British journal of hospital medicine最新文献

{"title":"Analysis of Risk Factors and Establishment of a Risk Prediction Model for Severe Postpartum Haemorrhage.","authors":"Jing Wang, Pin Hu, Ying Yang, Yu Zhang, Yihong Lu, Xiaoqin Wang","doi":"10.12968/hmed.2024.0455","DOIUrl":"https://doi.org/10.12968/hmed.2024.0455","url":null,"abstract":"<p><p><b>Aims/Background</b> Severe postpartum haemorrhage (PPH) is a dangerous condition, characterized by rapid progression and poor prognosis. It remains the leading preventable cause of maternal death worldwide. This study aimed to investigate the risk factors for severe PPH and establish a prediction model to identify severe PPH early, allowing for early intervention reduce maternal death. <b>Methods</b> Clinical data were collected from 784 patients diagnosed with PPH and delivered at the Second Affiliated Hospital of Anhui Medical University between December 2018 and December 2023. These cases were categorized into the training cohort. Severe PPH was diagnosed in 234 patients based on the criterion of the volume of vaginal bleeding volume exceeding 1000 mL within 24 hours after delivery; these patients were assigned to the experimental group. The remaining 550 patients with nonsevere PPH were assigned to the control group. Data from an additional 338 postpartum women from the same period were selected and classified into the validation cohort. Univariate and multivariate logistic regression analyses were performed to pinpoint the determinants associated with severe PPH. Additionally, these analyses were instrumental for developing and assessing a prediction model to forecast the risk of such complications. <b>Results</b> Most of the PPH cases in this study stemmed from uterine atony, the leading aetiology. The second most common factor was soft birth canal lacerations and haematoma formation, accounting for 7.26% of the subjects in experimental group and 6.55% of those in the control group. Uterine rupture, uterine inversion, and amniotic fluid embolism were exclusively observed in the experimental group. In the univariate analysis, notable disparities were identified across various parameters, including maternal age, gravidity, parity, abortion frequency, gestational week at delivery, prothrombin time (PT), activated partial thromboplastin time (APTT), <i>in vitro</i> fertilisation, foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy (<i>p</i> < 0.05). A multivariate logistic regression model revealed that a parity of two or more, two or more abortions, <i>in vitro</i> fertilisation, gestational weeks at delivery, foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy were independent predictors of severe PPH (<i>p</i> < 0.05). The predictive model demonstrated excellent calibration for the training and validation datasets, with the areas under the curve (AUC) for receiver operating characteristic (ROC) curves measuring 0.799 and 0.759, respectively. Clinical decision curve analysis (DCA) confirmed a significant threshold exceeding 0.9, signifying a substantial net benefit and model precision. <b>Conclusion</b> Parity ≥2 times, abortion ≥2 times, <i>in vitro</i> fertilisation, gestational week at delivery, abnormal foetal position, caesarean del","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765872","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 Survey on Surgical Site Infections Prevention Guidelines Knowledge and Implementation Level of Trauma Centre Healthcare Professionals.","authors":"Eris Nepravishta, Skënder Topi, Ervin Toçi, Ervin Nepravishta, Armela Kapaj","doi":"10.12968/hmed.2024.0333","DOIUrl":"https://doi.org/10.12968/hmed.2024.0333","url":null,"abstract":"<p><p><b>Aims/Background</b> Surgical site infections (SSIs) significantly influence patient safety and healthcare quality, particularly in low- and middle-income countries where the burden is most evident. This manuscript aims to evaluate the awareness and adherence to SSI prevention guidelines among healthcare providers at a tertiary trauma centre situated in Tirana, Albania. <b>Methods</b> This cross-sectional survey was conducted among practising surgeons, residents and nurses of Trauma University Hospital, Tirana. The questionnaire explores awareness, attitudes and practices towards SSI prevention in preoperative, perioperative and postoperative phases. <b>Results</b> The participants demonstrated a high level of patient education about SSI risks (91.9%), but lower adherence to individual prevention practices. <b>Conclusion</b> Despite adequate knowledge, there remains a significant gap in the implementation of SSI prevention guidelines. Strengthening continuous medical education is crucial to addressing systemic barriers, improving compliance with guidelines, and decreasing SSI rates.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766440","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 Intensive Nursing Management on Quality of Life and Mental Health in Elderly Gastric Cancer Patients Undergoing Chemotherapy: A Retrospective Study.","authors":"Linlin Zhang, Huan Yu, Jingjing Zhang","doi":"10.12968/hmed.2024.0412","DOIUrl":"10.12968/hmed.2024.0412","url":null,"abstract":"<p><p><b>Aims/Background</b> Implementing effective nursing management is particularly critical in the case of elderly gastric cancer (GC) patients receiving chemotherapy, who are more vulnerable to risk events. Therefore, this study explored the effect of intensive nursing management on quality of life (QoL) and mental health in elderly GC patients receiving chemotherapy. <b>Methods</b> A total of 155 elderly patients with GC undergoing chemotherapy in Central Hospital Affiliated to Shandong First Medical University from July 2021 to July 2023 were selected as the study subjects. The sample was divided into two groups according to different nursing methods: 74 patients who received intensive nursing management were classified in the observation group, while 81 patients treated with routine nursing management were classified under the reference group. The QoL, mental health and adverse reactions to chemotherapy were compared between the two groups. <b>Results</b> Before nursing management was implemented, there was no significant difference in the scores of the quality of life questionnaire-core 30 (QLQ-C30), patient health questionnaire-9 items (PHQ-9), and the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) (<i>p</i> > 0.05). After management, in comparison with the reference group, the observation group showed significantly higher scores in each dimension of QLQ-C30, as well as significantly lower scores in PHQ-9 and MDASI-C (<i>p</i> < 0.001). The incidences of gastrointestinal reaction, myelosuppression, neurotoxicity, and hepatorenal damage were lower in the observation group than in the reference group (45.95% vs 70.37%, 40.54% vs 65.43%, 35.14% vs 53.09%, and 33.78% vs 51.25%, respectively; <i>p</i> < 0.05). <b>Conclusion</b> The application of intensive nursing management in treating elderly GC patients during chemotherapy effectively improves their physical and mental states, ameliorates clinical symptoms and enhances the QoL, showing certain clinical application value.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766333","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 Application of Terlipressin in the Management of Ascites in Liver Cirrhosis: Current Status and Prospects.","authors":"Lixiao Shen, Jie Ying, Junbiao Zhao","doi":"10.12968/hmed.2024.0606","DOIUrl":"10.12968/hmed.2024.0606","url":null,"abstract":"<p><p>Ascites due to liver cirrhosis is a common complication in patients with liver disease, severely affecting their prognosis and quality of life. Traditional treatment methods have significant limitations in managing ascites, highlighting the need for new therapeutic approaches. As an antidiuretic drug, terlipressin has shown good efficacy and potential in treating ascites. This review covers terlipressin's application in managing ascites caused by liver cirrhosis, covering the mechanism of action, usage strategies, clinical effects, and potential side effects. Clinical trial results are discussed to provide a glimpse into the efficacy and safety of terlipressin in managing ascites and its side effects. Additionally, we provide detailed discussions on medication precautions and management strategies for adverse reactions in high-risk patients. Finally, this review outlines future research directions, such as new clinical trial designs, comparisons of terlipressin with other novel drugs, and the exploration of individualized treatment models. These efforts aim to provide references for clinical practice and promote further development in this field.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Gestational Diabetes Mellitus on Neonatal Birth Outcomes.","authors":"Ying Liu, Meixia Wang, Jin Zhou","doi":"10.12968/hmed.2024.0410","DOIUrl":"https://doi.org/10.12968/hmed.2024.0410","url":null,"abstract":"<p><p><b>Aims/Background</b> The purpose of this study is to investigate the risk factors for gestational diabetes mellitus (GDM) during pregnancy and its impact on neonatal birth outcomes. <b>Methods</b> A total of 2010 cases of mothers with GDM who underwent routine prenatal examinations and delivered at The Fourth Hospital of Shijiazhuang from June 2021 to April 2022, and their newborns were selected as the GDM group. For comparison, 2087 cases of mothers with normal glucose tolerance (NGT) and their newborns during the same period were selected as the NGT group. Birth outcomes of both groups were compared. <b>Results</b> Pregnant women in the GDM group exhibited significantly higher proportions of advanced age, higher body mass index (BMI), and irregular dietary habits compared to the NGT group (<i>p</i> < 0.05). Conversely, the GDM group had significantly lower proportions of nutrient supplementation and prenatal exercise compared to the NGT group (<i>p</i> < 0.05). The incidences of macrosomia, neonatal hypoglycemia, hyperbilirubinemia, and acute respiratory distress syndrome (ARDS) were significantly higher in the GDM group compared to the NGT group (<i>p</i> < 0.05 for all). Among GDM women with adverse outcomes, significant differences were observed in pre-pregnancy BMI, insufficient or excessive weight gain during pregnancy, and poor glycemic control during pregnancy compared to those without adverse outcomes (<i>p</i> < 0.05 for all). Poor glycemic control during pregnancy, pre-pregnancy BMI, and inadequate or excessive weight gain were significant factors influencing adverse pregnancy outcomes in GDM patients (<i>p</i> < 0.05). <b>Conclusion</b> The risk factors for GDM include advanced maternal age, being underweight, overweight, or obese prior to pregnancy, irregular eating habits, dietary nutritional deficiencies, and lack of prenatal exercise. The incidence of adverse pregnancy outcomes is higher in GDM patients compared to those without GDM. Poor glycemic control during pregnancy and higher pre-pregnancy BMI are significant factors that contribute to negative outcomes for both GDM patients and their newborns.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766349","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 Rare Complication of Atraumatic Splenic Rupture in Infectious Mononucleosis: A Case Report.","authors":"Paschalis Gavriilidis, Pantelis Xanthakos","doi":"10.12968/hmed.2024.0494","DOIUrl":"https://doi.org/10.12968/hmed.2024.0494","url":null,"abstract":"<p><p><b>Aims/Background</b> Atraumatic splenic rupture is a very rare and potentially life-threatening event usually associated with underlying pathological conditions. Splenic rupture in infectious mononucleosis occurs only in 0.1%-0.5% of patients. The aim of the present study was to publish a case report of the atraumatic splenic rupture and to present a mini-review of the international literature. <b>Case Presentation</b> A 30-year-old man of mixed races (Caucasian and African) diagnosed with acute cholecystitis was referred by a rural doctor to a secondary district hospital. His past medical and family history was unremarkable. He did not report any allergies. On arrival, his vital signs were stable. However, laboratory examinations demonstrated: white blood cells 26 × 10³/μL (4-11), neutrophils 38.8% (35%-72%), lymphocytes 58% (20%-45%), red blood cells 3.59 M/μL (0-0.6), haemoglobin 10.9 g/dL (13.5-17.5), haematocrit 33.4% (40%-54%), platelets 11.5 fL (6.5-11), prothrombin time 13.2 s (9.4-12.5), glucose 70 mg/dL (74-107), sodium 135 mmol/L (137-146), calcium 7.6 mg/dL (8.8-106), serum glutamic-oxaloacetic transaminase 426 U/L (10-45), serum glutamate pyruvate transaminase 530 U/L (7-45), gamma glutamyl transferase 151 U/L (7-49), total albumins 5.3 g/dL (6.6-8.3), C-reactive protein 235 mg/L (<5), and Epstein-Barr virus 15.50 S/CO (0-1.0). In addition, computed tomography determined hepatosplenomegaly, haemoperitoneum, and spleen rupture. Physical examination revealed abdominal rigidity, left shoulder tip pain, shortened capillary refill time, and neck lymphadenopathy. <b>Results</b> The patient underwent expeditious total splenectomy, postoperative period was uneventful and he was discharged on the sixth postoperative day. He was scheduled to undergo the post-splenectomy vaccinations and regular follow-ups with his general practitioner abroad. <b>Conclusion</b> In patients without a history of trauma, spontaneous splenic rupture should be considered in the differential diagnosis if patients have complaints of abdominal and left shoulder tip pain, and laboratory results indicate low haemoglobin and haematocrit levels.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766438","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":"Comparison of Effects between Nasal Bi-Level Positive Airway Pressure and Nasal Synchronized Intermittent Mandatory Ventilation in Neonatal Respiratory Distress Syndrome.","authors":"Yu Zhang, Juan Zhang","doi":"10.12968/hmed.2024.0454","DOIUrl":"https://doi.org/10.12968/hmed.2024.0454","url":null,"abstract":"<p><p><b>Aims/Background</b> Neonatal respiratory distress syndrome (NRDS) is characterized by progressive aggravation and rapid progression of respiratory distress, with a high incidence rate among premature infants. If left untreated, NRDS results in a poor prognosis. In recent years, various respiratory support modalities have received extensive attention in clinical practice. The therapeutic effect of different respiratory support modes on NRDS has gradually become the focus of clinical research. The aim of this study was to explore the therapeutic effects of nasal bi-level positive airway pressure (nBiPAP) and nasal synchronized intermittent mandatory ventilation (nSIMV) on NRDS. <b>Methods</b> This study retrospectively analyzed the clinical data of 157 newborns with NRDS in the Mudanjiang Medical University Affiliated Second Hospital from January 2021 to December 2023, finally including 153 cases after excluding 4 cases with missing clinical data. According to the non-invasive ventilation method, these newborns were categorized into a nBiPAP group (receiving nBiPAP treatment, n = 77) and an nSIMV group (receiving nSIMV treatment, n = 76). The blood gas indices, using time of ventilator, hospitalization time, therapeutic effects, and incidence of complications were compared between the two groups. <b>Results</b> The PaCO₂, PaO₂, and pH levels in the nBiPAP group were basically consistent with those in the nSIMV group before and after treatment (<i>p</i> > 0.05). The use time of ventilator, hospitalization time, and therapeutic effects in the nBiPAP group were similar to those in the nSIMV group (<i>p</i> > 0.05). Additionally, both groups demonstrated no significant difference in the incidence of complications such as intraventricular hemorrhage, apnea, necrotizing enterocolitis, and feeding intolerance (<i>p</i> > 0.05). The incidence rates of ventilator-associated lung injury and neonatal bronchopulmonary dysplasia in the nBiPAP group were lower than those in the nSIMV group, with a significant difference (<i>p</i> < 0.05). <b>Conclusion</b> Both nBiPAP and nSIMV have shown good effects in treating NRDS, with nBiPAP showing a significant advantage in reducing the incidence rates of complications such as ventilator-associated lung injury and neonatal bronchopulmonary dysplasia.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766237","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":"Application of Intelligent Management Model Based on Electronic Patient-Reported Outcome During Immunotherapy in Patients with Gastric Cancer: A Single-Center Retrospective Study.","authors":"Cuizhen Li, Danna Wu","doi":"10.12968/hmed.2024.0409","DOIUrl":"https://doi.org/10.12968/hmed.2024.0409","url":null,"abstract":"<p><p><b>Aims/Background</b> Gastric cancer is the third leading cause of cancer-related death worldwide, which seriously affects the health of patients. Immunotherapy is a commonly used clinical treatment for gastric cancer, but the adverse events caused by it seriously affect the prognosis of patients. Therefore, it is necessary to control and manage the disease risk of patients during immunotherapy. To explore the effect of applying an intelligent management model based on electronic patient-reported outcome (ePRO) in patients with gastric cancer during immunotherapy. <b>Methods</b> The clinical data of 184 gastric cancer patients receiving immunotherapy in The Fourth Hospital of Hebei Medical University from September 2021 to September 2023 were retrospectively analyzed. Ninety patients receiving ePRO-based intelligent management were selected, and 85 patients were included in the observation group after excluding 5 patients. For the reference group, 94 patients receiving common case management were selected, with 90 patients being included after excluding 4 patients. After 6 months of follow-up, the nutritional status score, quality of life, treatment compliance and adverse events were compared between the two groups. <b>Results</b> No significant difference was detected in nutritional status and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores of the patients before discharge (<i>p</i> > 0.05). After 2 months of follow-up, compared with the reference group, the observation group had a higher proportion of patients in grade A and grade B, which was not statistically significant (<i>p</i> > 0.05), and significantly higher physiological and psychological scores (<i>p</i> < 0.001), but showed no meaningful differences in other fields (<i>p</i> > 0.05). After 4 months of follow-up, the nutritional status in the observation group was significantly improved (<i>p</i> < 0.05), and the subjects displayed higher WHOQOL-BREF scores (<i>p</i> < 0.05) than those in the reference group. No significant difference in the incidence of adverse events was detected (<i>p</i> > 0.05). After 6 months of follow-up, the treatment compliance of the observation group was 83.53%, which was significantly higher than that of the reference group (70.00%; <i>p</i> < 0.05). <b>Conclusion</b> The intelligent management model based on ePRO is conducive to improving the nutritional status of patients with gastric cancer during immunotherapy, as well as enhancing their quality of life and treatment compliance, making it worthy of clinical application.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766284","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":"SGLT2 Inhibitors in Cardiovascular Medicine: Panacea or Pandora's Box?","authors":"Stella de Aguiar Trigueirinho Ferreira, Lucas Lentini Herling de Oliveira, Arthur Cicupira Rodrigues de Assis, Paulo Rogério Soares, Thiago Luis Scudeler","doi":"10.12968/hmed.2024.0546","DOIUrl":"https://doi.org/10.12968/hmed.2024.0546","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are antidiabetic agents that effectively lower blood glucose levels in patients with Type 2 Diabetes Mellitus (T2DM). Beyond their glycemic control properties, SGLT2 inhibitors have demonstrated significant cardiovascular benefits, including reductions in major adverse cardiovascular events. However, the limitations of the pivotal trials investigating these outcomes have not been fully explored. This letter aims to critically assess the major randomized clinical trials that evaluated the cardiovascular effects of SGLT2 inhibitors, highlighting both their strengths and limitations.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766427","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 can Four-Dimensional Magnetic Resonance Imaging Improve the Diagnosis of Heart Disease?","authors":"Ciaran Grafton-Clarke, Liandra Ramachenderam, Gareth Matthews, Jordi Broncano, Pankaj Garg","doi":"10.12968/hmed.2024.0382","DOIUrl":"10.12968/hmed.2024.0382","url":null,"abstract":"<p><p>This review describes the evolution and enhanced diagnostic capabilities introduced by four-dimensional (4D) flow cardiac magnetic resonance (CMR) in cardiovascular imaging. It charts the historical advancements from echocardiography through to two-dimensional phase-contrast magnetic resonance imaging (2D-PC MRI), culminating in the adoption of 4D flow MRI. This technique affords exhaustive, time-resolved, three-dimensional visualisations of intracardiac and vascular blood flow, refining the accuracy of cardiovascular assessments over traditional methods, especially in complex anatomical settings. The review elaborates on the capacity of 4D flow MRI to offer unparalleled insights into flow dynamics, vessel wall interactions, and cardiac function, thereby enhancing disease detection, risk stratification, and therapeutic evaluations. It accentuates the impact of 4D flow MRI on modern cardiological practices, highlighting its pivotal role in advancing diagnostics and patient management in the context of diverse cardiovascular pathologies.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766348","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}