Cardiology Department of Yixing People's Hospital between January 2015 and December 2022. All participants underwent coronary angiography (CAG) to evaluate the incidence of ISR and were categorized into two groups based on CAG results: non-ISR (n = 346) and ISR (n = 64). Laboratory parameters were evaluated prior to CAG for all participants. A restricted cubic spline (RCS) analysis was performed to evaluate the potential nonlinear associations between SHR and ISR. Multivariate logistic regression was used to identify independent risk factors for ISR, while the predictive value of SHR for ISR was assessed using receiver operating characteristic (ROC) analysis. <b>Results</b> RCS analysis revealed a nonlinear, J-shaped relationship between SHR and ISR (<i>p</i> < 0.05). Multivariate logistic regression identified SHR as an independent risk factor of ISR (odds ratio (OR) = 32.05, 95% confidence interval (CI): 6.827-150.450, <i>p</i> < 0.05). ROC analysis revealed that SHR had a high predictive value for ISR, with an area under the curve (AUC) of 0.81 (95% CI: 0.74-0.87, <i>p</i> < 0.001). The optimal SHR cutoff value was 0.87, with a sensitivity of 79.69% and a specificity of 73.41%. <b>Conclusion</b> Our findings identified a significant association between SHR and the risk of ISR in patients with coronary heart disease (CHD) undergoing PCI with DES implantation. SHR may serve as a valuable biomarker for predicting ISR, enabling improved risk stratification and patient management.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 4","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976860","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}