British journal of hospital medicine最新文献

{"title":"Impact of Family-Centred Continuity of Care on Depression, Anxiety, Self-Esteem, and Quality of Life in Children With Leukemia.","authors":"Yanhua Zhang, Ying Shen, Qian Zhang, Fei Wang, Yingwei Wang, Cuifang Zhao, Yuqiao Diao, Dong Xie","doi":"10.12968/hmed.2025.0256","DOIUrl":"https://doi.org/10.12968/hmed.2025.0256","url":null,"abstract":"<p><p><b>Aims/Background</b> Leukemia is the most prevalent pediatric malignancy and has a significant impact on the psychological, emotional well-being, and quality of life of affected children. This study aimed to evaluate the effects of family-centred continuity of care (FCCC) on the psychological state, self-esteem, and quality of life in children with leukemia. <b>Methods</b> A retrospective analysis was conducted on 243 pediatric leukemia patients admitted to the Fourth Hospital of Hebei Medical University between January 2019 and December 2022. Patients were divided into two groups: Routine care (n = 135), who received standard hospital care, and home care (n = 108), who received FCCC. Data were collected and analysed using the Self-Esteem Scale (SES), Screen for Child Anxiety Related Emotional Disorders (SCARED), Depression Self-Rating Scale for Children (DSRSC), and Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS). <b>Results</b> Post-intervention, the home care group demonstrated significant improvements in self-management, emotional and mental health functioning, and physical and social functioning (<i>p</i> < 0.05). The group also demonstrated decreased depression, enhanced self-esteem, improved quality of life, and reduced anxiety levels, indicating the efficacy of FCCC. <b>Conclusion</b> FCCC significantly enhances psychological well-being and quality of life in pediatric leukemia patients by integrating family members into the care process and offering emotional support and empowerment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706385","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 Ageing of the Human Lower Bowel.","authors":"Nicholas Baidoo, Gareth J Sanger","doi":"10.12968/hmed.2024.0734","DOIUrl":"https://doi.org/10.12968/hmed.2024.0734","url":null,"abstract":"<p><p>Older people suffer a greater number of disorders of the gastrointestinal tract, including chronic constipation and faecal incontinence. In this review, we examine the age-related degenerative changes that have been identified in the lower bowel of humans. Firstly, older individuals may experience less abdominal pain and a lower incidence of gut-brain disorders that are defined partly by abdominal pain (e.g., irritable bowel syndrome); the causes are unclear. Secondly, an age-dependent reduction in mucosal barrier functions may follow a decline in intestinal stem cell activity, a reduced density of tight junction proteins linking epithelial cells and a decline in mucus layer thickness. This allows antigenic and toxic material to enter the wall of the colon. Thirdly, degenerative changes within the wall of the colon occur in both the ascending and descending regions, but the ascending colon appears most vulnerable. Here, there is reduced cholinergic neuromuscular function (potentially reducing colonic motility), perhaps because of dysfunctional nerve axon transport, and associated senescence-like activity. These changes lower the 'intestinal reserve', that is the capacity of neuromuscular functions to absorb other 'life events' that affect bowel motility (e.g., changes in lifestyle or eating habits, medications that affect neuromuscular functions and diseases such as diverticulosis) without generating symptoms such as constipation. When combined, symptoms are more likely to develop.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706394","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":"Clinicopathological Determinants of Lymph Node Metastasis in Early-Stage Cervical Cancer: A Retrospective Cohort Study.","authors":"Shanliang Shang, Jianhua Yang, Zhi Ma, Xiao Zhang","doi":"10.12968/hmed.2025.0175","DOIUrl":"https://doi.org/10.12968/hmed.2025.0175","url":null,"abstract":"<p><p><b>Aims/Background</b> Accurate identification of lymph node metastasis is critical for optimising surgical strategies in early-stage cervical cancer. This study aimed to analyse multiple clinicopathological factors which are potentially associated with lymph node metastasis to guide personalised lymphadenectomy decisions. <b>Methods</b> This retrospective cohort study included 266 patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IA1 to IIA2) who underwent surgical treatment at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, between 1 December 2014 and 31 December 2019. Patients were followed up every 3 months for the first 2 years, every 6 months for the next 3 years, and annually thereafter. The presence of lymph node metastasis was included as the primary outcome, while the associated factors as secondary outcomes. The univariate and multivariate logistic regression were performed to identify risk factors associated with lymph node metastasis. <b>Results</b> The mean age of the study participants (n = 266) was 44.26 years (standard deviation [SD] = 10.19), and the median follow-up duration was 48.7 months (range 12-72 months). Lymph node metastasis was observed in 15.41% of patients. The metastatic rates increased with advancing FIGO stage: IA1 and IA2 (0%), IB1 (13.44%), IB2 (15.00%), IIA1 (23.33%), and IIA2 (66.67%). Univariate analysis identified FIGO stage (<i>p</i> < 0.001), depth of stromal invasion (<i>p</i> < 0.001), tumour size (<i>p</i> = 0.017), parametrial invasion (<i>p</i> < 0.001), and lymphovascular space invasion (LVSI) (<i>p</i> < 0.001) as significantly associated risk factors for lymph node metastasis. Multivariate analysis identified tumour size ≥4 cm (adjusted odds ratio [OR]: 3.857; 95% confidence interval [CI]: 1.530-9.728; <i>p</i> = 0.004), FIGO stage II (adjusted OR: 8.247; 95% CI: 3.171-21.455; <i>p</i> < 0.001), LVSI (adjusted OR: 2.974; 95% CI: 1.344-6.632; <i>p</i> = 0.008), and parametrial invasion (adjusted OR: 5.585; 95% CI: 1.900-16.415; <i>p</i> = 0.002) as independent risk factors for nodal metastasis. <b>Conclusion</b> This study identifies several key clinicopathological factors associated with lymph node metastasis in early-stage cervical cancer. These findings underscore the importance of meticulous preoperative risk assessment and offer an evidence-based foundation for tailored surgical planning to improve patient outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706379","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 Age and Parity on Pelvic Floor Dysfunction and Recovery in the Early Postpartum Period: A Retrospective Cohort Study.","authors":"Zhirong Mao, Dandan Hao, Qiang Gao, Yaping Meng, Minxia Zhou, Lin Zhang","doi":"10.12968/hmed.2025.0195","DOIUrl":"https://doi.org/10.12968/hmed.2025.0195","url":null,"abstract":"<p><p><b>Aims/Background</b> Pregnancy and childbirth can significantly alter pelvic floor structure and function, particularly during the postpartum period, often resulting in dysfunction. Although maternal age and the number of vaginal deliveries have been reported as risk factors for pelvic floor dysfunction, studies on how these factors interact to impact pelvic floor dysfunction and recovery in the postpartum period are limited. Therefore, this study explored the integrated effects of age groups and the number of vaginal deliveries on pelvic floor electromyography and structural indicators among postpartum women. <b>Methods</b> This retrospective cohort study collected data of 245 postpartum women 42-60 days after delivery from the clinic's records of the Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences between January 2020 and December 2022. Of these patients, 108 were multiparous and 137 were primiparous. Based on age, participants were divided into two groups: ≤30 (n = 102) and >30 (n = 143) years groups. Pelvic floor recovery was compared across these subgroups using ultrasound and electromyography (EMG). <b>Results</b> Findings revealed age-related disparities in electromyography findings of slow-twitch pelvic floor muscles. Postpartum women aged ≤30 years exhibited higher endurance contraction variability of slow-twitch muscles (<i>p</i> = 0.049). Pelvic floor ultrasound showed that women aged >30 years had greater anorectal angles (<i>p</i> = 0.024) and levator hiatus areas (<i>p</i> = 0.034) after the Valsalva maneuver. Multiparous women exhibited increased variability in slow-twitch muscle contractions (<i>p</i> = 0.026) and prolonged relaxation time (<i>p</i> = 0.031). Primiparous women showed higher post-resting average values (<i>p</i> = 0.009). Pelvic floor ultrasound indicated greater bladder neck mobility (<i>p</i> < 0.001), levator hiatus area (<i>p</i> = 0.013), and urinary incontinence prevalence (<i>p</i> = 0.026) in multiparous women. When cross-grouped, multiparas ≤30 years exhibited higher pre-resting EMG values (<i>p</i> = 0.035). Additionally, tonic contraction variability (<i>p</i> = 0.014), tonic contraction relaxation time (<i>p</i> = 0.025), and post-resting mean values (<i>p</i> = 0.003) showed significant differences, particularly in women over 30. In contrast, multiparas demonstrated both increased bladder neck mobility (<i>p</i> = 0.004) and significant differences in the anorectal angle (<i>p</i> < 0.001) and levator hiatus area (<i>p</i> = 0.038) compared to other groups. <b>Conclusion</b> Reproductive-aged women over 30 years with multiple deliveries exhibit compounded pelvic floor dysfunction, particularly in slow-twitch muscle coordination and structural support parameters (anorectal angle and levator hiatus area), informing targeted rehabilitation strategies to optimize rapid recovery.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-24"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706382","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":"Analysis of the Incidence and Influencing Factors of <i>Ureaplasma urealyticum</i> Infection in Premature Neonates.","authors":"Jinghua Li, Chaoqun Zhou, Fengwei Chu","doi":"10.12968/hmed.2025.0126","DOIUrl":"https://doi.org/10.12968/hmed.2025.0126","url":null,"abstract":"<p><p><b>Aims/Background</b> Premature newborns face a higher risk of <i>Ureaplasma urealyticum</i> (UU) infection, which is closely associated with many diseases in the neonatal period. Therefore, this study retrospectively analysed the occurrence of UU infection in premature newborns and further explored its influencing factors, which are instrumental for enabling early diagnosis of UU infection in premature infants. <b>Methods</b> In this retrospective study, 870 preterm infants born in the Affiliated Yangming Hospital of Ningbo University from June 2021 to December 2024 were selected as the study subjects. Ninety-three premature infants who tested positive for UU in nasopharyngeal aspirates were included in the UU group (<i>n</i> = 93) as cases, whereas 777 premature infants who tested negative for UU were included in the non-UU group (<i>n</i> = 777). Medical records and laboratory test results of the two groups of premature infants were collected. Univariate analysis and multiple logistic regression analysis were performed to identify factors influencing UU infection in premature newborns. Predictive efficacy of indicators showing differences in predicting UU infection in premature newborns was evaluated by means of receiver operating characteristic (ROC) curve analysis. <b>Results</b> The incidence rate of UU infection in preterm neonates was 10.69% (93/870). Univariate analysis identified maternal age (<i>p</i> < 0.001), gestational hypertension (<i>p</i> = 0.016), delivery method (<i>p</i> < 0.001), premature rupture of membranes (<i>p</i> = 0.006), gestational age (<i>p</i> = 0.001), white blood cell count (<i>p</i> < 0.001), neutrophil count (<i>p</i> < 0.001), serum C-reactive protein (<i>p</i> < 0.001) and procalcitonin levels (<i>p</i> = 0.003) as factors associated with UU infection in premature newborns. The multiple logistic regression analysis identified natural birth/forceps delivery (<i>p</i> < 0.001), low gestational age (<i>p</i> = 0.004), and serum C-reactive protein >0.5 mg/L (<i>p</i> = 0.001) as significant risk factors for UU infection in premature newborns. Concerning the combined use of delivery method (natural birth/forceps delivery), gestational age and serum C-reactive protein (>0.5 mg/L), the area under the curve (AUC) was found to be 0.800 (0.758-0.843, <i>p</i> < 0.001), with a sensitivity of 74.2%, specificity of 75.3%, and Youden index of 0.495. <b>Conclusion</b> The incidence of UU infection in preterm infants stands at about 10%, with delivery method, gestational age and C-reactive protein level being the independent influencing factors. The combination of these three factors holds certain clinical potential in predicting neonatal UU infection.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706376","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":"Psychiatric Comorbidity in Intellectual Developmental Disorders: A Systematic Review.","authors":"Borja Astilleros Martínez, Maria Pilar Martin, Yasuhiro Kotera","doi":"10.12968/hmed.2024.0686","DOIUrl":"https://doi.org/10.12968/hmed.2024.0686","url":null,"abstract":"<p><p><b>Aims/Background</b> Intellectual developmental disorders (IDD) are characterized by significant limitations in intellectual functioning and adaptive behavior, affecting conceptual, social, and practical skills. They impact 1% of the global population, with mild cases being more common. Major causes include prenatal, perinatal, and postnatal factors, although a clear cause is often not identified. This study aims to evaluate the comorbidity of psychological disorders in individuals diagnosed with IDD. <b>Methods</b> Following the \"Preferred Reporting Items for Systematic reviews and Meta-Analyses\" (PRISMA) statement, studies from 2014 to 2024 were considered using the databases Web of Science, PsycInfo, and PubMed. Articles focusing on psychopathology in individuals with IDD from birth were selected, excluding studies involving individuals under 16 years old and cases of severe and profound IDD. <b>Results</b> Of the 2895 articles retrieved, 11 were included. These studies showed heterogeneity in comorbidities such as schizophrenia spectrum and other psychotic disorders, mood disorders, anxiety disorders, developmental disorders, personality disorders, substance use disorders, and adjustment and stress reaction disorders. <b>Conclusion</b> Individuals with IDD are more vulnerable to mental health conditions, underscoring the need for comprehensive assessments and multidisciplinary treatments to improve their quality of life and optimize public resources. Future research should develop validated diagnostic tools for IDD and conduct longitudinal studies on their impact on quality of life. It should also explore gender differences and address specific needs in disadvantaged contexts with tailored interventions. <b>Systematic Review Registration</b> PROSPERO (CRD42024529405).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-26"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706389","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 Impact of Different Chronic Airway Inflammatory Diseases on Pathological Types and Prognosis of Lung Cancer Patients.","authors":"Shuhui Gao, Guibin Zhang, Deyang Meng, Li Yan","doi":"10.12968/hmed.2025.0031","DOIUrl":"https://doi.org/10.12968/hmed.2025.0031","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Chronic obstructive pulmonary disease (COPD), chronic bronchitis, and bronchial asthma are common chronic airway inflammatory diseases that have been reported to be associated with increased risk for lung cancer and impact prognosis. The purpose of this study was to investigate the impact of different chronic airway inflammatory diseases on the pathological types and prognosis of lung cancer patients. &lt;b&gt;Methods&lt;/b&gt; A total of 200 patients with newly diagnosed lung cancer were recruited from January 2021 to January 2024. The clinical data of patients were retrospectively analyzed. According to the pathological type of lung cancer, patients were divided into small cell lung cancer (SCLC) group (&lt;i&gt;n&lt;/i&gt; = 38) and non-small cell lung cancer (NSCLC) group (&lt;i&gt;n&lt;/i&gt; = 162). Logistic regression was used to analyze the risk factors for SCLC. Patients were divided into airway inflammation group (&lt;i&gt;n&lt;/i&gt; = 113) and non-airway inflammation group (&lt;i&gt;n&lt;/i&gt; = 87) in accordance with the presence of inflammatory airway diseases. Propensity score matching (PSM) was employed to balance clinical characteristics between airway inflammation and non-airway inflammation groups, followed by Kaplan-Meier analysis to analyze the influence of airway inflammation on the overall survival of lung cancer. Cox proportional hazard model was used to analyze the influencing factors on the prognosis of lung cancer patients. &lt;b&gt;Results&lt;/b&gt; Among all patients, 87 cases (43.5%) were lung adenocarcinoma, 65 cases (32.5%) were squamous carcinoma, 38 cases (19.0%) were SCLC, and 6 cases (3.0%) were large cell carcinoma; 72 (36.0%), 49 (24.5%) and 9 (4.5%) cases had COPD, chronic bronchitis, and bronchial asthma, respectively. Of the COPD patients, 43.1% (31/72) had squamous carcinoma, 29.2% (21/72) had SCLC, and 22.2% (16/72) was lung adenocarcinoma. In chronic bronchitis, lung adenocarcinoma has the highest proportion (27/49, 55.1%), followed by squamous carcinoma (16/49, 32.7%), and SCLC accounted for 8.2% (4/49). Logistic regression analysis showed that COPD (&lt;i&gt;p&lt;/i&gt; = 0.012, OR [95% CI] = 2.696 [1.247-5.829]) and body mass index (BMI) (&lt;i&gt;p&lt;/i&gt; = 0.020, OR [95% CI] = 1.132 [1.020-1.256]) were the independent influencing factors of SCLC. The Kaplan-Meier survival curves showed that the overall survival rate in the airway inflammation group was significantly worse than that in the non-airway inflammation group after PSM (&lt;i&gt;p&lt;/i&gt; = 0.033, HR [95% CI] = 1.960 [1.039-3.697]). Cox regression analysis displayed that SCLC (&lt;i&gt;p&lt;/i&gt; &lt; 0.001, HR [95% CI] = 10.678 [4.416-25.822]), clinical stages (III-IV) (&lt;i&gt;p&lt;/i&gt; = 0.003, HR [95% CI] = 3.234 [1.501-6.969]) and COPD (&lt;i&gt;p&lt;/i&gt; = 0.014, HR [95% CI] = 1.987 [1.152-3.427]) were the risk factors affecting prognosis, while surgical treatment (&lt;i&gt;p&lt;/i&gt; = 0.022, HR [95% CI] = 0.336 [0.132-0.854]) was a protective factor for prognosis. &lt;b&gt;Conclusion&lt;/b&gt; COPD, chronic bronchitis and asthma differ in the distribution of","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706395","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 Tirofiban on Cognitive Function in Patients With Unruptured Intracranial Aneurysms After Endovascular Embolization.","authors":"Xiang Bao, Pingyou He, Xiaobo Liu, Wei Xu, Danfeng Yu, Feng Chen, Chenxing Ye, Fengfeng Jiang","doi":"10.12968/hmed.2025.0260","DOIUrl":"https://doi.org/10.12968/hmed.2025.0260","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; An unruptured intracranial aneurysm (UIA) is a cerebrovascular disease with a potential risk of rupture. Rupture of UIA is a leading cause of spontaneous subarachnoid hemorrhage, which carries a high mortality rate. While endovascular intervention emerged as the primary treatment option for UIA, postoperative cognitive dysfunction (POCD) remains a common complication, affecting patients' postoperative recovery. Therefore, identifying effective interventions is clinically crucial for improving postoperative cognitive function. Tirofiban, an antiplatelet agent, has shown potential neuroprotective effects in neurointerventional procedures. Hence, this study aims to evaluate the effect of tirofiban on postoperative cognitive function in patients with UIA. &lt;b&gt;Methods&lt;/b&gt; This retrospective study analyzed 125 UIA patients who underwent treatment between January 2021 and December 2024. All patients underwent simple coil embolization and were divided into two groups: an observation group (treated with tirofiban) and a control group (without tirofiban). Before surgery, these patients were routinely treated with aspirin and clopidogrel. However, patients in the observation group were given tirofiban in addition to standard care for 12 hours after the procedure. Furthermore, cognitive function was assessed before and after surgery using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores. Additionally, the incidence of postoperative silent cerebral infarction (SCI) and variations in inflammatory marker levels were compared between the two groups. &lt;b&gt;Results&lt;/b&gt; Cognitive function showed no significant difference between the two groups before surgery. After the procedure, the observation group demonstrated significantly higher MoCA (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and MMSE (&lt;i&gt;p&lt;/i&gt; = 0.001) scores than the control group, indicating a significant advantage of tirofiban in improving cognitive function. Within 72 hours postoperatively, 7 cases in the observation group developed SCI compared to 18 cases in the control group, with a significantly lower incidence of SCI in the observation group (&lt;i&gt;p&lt;/i&gt; = 0.025). Preoperative comparison of inflammatory markers revealed no difference between the two groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). However, their postoperative levels were significantly lower in the observation group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The cognitive function scores remained significantly higher in the observation group than in the control group over one month follow-up period (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). &lt;b&gt;Conclusion&lt;/b&gt; Tirofiban improves cognitive function and reduces SCI and inflammation following UIA embolization, possibly via antiplatelet and anti-inflammatory mechanisms. While statistically significant, the clinical relevance of cognitive improvement (1 point) is limited and requires further investigation. Furthermore, prospective randomized trials are needed to validate the long-term efficacy of tirofiban and elucidate un","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706381","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":"Validity and Reliability of a Chinese-Tailored Scale for the Evaluation of End-of-Life Care in Dementia Patients.","authors":"Linbing Chen, Ye Ouyang, Chunyu Cheng, Zhenfei Chen, Liping Wang","doi":"10.12968/hmed.2025.0129","DOIUrl":"https://doi.org/10.12968/hmed.2025.0129","url":null,"abstract":"<p><p><b>Aims/Background</b> Highly valid and reliable instruments for evaluating end-of-life care for dementia patients and caregivers are lacking in clinical settings, hampering the progress of pertinent research on palliative care in China. Therefore, the present work focused on assessing the adaptability and reliability of the Chinese version of the End-of-Life Care in Dementia (EOLD) scale in evaluating nursing home caregivers who have cared for advanced dementia patients. <b>Methods</b> A convenience sample of 170 caregivers was recruited from five nursing homes. The data collection instruments included a demographic form and the Chinese version of the EOLD scale. The Chinese version of the EOLD scale comprises three subscales: Satisfaction with Care at the End of Life in Dementia (SWC-EOLD); Symptom Management at the End of Life in Dementia (SM-EOLD), which includes further scales for psychological symptoms and physical symptoms; and the Comfort Assessment in Dying with Dementia (CAD-EOLD), which encompasses further evaluation scales for physical distress, dying symptoms, well-being, and emotional distress. <b>Results</b> The reliability of all the scales ranged from satisfactory to good, with SWC-EOLD's α = 0.806, SM-EOLD's α = 0.879, and CAD-EOLD's α = 0.827. <b>Conclusion</b> In this study, a preliminary reliability assessment on the Chinese version of the EOLD scale was conducted, revealing that the three subscales exhibit strong internal consistency in reliability and structural validity. These results further confirm the applicability of the EOLD scale in dementia research within the context of palliative care.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706407","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":"Corneal Topography Parameters and Tear Film Break-up Characteristics in Keratoconus Patients.","authors":"Dan Wu, Jiaxu Hong, Suqian Wu, Jianjiang Xu","doi":"10.12968/hmed.2024.0825","DOIUrl":"https://doi.org/10.12968/hmed.2024.0825","url":null,"abstract":"<p><p><b>Aims/Background</b> Previous studies have found that keratoconus (KC) patients are highly susceptible to dry eye disease (DED); however, the specific relationship between KC and DED has not been thoroughly investigated. This study aims to investigate the corneal topography parameters and tear film (TF) break-up characteristics in KC patients with and without DED. <b>Methods</b> This cross-sectional, single-masked study consisted of 44 KC patients (44 eyes; KC group) and 31 normal individuals (31 eyes; control group). All the participants were recruited from the Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University (Shanghai, China) from February 2018 to January 2023. They underwent a routine ophthalmic examination, ocular surface disease index questionnaire, corneal fluorescein staining, and Schirmer I test. Additionally, the participants were examined using the Oculus Keratograph® (OCULUS Inc., Arlington, TX, USA) to determine their corneal topography, noninvasive TF break-up time, and TF break-up point. The KC patients were further divided into KC-DED and KC-non-DED subgroups to analyze the impact of KC on TF characteristics and the incidence of DED. Finally, the relationship between the TF break-up point and the maximum cornea curvature quadrant was investigated. <b>Results</b> In the KC group, 21 patients (21 eyes; 47.72%) were diagnosed with DED. The KC-DED and KC-non-DED subgroups exhibited significantly different maximum keratometry (Kmax, <i>p</i> = 0.021), index of surface variance (<i>p</i> = 0.048), and index of height decentration (<i>p</i> = 0.011) values. The logistic model showed a strong correlation between KC-DED incidence and Kmax value (odds ratio = 1.169, 95% confidence interval: 1.020-1.340, <i>p</i> = 0.025). Moreover, the occurrence of DED increased from 36.67% to 71.43% when the Kmax was >52.00 D (χ² = 4.623, <i>p</i> = 0.031). Furthermore, TF was more prone to break-up in the maximum corneal curvature quadrant in the KC group than in the control group (<i>p</i> < 0.001). <b>Conclusion</b> TF should be closely monitored in KC patients, as they are highly prone to DED incidence (Kmax >52.00 D) and experience initial TF break-up in the maximum corneal curvature quadrant.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706380","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}