British journal of hospital medicine最新文献

{"title":"Effects of Left Bundle Branch Pacing and Right Ventricular Pacing on Blood Pressure and Cardiac Function in Patients With Bradyarrhythmia Complicated With Hypertension.","authors":"Xiaoming Lian, Rui Zhang, Xiaomin Yang, Yigang Li, Bo Liu","doi":"10.31083/BJHM54928","DOIUrl":"10.31083/BJHM54928","url":null,"abstract":"<p><strong>Aims/background: </strong>Individuals affected with bradyarrhythmia and hypertension exhibit distinct clinical manifestations. Arrhythmia is commonly managed with an artificial cardiac pacemaker. This study aims to investigate the effects of left bundle branch pacing (LBBP) and right ventricular septal pacing (RVSP) on blood pressure and cardiac function in patients with bradyarrhythmia and hypertension.</p><p><strong>Methods: </strong>This retrospective study included 1060 patients with bradyarrhythmia and hypertension who were treated in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between January 2020 and December 2023. According to the placement of cardiac pacing leads, patients were divided into the LBBP group (N = 260) and the RVSP group (N = 800). Baseline clinical characteristics were recorded, and intergroup comparisons were performed for postoperative blood pressure, cardiac function indicators, pacing parameters, QRS duration, and incidence of postoperative adverse events.</p><p><strong>Results: </strong>Postoperatively, the LBBP group demonstrated significantly lower systolic blood pressure (SBP) and pulse pressure (PP) compared to the RVSP group (both <i>p</i> < 0.05). Regarding the time × group interaction, the interaction was significant for PP and SBP (<i>p</i> < 0.05). Significant time effects were observed for left ventricular ejection fraction (LVEF), cardiac output (CO), and cardiac index (CI) in both groups (all <i>p</i> < 0.05), and the group effect was significant for CI (<i>p</i> < 0.05). Regarding ventricular pacing percentage, both groups showed a significant decrease over time (<i>p</i> < 0.05); the LBBP group exhibited a slightly lower percentage than the RVSP group (<i>p</i> < 0.05), with a significant time × group interaction (<i>p</i> < 0.05). Similarly, threshold decreased over time (<i>p</i> < 0.05), while perception and impedance remained stable (<i>p</i> > 0.05). The paced QRS duration was significantly narrower with LBBP during the follow-up period (<i>p</i> < 0.05). Additionally, no significant differences were observed in the incidence of adverse events between the two groups, indicating comparable safety profiles (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>In patients with bradyarrhythmia and hypertension, LBBP offers significant therapeutic benefits in reducing SBP, pulse pressure, and QRS duration, while maintaining safety profiles and stable pacing parameters.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54928"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396036","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 Association Between Glycemic Disorders and Acute Coronary Syndrome: Plaque Vulnerability in Perimenopausal and Post-Menopausal Women With Diabetes.","authors":"Rongchen Liu, Chen Sheng, Yujie Song, Yangjie Yu, Ke Yang, Qi Zhang, Junjie Pan, Zhidong Zhu, Huanchun Ni, Jian Li, Wei Shen, Xinping Luo, Haiming Shi, Yong Li, Liwen Bao","doi":"10.31083/BJHM54927","DOIUrl":"10.31083/BJHM54927","url":null,"abstract":"<p><strong>Aims/background: </strong>Type 2 diabetes mellitus (T2DM) is a well-established risk factor for acute coronary syndrome (ACS). However, the association between prediabetes and ACS remains less clearly characterized, particularly regarding sex-based differences in this association. This study aimed to examine how specific glycemic disorders distinctly influence the risk of plaque erosion and rupture, and to explore sex-based variations in the association.</p><p><strong>Methods: </strong>In this cross-sectional study, participants with coronary artery disease (CAD), including ACS and chronic coronary syndrome (CCS), who underwent percutaneous coronary intervention (PCI) with recorded glycemic measurement between 2016 and 2020 were enrolled. Using patients with CCS undergoing PCI as the controls, multivariable logistic regression models were designed to evaluate the association between different glycemic disorders and the risk of ACS manifested as either plaque erosion or rupture. ACS patients with prediabetes and diabetes were respectively matched 1:1 using propensity score matching. The heterogeneity of age, sex and body mass index (BMI) in the association was also investigated.</p><p><strong>Results: </strong>Among 1806 screened participants, 1525 participants with recorded glycemic measurement were enrolled in the analysis, consisting of 1158 (75.9%) males with an average age of 65.8 years. With CCS patients undergoing PCI as the controls, compared to participants without diabetes, the associations between prediabetes and diabetes and the risk of ACS were attenuated toward the null after 1:1 propensity score matching. The association between glycemic disorders and ACS was modified by sex (<i>p</i> for interaction = 0.005), rather than age and BMI. Among female participants, 93.7% of whom were over 55 years of age, diabetes was associated with a two-fold higher risk of ACS compared to non-diabetic controls (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.02-4.15, <i>p</i> = 0.042).</p><p><strong>Conclusion: </strong>The general association between prediabetes and ACS is similar to that in individuals with normal glycemic status. Perimenopausal and post-menopausal women with diabetes may face an elevated risk of plaque erosion or rupture compared to their non-diabetic counterparts, implicating a potential loss of estrogen's plaque-stabilizing effect in the context of glycemic disorders.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54927"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396093","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 the Impact of Continuing Care Model on Quality of Life and Cardiac Function in Patients With Coronary Heart Disease.","authors":"Yuping Xu, Hui Zhang, Juanyu Gao","doi":"10.31083/BJHM54930","DOIUrl":"10.31083/BJHM54930","url":null,"abstract":"<p><strong>Aims/background: </strong>The transition from hospital to home is a critical period for patients with coronary heart disease (CHD), and inadequate post-discharge care can adversely affect recovery. Continuing care models have been proposed to address these challenges, but their relative effectiveness compared with standard care still requires further evaluation. Therefore, this study evaluated the impact of continuing care on quality of life and recovery of cardiac function in patients with CHD.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included 135 discharged CHD patients. Based on nursing plans, patients were allocated into two groups: a Continuing Care Group (n = 61) and a Routine Care Group (n = 74). The Continuing Care Group received a structured, nurse-led 3-month program, while the Routine Care Group received standard post-discharge instructions. Various parameters, including cardiac function, quality of life, psychological well-being, self-care capacity, medication adherence, overall comfort, and nursing satisfaction, were compared between groups at 3-month follow-up.</p><p><strong>Results: </strong>At 3 months, the Continuing Care Group showed significantly greater improvement in left ventricular ejection fraction (LVEF, 58.31% vs. 54.88%), six-minute walk distance (6MWD, 399.34 m vs. 382.25 m), 36-Item Short-Form Health Survey Physical Component Summary (SF-36 PCS, 67.94 vs. 63.92), and 36-Item Short-Form Health Survey Mental Component Summary (SF-36 MCS, 71.46 vs. 66.87). Patients in the Continuing Care Group also reported lower Depression Anxiety Stress Scales-21 (DASS-21, 17.24 vs. 18.31) and Perceived Stress Scale-10 (PSS-10) scores (22.01 vs. 23.14), higher Psychological General Well-Being Index (PGWBI, 85.95 vs. 83.47), Exercise of Self-Care Agency Scale (ESCA, 116.03 vs. 113.72), and Post-Traumatic Growth Inventory (PTGI) scores (74.81 vs. 72.31), along with superior medication adherence (84.16 vs. 82.35), comfort (87.06 vs. 84.91) and nursing satisfaction (86.94 vs. 84.89). At 3-month follow-up, Seattle Angina Questionnaire (SAQ) scores improved significantly from baseline in both groups, but no significant between-group difference was observed.</p><p><strong>Conclusion: </strong>Continuing care is associated with potential improvements in cardiac function, quality of life, psychological well-being, self-management, medication adherence, and patient-reported experiences compared with routine care in patients with CHD.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54930"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396097","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":"Early Quantitative Electroencephalography Parameters Predicting Clinical Outcomes of Intravenous rt-PA Thrombolysis in Acute Ischemic Stroke: A Retrospective Cohort Study.","authors":"Hangtian Lv, Yangchun Chen","doi":"10.31083/BJHM54931","DOIUrl":"10.31083/BJHM54931","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims/background: &lt;/strong&gt;Timely and accurate assessment of the response to intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) is crucial for guiding subsequent interventions in acute ischemic stroke (AIS). Quantitative electroencephalography (qEEG) offers a real-time measure of cerebral function sensitive to ischemia. This study aimed to investigate the predictive value of ultra-early dynamic changes in qEEG parameters following thrombolysis and develop a predictive model for 24-hour clinical efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a single-center retrospective analysis of 216 patients with AIS who received intravenous rt-PA at the Stroke Center of Xinchang Hospital Affiliated to Shaoxing University between January 2023 and December 2024. qEEG recordings were acquired immediately before (T0) and 1 hour after the initiation of rt-PA infusion (T1). The primary qEEG parameter was the Delta-Theta/Alpha-Beta Ratio (DTABR). We calculated the DTABR reduction value (T0 DTABR-T1 DTABR) to quantify early neurophysiological improvement. The primary outcome was early clinical efficacy at 24 hours, defined as a reduction of ≥4 points in the National Institutes of Health Stroke Scale (NIHSS) score or an NIHSS score of 0-1. The cohort was randomized (7:3) into training (&lt;i&gt;n&lt;/i&gt; = 151) and validation (&lt;i&gt;n&lt;/i&gt; = 65) sets. A nomogram was constructed based on multivariate logistic regression. Model performance was evaluated using the area under the curve (AUC), calibration plots with the Hosmer-Lemeshow test, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) analysis was employed for model interpretation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Early clinical efficacy was achieved in 53.7% of patients. The DTABR reduction value was significantly higher in responders compared to non-responders (median 1.20 vs. 0.20, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). In the multivariate analysis, the DTABR reduction value emerged as a strong independent predictor of favorable outcomes (adjusted odds ratio [OR] = 2.745, 95% confidence interval [CI]: 1.283-5.870, &lt;i&gt;p&lt;/i&gt; = 0.009). A nomogram integrating this dynamic qEEG marker with clinical variables (age, diabetes, onset-to-needle time, baseline diastolic blood pressure, baseline glucose, baseline NIHSS) demonstrated good discriminative ability, with an AUC of 0.77 (95% CI: 0.70-0.85) in the training set and 0.77 (95% CI: 0.65-0.88) in the validation set. The model exhibited excellent calibration and provided significant net clinical benefit across a wide range of threshold probabilities in the DCA. SHAP analysis identified the DTABR reduction value as the most influential feature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The magnitude of DTABR reduction within 1 hour of initiating intravenous thrombolysis is a robust, independent biomarker for early neurophysiological recovery. The developed nomogram offers a validated tool for real-time, individualized prediction of early trea","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54931"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395954","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":"Assessing Effectiveness and Compliance Barriers of Intermittent Pneumatic Compression Devices in Preventing Venous Thromboembolism After Femoral Fracture Surgery.","authors":"Lin Ma, Jianan Chen","doi":"10.31083/BJHM54929","DOIUrl":"https://doi.org/10.31083/BJHM54929","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims/background: &lt;/strong&gt;Venous thromboembolism (VTE) is a frequent complication following femoral fracture surgery. While intermittent pneumatic compression (IPC) devices serve as an effective mechanical prophylaxis, patient compliance is often suboptimal. This study aimed to investigate the effectiveness of IPC in preventing VTE after femoral fracture surgery and to analyse the key factors influencing patient compliance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 213 patients with femoral fractures who underwent surgical treatment at Ningbo No.6 Hospital between December 2021 and December 2024. Based on postoperative IPC device usage records from medical charts, patients were divided into a good compliance group (n = 51) and a compliance barrier group (n = 162). Postoperative coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and D-dimer (D-D)], VTE incidence at 5 days postoperatively, and the length of hospital stay were systematically collected and compared between the two groups. A self-designed questionnaire was used to assess factors influencing IPC compliance barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 213 included patients who underwent femoral fracture surgery, the incidence of postoperative IPC device compliance barriers was 76.06% (162/213). At 5 days postoperatively, significant differences were observed in all coagulation parameters between the two groups. Specifically, the good compliance group had significantly higher PT, APTT, and TT levels compared with the compliance barrier group (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). In contrast, FIB and D-D levels were significantly lower in the good compliance group (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Regarding clinical outcomes, the incidence of VTE in the good compliance group was 19.61%, significantly lower than the 38.27% in the compliance barrier group (&lt;i&gt;p&lt;/i&gt; = 0.014). Furthermore, the median length of hospital stay in the good compliance group [8.00 (8.00, 17.00) days] was significantly shorter than that in the compliance barrier group [12.00 (9.00, 17.00) days] (&lt;i&gt;p&lt;/i&gt; = 0.009). The survey results of 162 patients in the compliance barrier group showed that the main obstacles affecting IPC device application compliance were concentrated at the level of patient cognition, experience, and perception. A smaller proportion of patients had concerns about out-of-pocket costs. Healthcare-related factors and device-related factors had a relatively lower impact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The use of IPC after femoral fracture surgery can effectively improve the hypercoagulable state, reduce the incidence of VTE, and shorten hospitalization. However, patient compliance is generally low, primarily influenced by insufficient cognition, poor user experience, and low perceived value of treatment. It is recommended to improve compliance through systematic health education, optimizing comfort an","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54929"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395623","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 Obesity and Neonatal Cardiac Remodeling Among Cesarean Deliveries: The Predictive Role of Maternal Lipid Profiles and Pre-Pregnancy BMI Based on Echocardiographic Assessment.","authors":"Qiaoli Tong, Yanyan Li, Yan Tu, Jingxia Ying","doi":"10.31083/BJHM54925","DOIUrl":"10.31083/BJHM54925","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims/background: &lt;/strong&gt;Maternal obesity has been recognized as a critical factor influencing fetal cardiovascular development. Metabolic disturbances during pregnancy potentially affect neonatal cardiac structure and function. Cesarean section, which is more frequently performed among obese pregnant women, may further influence neonatal adaptation after birth. This study aimed to investigate the association between maternal pre-pregnancy obesity and neonatal left ventricular (LV) structure and function in a cohort of cesarean deliveries and to analyze the associations between maternal gestational weight, lipid profile, and neonatal cardiac function parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study was conducted at Yongkang Women and Children's Health Hospital between January 2021 and August 2024. Initially, 231 pregnant women were screened, of whom 161 mother-infant pairs met the predetermined inclusion criteria. Pregnant women undergoing cesarean delivery were assigned to a non-obese group and an obese group. Maternal demographic data, lipid profiles during pregnancy (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]), and neonatal echocardiographic parameters (interventricular septal thickness in diastole [IVSd], left ventricular posterior wall thickness in diastole [LVPWd], IVSd/LVPWd ratio, left ventricular ejection fraction [LVEF], mitral annular plane systolic excursion [MAPSE], tricuspid annular plane systolic excursion [TAPSE], right ventricular fractional area change [RVFAC], left ventricular deceleration time [LV DCT], Tei index, and E/e') were collected. Correlation and multivariate regression analyses were conducted to evaluate the effects of maternal obesity and lipid levels on neonatal cardiac function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pre-pregnancy body mass index (BMI) and neonatal birth weight were significantly higher in the obese group compared to the non-obese group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Neonates in the obese group had significantly increased IVSd, LVPWd, and LV DCT, while IVSd/LVPWd ratio and TAPSE were significantly lower than those in the non-obese group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). IVSd/LVPWd ratio was positively correlated with neonatal birth weight and maternal TG levels in late pregnancy. Furthermore, TAPSE showed a positive correlation with maternal HDL-C levels and a negative correlation with maternal pre-pregnancy TG and BMI, while LV DCT demonstrated a positive correlation with neonatal birth weight, pre-pregnancy BMI, and maternal TC, TG, and LDL-C levels in late pregnancy. Multivariate regression analysis identified neonatal birth weight, pre-pregnancy BMI, and maternal TC and LDL-C levels as independent predictors of LV DCT (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Maternal pre-pregnancy BMI and lipid levels during pregnancy significantly affect neonatal LV structure and function. These fi","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54925"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396073","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":"Thinking Beyond the Hip: A Clinico-Radiological Approach to Atypical Paediatric Hip Pain for the Generalist.","authors":"Shicheng Zhou, Aline Yu Xian Sim, Timothy Shao Ern Tan","doi":"10.31083/BJHM54926","DOIUrl":"10.31083/BJHM54926","url":null,"abstract":"<p><p>Paediatric hip pain is a common clinical presentation and can be caused by a wide range of aetiologies, many of which are uniquely related to the growing immature skeletal system such as developmental hip dysplasia, Perthes disease and slipped capital femoral epiphysis. However, atypical or referred causes of hip pain often require a broader diagnostic approach beyond the hip joint itself, and can pose diagnostic challenges for clinicians. This article aims to provide a comprehensive review from an imaging perspective, highlighting common pathologies outside the hip that can also present with similar symptoms, including important pelvic, abdominal, and neoplastic pathologies, which are discussed. By expanding the diagnostic spectrum, we aim to improve the accuracy and timeliness of diagnosis and management in children with atypical causes of hip pain.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54926"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396098","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":"Early Liver Transplantation: The Last Chance Therapy for Patients With Alcohol-Associated Hepatitis and Acute on Chronic Liver Failure.","authors":"Baila R Elkin, Michael R Lucey","doi":"10.31083/BJHM53133","DOIUrl":"https://doi.org/10.31083/BJHM53133","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"53133"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395974","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":"Non-Antibiotic Prophylaxis for Recurrent Urinary Tract Infection: A Narrative Review & Clinical Guide for Primary and Hospital Care.","authors":"Vaki Antoniou, Bhaskar Somani","doi":"10.31083/BJHM49956","DOIUrl":"10.31083/BJHM49956","url":null,"abstract":"<p><p>Recurrent urinary tract infection (rUTI) is a common and distressing condition disproportionately affecting females. It also accounts for a substantial proportion of antibiotic prescribing in primary care. Repeated antibiotic exposure contributes to adverse effects, disruption of the urogenital microbiome and the accelerating global threat of antimicrobial resistance. Consequently, contemporary clinical guidelines increasingly emphasise non-antibiotic prophylactic strategies as a core component of rUTI management. This narrative review synthesises contemporary evidence and guideline recommendations from the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE), and the American Urological Association (AUA) on non-antibiotic prophylaxis for rUTI. It places particular focus on practical implementation in primary care. Behavioural and risk-factor optimisation, methenamine hippurate, topical estrogen, D-mannose, probiotics, cranberry products, immunoactive prophylaxis and intravesical therapies are reviewed. These are appraised with respect to efficacy, safety, tolerability, accessibility and quality of evidence. This review highlights key differences in guideline positioning and identifies areas of ongoing uncertainty and future research. Additionally, this review explores the central role of general practitioners in confirming diagnosis and initiating first-line non-antibiotic prophylaxis. Moreover, their role in supporting shared decision-making and managing timely specialist referral, where appropriate, is highlighted. Considerations for both men and women with rUTI are discussed. To support the translation of evidence into practice, this article includes pragmatic clinical tools, such as a shared decision-making aid, a stepwise treatment algorithm, and a structured risk-factor checklist. By integrating evidence-based non-antibiotic strategies into routine care, clinicians can reduce antibiotic exposure, improve patient outcomes, and respond proactively to the global challenge of antimicrobial resistance.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"49956"},"PeriodicalIF":1.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396013","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":"Diagnostic Utility of Eosinophil and Platelet in Newborns With Food Protein-Induced Allergic Proctocolitis: A Retrospective Study.","authors":"Fengwei Chu, Qing Ye","doi":"10.31083/BJHM54903","DOIUrl":"10.31083/BJHM54903","url":null,"abstract":"<p><strong>Aims/background: </strong>Food protein-induced allergic proctocolitis (FPIAP) is a common allergic disease in the clinic. Despite being the diagnostic gold-standard method, the avoidance-provocation test has certain limitations that hinder its clinical applications. Detection of peripheral blood cells has emerged as an important research hotspot because of its relative methodological simplicity. Platelets and eosinophils play an important role in allergic diseases, but relevant studies on newborns with FPIAP remain scarce. The purpose of this study was to investigate the changes of eosinophil and platelet levels in children with allergic enteritis, and to explore its application value in the differential diagnosis of newborns with FPIAP.</p><p><strong>Methods: </strong>This retrospective study included 41 newborns with FPIAP admitted to The Affiliated Yangming Hospital of Ningbo University from December 2022 to December 2024 and 80 healthy newborns who underwent physical examination during the same period as controls. Data of all selected newborns and their mothers were collected from their medical records. The morning venous blood samples of the two groups were collected. White blood cell count, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets and hemoglobin were detected using an automatic blood cell analyzer. Logistic regression analysis was used to analyze the risk factors of newborns with FPIAP. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of these blood parameters for newborns with FPIAP.</p><p><strong>Results: </strong>The results showed that eosinophils and platelets in the FPIAP group were significantly higher than those in the control group (<i>p</i> < 0.05). Logistic regression analysis showed that elevated levels of eosinophils and platelets were risk factors for newborns with FPIAP (<i>p</i> < 0.05). The combined detection of peripheral blood platelet and eosinophil counts yielded an area under the ROC curve of 0.862 for the diagnosis of FPIAP in newborns, with a specificity of 0.825 and a sensitivity of 0.805.</p><p><strong>Conclusion: </strong>Newborns with FPIAP feature increased eosinophil and platelet counts, which provide an invaluable diagnostic reference for the allergic disease when used in combination.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"54903"},"PeriodicalIF":1.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395972","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}