British journal of hospital medicine最新文献

{"title":"Effects of Virtual Reality-Based Digital Therapy on Negative Emotion, Pain Level and Quality of Life in Patients With Postherpetic Neuralgia.","authors":"Lili Zhong, Hong Wang, Baiyun Ni, Junjun He, Mingming Xu, Qun Chen, Yuan Hu, Shouhua Xu, Zhipeng Dong","doi":"10.12968/hmed.2025.0337","DOIUrl":"10.12968/hmed.2025.0337","url":null,"abstract":"<p><p><b>Aims/Background</b> Patients with postherpetic neuralgia (PHN) often experience impairments of emotion, sleep and quality of life. This study aims to explore the usage of digital therapy enhanced with virtual reality technology in the improvement of mood, pain level, and quality of life in patients experiencing moderate to severe pain. <b>Methods</b> In this prospective, single-centre clinical study, 100 herpes zoster patients experiencing moderate to severe neuropathic pain from November 2024 to January 2025 were enrolled. In addition to the application of 5% lidocaine topical patch combined with Pre-Bahrain system medication, the patients received a 14-day virtual reality (VR) treatment, encompassing evaluations at several time points: the first day (T0), the third day (T1), the seventh day (T2), and the 14th day (T3). <b>Results</b> The results of emotion and pain in all PHN patients evaluated at four time points showed that the self-reported scores of generalised anxiety disorder 7 (GAD-7), numerical rating scale (NRS), and visual analogue scale (VAS) were improved during the 14-day treatment period (<i>p</i> < 0.05). Outcomes in sleep, stress and mood disturbance scale, based on the Patient-Reported Outcomes Measurement Information System (PROMIS-A) and PROMIS-B, showed that the patients' sleep status, stress levels and emotional problems achieved improvements. The PROMIS-A and PROMIS-B of VR treatment at T1, T2 and T3 were significantly higher compared with that at T0 (<i>p</i> < 0.05). PHN patients achieved significantly higher levels of self-efficacy at T1, T2 and T3 during VR treatment compared with results recorded at T0 (<i>p</i> < 0.05). Meanwhile, the Patient Health Questionnaire-9 (PHQ-9) results showed that the quality of life and health of PHN patients were significantly improved following the 14-day treatment (<i>p</i> < 0.05). Over time, PHN patients have grown satisfied with VR therapy. <b>Conclusion</b> Digital therapy based on virtual reality technology has a profoundly beneficial impact on the management of pain, the alleviation of psychiatric symptoms, and the improvement of the quality of life of PHN patients. <b>Clinical Trial Registration</b> Chinese Clinical Trial Registry (ChiCTR2400092850).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136535","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 Analysis of Risk Factors of Premature Infants With Respiratory Distress Syndrome Complicated With Thrombocytopenia.","authors":"Chaoqun Zhou, Jinghua Li, Wendan Zhu","doi":"10.12968/hmed.2025.0391","DOIUrl":"https://doi.org/10.12968/hmed.2025.0391","url":null,"abstract":"<p><p><b>Aims/Background</b> Neonatal respiratory distress syndrome (NRDS) is a leading cause of mortality in premature infants. Platelets play an important role in lung remodeling. The purpose of this study was to elucidate the clinical characteristics of NRDS complicated with thrombocytopenia to better guide treatment clinically. <b>Methods</b> A total of 234 premature infants diagnosed with NRDS and admitted to the Affiliated Yangming Hospital of Ningbo University between January 2024 and December 2024 were retrospectively analyzed. Three classification methods were used: the first based on platelet count, the second on gestational age, and the third on severity of NRDS. Clinical data of children and their mothers were collected. The clinical characteristics of children across different groups were analyzed, and independent risk factors for NRDS complicated by thrombocytopenia were determined using binary logistic regression analysis. <b>Results</b> The thrombocytopenia group had significantly lower birth weight, gestational age, as well as 1- and 5-minute Apgar scores compared to the non-thrombocytopenia group (<i>p</i> < 0.05). Moreover, the incidence of low Apgar scores and length of hospital stay were significantly higher in the thrombocytopenia group than in the non-thrombocytopenia group (<i>p</i> < 0.05). Binary logistic regression analysis showed that gestational age was a significant protective factor for thrombocytopenia in premature infants with NRDS. When infants were divided into extremely preterm infant (EPI), early preterm birth (EPB), and moderate-late preterm birth (MLPB) according to gestational age, significant differences were found in birth weight, 1-minute Apgar, 5-minute Apgar, minimum platelet value, use of invasive ventilation, pulmonary surfactant administration, and length of hospital stay (<i>p</i> < 0.05). Point-biserial correlation analysis showed that lower platelet counts were associated with increased NRDS severity (correlation coefficient = -0.363, <i>p</i> < 0.05). <b>Conclusion</b> NRDS accompanied by thrombocytopenia indicates a more severe condition and is associated with poorer clinical outcomes. Gestational age is an important protective factor for thrombocytopenia in premature infants with NRDS.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-16"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136509","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 Correlation of Geriatric Nutritional Risk Index With the Progression of Sarcopenia in Patients With Lung Cancer.","authors":"Xianbao Zhao, Junpei Wu, Lanying Jia, Quan Fang","doi":"10.12968/hmed.2025.0286","DOIUrl":"https://doi.org/10.12968/hmed.2025.0286","url":null,"abstract":"<p><p><b>Aims/Background</b> Malnutrition and sarcopenia frequently occur in individuals with lung cancer and are strongly associated with adverse clinical outcomes. The Geriatric Nutritional Risk Index (GNRI), which integrates serum albumin with body weight, offers a straightforward assessment of nutritional condition. Hence, this retrospective study aimed to investigate the association between GNRI scores and sarcopenia in a cohort of lung cancer patients. <b>Methods</b> This retrospective study collected clinical data from lung cancer patients (n = 102) admitted between January 2023 and December 2024. Logistic regression analyses, both univariate and multivariate, were utilized to assess the association between GNRI and sarcopenia. Furthermore, the diagnostic utility of GNRI was evaluated using receiver operating characteristic (ROC) curve analysis. <b>Results</b> Of the total recruited lung cancer patients (n = 102), 41 (40.2%) were diagnosed with sarcopenia. Multivariate logistic regression analysis identified GNRI as an independent predictor of sarcopenia (odds ratio [OR] = 0.912, 95% confidence interval [CI]: 0.865-0.961, <i>p</i> < 0.001). The ROC analysis yielded an area under the curve (AUC) of 0.805 (95% CI: 0.718-0.892), indicating that GNRI has excellent diagnostic performance for detecting sarcopenia. <b>Conclusion</b> GNRI serves as an independent predictor of sarcopenia among lung cancer patients and demonstrates favorable clinical utility. As a practical and cost-effective screening measure, GNRI can facilitate early identification of patients at nutritional risk, informing timely intervention.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136549","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":"'Twist and Shout': A Review of the Pathway and Quality of Care Provided to Children and Young People With Testicular Torsion.","authors":"Nicholas Mahoney, Heather Freeth, Antony Michalski, Martin Sinclair","doi":"10.12968/hmed.2024.0623","DOIUrl":"https://doi.org/10.12968/hmed.2024.0623","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136596","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":"Obesity and Metabolic Syndrome: Current Insights and Future Directions.","authors":"Zaiem Zarkasi, Rajshekhar N Mudaliar, Waseem A Majeed, Akheel A Syed","doi":"10.12968/hmed.2025.0127","DOIUrl":"https://doi.org/10.12968/hmed.2025.0127","url":null,"abstract":"<p><p>Obesity and metabolic syndrome are global health challenges, significantly increasing risks for type 2 diabetes, cardiovascular and cerebrovascular diseases, and overall mortality. This narrative review aims to discuss the relationship between obesity and metabolic syndrome; the past, present and future of anti-obesity medications including new advances in incretin-based therapies which have enabled patients to achieve significant weight loss and improvement in metabolic parameters; and the role of metabolic/bariatric surgery which remains the most effective durable treatment for severe obesity, with high remission rates of metabolic comorbidities like type 2 diabetes. Multimodal approaches involving the combination of lifestyle, medical and surgical advances will revolutionise our approach to treating obesity and metabolic syndrome in the future.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136516","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":"Suicide in the General Hospital.","authors":"Ricky Burns, Leo Sher","doi":"10.12968/hmed.2025.0244","DOIUrl":"https://doi.org/10.12968/hmed.2025.0244","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136518","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 General Anesthesia Induced by Remimazolam and Propofol on Adverse and Inflammatory Reactions in Patients After Colorectal Cancer Surgery: A Retrospective Study.","authors":"Fang Wang, Hua Zhuo, Hui Zhang","doi":"10.12968/hmed.2025.0255","DOIUrl":"https://doi.org/10.12968/hmed.2025.0255","url":null,"abstract":"<p><p><b>Aims/Background</b> Globally, colorectal cancer ranks as the third most common malignant tumor. This study aims to evaluate and compare the effects of remimazolam versus propofol in patients undergoing surgical treatment for colorectal cancer. <b>Methods</b> This study retrospectively analyzed 160 patients who underwent colorectal cancer surgery from January 2023 to December 2024 at the First People's Hospital of Xiaoshan District. Seventy-five patients receiving propofol anesthesia were classified in the control group, whereas 85 patients anesthesized with remimazolam were categorized in the study group. Anesthesia index levels, recovery quality (Riker sedation-agitation scale [SAS] and confusion assessment method-Chinese revision [CAM-CR]), mean arterial pressure (MAP), heart rate (HR), adverse effects and levels of inflammatory factors, such as interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNF-α), were analyzed using chi-squared test and <i>t</i>-tests. <b>Results</b> In the study group, the time to anesthesia onset, recovery duration, length of stay in the post-anesthesia care unit (PACU), as well as the SAS and CAM-CR scores, were significantly shorter compared to those in the control group (<i>p</i> < 0.05). At 3 min before anesthesia (T1), there were no differences in MAP and heart rate levels between the two groups (<i>p</i> > 0.05). At 30 min after anesthesia (T2), immediately after surgery (T3), and 5 min after surgery (T4), the MAP of the study group exceeded those observed in the control group (<i>p</i> < 0.05). The incidence of adverse reactions in the study group was 10.59% (9/85), which was significantly lower than that in the control group (37.33% (28/75)) (<i>p</i> < 0.05). Furthermore, during the same postoperative period, levels of IL-6, IL-8, and TNF-α were found to be reduced in the study group compared to the control group (<i>p</i> < 0.05). <b>Conclusion</b> Remimazolam outperforms propofol in inducing general anesthesia for patients undergoing colorectal cancer surgery, evidenced by improvement in recovery quality and hemodynamic level, as well as reduction in the incidence of adverse effects and inflammatory level.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136520","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 Values of Combined Heparin-Binding Protein and Procalcitonin Testing in the Diagnosis and Management of Severe Pneumonia in Children.","authors":"Xiang He, Yingbo Zou, Yunrong Li, Chao Fu, Chengcheng Li, Xiaolan Zhou, Bo Huang","doi":"10.12968/hmed.2025.0173","DOIUrl":"https://doi.org/10.12968/hmed.2025.0173","url":null,"abstract":"<p><p><b>Aims/Background</b> With the increasing incidence of severe pneumonia in children, timely and accurate diagnosis and treatment are essential for improving prognosis. In recent years, heparin-binding protein (HBP) and procalcitonin (PCT) have gained attention as inflammatory biomarkers in clinical settings. However, their precise roles in the diagnosis and treatment of severe pediatric pneumonia remain unclear. This study aimed to evaluate the clinical value of combining HBP and PCT in diagnosing severe pneumonia in children and assessing the efficacy of antibiotic therapy. <b>Methods</b> Data were collected from 189 pediatric patients hospitalized with pneumonia in the Pediatric Intensive Care Unit, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University) between May 2022 and August 2023. Serum HBP and PCT levels were measured using fluorescence immunochromatography. Spearman and Pearson correlation analyses, along with logistic regression, were performed to identify influencing factors and evaluate diagnostic performance. Receiver operating characteristic (ROC) curves were plotted to assess diagnostic accuracy. <b>Results</b> HBP and PCT levels were significantly elevated in the severe pneumonia group compared to the mild pneumonia group (<i>p</i> < 0.05). Multivariate logistic regression analysis showed that HBP and PCT were independent risk factors for severe pneumonia (<i>p</i> < 0.05). ROC curve analysis demonstrated that the combined use of HBP, PCT, age, and body mass index (BMI) improved diagnostic accuracy, with the highest area under the curve (AUC) observed for the combination of PCT + HBP + BMI + Age (AUC = 0.922; 95% CI: 0.879-0.965; <i>p</i> < 0.001). Additionally, HBP and PCT levels were significantly higher in the severe bacterial infection group than in the severe non-bacterial infection group (<i>p</i> < 0.05). Multivariate logistic regression identified HBP as an independent risk factor for severe bacterial pneumonia in children (<i>p</i> < 0.001). ROC analysis showed that HBP had a high predictive value for severe bacterial pneumonia, with an AUC of 0.884 (95% CI: 0.766-0.921; <i>p</i> < 0.001). Dynamic changes in HBP and PCT levels reflected the efficacy of antibiotic treatment. <b>Conclusion</b> HBP and PCT are valuable for early diagnosis and antibiotic assessment in children with severe pneumonia.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136540","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 Deep Learning-Based Fully Automated Vertebra Segmentation and Labeling Workflow.","authors":"Hongjiang Lu, Miao Liu, Kun Yu, Yuan Fang, Jing Zhao, Yang Shi","doi":"10.12968/hmed.2025.0443","DOIUrl":"https://doi.org/10.12968/hmed.2025.0443","url":null,"abstract":"<p><p><b>Aims/Background</b> Spinal disorders, such as herniated discs and scoliosis, are highly prevalent conditions with rising incidence in the aging global population. Accurate analysis of spinal anatomical structures is a critical prerequisite for achieving high-precision positioning with surgical navigation robots. However, traditional manual segmentation methods are limited by issues such as low efficiency and poor consistency. This work aims to develop a fully automated deep learning-based vertebral segmentation and labeling workflow to provide efficient and accurate preoperative analysis support for spine surgery navigation robots. <b>Methods</b> In the localization stage, the You Only Look Once version 7 (YOLOv7) network was utilized to predict the bounding boxes of individual vertebrae on computed tomography (CT) sagittal slices, transforming the 3D localization problem into a 2D one. Subsequently, the Density-Based Spatial Clustering of Applications with Noise (DBSCAN) clustering algorithm was employed to aggregate the 2D detection results into 3D vertebral centers. This approach significantly reduces inference time and enhances localization accuracy. In the segmentation stage, a 3D U-Net model integrated with an attention mechanism was trained using the region of interest (ROI) based on the vertebral center as input, effectively extracting the 3D structural features of vertebrae to achieve precise segmentation. In the labeling stage, a vertebra labeling network was trained by combining deep learning architectures-ResNet and Transformer, which are capable of extracting rich intervertebral features, to obtain the final labeling results through post-processing based on positional logic analysis. To verify the effectiveness of this workflow, experiments were conducted on a dataset comprising 106 spinal CT datasets sourced from various devices, covering a wide range of clinical scenarios. <b>Results</b> The results demonstrate that the method performed excellently in the three key tasks of localization, segmentation, and labeling, with a Mean Localization Error (MLE) of 1.42 mm. The segmentation accuracy metrics included a Dice Similarity Coefficient (DSC) of 0.968 ± 0.014, Intersection over Union (IoU) of 0.879 ± 0.018, Pixel Accuracy (PA) of 0.988 ± 0.005, mean symmetric distance (MSD) of 1.09 ± 0.19 mm, and Hausdorff Distance (HD) of 5.42 ± 2.05 mm. The degree of classification accuracy reached up to 94.36%. <b>Conclusion</b> These quantitative assessments and visualizations confirm the effectiveness of our method (vertebra localization, vertebra segmentation and vertebra labeling), indicating its potential for deployment in spinal surgery navigation robots to provide accurate and efficient preoperative analysis and navigation support for spinal surgeries.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-22"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136559","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":"Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure-Therapy or Futility?","authors":"Yael Ben-Baruch Golan, Pier D Lambiase","doi":"10.12968/hmed.2024.0870","DOIUrl":"https://doi.org/10.12968/hmed.2024.0870","url":null,"abstract":"<p><p>Atrial fibrillation (AF) and heart failure (HF) frequently coexist, creating a bidirectional relationship in which each condition exacerbates the other, worsening patient prognosis. This interplay also presents therapeutic challenges, as traditional pharmacological strategies for rate and rhythm control are often limited in HF. Catheter ablation (CA) is an established treatment for maintaining sinus rhythm and providing symptomatic relief in patients with AF; however, its effect on clinical outcomes and prognosis in HF populations remains under investigation. This article offers a comprehensive overview of the management of AF and HF, with a focus on the evidence surrounding CA in this population. By analysing recent randomized controlled trials (RCTs) and guideline recommendations, this review aims to provide insights into the role of CA in managing AF and HF.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-22"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136589","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}