British journal of hospital medicine最新文献

{"title":"Psychological Distress of Psoriasis Patients.","authors":"Catherine O'Leary","doi":"10.12968/hmed.2024.0802","DOIUrl":"https://doi.org/10.12968/hmed.2024.0802","url":null,"abstract":"<p><p>This review explores the psychological challenges experienced by people with psoriasis. Psychological distress is associated with a wide range of challenges including depression, anxiety, low self-esteem, relationship difficulties and sleep disorders. Though psychological distress is prevalent and may significantly impact the quality of life, treatment outcomes and the delivery of healthcare, it is often unrecognised and untreated. The review explores why the assessment of the psychological impact of psoriasis is essential to meet the holistic needs of individuals with psoriasis. Multidisciplinary psychodermatology teams, using a stepped-care approach to addressing psychological distress, may be best placed to care for the needs of this population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943725","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":"Improving Familial Hypercholesterolemia Detection Through Implementation of Nurse-led Cascade Screening.","authors":"Eamon Patrick McCarron, Cathy Rocks, Pádraig Hart, Kathryn Ryan, Paul Hamilton, Maurice O'Kane","doi":"10.12968/hmed.2024.0785","DOIUrl":"https://doi.org/10.12968/hmed.2024.0785","url":null,"abstract":"<p><p><b>Aims/Background</b> Familial hypercholesterolemia (FH) is a genetic disorder that leads to premature cardiovascular disease. Early detection and treatment are crucial for reducing morbidity and mortality. This study describes the development and impact of a nurse-led cascade screening service in Northern Ireland (NI). <b>Methods</b> A retrospective cross-sectional analysis and audit of data from 2010 to present was conducted using patient databases, clinical notes, and electronic records. <b>Results</b> An estimated 6925 individuals in NI have FH, with 26.9% identified (1866/6925). The mean detection rate per proband was 3.2 cases. The average age of diagnosis was 46.7 years for probands and 36.1 years for the FH population as a whole (35.1 for males, 36.9 for females). Excluding children (<18 years), the adjusted mean age was 43.7 for males and 44.4 for females. The overall male-to-female ratio was 0.817 (824 males:1008 females). Six common mutations in the low-density lipoprotein receptor (<i>LDLR</i>) and apolipoprotein B (<i>APOB</i>) genes account for 40% of cases, and 16.7% were diagnosed before age 16. NI benefits from a favourable FH nurse-to-population ratio (1:380,000). <b>Conclusion</b> Nurse-led cascade screening has enabled NI to surpass the National Health Service (NHS) 'Long Term Plan' target of 25%, demonstrating sustained high detection rates, particularly among females and children. Ongoing funding is essential to further expand the service and support the continued development of the FH nurse role.</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":"144943689","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 Convergence of Artificial Intelligence and the Internet of Things in Dentistry and Medicine.","authors":"Enis Veseli, Dinesh Rokaya, Betsy Joseph","doi":"10.12968/hmed.2025.0110","DOIUrl":"https://doi.org/10.12968/hmed.2025.0110","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":"144943706","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":"Artificial Intelligence in Healthcare: Current Regulatory Landscape and Future Directions.","authors":"Nurittin Ardic, Rasit Dinc","doi":"10.12968/hmed.2024.0972","DOIUrl":"https://doi.org/10.12968/hmed.2024.0972","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) in healthcare offers the potential to play a critical role in reshaping clinical practice. However, it also brings regulatory, ethical, implementation, social, and technical challenges that healthcare systems must overcome. It is necessary for the responsible parties in AI applications to be well defined by the regulations. To create standards that encourage innovation and address ethical and security concerns, collaboration between policymakers, AI developers and healthcare providers has a vital role. In this review, it was presented an overview of the current regulatory landscape for AI in healthcare, focusing primarily on frameworks in the European Union (EU), the United States (USA), and the United Kingdom (UK), which are leading countries in this regard. The review also emphasized the challenges that need to be addressed.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-21"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Pharmacological Treatments and Lifestyle Modifications for Managing Gastroesophageal Reflux Disease in Infants: A Literature Review.","authors":"Yeshaa Mirani, Yohan Joe Roy, Tania John","doi":"10.12968/hmed.2024.0921","DOIUrl":"https://doi.org/10.12968/hmed.2024.0921","url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) is a common condition in infants, causing vomiting, irritability, and feeding difficulties. Though typically mild and self-limiting, severe cases may result in complications such as esophagitis, failure to thrive, or recurrent aspiration pneumonia. This review highlights a tiered approach to management, emphasizing non-pharmacological methods such as feeding adjustments, and thickened feeds as first-line treatments. These strategies are effective for mild to moderate cases, reducing unnecessary medication risks. Pharmacologic interventions, primarily proton pump inhibitors and histamine-2 receptor antagonists, are reserved for severe cases, such as erosive esophagitis or persistent respiratory symptoms, where non-pharmacological approaches have failed. While medications promote mucosal healing, their efficacy for symptoms like irritability or vomiting in non-severe cases is mixed, raising concerns about overuse. Adverse effects include increased infection risks, gut microbiota changes, and nutrient malabsorption. Future research should refine diagnostic criteria and develop evidence-based guidelines to prevent overtreatment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943758","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 Significance of Aging-Related Secretory Phenotypic Factors in Diagnosing Type 2 Diabetes Mellitus-Associated Peri-Implantitis: A Retrospective Analysis.","authors":"Wei Chen, Siyi Chen, Jiqin Zhang","doi":"10.12968/hmed.2025.0294","DOIUrl":"https://doi.org/10.12968/hmed.2025.0294","url":null,"abstract":"<p><p><b>Aims/Background</b> Type 2 diabetes mellitus (T2DM) has been reported as a critical contributor to peri-implantitis. Hyperglycemia and associated metabolic changes in diabetes promote cellular senescence. This study aims to investigate the significance of aging-related secretory factors, known as senescence-associated secretory phenotypes (SASPs), in peri-implant crevicular fluid (PICF) in diagnosing type 2 diabetes mellitus-associated peri-implantitis (T2DM-PI). <b>Methods</b> This study included 72 patients with T2DM-PI (designated as a T2DM-PI group) and 45 patients with peri-implantitis (as a control group). The patients were selected at the Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine between December 2021 and December 2023. Patients in both groups were further divided into the middle-aged group and the elderly group. Furthermore, patients were stratified as the middle-aged peri-implantitis (M-PI) group, the middle-aged type 2 diabetes mellitus-associated peri-implantitis (M-DPI) group, the elderly peri-implantitis (E-PI) group, and the elderly type 2 diabetes mellitus-associated peri-implantitis (E-DPI) group. Baseline characteristics and the level of SASPs in PICF were compared between the two groups. We analyzed the factors influencing the occurrence of peri-implantitis in type 2 diabetes, conducted multiple collinearity testing on the selected variables, and incorporated variables with a variance inflation factor (VIF) <5 into a multi-factor binary logistic regression analysis to identify independent risk factors for type 2 diabetes mellitus-associated peri-implantitis. Furthermore, a receiver operating characteristic (ROC) curve was constructed to assess the diagnostic value of SASP levels in patients with T2DM-PI. <b>Results</b> Compared to the control group, the level of SASPs was significantly higher in the T2DM-PI group, with elevated SASP levels positively correlated with the severity of periodontal indicators. Binary logistic regression analysis identified body mass index (BMI), interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and matrix metalloproteinase 8 (MMP8) as independent risk factors for the occurrence of T2DM-PI in the middle-aged group (<i>p</i> < 0.05). BMI was found to be an independent risk factor for T2DM-PI in the elderly group (<i>p</i> < 0.05). The ROC curve analysis revealed that IL-1β had the highest diagnostic accuracy among the middle-aged T2DM-PI, with an area under the curve (AUC) of 0.861, a sensitivity of 85.40%, and a specificity of 82.10%. BMI demonstrated the highest diagnostic accuracy in elderly T2DM-PI, with an AUC of 0.904, a sensitivity of 100%, and a specificity of 70.60%. <b>Conclusion</b> Elevated SASP levels in PICF are associated with the severity of periodontal index outcomes in patients with T2DM-PI. Furthermore, SASP levels hold significant diagnostic performance for T2DM-PI.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943766","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":"What Are Major Trauma Systems, Why Does the UK Need Them and How Can They Be Improved?","authors":"Joseph Furey, Vivien Graziadei, Isobel Pilkington","doi":"10.12968/hmed.2025.0050","DOIUrl":"https://doi.org/10.12968/hmed.2025.0050","url":null,"abstract":"<p><p>Major trauma, defined by the World Health Organisation (WHO) as 'multiple, serious injuries that could result in disability or death' is a significant cause of death worldwide. Trauma is the leading cause of death for 15-45 years old. Major Trauma Systems (MTS) should follow defined, evidence-based trauma pathways to optimise patient outcomes. In 2010, the Major Trauma Care in England Report found significant variability in trauma mortality outcomes between hospitals, highlighting a need for the establishment of MTS. We will review the current models of UK MTS, with a particular focus on the London Trauma System (LTS) and propose strategies to optimise patient care within the current framework. MTS can be divided into Exclusive and Inclusive Systems. In the former, one standalone Major Trauma Centre (MTC) is capable of providing care from start to finish for any major trauma patient. Inclusive systems are comprised of a MTC acts as a central component in a network with smaller Trauma Units (TUs) working in tandem, taking advice or transferring patients, to get the best care for a trauma patient. The National Major Trauma Registry (NMTR), which keeps detailed records of all trauma patients has shown a 44% increase in \"good overall care\" to trauma patients since the service began. Close links to research allow rapid implementation of emerging evidence-based medicine into standard care, for example administration of tranexamic acid to haemorrhaging patients. Limitations of our current MTS include difficulty in transferring non-urgent patients from TUs to the MTCs; repatriating patients after treatment at an MTC; limited image transfer between hospitals; and a widespread lack of rehabilitation resources. For future improvement, it is imperative to implement trauma prevention methods and community outreach programmes, targeting the population demographics most affected by such trauma. Additional research is required to determine the effectiveness of changes in rehabilitation funding and policies. Particular attention should also be given to the benefit to long term outcomes, including quality of life and functional recovery scores.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943682","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 Condition: Nonhemorrhagic Infarct of Adrenal Gland in Pregnancy.","authors":"Zeynep Ayvat Ocal, Yasemin Demirci","doi":"10.12968/hmed.2024.0783","DOIUrl":"https://doi.org/10.12968/hmed.2024.0783","url":null,"abstract":"<p><p>Adrenal infarction can be hemorrhagic or non-hemorrhagic, while the latter is much less common. Non-hemorrhagic adrenal infarction (NHAI) is a rare but potentially serious cause of acute abdominal pain in pregnancy that can lead to significant adverse outcomes for both mother and baby if not treated promptly and appropriately. Diagnosis of this condition is challenging due to the non-specific nature of clinical and laboratory findings. Ultrasound (US) has limited utility in diagnosing retroperitoneal pathology, while the use of computed tomography (CT) is restricted due to concerns about fetal radiation exposure. Diagnosis is typically based on magnetic resonance imaging (MRI) findings, with other potential etiological causes of abdominal pain being systematically ruled out. Treatment primarily consists of analgesics and anticoagulants. In this case report, we present a pregnant patient who arrived at the emergency department with an acute abdomen. Various MR images are provided, illustrating the diagnostic process. The patient was successfully treated with anticoagulants and antibiotherapy. Through this case, we aim to highlight the role of imaging in the differential diagnosis, management, and follow-up of pregnant patients presenting with acute abdominal conditions.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943698","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 and Defragmenting Multi-Specialty Care for People With Multiple Long-Term Conditions.","authors":"Chris A O'Callaghan, Jennifer J Rayner, Gaya Thanabalasingham, Michael Matheou, Alistair Lumb, Rustam D Rea, Luke Solomons, Michael E Reschen","doi":"10.12968/hmed.2024.0728","DOIUrl":"https://doi.org/10.12968/hmed.2024.0728","url":null,"abstract":"<p><p>There is an increasing prevalence of people living with multiple long-term conditions (MLTC), defined as two or more long-term conditions. People with MLTC have reduced life expectancy and increased healthcare usage compared to people without MLTC. Most hospital healthcare systems have developed to deal with single conditions in isolation. For people with MLTC, this results in fragmentation of their care across multiple different specialty clinics, which can waste resources and is often unsatisfactory for patients and for their primary care clinicians. Clinical trials are commonly undertaken on patients with only a single condition and there is little evidence about care for patients with MLTC. We have developed an integrated multi-specialty clinic in which multiple specialists meet the patient in a single room at the same time to develop a realistic consensus management plan. Further research is needed to determine the most effective ways to deliver integrated healthcare for people with MLTC.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 8","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943701","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":"New Names, New Drugs, Better Outcomes in Steatotic Liver Disease.","authors":"Matthew Peverelle, Mzamo Mbelle, Deepak Joshi","doi":"10.12968/hmed.2024.0655","DOIUrl":"https://doi.org/10.12968/hmed.2024.0655","url":null,"abstract":"<p><p>Steatotic liver disease (SLD) is a growing cause of chronic liver disease, with potential progression to cirrhosis, hepatocellular carcinoma (HCC), and liver failure. Previously known as non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), new terminology, including metabolic-dysfunction associated steatotic liver disease (MASLD) and metabolic-dysfunction associated steatohepatitis (MASH), was introduced to improve diagnostic clarity and reduce stigmatization. MASLD is now recognized as the hepatic manifestation of the metabolic syndrome and is the most common cause of liver disease in the UK, affecting up to 20% of adults. The incidence of MASLD-related cirrhosis and HCC is expected to rise significantly by 2030, highlighting the need for early diagnosis and treatment. For over two decades, effective medical therapies for MASLD were elusive. However, recent trials of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), thyroid hormone receptor-β (THR-β) agonist resmetirom, and fibroblast growth factor 21 (FGF21) agonists have shown promising results in reversing steatohepatitis and potentially fibrosis. These agents potentially offer new disease-modifying treatment options for MASLD, with GLP-1 RAs particularly effective in achieving weight loss and all drugs showing promising histological benefits in patients with MASH. This review summarizes nomenclature changes, provides an update on the UK's SLD burden, with a particular focus on MASLD and MASH, and discusses new therapeutic strategies for managing this complex and increasingly prevalent condition.</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":"144943727","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}