British journal of hospital medicine最新文献

{"title":"Impact of Fluticasone Propionate and Salmeterol Combined with Pulmonary Rehabilitation on Pulmonary Function, Exercise Tolerance, and Quality of Life in Elderly Patients with Stable Chronic Obstructive Pulmonary Disease.","authors":"Yong Yang","doi":"10.12968/hmed.2024.0708","DOIUrl":"https://doi.org/10.12968/hmed.2024.0708","url":null,"abstract":"<p><p><b>Aims/Background</b> Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by persistent respiratory problems. COPD has become a major public health concern worldwide as the population ages. Therefore, we investigated the impact of fluticasone propionate and salmeterol inhalation combined with pulmonary rehabilitation on pulmonary function, exercise tolerance, and quality of life in elderly patients with stable COPD. <b>Methods</b> This retrospective study included 102 elderly patients with stable COPD who were treated between January 2021 and October 2023. Based on previous treatment regimens, patients were divided into a fluticasone propionate and salmeterol inhalation combined with a pulmonary rehabilitation group (n = 58) and a pulmonary rehabilitation alone group (n = 44). We collected baseline data upon admission and other relevant data after 3 months of follow-up. Furthermore, we evaluated pulmonary function [forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF)], inflammatory markers [interleukin-8 (IL-8), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), tumour necrosis factor-β (TNF-β)], exercise tolerance [6-minute walk test (6MWT)], and quality of life [COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ)] between the two experimental groups. Additionally, the recurrence rate and adverse events during the 3-month follow-up were examined. <b>Results</b> Compared to baseline, FEV1, FVC, PEF, and 6MWT levels were significantly improved in both groups at the 3-month follow-up, with the combined treatment group performing better than the pulmonary rehabilitation alone group (<i>p</i> < 0.05). CAT and SGRQ scores decreased significantly, with the combined treatment group scoring lower than the pulmonary rehabilitation alone group (<i>p</i> < 0.05). Inflammatory markers, such as IL-8, IL-6, TNF-α, and TNF-β were significantly reduced in the combined treatment group and were lower than in the pulmonary rehabilitation alone group (<i>p</i> < 0.05). The recurrence rate in the combined treatment group was significantly lower than in the pulmonary rehabilitation alone group (<i>p</i> = 0.018), with no significant difference in the incidence of adverse events between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> Fluticasone propionate and salmeterol inhalation combined with pulmonary rehabilitation can reduce recurrence rates, and improve pulmonary function, inflammatory status, and exercise tolerance, thereby significantly enhancing the quality of life for elderly patients with stable COPD.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708658","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":"Role for MRI in Secondary Screening for Placenta Accreta.","authors":"Edward Golob, Kashif Burney, Tamal Datta, Sally Lewis, Jazmin Gajadhar, Ramesh Ganapathy","doi":"10.12968/hmed.2024.0528","DOIUrl":"https://doi.org/10.12968/hmed.2024.0528","url":null,"abstract":"<p><p><b>Aims/Background</b> Rates of both placenta praevia and placenta accreta spectrum (PAS) are rising. There is significant morbidity associated with PAS and antenatal detection reduces morbidity at delivery. In the UK there is a move to centralise care of these cases in dedicated units. Incidental diagnosis is more common, in the absence of a regular screening program. In non-specialist hospitals, there is a need to consider adjunct confirmatory diagnostics prior to referral to specialist centres. This is important to ensure capacity management in specialist centres. Ultrasound (US) and Magnetic Resonance Imaging (MRI) have both been used to diagnose PAS with high levels of accuracy with experienced operators. The role of MRI as an adjunct with US has not been clearly defined but is often requested. <b>Methods</b> A retrospective analysis of all cases referred for MRI as a secondary modality after US to evaluate possible PAS. A total of 41 cases had MRI performed over 13 years with a trend of increasing demand over time. <b>Results</b> The series identified eleven cases of PAS. MRI demonstrated a high level of accuracy, similar to published literature (sensitivity 81.8%, Specificity 86.6%) and correctly reclassified 2 cases as PAS, which were considered normal on US. There were 2 cases of PAS which were missed by both US and MRI. <b>Conclusion</b> This series demonstrates increasing demand in our trust for MRI over the period of the study. The addition of MRI as a second test improved accuracy compared to ultrasound alone. MRI has a role in secondary screening for PAS in non-specialist units.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708667","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":"Association between Intestinal Flora Metabolites and Coronary Artery Vulnerable Plaque Characteristics in Coronary Heart Disease.","authors":"Xi You, Bo Gao","doi":"10.12968/hmed.2024.0772","DOIUrl":"https://doi.org/10.12968/hmed.2024.0772","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; The incidence of coronary heart disease (CHD) has been increasing annually. Patients with severe conditions may die from myocardial infarction, heart failure or malignant arrhythmia. Intestinal flora plays an important role in various metabolic processes, such as atherosclerosis, tumour formation, and inflammation. However, its direct role in promoting plaque vulnerability must be further explored and validated. Therefore, this study aims to explore the relationship between changes in intestinal flora, its metabolites in CHD patients and the vulnerability characteristics of coronary plaques. &lt;b&gt;Methods&lt;/b&gt; This study recruited 180 subjects, among these, 90 CHD patients diagnosed between January 2023 and January 2024 were selected as the CHD group and 90 healthy volunteers were selected as the control group following a principle of 1:1 ratio. The differences in intestinal flora composition, metabolite levels, and blood biochemical indexes were compared between the two study groups. Based on the coronary angiography (CAG) and intravascular ultrasound (IVUS) results, the CHD group was divided into two sub-groups for stratified comparative analysis: the stable plaque group (n = 49) and the vulnerable plaque group (n = 41). &lt;b&gt;Results&lt;/b&gt; The CHD group had reduced intestinal &lt;i&gt;Bifidobacteria&lt;/i&gt; and lactic acid bacteria counts and higher intestinal &lt;i&gt;Escherichia coli&lt;/i&gt; and &lt;i&gt;Enterococcus&lt;/i&gt; levels than the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Moreover, trimethylamine-N-oxide (TMAO) and phenylacetylglutamine (PAGln) levels were significantly higher in the CHD group compared to the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Similarly, the CHD group exhibited substantially elevated serum triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels compared to the control group. However, compared to the control group, the high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in the CHD group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Furthermore, the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum urea nitrogen (BUN), and serum creatinine (Scr) were comparable in the two experimental groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Similarly, intestinal &lt;i&gt;Bifidobacteria&lt;/i&gt;, lactic acid bacteria, &lt;i&gt;Escherichia&lt;/i&gt; &lt;i&gt;coli&lt;/i&gt;, and &lt;i&gt;Enterococcus&lt;/i&gt; compositions were comparable in CHD patients with vulnerable plaque and those with stable plaque (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Moreover, CHD patients with vulnerable plaque had elevated TMAO and PAGln levels than those with stable plaque (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, TG, TC, HDL-C, LDL-C, ALT, AST, BUN, and Scr levels were comparable between CHD patients with a vulnerable plaque and those with stable plaque (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Multivariate regression analysis showed that diabetes, elevated TMAO levels, and elevated PAGln levels were potential risk factors for coronary plaque vulnerability (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). &lt;b&gt;Conclusion&lt;/b&gt; In summary, CHD patient","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708641","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":"Predictive Value of Dietary Inflammatory Index for Recurrence of Plaque Psoriasis-A Retrospective Study.","authors":"Zheng Gu, Xiaoyan Zhang","doi":"10.12968/hmed.2024.0882","DOIUrl":"https://doi.org/10.12968/hmed.2024.0882","url":null,"abstract":"<p><p><b>Aims/Background</b> Determining the predictive value of dietary inflammatory index on the recurrence of plaque psoriasis vulgaris is an emerging research area. This study aims to investigate the predictive value of the dietary inflammatory index (DII) for the recurrence of plaque psoriasis. <b>Methods</b> A retrospective study was conducted on 200 patients with plaque psoriasis who were treated at the China-Japan Friendship Hospital from October 2022 to December 2023. Patients were divided into the recurrence group (n = 95) and the non-recurrence group (n = 105) based on whether they had experienced a recurrence during follow-up. Univariate and multivariate logistic regression analyses were performed to determine the influencing factors of plaque psoriasis recurrence. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the DII for plaque psoriasis recurrence. <b>Results</b> Comparisons of age, gender, Drinking, duration of illness, family history, season of onset, and history of skin allergies showed no statistically significant differences between the recurrence group and non-recurrence group (<i>p</i> > 0.05). However, comparisons of sleep inadequacy, anxiety, smoking, infections, and DII showed statistically significant differences between the recurrence group and non-recurrence group (<i>p</i> < 0.05). The results of the multivariate logistic regression analysis indicated that sleep inadequacy, anxiety, smoking, infections, and DII were independent influencing factors for the recurrence of plaque psoriasis (<i>p</i> < 0.05). The ROC analysis results showed that the predicted area under the curve of DII in predicting recurrence of plaque psoriasis vulgaris was 0.815, and the standard error was 0.031 (95% confidence interval (CI): 0.754-0.877, <i>p</i> < 0.001) with a Youden's index of 0.60, sensitivity of 74.7%, and specificity of 84.8%. DII has the highest predictive value. <b>Conclusion</b> Characterized by high specificity and sensitivity from the ROC curve analysis, the DII exhibits a high predictive value for plaque psoriasis recurrence.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708665","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":"Comparative Evaluation of Volumetric-Modulated Arc Therapy and Intensity-Modulated Radiotherapy in Postoperative Breast Cancer Treatment.","authors":"Lei Zhang, Dandan Ji, Xiaomei Huang, Yongjian Ju","doi":"10.12968/hmed.2024.0809","DOIUrl":"https://doi.org/10.12968/hmed.2024.0809","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Breast cancer (BC) is one of the most prevalent malignancies among women globally, with postoperative radiotherapy playing a pivotal role in its multidisciplinary management. Volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) are advanced radiotherapy techniques that improve dose distribution uniformity within the target volume while minimizing damage to surrounding normal tissues. This study aimed to compare the effects of VMAT and IMRT on immune function and prognosis in postoperative BC patients, providing a scientific basis for clinical decision-making and optimizing BC treatment strategies. &lt;b&gt;Methods&lt;/b&gt; Between January 2022 and January 2024, 265 postoperative BC patients who underwent radiotherapy with VMAT or IMRT at Nantong First People's Hospital were retrospectively analyzed. Based on the radiotherapy technique, patients were categorized into the VMAT group (129 cases) and the IMRT group (136 cases). The efficacies of the 2 radiotherapy techniques were compared by assessing overall radiotherapy effectiveness, levels of cancer biomarkers, levels of immune factors, quality of life and the incidence of adverse reactions. &lt;b&gt;Results&lt;/b&gt; The overall objective response rate (ORR) and disease control rate (DCR) were significantly higher in the VMAT (75.97% and 93.80%, respectively) compared to the IMRT group (63.24% and 86.03%, respectively, &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Serum levels of cancer antigen 15-3 (CA15-3), human epidermal growth factor receptor 2 (HER2), carcinoembryonic antigen (CEA), and interleukin-6 (IL-6) significantly decreased in both groups at 1-, 3-, and 6-month post-radiotherapy compared to levels immediately after radiotherapy (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Conversely, levels of interleukin-2 (IL-2) and interferon-α (IFN-α) demonstrated a significant increase over the same time points (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Notably, at 1-month post-radiotherapy, the VMAT group exhibited significantly lower serum levels of CA15-3, HER2, CEA, and IL-6 and significantly higher levels of IL-2 and IFN-α compared to the IMRT group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Post-radiotherapy, quality of life (QoL) scores encompassing mental health, physical health, environmental conditions, and social relationships significantly improved in both groups compared to pre-radiotherapy levels (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, no statistically significant differences in QoL were observed between the two groups after treatment (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). The incidence of adverse reactions was significantly lower in the VMAT group (9.30%) compared to the IMRT (19.12%) group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). &lt;b&gt;Conclusion&lt;/b&gt; VMAT and IMRT effectively improve cancer marker profiles, modulate immune factors, and enhance QoL in postoperative BC patients. VMAT exhibited superior efficacy, achieving higher ORR and DCR and a significant reduction in radiotherapy-related adverse reactions compared to IMRT. These findings highlight the advantages of VMAT in comprehensive BC treatm","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708492","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 Efficacy and Safety between Two Silver-Containing Dressings in the Treatment of Deep Partial-Thickness Thermal Burns: A Multicenter, Double-Blind, Non-Inferiority, Randomized Clinical Trial.","authors":"ZiQing Ye, Shuhua Liu, Weiguo Xie, Wei Zhang, Danlong Liu, Gang Yu, Zhengjun Cui, Jun Zheng, Wenjun Liu, Meijun Jiang, Zhongzhi Zhou","doi":"10.12968/hmed.2024.0218","DOIUrl":"https://doi.org/10.12968/hmed.2024.0218","url":null,"abstract":"<p><p><b>Aims/Background</b> Silver-containing dressings are commonly utilized in burns treatment by virtue of their excellent antibacterial properties. Further research is needed to determine the type of silver-containing dressing that is more effective and safer for burns treatment. Pyperbranched polyamide-Ag dressing (HBPs-Ag dressing) is a modified polyamide dressing with a uniform coating of the Amino-terminated hyperbranched polymer (HBP-NH₂)/Ag⁺ compound on its surface. This study aimed to evaluate the efficacy and safety of a silver ion-containing dressing (HBPs-Ag) for wound contact layer in the treatment of deep partial-thickness burns versus a silver-impregnated tulle dressing (Atrauman Ag). <b>Methods</b> This study was conducted between October 2019 to January 2021 at six sites in China. A total of 132 patients with deep partial-thickness burns (aged 18-65 years, injury occurring within 72 hours, burns <30% total burn surface area) were randomized 1:1 to HBPs-Ag group (study group) or Atrauman Ag group (control group). Data were obtained and analyzed, including total efficacy, wound healing rate, wound healing time, rate of negative bacterial culture from wound secretions, systemic response, skin or tissue irritation, local skin color changes, wound swelling, wound pain and adverse events. <b>Results</b> For partial thickness burns, the HBPs-Ag dressing was not inferior to Atrauman Ag dressing because the total efficiency of HBPs-Ag group (98.3%) was comparable to that of Atrauman Ag group (94.7%) (<i>p</i> > 0.05). There were no significant differences in efficacy, wound healing rate, wound healing time, and rate of negative bacterial culture from wound secretions between the two groups (<i>p</i> > 0.05). There were no statistical differences in all safety indicators tested between the two groups (<i>p</i> > 0.05). Silver was detected in the blood or urine of only 5 patients (3.79%). <b>Conclusion</b> The HBPs-Ag dressing was not inferior to Atrauman Ag dressing in deep partial-thickness burns treatment, with both of them showcasing comparable efficacy and safety. <b>Clinical Trial Registration</b> Chinese Clinical Trial Registry (ChiCTR2100049814).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Venetoclax Combined with Azacitidine on the Immune Function and Quality of Life in Patients with Relapsed Acute Myeloid Leukemia.","authors":"Yanfang Wu, Huiyan Huang, Aiwei Wang, Wenzhong Shang","doi":"10.12968/hmed.2024.0416","DOIUrl":"https://doi.org/10.12968/hmed.2024.0416","url":null,"abstract":"<p><p><b>Aims/Background</b> Patients with relapsed acute myeloid leukemia (AML) have a poor prognosis and limited treatment options. The combination of azacitidine and venetoclax has demonstrated some efficacy in relapsed AML. This study aimed to investigate the effects of venetoclax combined with azacitidine on immune function and quality of life in patients with relapsed AML. <b>Methods</b> This study retrospectively analyzed the clinical data of 104 patients with relapsed AML who were admitted to the First People's Hospital of Fuyang from January 2020 to January 2024. The patients were divided into a combination group (n = 53, treated with a combination of venetoclax and azacitidine) and an azacitidine group (n = 51, treated with azacitidine) according to the treatment protocol. Hematological parameters (proportion of bone marrow progenitor cells [PBMPC], white blood cell count [WBC], platelet count [PLT], neutrophil count [NEUT], and hemoglobin [Hb]), serum immunoglobulin (immunoglobulin G [IgG], IgA, and IgM) and inflammatory factor (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) levels, as well as European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) scores were compared between the two groups, and adverse reactions were recorded. <b>Results</b> The remission rate in the combination group (66.0%) was significantly higher than that in the azacitidine group (45.1%, <i>p</i> < 0.05). Both azacitidine monotherapy and the combination therapy with venetoclax improved hematological indicators and quality of life while reducing serum immunoglobulin levels and inflammatory factors. Compared with the azacitidine group, the combination group demonstrated a significant reduction in PBMPC (<i>p</i> < 0.05), alongside an increase in WBC, PLT, NEUT, and Hb (<i>p</i> < 0.05). Additionally, combination therapy led to a greater reduction in serum levels of IgG, IgA, IgM, IL-6, and TNF-α compared to azacitidine alone (<i>p</i> < 0.05). Moreover, combination therapy significantly improved scores for physical, emotional, cognitive, social function, and general health status (<i>p</i> < 0.05), while reducing scores for nausea, dyspnea, insomnia, pain, and constipation (<i>p</i> < 0.05). Importantly, there was no significant difference in the incidence of adverse reactions between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> The combination of venetoclax and azacitidine could regulate the immune function, improve hematological indicators and quality of life, without increasing the incidence of adverse reactions in patients with relapsed AML.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708642","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":"Evaluating the Clinical Characteristics and Ophthalmic Manifestations in Children and Adolescents with Acquired Demyelinating Disorders in China.","authors":"Si-Yuan Li, Chun-Xia Peng, Hua-Xin Zuo, Qi Lin, Ji-Feng Yu, Wen Liu, Li Li, Wei Shi","doi":"10.12968/hmed.2024.0555","DOIUrl":"https://doi.org/10.12968/hmed.2024.0555","url":null,"abstract":"<p><p><b>Aims/Background</b> Pediatric acquired demyelinating disorders (ADS) include various monophasic and recurrent inflammatory conditions of the central nervous system (CNS). Optic neuritis (ON) is a demyelinating disease primarily affecting the optic nerve axons due to autoimmune inflammation. To investigate the clinical characteristics, ophthalmic manifestations, laboratory test results, and prognostic indicators of Chinese children and adolescents with ADS. <b>Methods</b> The clinical data of 57 patients with ADS treated in the Beijing Children's Hospital from March 2021 to December 2023, were retrospectively collected and analyzed. The primary outcomes include best-corrected visual acuity (BCVA) at onset, peripapillary retinal nerve fiber layers (RNFL) thickness, serum myelin oligodendrocyte glycoprotein (MOG) antibody level, aquaporin-4 (AQP4) antibody level, and final BCVA after hormone therapy. <b>Results</b> The analyses included 57 children and adolescents in the study, including 38 optic neuritis (ON), 12 neuromyelitis optica spectrum disorder (NMOSD), 5 acute disseminated encephalomyelitis (ADEM), and 2 multiple sclerosis (MS) patients. The median age of patients facing the initial attack of ON was 9 years (3-15 years), with 23 children and adolescents (40.4%) aged eight years or younger, and 37 patients (64.9%) were bilaterally affected. Half of the children and adolescents (15/30) were MOG-Ab seropositive, and 19.4% (6/31) were AQP4-Ab seropositive. Children and adolescents with NMOSD were more likely to have severe visual impairment at acute onset (<i>p</i> < 0.05), with 84.2% of them having low vision acuity (BCVA worse than 0.1), as compared with 64.9% in the ON group. The RNFL thickness of affected eye was thinner than unaffected eyes (median 72.0 μm vs. median 102.0 μm, <i>p</i> < 0.05). Patients with NMOSD exhibited lower RNFL thickness across all measured sectors compared to those with ON. Significant differences were noted in the average RNFL and in each specific region of the retina, including the temporal RNFL, nasal RNFL, nasal superior RNFL, nasal inferior RNFL, temporal superior RNFL, and temporal inferior RNFL (all <i>p</i> < 0.05). After the treatment with intravenous methylprednisolone, both patients with ON (52 eyes; 86.7%) or NMOSD (20 eyes; 90.9%) group had functional visual recovery (BCVA better or equal 0.4). <b>Conclusion</b> This study shows that Chinese children and adolescents with ADS present distinctive clinical features, including earlier onset and more bilateral involvement. Furthermore, NMOSD patients experience more severe visual acuity impairment and thinner peripapillary RNFL. All children and adolescents of ON or NMOSD respond well to methylprednisolone treatment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708643","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":"Vaping: Harm Reduction or Chucking Children under the Bus?","authors":"Andrew Bush, Jonathan Coutts, Ross Langley, Kenneth Macleod","doi":"10.12968/hmed.2024.0855","DOIUrl":"https://doi.org/10.12968/hmed.2024.0855","url":null,"abstract":"<p><p>Tobacco is one of the great scourges of modern health, and e-cigarettes are suggested to be a means of smoking cessation and harm reduction. This editorial shows that, far from being a source of harm reduction, they are being aggressively marketed to children and young people. The acute effects of e-cigarettes are greater than those of tobacco, and thus we cannot be complacent about the long-term effects. There is accumulating data that e-cigarettes are immunosuppressive, pro-inflammatory and lead to epigenetic effects that are pre-cancerous. There is an urgent need for legislation that is actually enforced to protect children from being the next-generation nicotine addicts.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708687","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":"Survey and Analysis of Mental Health among Otolaryngology Nurses Following the Conclusion of COVID-19 Prevention and Control Measures.","authors":"Xiuli Yang, Rong Yu, Huiling Zhao","doi":"10.12968/hmed.2024.0770","DOIUrl":"https://doi.org/10.12968/hmed.2024.0770","url":null,"abstract":"<p><p><b>Aims/Background</b> The coronavirus disease 2019 (COVID-19) pandemic placed unique pressures on healthcare workers, especially nurses. This study examines the factors influencing mental health, stress perception, and burnout among otolaryngology nurses after the cessation of COVID-19 prevention and control. <b>Methods</b> A cross-sectional study was conducted among 220 otolaryngology nurses in Sichuan province from 20 January to 28 January, 2023. Data were collected using a general information questionnaire, the Nurse Workplace Mental Health Questionnaire, the Chinese Perceived Stress Scale (CPSS-14), and the Maslach Burnout Inventory-General Survey (MBI-GS). Statistical analyses included the Kruskal-Wallis test, Spearman correlation analysis, and multiple linear regression to identify significant factors and relationships within the dataset. <b>Results</b> Of the 220 questionnaires distributed, 218 were valid, yielding a recovery rate of 99.09%. The cohort included 3 males (mean age: 34.67 ± 12.39) and 215 females (mean age: 35.63 ± 9.27). The average mental health score was 128.10 ± 21.29, indicating a moderate level of psychological well-being. The CPSS-14 average score was 37.42 ± 7.27, reflecting moderate stress, while MBI-GS scores highlighted varying levels of burnout, especially in emotional exhaustion (median = 10.00). The Kruskal-Wallis test identified significant factors affecting mental health, stress, and burnout, including family support, COVID-19 testing status, staffing adequacy, frequency of caring for critically ill patients, teamwork satisfaction, job satisfaction, and resignation plans (<i>p</i> < 0.05). Spearman correlation analysis revealed significant negative associations between mental health and stress (r = -0.525) and total burnout scores (r = -0.646; <i>p</i> < 0.01). Multiple linear regression identified emotional exhaustion (β = -0.922), low personal accomplishment (β = -0.623), and inadequate staffing (β = -2.769) as significant negative predictors of mental health, while teamwork satisfaction (β = 5.516) and job satisfaction (β = 5.032) were positively associated with improved mental health (<i>p</i> < 0.01). <b>Conclusion</b> Otolaryngology nurses experience notable mental health challenges in the post-pandemic era, driven by stress and burnout. Addressing staffing shortages, fostering teamwork, and enhancing job satisfaction are critical strategies to improve their psychological well-being.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 3","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708682","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}