British journal of hospital medicine最新文献

{"title":"Neonatal Congenital Pulmonary Airway Malformation Causing Respiratory Failure Managed With Early Surgical Resection: A Case Report.","authors":"Linlin Fan, Yanan Hu","doi":"10.12968/hmed.2025.0284","DOIUrl":"https://doi.org/10.12968/hmed.2025.0284","url":null,"abstract":"<p><p>Congenital pulmonary airway malformation (CPAM) is a rare cystic lung anomaly in newborns. It can range from asymptomatic to causing life-threatening respiratory distress. However, severe respiratory failure occurring in the immediate neonatal period is uncommon. We report the case of a neonate with CPAM who developed respiratory failure requiring urgent surgical management. The case aims to highlight the importance of early diagnosis and surgical intervention in neonates presenting with severe CPAM to prevent fatal outcomes and support complete recovery. A 29-hour-old male neonate was admitted with cyanosis and severe respiratory distress at birth. His oxygen saturation was only 50% on supplemental oxygen. Chest X-ray and computed tomography (CT) scan revealed a massive multicystic lesion in the left lung consistent with CPAM, with mediastinal shift and compression of the right lung. The baby was intubated and placed on mechanical ventilation, but his respiratory status remained critical. Emergent surgical resection of the left upper lobe was performed. Histopathological examination confirmed a mixed Type I and Type II CPAM. Following early surgical lobectomy, the neonate's respiratory status improved rapidly. He was weaned from the ventilator without difficulty, and mediastinal structures returned to midline. Post-operative course was uneventful, and the infant was discharged in good condition within two weeks. Follow-up at four years showed normal respiratory function, normal pulmonary development on imaging, and no evidence of recurrent pulmonary disease. Early diagnosis and intervention of neonatal CPAM are crucial in the presence of severe respiratory compromise. This case illustrates that urgent surgical resection was effective in correcting respiratory failure caused by a large CPAM, and complete recovery is achievable. Clinicians should consider congenital lung malformations when assessing newborns with unexplained respiratory distress.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136514","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":"AI in Healthcare: Redefining Liability for Doctors and Hospitals.","authors":"Robert Kellar","doi":"10.12968/hmed.2025.0212","DOIUrl":"https://doi.org/10.12968/hmed.2025.0212","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":"145136529","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":"Ageing, Nutrition, and Infection: The Forgotten Triad.","authors":"Dominic Adam Worku","doi":"10.12968/hmed.2024.0873","DOIUrl":"https://doi.org/10.12968/hmed.2024.0873","url":null,"abstract":"<p><p>Ageing is a complex sociocultural and physiological process characterised by declines in nutritional and functional status and the immune response. The ageing immune system is plagued by both quantitative and qualitative deficits in the innate and adaptive immune system characterised by reduced responsiveness to de novo antigens and vaccines, along with low-level inflammation which is modulated by nutrition. In this short review, we will highlight the vicious cycle of infection and malnutrition, which is prevalent in the elderly. In doing so we will highlight the relevant contributions of both macronutrient and micronutrient deficiency to immune system dysfunction highlighting the need to research and modify nutrition in the elderly to improve health-related outcomes and protect healthcare systems from anticipated rises in the ageing population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 9","pages":"1-25"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136569","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":"Using Genomic Data in Clinical Decision Making: The Opportunities and Challenges.","authors":"Julia Darko, Videha Sharma, John H McDermott","doi":"10.12968/hmed.2025.0098","DOIUrl":"https://doi.org/10.12968/hmed.2025.0098","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943687","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":"Preventing Alcohol-Related Harm: Effective Strategies and the Role of Health Professionals.","authors":"William Gilmore, Ian Gilmore","doi":"10.12968/hmed.2024.0719","DOIUrl":"https://doi.org/10.12968/hmed.2024.0719","url":null,"abstract":"<p><p>Clinicians and other health and medical professionals are increasingly dealing with the harms of alcohol consumption across the UK. Briefly charting the history of consumption, attempts to regulate drinking, and alcohol's contribution to injury and disease, this narrative review highlights that reducing overall alcohol consumption across the population is most effective in reducing alcohol-related harm. Health professionals can play a role in reducing harm across the community by advocating for effective population-level prevention policies assisting individuals in reducing alcohol-related harm. Public health measures that have been shown to have the greatest impact on alcohol consumption and related harms focus on price, marketing and accessibility, and there is evidence supporting alcohol screening, brief intervention and referral to treatment in health settings.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943694","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":"Global Burden of Severe Heart Failure Attributable to Chronic Kidney Disease in Diabetes Populations: A Systematic Analysis of the Global Burden of Disease Study 2021.","authors":"Xingfang Wang, Dun Su","doi":"10.12968/hmed.2025.0408","DOIUrl":"https://doi.org/10.12968/hmed.2025.0408","url":null,"abstract":"<p><p><b>Aims/Background</b> Severe heart failure (SHF) secondary to chronic kidney disease (CKD) in type 1/2 diabetes mellitus (T1/T2DM) patients presents a critical global health challenge. Leveraging data from the Global Burden of Disease (GBD) 2021, we analyse epidemiological trends (1990-2021) and project disease trajectories to 2040, focusing on sociodemographic disparities and metabolic determinants. <b>Methods</b> Utilising GBD 2021 data, the estimated prevalence and years lived with disability (YLDs) values were extracted for SHF-CKD-T1/T2DM, along with their corresponding 95% uncertainty intervals (UIs). The trend in SHF-CKD-T1/T2DM burden between 1990 and 2021 was evaluated from both a global and local perspective. Subgroup analysis was employed to examine the burden of SHF-CKD-T1/T2DM across various subpopulations. Additionally, decomposition analysis was used to assess the contributions of population size, age structure, and epidemiological changes to SHF-CKD-T1/T2DM burden. The Bayesian Age-Period-Cohort (BAPC) model and the Nordpred model projected the burden through 2040. <b>Results</b> In 2021, the prevalence of SHF-CKD-T1DM was 5723 (95% UI: 4397 to 7284) and SHF-CKD-T2DM was 122,404 (95% UI: 89,920 to 169,580). The age-standardised years lived with disability (YLDs) rates for SHF-CKD-T1DM in 2021 exhibited a significant increase to 0.012 (95% UI: 0.008 to 0.019), while YLDs rates for SHF-CKD-T2DM also showed a notable rise to 0.249 (95% UI: 0.146 to 0.394). The global burden of SHF-CKD-T1/T2DM showed variability across different sociodemographic index (SDI) regions. In 2021, the overall burden of SHF-CKD-T1/T2DM continued to increase, with age being a significant contributor. Similarly, SHF-CKD-T1/T2DM burden exhibited gender-specific variability. Decomposition analysis indicated that epidemiological changes were the primary contributors to the global burden of prevalence and YLDs associated with SHF-CKD-T1/T2DM. It is projected that by 2040, the trends in prevalence and YLDs will stabilise; however, they are expected to continue rising. <b>Conclusion</b> The increasing burden of SHF-CKD-T1/T2DM is driven by epidemiological transitions, population growth, and regional disparities. Although growth rates have decelerated, the rising number of cases highlights the urgent need for targeted prevention and early intervention strategies in high-risk populations. To alleviate this burden, it is essential to address metabolic determinants, improve healthcare access in regions with high prevalence, expand diabetes treatment coverage in low-SDI regions, and incorporate cardiorenal risk stratification into diabetes management frameworks.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943729","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 Rare Case of Cerebral Infarct Leading to Acute Heart Failure With a 4-Year Follow-Up.","authors":"Sahil Ravisangar, Aravinth Sivagnanaratnam","doi":"10.12968/hmed.2024.0752","DOIUrl":"https://doi.org/10.12968/hmed.2024.0752","url":null,"abstract":"<p><p>It is not uncommon for ischaemic heart conditions to cause cerebral infarcts. However, what is rarely seen is a cerebral infarct leading to heart failure. This case report describes a 42-year-old male admitted with acute onset symptoms in keeping with a posterior circulation infarct, who later deteriorated during admission as a result of left ventricular heart failure. At the 18-month follow-up, the patient's overall condition had improved due to management for the cerebral infarct and the heart failure which restored the patient's heart function. The patient remained symptom-free throughout the follow-ups across 4 years. Due to the lack of pre-existing heart conditions in this patient, the most plausible cause of their heart failure was as a result of the reduced blood supply to the lateral medulla. This phenomenon has been rarely commented on thus far and warrants further discussion around its pathophysiological mechanisms and management.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943761","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":"Integrating Personalized Psychological Support With Death Education in Nursing Interventions for Elderly Terminal Cancer Patients: A Retrospective Study on Life and Death Perception.","authors":"Lili Wen, Jianyu Li, Shuying Zhang","doi":"10.12968/hmed.2025.0277","DOIUrl":"https://doi.org/10.12968/hmed.2025.0277","url":null,"abstract":"<p><p><b>Aims/Background</b> Terminal cancer patients face profound physical, psychological, and existential challenges. Traditional support often lacks comprehensive approaches to address the nuanced emotional needs of patients. This study evaluates the effectiveness of nursing interventions integrating death education with personalized psychological support-a combined approach designed to synergistically address existential distress-in reshaping life and death perceptions among terminal cancer patients. <b>Methods</b> This retrospective cohort study analyzed 251 advanced cancer patients aged ≥60 years. Propensity score matching (1:1 ratio) balanced covariates, including age, gender, body mass index (BMI), education, employment status, clinical stage, cancer type, and comorbidities, yielding 212 matched patients (106 pairs). Based on the type of nursing care, patients were divided into a conventional care group (n = 106) and a combined care group (n = 106). The conventional care group received standard health education, while the combined care group received additional death education and psychological support. Baseline and post-intervention assessments were conducted using the Death Attitude Profile-Revised (DAP-R), Anticipatory Grief Scale, Distress Thermometer (DT), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) for quality-of-life evaluation. <b>Results</b> After the intervention, the combined care group showed significant improvements in grief sensation, anger sensation, religious comfort, and perceived social support (<i>p</i> < 0.05) compared to the conventional care group. DAP-R scores indicated an enhanced approach and natural acceptance, with a decrease in death fear and avoidance (<i>p</i> < 0.05). Distress levels declined significantly, as evidenced by DT scores (<i>p</i> < 0.001). Quality-of-life scores demonstrated improvements in physical, role, emotional, and social functions (<i>p</i> < 0.05). <b>Conclusion</b> Integrating death education in nursing interventions effectively reshapes outlooks on life and death for terminal cancer patients. These interventions correlate with reduced negative emotional responses and improvements in quality-of-life metrics, suggesting their potential utility in palliative care settings.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943737","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":"Prognostic Performance of the FLAMB Model in Primary Gastric Diffuse Large B-Cell Lymphoma.","authors":"Jianbo Liu, Ao Li, Runhui Zheng, Haiying Wu, Yongqiang Wei, Ru Feng","doi":"10.12968/hmed.2025.0232","DOIUrl":"https://doi.org/10.12968/hmed.2025.0232","url":null,"abstract":"<p><p><b>Aims/Background</b> Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is a common gastrointestinal malignancy. While rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based regimens have improved survival, reliable prognostic tools remain scarce. The International Prognostic Index (IPI), though validated for nodal DLBCL, shows limited accuracy in PG-DLBCL. To address this, we developed an intelligent prognostic model integrating key clinical variables to optimize individualized risk stratification, particularly for resource-limited clinical settings. <b>Methods</b> A retrospective cohort study was conducted at Nanfang Hospital, Southern Medical University, enrolling patients diagnosed with PG-DLBCL between January 2007 and July 2022. Clinical data and survival outcomes were systematically collected. Optimal cut-off values were systematically determined for continuous variables using receiver operating characteristic (ROC) curve analysis. Survival rates were estimated using the Kaplan-Meier method, with survival curves plotted and univariate survival associations assessed using the log-rank test. Multivariable analyses were performed through Cox proportional hazards regression and random forest algorithms. A novel (ferritin, lactate dehydrogenase (LDH), age, monocyte count (mono), β2-microglobulin (β2-MG)) FLAMB prognostic model was constructed by integrating the Cox regression model with random forest classification. Model performance was evaluated by comparing its discriminative accuracy with that of the IPI scoring system. <b>Results</b> Statistically significant differences in 5-year survival among PG-DLBCL patients were observed for ferritin, age, mono, LDH, β2-MG, B symptoms, and cell of origin (COO) in univariate survival analysis (<i>p</i> < 0.05). We developed the FLAMB model using five routinely available variables (ferritin, LDH, age, mono, and β2-MG) to enhance risk stratification in PG-DLBCL. Compared to the IPI, FLAMB demonstrated superior discriminative power (C-index: 0.653 vs. 0.637, Δ = 1.6%) and more effectively identified high-risk patients requiring treatment intensification. This enhanced risk stratification was confirmed by a statistically significant log-rank test (<i>p</i> < 0.05). Survival analysis in subgroups of non-germinal center B-cell like (GCB) and B symptoms-negative patients yielded consistent results. <b>Conclusion</b> The newly developed FLAMB prognostic model offers more precise prognostic stratification than the IPI for patients with PG-DLBCL. FLAMB comprises five key variables derived from routine laboratory tests and general clinical characteristics, making it readily accessible. This model enables clinicians, particularly in primary care or community hospitals, to efficiently stratify patient risk, assess underlying disease severity, and inform timely treatment planning.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943696","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 Pathways: Current Practice and Future Prospects.","authors":"Dalal Mohammed Alshathri, Faisal Moujeb Alshareef, Ghadeer Sulaiman Aljuraiban","doi":"10.12968/hmed.2025.0197","DOIUrl":"https://doi.org/10.12968/hmed.2025.0197","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943719","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}