British journal of hospital medicine最新文献

{"title":"An Evaluation of Opportunities and Challenges of Blockchain Technology in Healthcare.","authors":"Rasit Dinc, Nurittin Ardic","doi":"10.12968/hmed.2024.0355","DOIUrl":"10.12968/hmed.2024.0355","url":null,"abstract":"<p><p>In a globalised world, patients may need to manage and track their health records with healthcare professionals anywhere and anytime with high data privacy and security. Blockchain technology (BcT) provides these necessities. This study aims to provide a general overview of the usability of BcT in healthcare applications. BcT has been adopted in many sectors, including healthcare. However, there is no unified record format among hospitals for tracking patients' medical histories. In BcT, recorded data cannot be modified without affecting the chain hash code. The blockchain creates a secure and public digital ledger. BcT can also ensure accurate and timely financial transactions by automating payment processes among providers, insurers, and patients through smart contracts. In conclusion, BcT plays a key role in the healthcare sector. It enables safer, cheaper, more dependable, and more effective pharmacotherapy by providing data security, traceability, and immutability.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Pulmicort Respules Combined with Azithromycin in the Treatment of Children with Recurrent Respiratory Tract Infection Caused by Mycoplasmal Pneumonia.","authors":"Jie Ke, Xiqing Tu","doi":"10.12968/hmed.2024.0456","DOIUrl":"https://doi.org/10.12968/hmed.2024.0456","url":null,"abstract":"<p><p><b>Aims/Background</b> The drug treatment of recurrent respiratory tract infection caused by mycoplasma pneumonia (MP) has a complex background, involving the characteristics of pathogens, drug resistance, and multiple treatment methods. This study aimed to analyze the therapeutic effect of pulmicort respules and azithromycin on children with recurrent respiratory tract infection caused by MP. <b>Methods</b> The clinical data of 106 children with recurrent respiratory tract infection caused by MP diagnosed in Huoqiu First People's Hospital from July 2021 to July 2023 were retrospectively analyzed. Based on different therapeutic methods, 56 children treated with azithromycin were included in the reference group, and 50 children treated with pulmicort respules and azithromycin were included in the observation group. The disappearance time of clinical symptoms, levels of inflammatory factors, immunoglobulin levels, and complications in both groups were observed and compared. <b>Results</b> After treatment, the disappearance time of fever, cough, pulmonary rales, and expectoration was shorter in the observation group, compared with the reference group (<i>p</i> < 0.001). No significant difference was observed in levels of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), or interleukin-6 (IL-6) between the two groups on the first day of admission (<i>p</i> > 0.05). After 1 week of treatment, the observation group had significantly higher levels of TNF-α, IL-2, and IL-6 compared with the reference group (<i>p</i> < 0.05). No significant difference was observed in levels of immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) between the two groups on the first day of admission (<i>p</i> > 0.05). After 1 week of treatment, the observation group had significantly lower levels of IgG, IgA, and IgM than the reference group (<i>p</i> < 0.01). This study revealed that the incidence of complications in the observation group was 16.00%, which was significantly lower than the 37.50% in the reference group (<i>p</i> < 0.05). <b>Conclusion</b> In the short-term clinical treatment, the combination application of pulmicort respules and azithromycin can effectively improve the immune function of children with recurrent respiratory tract infection caused by MP and relieve their clinical symptoms.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766344","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":"An Analysis of Hearing Outcomes in Children with Hutchinson-Gilford Progeria Syndrome.","authors":"Jing Sun, Jingjing Wang, Jing Bi","doi":"10.12968/hmed.2024.0449","DOIUrl":"https://doi.org/10.12968/hmed.2024.0449","url":null,"abstract":"<p><p><b>Aims/Background</b> Few hearing loss studies have been conducted in patients with progeria, and only the possibility of low-frequency conductive hearing loss has been mentioned. The primary objective of this study is to perform a comprehensive analysis of the clinical audiological characteristics of children with Hutchinson-Gilford progeria syndrome (HGPS), and the secondary objective is to analyse the causes of their hearing loss and what can be done to enable them to hear as well as possible. <b>Methods</b> Ten children with HGPS underwent impedance audiometry (tympanogram), otoacoustic emissions, and pure-tone audiometry tests. Otoscopic examination and imaging were also performed in the patients with abnormal hearing. <b>Results</b> Five patients had normal hearing, while the other five had varying degrees of hearing impairment manifesting as mild to moderate low-frequency or full-frequency conductive hearing loss. Otoscopic examination of those patients with abnormal hearing showed a narrowing of the external auditory canal, a thinning of the tympanic membrane, and a distorted cone of light. Further, computed tomography of one patient showed a poorly defined temporal bone morphology with scant pneumatization of the mastoid process. <b>Conclusion</b> Patients with HGPS differ from normally aging individuals with a predominant conductive pattern of hearing loss as opposed to sensorineural deafness, with more lower-frequency hearing impairment due to poor pneumatization of the mastoid process and the possible formation of osteophytes in the temporal bone.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766443","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":"An Application of Machine-Learning-Oriented Radiomics Model in Clear Cell Renal Cell Carcinoma (ccRCC) Early Diagnosis.","authors":"Gao Qiu, Zengzheng Dai, Hua Zhang","doi":"10.12968/hmed.2024.0238","DOIUrl":"https://doi.org/10.12968/hmed.2024.0238","url":null,"abstract":"<p><p><b>Aims/Background</b> Clear cell renal cell carcinoma (ccRCC) is a common and aggressive form of kidney cancer, where early diagnosis is crucial for improving prognosis and treatment outcomes. Radiomics, which utilizes machine learning techniques, presents a promising approach in medical imaging for the early detection and characterization of such conditions. This study aims to explore the clinical utility of a machine-learning-based radiomics model in the early diagnosis of ccRCC. <b>Methods</b> Case data and abdominal computed tomography (CT) tumour images of patients with ccRCC were obtained from The Cancer Imaging Archive (TCIA) database. The dataset included 31 cases in the training set (19 males and 12 females, with an average age of 58.1 years) and 13 cases in the validation set (8 males and 5 females, with an average age of 69.6 years). The volume of interest (VOI) was manually delineated, slice by slice, along the tumour's edge in cross-sectional images of ccRCC. Radiomics features were extracted from each region of interest (ROI) using the \"PyRadiomics\" plug-in in 3D Slicer software (version 5.1.0, Massachusetts Institute of Technology and Brigham and Women's Hospital, Boston, MA, USA). Feature selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, followed by 10-fold cross-validation. The selected radiomics features were then used to construct prediction models based on two different supervised machine learning algorithms: logistic regression and random forest. The diagnostic performance of these models was evaluated using receiver operating characteristic (ROC) curves and calibration curves. Finally, clinical data were integrated with the radiomics features to enhance the prediction model. <b>Results</b> A total of 44 radiomics features were ultimately selected to establish the prediction model based on the training set results. Among the two machine learning models, the logistic regression model demonstrated superior diagnostic performance. An evaluation of model establishment, considering both individual radiomics features (DifferenceVariance, JointEnergy.1, JointEntropy.2, MeanAbsoluteDeviation.7, SmallAreaHighGrayLevelEmphasis.7) and clinical data, indicated that the logistic regression model was stable and exhibited strong diagnostic performance, good calibration, and clinical applicability in patients with ccRCC. When clinical data were combined with radiomics features in the model, the area under the curve (AUC) reached 0.969, with an optimal threshold of -2.290, and sensitivity and specificity values of 89.3% and 95.2%, respectively. The calibration curve also confirmed that the logistic regression model had high calibration accuracy and greater clinical application value. <b>Conclusion</b> This machine-learning-based radiomics prediction model demonstrated significant value in the early diagnosis of clear cell renal cell carcinoma (ccRCC).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766457","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":"Clinical Efficacy of Ezetimibe Combined with Rosuvastatin in the Treatment of Patients with Primary Hypercholesterolemia Inadequately Controlled by Statin Therapy.","authors":"Zhifeng Wei, Fang Wang, Lina Zhang, Weixin Dai","doi":"10.12968/hmed.2024.0457","DOIUrl":"https://doi.org/10.12968/hmed.2024.0457","url":null,"abstract":"<p><p><b>Aims/Background</b> Primary hypercholesterolemia (PHC) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). Although the fact that statins effectively lower low-density lipoprotein cholesterol (LDL-C) levels, some patients fail to achieve target LDL-C levels and continue to have a high risk of cardiovascular disease. This study aims to evaluate the clinical efficacy and safety of ezetimibe combined with rosuvastatin in patients with PHC. <b>Methods</b> This study retrospectively examined 101 patients with PHC who received statins at the cardiology department of Jilin Province FAW General Hospital, between 2021 and 2024. Patients were divided into the observation (ezetimibe combined with rosuvastatin, n = 45) and control (rosuvastatin, n = 66) groups in accordance with their treatment regimens. Data were sourced from the hospital's electronic health records system, and statistical analysis was performed by using SPSS 25.0 software (IBM Corporation, Armonk, NY, USA). <b>Results</b> Baseline characteristics were similar between the two groups. After 12 weeks of treatment, the reduction in LDL-C levels in the observation group (-0.373 [-0.427, -0.348]) was greater than that in the control group (-0.240 [-0.318, -0.222], <i>p</i> < 0.001). The percentage changes in total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were significantly better in the observation group (TC: -0.230 [-0.302, -0.144], TG: -0.292 [-0.333, -0.237], and HDL-C: 0.081 [0.067, 0.111]) than in the control group (TC: -0.127 [-0.158, -0.119], TG: -0.082 [-0.101, -0.067], and HDL-C: 0.000 [-0.163, 0.133] with <i>p</i> < 0.001, <i>p</i> < 0.001, and <i>p</i> = 0.011, respectively). Regarding drug safety, the incidence of adverse events was comparable between the two groups (11.10% vs. 12.10%, <i>p</i> = 0.871). <b>Conclusion</b> The combination of ezetimibe and rosuvastatin demonstrates superior lipid-lowering efficacy and good safety in patients with PHC inadequately controlled by statin therapy, providing an effective alternative treatment option. Further large-scale, multicenter randomized controlled trials are warranted to confirm its long-term efficacy and safety.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766285","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":"Internal Quality Network Stress and Inflammation Reaction Indicators in the Expression and Significance of the Serum of Limited Pregnant Women's Serum.","authors":"Qi Shen, Litao Yu, Hui Zhang","doi":"10.12968/hmed.2024.0399","DOIUrl":"https://doi.org/10.12968/hmed.2024.0399","url":null,"abstract":"<p><p><b>Aims/Background</b> Fetal growth restriction (FGR) is a common clinical disorder in pregnant women. Inflammation and endoplasmic reticulum stress play an important role in the occurrence and development of FGR. The purpose of this study was to explore the expression and significance of endoplasmic reticulum stress and inflammatory response indicators in the serum of pregnant women with FGR. <b>Methods</b> The data of pregnant women admitted to Changzhou Maternal and Child Health Care Hospital from January 2020 to June 2023 were collected and analyzed by propensity score matching (PSM). Pregnant women with FGR were included in the observation group (n = 65), whereas healthy pregnant women admitted to the hospital during the same period were included in the control group (n = 65). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of inflammatory markers such as tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in all the pregnant women recruited in this study. The serum levels of glucose regulatory protein 78 (GRP78) and C/EBP homologous protein (CHOP), which are characteristic indicators of endoplasmic reticulum stress, in the two groups of pregnant women, were also detected and analyzed. A range of parameters concerning fetal growth and development indicators, such as fetal head circumference, abdominal circumference and fetal development index, of the two groups of study subjects were recorded and compared. Analyze the correlation between inflammatory response indicators and endoplasmic reticulum stress factors in pregnant women with FGR and fetal growth and development indicators. <b>Results</b> The serum levels of TNF-α, IL-1β and IL-6 in the observation group were significantly higher than those in the control group (<i>p</i> < 0.001). The serum levels of GRP78 and CHOP in the observation group were significantly higher than those in the control group (<i>p</i> < 0.001). The levels of GRP78 and CHOP in pregnant women with FGR were negatively correlated with fetal head circumference, abdominal circumference, and fetal growth and development index (<i>p</i> < 0.05). <b>Conclusion</b> The serum levels of inflammatory markers such as TNF-α, IL-1β and IL-6 in pregnant women with FGR were abnormally elevated, indicating severe inflammatory response. In addition, endoplasmic reticulum stress was observed in pregnant women with FGR, marked by significantly elevated levels of GRP78 and CHOP. The levels of TNF-α, IL-1β, IL-6, GRP78 and CHOP were negatively correlated with fetal head circumference, abdominal circumference and fetal growth and development index, implying their impacts on the occurrence and development of FGR.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Model to Predict the Risk of Adverse Ocular Outcomes in Pregnant Women.","authors":"Xintian Liu, Yiyi Wen, Haiqing Zou, Shuangyong Wang","doi":"10.12968/hmed.2024.0365","DOIUrl":"https://doi.org/10.12968/hmed.2024.0365","url":null,"abstract":"<p><p><b>Aims/Background</b> Pregnancy can affect various bodily functions, including metabolism, cardiovascular function, and eyesight. Pathological ocular changes observed during pregnancy are linked to the development of pregnancy-specific conditions, such as preeclampsia/eclampsia and gestational diabetes. This study aims to analyze clinical data disease history and maternal characteristics collected during pregnancy, to determine ocular parameters and develop a risk prediction model for adverse ocular outcomes. <b>Methods</b> We retrospectively analyzed the medical records of 760 pregnant women (1520 eyes) from September 2020 to September 2022 at The Third Affiliated Hospital of Guangzhou Medical University. We identified maternal variables that could influence adverse ocular outcomes, including maternal age, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), eclampsia, pre-eclampsia, uterine disease, fetal abnormalities, <i>in vitro</i> fertilization with embryo transfer, hypoproteinemia, and major comorbidities during pregnancy. Univariate and multivariate logistic regression analyses were conducted to evaluate the effects of these independent predictors on adverse ocular outcomes. Additionally, receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off probability with for optimal sensitivity and specificity. <b>Results</b> Eclampsia, pre-eclampsia, GDM, a history of chronic hypertension, and hypoproteinemia were identified as independent predictors of adverse ocular outcomes during pregnancy (<i>p</i> < 0.05). Maternal age, PIH, intrauterine growth retardation (IUGR), obesity, and pregnancy with immunoglobulin A nephropathy were predictors of moderate and severe retinal arteriole sclerosis during pregnancy (<i>p</i> < 0.05). Additionally, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome were predictors of retinal hemorrhage and exudate during pregnancy (<i>p</i> < 0.05). The area under the ROC curve for adverse ocular outcomes were 0.75 and 0.74, respectively. <b>Conclusion</b> Our predictive model effectively forecasts adverse ocular outcomes during pregnancy, incorporating risk factors such as maternal age, eclampsia and pre-eclampsia, GDM, obesity, a history of chronic hypertension, hypoproteinemia, IUGR, pregnancy with immunoglobulin A nephropathy, and HELLP syndrome.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766436","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 Cardiopulmonary Exercise Testing Parameters for Pulmonary Arterial Hypertension in Peritoneal Dialysis Patients-A Retrospective Study.","authors":"Yunxiu Xie, Xiaonan Qiu, Ying Zhang, Ying Liu, Zhongcheng Yin","doi":"10.12968/hmed.2024.0469","DOIUrl":"https://doi.org/10.12968/hmed.2024.0469","url":null,"abstract":"<p><p><b>Aims/Background</b> Pulmonary arterial hypertension (PAH) is a significant contributor to increased overall and cardiovascular mortality in peritoneal dialysis (PD) patients. Cardiopulmonary exercise testing (CPET) is an accurate method for measuring cardiorespiratory fitness (CRF) during both submaximal and peak exercise. Previous studies have demonstrated a strong correlation among CRF and increased cardiovascular and overall mortality rates. However, no literature currently reports the predictive value of CPET parameters for PAH occurrence in PD patients. This study primarily aims to analyze the risk factors for PAH in PD patients, assess the predictive value of CPET parameters, and provide a reference for the clinical prevention and management of PAH. <b>Methods</b> The clinical data of 121 PD patients who underwent CPET were retrospectively collected at Xuzhou Medical University Affiliated Hospital. Based on the event of PAH, patients were divided into two groups: a PAH group (n = 39) and a non-PAH group (n = 82). Clinical data, laboratory results, ultrasound findings, and CPET parameters were compared between the groups. Multifactorial logistic regression analysis was performed to identify the risk factors for PAH. The predictive value of CPET parameters was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) using ROC curve analysis. <b>Results</b> White blood cell count (WBC) was an independent risk factor for PAH in PD patients (<i>p</i> < 0.05). VO₂peak (peak oxygen uptake), VO₂AT (anaerobic threshold oxygen uptake), METspeak (peak metabolic equivalents), WRpeak (peak power load) were identified as protective factors for PAH in PD patients (<i>p</i> < 0.05). ROC curve analysis showed that the AUC values for predicting PAH in PD patients using VO₂peak, VO₂AT, METspeak, and WRpeak were 0.675, 0.651, 0.719, and 0.689, respectively, with METspeak demonstrating the highest AUC for prediction. <b>Conclusion</b> The occurrence of PAH in PD patients is associated with WBC, VO₂peak, VO₂AT, METspeak, and WRpeak. Additionally, CPET parameters exhibit predictive value for PAH, with METspeak showing the highest AUC for prediction.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766425","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 Rheumatic Diseases and the Risk of Polycystic Ovary Syndrome: A Two-Sample Mendelian Randomization Analysis.","authors":"Jing Wang, Qi Zhou","doi":"10.12968/hmed.2024.0478","DOIUrl":"https://doi.org/10.12968/hmed.2024.0478","url":null,"abstract":"<p><p><b>Aims/Background</b> The association between rheumatic immune diseases and polycystic ovary syndrome (PCOS) remains elusive. The purpose of this study was to investigate the causal relationship between rheumatic immune diseases and the risk of PCOS through a two-sample Mendelian randomization (MR) analysis. <b>Methods</b> In the assessment of exposure variables, we chose systemic lupus erythematosus (SLE), polymyositis (PM), and rheumatoid arthritis (RA) as representative rheumatic immune diseases, while PCOS was designated as the outcome of interest. All data utilized in this investigation were obtained from the Medical Research Council Integrative Epidemiology Unit (MRC-IEU) database. A two-sample MR analysis was conducted using summary statistics for both the exposure and outcome variables, which were gathered from the genome-wide association study (GWAS) datasets. Single nucleotide polymorphisms (SNPs) significantly associated with rheumatic diseases were selected as instrumental variables (IVs) to estimate the causal effects on PCOS. The final results were analyzed using five MR analysis methods, namely MR-Egger, inverse variance weighted (IVW), weighted median (WM), simple mode, and weighted mode. Causal estimation of MR was primarily obtained using the IVW method. Sensitivity analyses were also conducted to evaluate pleiotropy and heterogeneity. <b>Results</b> In this two-sample MR analysis, a total of 1,000,246 participants were included. Among them, there were 647 cases of SLE, 44 cases of PM, 5539 cases of RA, and 797 cases of PCOS. The IVW approach indicated a causal relationship between RA and an increased risk of PCOS (odds ratio [OR] = 1.069, 95% confidence interval [CI] = 1.007-1.134, <i>p</i> = 0.041). The MR-Egger intercept and Cochran's Q test (<i>p</i> > 0.005) further verified the stability of the MR results. However, no significant correlation was observed between the other two rheumatic immune diseases (PM and SLE) and the risk of developing PCOS (both <i>p</i> > 0.05). <b>Conclusion</b> This study suggests a potential causal association between RA and PCOS, while SLE and PM do not exhibit a causal association with PCOS, enhancing our comprehension of the etiological factors of PCOS and shedding light on prevention strategies for the disease. Additional research is required to elucidate the underlying biological mechanisms by which RA contributes to the progression of PCOS.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766431","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":"Omadacycline in the Treatment of <i>Chlamydia psittaci</i> Pneumonia: A Retrospective Study on Efficacy and Safety.","authors":"Hangyang Li, Xiaochun Mao, Zhenping Wu, Wenqiao Yu","doi":"10.12968/hmed.2024.0381","DOIUrl":"https://doi.org/10.12968/hmed.2024.0381","url":null,"abstract":"<p><p><b>Aims/Background</b> <i>Chlamydia psittaci</i> is an obligate intracellular bacterium that primarily infects birds, but can cause respiratory infections in humans. Clinical evidence supporting the use of omadacycline for the treatment of <i>Chlamydia psittaci</i> pneumonia remains limited; therefore, this study aimed to evaluate the potential of omadacycline in treating <i>Chlamydia psittaci</i> pneumonia by analyzing the patients' clinical outcomes and the drug safety profile. <b>Methods</b> We retrospectively reviewed the medical records of 15 patients with <i>Chlamydia psittaci</i> pneumonia treated at the First Affiliated Hospital, Zhejiang University School of Medicine between January and December 2023. Following diagnosis with the aid of metagenomic next-generation sequencing, the patients received omadacycline for treatment, and their clinical outcomes and laboratory marker profiles were monitored to assess the treatment efficacy and safety. <b>Results</b> Significant improvements were observed in clinical symptoms and laboratory markers, including C-reactive protein (<i>p</i> < 0.001), procalcitonin (<i>p</i> = 0.001), neutrophil percentage (<i>p</i> < 0.001), and the SpO₂/FiO₂ ratio (<i>p</i> < 0.001), after treatment with omadacycline. A 100% cure rate was reported within 28 days of treatment initiation, with gastrointestinal disturbances being the most common side effect. <b>Conclusion</b> Omadacycline shows promise in treating <i>Chlamydia psittaci</i> pneumonia and is well tolerated by the users. However, further controlled trials involving larger samples are required to confirm the efficacy and safety of the drug.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 11","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766383","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}