British journal of hospital medicine最新文献

{"title":"Analysis of the Incidence and Influencing Factors of <i>Ureaplasma urealyticum</i> Infection in Premature Neonates.","authors":"Jinghua Li, Chaoqun Zhou, Fengwei Chu","doi":"10.12968/hmed.2025.0126","DOIUrl":"https://doi.org/10.12968/hmed.2025.0126","url":null,"abstract":"<p><p><b>Aims/Background</b> Premature newborns face a higher risk of <i>Ureaplasma urealyticum</i> (UU) infection, which is closely associated with many diseases in the neonatal period. Therefore, this study retrospectively analysed the occurrence of UU infection in premature newborns and further explored its influencing factors, which are instrumental for enabling early diagnosis of UU infection in premature infants. <b>Methods</b> In this retrospective study, 870 preterm infants born in the Affiliated Yangming Hospital of Ningbo University from June 2021 to December 2024 were selected as the study subjects. Ninety-three premature infants who tested positive for UU in nasopharyngeal aspirates were included in the UU group (<i>n</i> = 93) as cases, whereas 777 premature infants who tested negative for UU were included in the non-UU group (<i>n</i> = 777). Medical records and laboratory test results of the two groups of premature infants were collected. Univariate analysis and multiple logistic regression analysis were performed to identify factors influencing UU infection in premature newborns. Predictive efficacy of indicators showing differences in predicting UU infection in premature newborns was evaluated by means of receiver operating characteristic (ROC) curve analysis. <b>Results</b> The incidence rate of UU infection in preterm neonates was 10.69% (93/870). Univariate analysis identified maternal age (<i>p</i> < 0.001), gestational hypertension (<i>p</i> = 0.016), delivery method (<i>p</i> < 0.001), premature rupture of membranes (<i>p</i> = 0.006), gestational age (<i>p</i> = 0.001), white blood cell count (<i>p</i> < 0.001), neutrophil count (<i>p</i> < 0.001), serum C-reactive protein (<i>p</i> < 0.001) and procalcitonin levels (<i>p</i> = 0.003) as factors associated with UU infection in premature newborns. The multiple logistic regression analysis identified natural birth/forceps delivery (<i>p</i> < 0.001), low gestational age (<i>p</i> = 0.004), and serum C-reactive protein >0.5 mg/L (<i>p</i> = 0.001) as significant risk factors for UU infection in premature newborns. Concerning the combined use of delivery method (natural birth/forceps delivery), gestational age and serum C-reactive protein (>0.5 mg/L), the area under the curve (AUC) was found to be 0.800 (0.758-0.843, <i>p</i> < 0.001), with a sensitivity of 74.2%, specificity of 75.3%, and Youden index of 0.495. <b>Conclusion</b> The incidence of UU infection in preterm infants stands at about 10%, with delivery method, gestational age and C-reactive protein level being the independent influencing factors. The combination of these three factors holds certain clinical potential in predicting neonatal UU infection.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Comorbidity in Intellectual Developmental Disorders: A Systematic Review.","authors":"Borja Astilleros Martínez, Maria Pilar Martin, Yasuhiro Kotera","doi":"10.12968/hmed.2024.0686","DOIUrl":"https://doi.org/10.12968/hmed.2024.0686","url":null,"abstract":"<p><p><b>Aims/Background</b> Intellectual developmental disorders (IDD) are characterized by significant limitations in intellectual functioning and adaptive behavior, affecting conceptual, social, and practical skills. They impact 1% of the global population, with mild cases being more common. Major causes include prenatal, perinatal, and postnatal factors, although a clear cause is often not identified. This study aims to evaluate the comorbidity of psychological disorders in individuals diagnosed with IDD. <b>Methods</b> Following the \"Preferred Reporting Items for Systematic reviews and Meta-Analyses\" (PRISMA) statement, studies from 2014 to 2024 were considered using the databases Web of Science, PsycInfo, and PubMed. Articles focusing on psychopathology in individuals with IDD from birth were selected, excluding studies involving individuals under 16 years old and cases of severe and profound IDD. <b>Results</b> Of the 2895 articles retrieved, 11 were included. These studies showed heterogeneity in comorbidities such as schizophrenia spectrum and other psychotic disorders, mood disorders, anxiety disorders, developmental disorders, personality disorders, substance use disorders, and adjustment and stress reaction disorders. <b>Conclusion</b> Individuals with IDD are more vulnerable to mental health conditions, underscoring the need for comprehensive assessments and multidisciplinary treatments to improve their quality of life and optimize public resources. Future research should develop validated diagnostic tools for IDD and conduct longitudinal studies on their impact on quality of life. It should also explore gender differences and address specific needs in disadvantaged contexts with tailored interventions. <b>Systematic Review Registration</b> PROSPERO (CRD42024529405).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-26"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Different Chronic Airway Inflammatory Diseases on Pathological Types and Prognosis of Lung Cancer Patients.","authors":"Shuhui Gao, Guibin Zhang, Deyang Meng, Li Yan","doi":"10.12968/hmed.2025.0031","DOIUrl":"https://doi.org/10.12968/hmed.2025.0031","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Chronic obstructive pulmonary disease (COPD), chronic bronchitis, and bronchial asthma are common chronic airway inflammatory diseases that have been reported to be associated with increased risk for lung cancer and impact prognosis. The purpose of this study was to investigate the impact of different chronic airway inflammatory diseases on the pathological types and prognosis of lung cancer patients. &lt;b&gt;Methods&lt;/b&gt; A total of 200 patients with newly diagnosed lung cancer were recruited from January 2021 to January 2024. The clinical data of patients were retrospectively analyzed. According to the pathological type of lung cancer, patients were divided into small cell lung cancer (SCLC) group (&lt;i&gt;n&lt;/i&gt; = 38) and non-small cell lung cancer (NSCLC) group (&lt;i&gt;n&lt;/i&gt; = 162). Logistic regression was used to analyze the risk factors for SCLC. Patients were divided into airway inflammation group (&lt;i&gt;n&lt;/i&gt; = 113) and non-airway inflammation group (&lt;i&gt;n&lt;/i&gt; = 87) in accordance with the presence of inflammatory airway diseases. Propensity score matching (PSM) was employed to balance clinical characteristics between airway inflammation and non-airway inflammation groups, followed by Kaplan-Meier analysis to analyze the influence of airway inflammation on the overall survival of lung cancer. Cox proportional hazard model was used to analyze the influencing factors on the prognosis of lung cancer patients. &lt;b&gt;Results&lt;/b&gt; Among all patients, 87 cases (43.5%) were lung adenocarcinoma, 65 cases (32.5%) were squamous carcinoma, 38 cases (19.0%) were SCLC, and 6 cases (3.0%) were large cell carcinoma; 72 (36.0%), 49 (24.5%) and 9 (4.5%) cases had COPD, chronic bronchitis, and bronchial asthma, respectively. Of the COPD patients, 43.1% (31/72) had squamous carcinoma, 29.2% (21/72) had SCLC, and 22.2% (16/72) was lung adenocarcinoma. In chronic bronchitis, lung adenocarcinoma has the highest proportion (27/49, 55.1%), followed by squamous carcinoma (16/49, 32.7%), and SCLC accounted for 8.2% (4/49). Logistic regression analysis showed that COPD (&lt;i&gt;p&lt;/i&gt; = 0.012, OR [95% CI] = 2.696 [1.247-5.829]) and body mass index (BMI) (&lt;i&gt;p&lt;/i&gt; = 0.020, OR [95% CI] = 1.132 [1.020-1.256]) were the independent influencing factors of SCLC. The Kaplan-Meier survival curves showed that the overall survival rate in the airway inflammation group was significantly worse than that in the non-airway inflammation group after PSM (&lt;i&gt;p&lt;/i&gt; = 0.033, HR [95% CI] = 1.960 [1.039-3.697]). Cox regression analysis displayed that SCLC (&lt;i&gt;p&lt;/i&gt; &lt; 0.001, HR [95% CI] = 10.678 [4.416-25.822]), clinical stages (III-IV) (&lt;i&gt;p&lt;/i&gt; = 0.003, HR [95% CI] = 3.234 [1.501-6.969]) and COPD (&lt;i&gt;p&lt;/i&gt; = 0.014, HR [95% CI] = 1.987 [1.152-3.427]) were the risk factors affecting prognosis, while surgical treatment (&lt;i&gt;p&lt;/i&gt; = 0.022, HR [95% CI] = 0.336 [0.132-0.854]) was a protective factor for prognosis. &lt;b&gt;Conclusion&lt;/b&gt; COPD, chronic bronchitis and asthma differ in the distribution of","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Tirofiban on Cognitive Function in Patients With Unruptured Intracranial Aneurysms After Endovascular Embolization.","authors":"Xiang Bao, Pingyou He, Xiaobo Liu, Wei Xu, Danfeng Yu, Feng Chen, Chenxing Ye, Fengfeng Jiang","doi":"10.12968/hmed.2025.0260","DOIUrl":"https://doi.org/10.12968/hmed.2025.0260","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; An unruptured intracranial aneurysm (UIA) is a cerebrovascular disease with a potential risk of rupture. Rupture of UIA is a leading cause of spontaneous subarachnoid hemorrhage, which carries a high mortality rate. While endovascular intervention emerged as the primary treatment option for UIA, postoperative cognitive dysfunction (POCD) remains a common complication, affecting patients' postoperative recovery. Therefore, identifying effective interventions is clinically crucial for improving postoperative cognitive function. Tirofiban, an antiplatelet agent, has shown potential neuroprotective effects in neurointerventional procedures. Hence, this study aims to evaluate the effect of tirofiban on postoperative cognitive function in patients with UIA. &lt;b&gt;Methods&lt;/b&gt; This retrospective study analyzed 125 UIA patients who underwent treatment between January 2021 and December 2024. All patients underwent simple coil embolization and were divided into two groups: an observation group (treated with tirofiban) and a control group (without tirofiban). Before surgery, these patients were routinely treated with aspirin and clopidogrel. However, patients in the observation group were given tirofiban in addition to standard care for 12 hours after the procedure. Furthermore, cognitive function was assessed before and after surgery using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores. Additionally, the incidence of postoperative silent cerebral infarction (SCI) and variations in inflammatory marker levels were compared between the two groups. &lt;b&gt;Results&lt;/b&gt; Cognitive function showed no significant difference between the two groups before surgery. After the procedure, the observation group demonstrated significantly higher MoCA (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and MMSE (&lt;i&gt;p&lt;/i&gt; = 0.001) scores than the control group, indicating a significant advantage of tirofiban in improving cognitive function. Within 72 hours postoperatively, 7 cases in the observation group developed SCI compared to 18 cases in the control group, with a significantly lower incidence of SCI in the observation group (&lt;i&gt;p&lt;/i&gt; = 0.025). Preoperative comparison of inflammatory markers revealed no difference between the two groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). However, their postoperative levels were significantly lower in the observation group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The cognitive function scores remained significantly higher in the observation group than in the control group over one month follow-up period (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). &lt;b&gt;Conclusion&lt;/b&gt; Tirofiban improves cognitive function and reduces SCI and inflammation following UIA embolization, possibly via antiplatelet and anti-inflammatory mechanisms. While statistically significant, the clinical relevance of cognitive improvement (1 point) is limited and requires further investigation. Furthermore, prospective randomized trials are needed to validate the long-term efficacy of tirofiban and elucidate un","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and Reliability of a Chinese-Tailored Scale for the Evaluation of End-of-Life Care in Dementia Patients.","authors":"Linbing Chen, Ye Ouyang, Chunyu Cheng, Zhenfei Chen, Liping Wang","doi":"10.12968/hmed.2025.0129","DOIUrl":"https://doi.org/10.12968/hmed.2025.0129","url":null,"abstract":"<p><p><b>Aims/Background</b> Highly valid and reliable instruments for evaluating end-of-life care for dementia patients and caregivers are lacking in clinical settings, hampering the progress of pertinent research on palliative care in China. Therefore, the present work focused on assessing the adaptability and reliability of the Chinese version of the End-of-Life Care in Dementia (EOLD) scale in evaluating nursing home caregivers who have cared for advanced dementia patients. <b>Methods</b> A convenience sample of 170 caregivers was recruited from five nursing homes. The data collection instruments included a demographic form and the Chinese version of the EOLD scale. The Chinese version of the EOLD scale comprises three subscales: Satisfaction with Care at the End of Life in Dementia (SWC-EOLD); Symptom Management at the End of Life in Dementia (SM-EOLD), which includes further scales for psychological symptoms and physical symptoms; and the Comfort Assessment in Dying with Dementia (CAD-EOLD), which encompasses further evaluation scales for physical distress, dying symptoms, well-being, and emotional distress. <b>Results</b> The reliability of all the scales ranged from satisfactory to good, with SWC-EOLD's α = 0.806, SM-EOLD's α = 0.879, and CAD-EOLD's α = 0.827. <b>Conclusion</b> In this study, a preliminary reliability assessment on the Chinese version of the EOLD scale was conducted, revealing that the three subscales exhibit strong internal consistency in reliability and structural validity. These results further confirm the applicability of the EOLD scale in dementia research within the context of palliative care.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal Topography Parameters and Tear Film Break-up Characteristics in Keratoconus Patients.","authors":"Dan Wu, Jiaxu Hong, Suqian Wu, Jianjiang Xu","doi":"10.12968/hmed.2024.0825","DOIUrl":"https://doi.org/10.12968/hmed.2024.0825","url":null,"abstract":"<p><p><b>Aims/Background</b> Previous studies have found that keratoconus (KC) patients are highly susceptible to dry eye disease (DED); however, the specific relationship between KC and DED has not been thoroughly investigated. This study aims to investigate the corneal topography parameters and tear film (TF) break-up characteristics in KC patients with and without DED. <b>Methods</b> This cross-sectional, single-masked study consisted of 44 KC patients (44 eyes; KC group) and 31 normal individuals (31 eyes; control group). All the participants were recruited from the Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University (Shanghai, China) from February 2018 to January 2023. They underwent a routine ophthalmic examination, ocular surface disease index questionnaire, corneal fluorescein staining, and Schirmer I test. Additionally, the participants were examined using the Oculus Keratograph® (OCULUS Inc., Arlington, TX, USA) to determine their corneal topography, noninvasive TF break-up time, and TF break-up point. The KC patients were further divided into KC-DED and KC-non-DED subgroups to analyze the impact of KC on TF characteristics and the incidence of DED. Finally, the relationship between the TF break-up point and the maximum cornea curvature quadrant was investigated. <b>Results</b> In the KC group, 21 patients (21 eyes; 47.72%) were diagnosed with DED. The KC-DED and KC-non-DED subgroups exhibited significantly different maximum keratometry (Kmax, <i>p</i> = 0.021), index of surface variance (<i>p</i> = 0.048), and index of height decentration (<i>p</i> = 0.011) values. The logistic model showed a strong correlation between KC-DED incidence and Kmax value (odds ratio = 1.169, 95% confidence interval: 1.020-1.340, <i>p</i> = 0.025). Moreover, the occurrence of DED increased from 36.67% to 71.43% when the Kmax was >52.00 D (χ² = 4.623, <i>p</i> = 0.031). Furthermore, TF was more prone to break-up in the maximum corneal curvature quadrant in the KC group than in the control group (<i>p</i> < 0.001). <b>Conclusion</b> TF should be closely monitored in KC patients, as they are highly prone to DED incidence (Kmax >52.00 D) and experience initial TF break-up in the maximum corneal curvature quadrant.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Functional Assessment.","authors":"Stephen Richard Waite, Duncan Hargreaves","doi":"10.12968/hmed.2024.0811","DOIUrl":"10.12968/hmed.2024.0811","url":null,"abstract":"<p><p>Perioperative functional assessment is used to inform perioperative risk estimation and to target interventions such as prehabilitation, particularly in higher-risk cohorts. There are a variety of measures used and practice is variable. UK national guidance recommends cardiopulmonary exercise testing (CPET) or alternative objective measures when reduced functional capacity is identified on screening.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706387","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":"Serum Neuron-Specific Enolase and High-Sensitivity C-Reactive Protein Expression Levels and Their Clinical Significance in Patients With Alzheimer's Disease.","authors":"Zhangning Zhou, Feimin Zhao","doi":"10.12968/hmed.2025.0074","DOIUrl":"https://doi.org/10.12968/hmed.2025.0074","url":null,"abstract":"<p><p><b>Aims/Background</b> Alzheimer's disease (AD) is a degenerative disease of the central nervous system. Identifying effective and highly specific serum biomarkers is crucial for the early diagnosis and therapeutic monitoring of AD. This study aimed to explore the serum levels of neuron-specific enolase (NSE) and high-sensitivity C-reactive protein (hs-CRP) and their clinical significance in AD patients. <b>Methods</b> This retrospective study recruited 112 AD patients hospitalized between June 2021 and June 2023 as an AD group. For comparison, 80 healthy individuals who underwent physical examination during the same period were selected as the control group. The levels of NSE and hs-CRP were assessed using enzyme-linked immunosorbent assay (ELISA). The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were also determined using ELISA. Furthermore, the severity of cognitive impairment was evaluated using the Mini-mental State Examination (MMSE) score, the Global Deterioration Scale (GDS), and the Clinical Dementia Rating Scale (CDR). Pearson correlation analysis was used to analyze the correlation between serum NSE and hs-CRP levels and disease-related indicators in the AD group, and the receiver operating characteristic (ROC) was used to analyze their diagnostic efficacy. <b>Results</b> The AD group exhibited significantly higher GDS and CDR scores, as well as serum NSE and hs-CRP levels, and significantly lower MMSE scores compared to the control group (<i>p</i> < 0.001). GDS and CDR scores, and serum NSE and hs-CRP levels were significantly higher in the moderate-to-severe group than in the mild group, and significantly lower MMSE scores (<i>p</i> < 0.001). Pearson correlation analysis revealed that serum NSE and hs-CRP levels were negatively correlated with MMSE scores in AD patients (<i>p</i> < 0.05) and were positively correlated with GDS and CDR scores (<i>p</i> < 0.05). ROC curve analysis showed that the serum NSE (area under the curve [AUC]: 0.856, 95% CI 0.787-0.925, <i>p</i> < 0.001) and hs-CRP (AUC: 0.728, 95% CI 0.631-0.825, <i>p</i> < 0.001) levels individually had significant diagnostic efficacy for AD; however, the combined assessment of their levels (AUC: 0.879, 95% CI 0.815-0.943, <i>p</i> < 0.001) demonstrated higher diagnostic efficacy than hs-CRP alone (<i>p</i> < 0.001). <b>Conclusion</b> Serum NSE and hs-CRP levels are closely associated with the cognitive function in AD patients, and their combined evaluation exhibits a higher diagnostic value.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706392","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":"Reactivation of Epstein-Barr Virus Among Neurointensive Care Patients: A Prospective Observational Study.","authors":"Xiaojiao Xu, Jiahua Zhao, Xiaosa Yang, Rui Liu, Yan Wang, Yubao Ma, Mianwang He, Fei Yang, Jiatang Zhang","doi":"10.12968/hmed.2025.0152","DOIUrl":"10.12968/hmed.2025.0152","url":null,"abstract":"<p><p><b>Aims/Background</b> Approximately 90% of the population is seropositive for Epstein-Barr virus (EBV), and its reactivation has been reported to be associated with increased morbidity and mortality in critically ill patients. However, the clinical significance of EBV reactivation among patients in neurointensive care units (NICU) has rarely been investigated. This study aimed to demonstrate the association between EBV reactivation and clinical outcomes in neurocritically ill patients. <b>Methods</b> Clinical data were collected from 179 patients admitted to the NICU of the Chinese PLA General Hospital between October 2021 and January 2024. These patients were divided into two groups based on EBV infection status: the EBV reactivation group (<i>n</i> = 80) and the non-EBV reactivation group (<i>n</i> = 99). Gender, age, laboratory test results, diagnosis and functional prognosis were compared between the two groups to evaluate the clinical significance of EBV reactivation in neurocritically ill patients. <b>Results</b> A total of 179 patients were included in this study, of which 80 (44.69%) had EBV reactivation. Patients with EBV reactivation demonstrated higher levels of serum lactic dehydrogenase (32.50% versus 16.16%, <i>p</i> = 0.010), C-reactive protein (36.25% versus 21.21%, <i>p</i> = 0.026), immunoglobulin G (26.25% versus 12.12%, <i>p</i> = 0.015), cerebrospinal fluid leukocyte counts (67.50% versus 47.47%, <i>p</i> = 0.007), interleukin-6 (68.75% versus 42.42%, <i>p</i> < 0.001), and interleukin-10 (33.75% versus 17.17%, <i>p</i> = 0.010). There was no significant difference in 6-month mortality between patients with and without EBV reactivation (7.50% versus 3.03%, <i>p</i> = 0.302). However, patients with EBV reactivation exhibited poorer functional prognosis compared to those without (42.50% versus 26.26%, <i>p</i> = 0.022). Central nervous system lymphoproliferative disorders are more common in patients with EBV reactivation. <b>Conclusion</b> EBV reactivation is frequent among immunocompetent, neurocritically ill patients and is associated with poorer functional prognosis but not with increased 6-month mortality. Furthermore, EBV reactivation is associated with systemic inflammation.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-14"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706390","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":"Exploration of the Therapeutic Efficacy of Azithromycin Sequential Therapy in Children With Mycoplasma Pneumonia.","authors":"Heng Huang, Fanglu Ji","doi":"10.12968/hmed.2025.0005","DOIUrl":"https://doi.org/10.12968/hmed.2025.0005","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Mycoplasma pneumonia (MP) is a relatively common infection in children. While sequential treatment with azithromycin is a commonly used regimen, therapeutic response varies substantially among children. This study aims to establish a column chart prediction model based on the clinical characteristics and pathogenic outcomes of Mycoplasma pneumonia in children, enabling accurate decision-making for clinical interventions. &lt;b&gt;Methods&lt;/b&gt; This retrospective study analysed the clinical data of 234 children with Mycoplasma pneumonia admitted to Cangnan Hospital of Wenzhou Medical University between March 2021 and October 2023. The data included general information, clinical symptoms, laboratory examination, and pathogenic profiles. The children were randomly divided into a training set (n = 164) and a validation set (n = 70) in a 7:3 ratio. Based on the efficacy of azithromycin sequential therapy, children in the training set were further divided into a poor efficacy group (n = 36) and a good efficacy group (n = 128). Independent risk factors for Mycoplasma pneumonia in the training set were identified using multiple logistic regression analysis. Furthermore, a column chart prediction model was constructed, and the model's performance was evaluated using receiver operating characteristic (ROC) curve analysis, followed by calibration curves. The predictive model was validated using an independent validation set, and decision curve analysis (DCA) assessed the model's clinical utility. &lt;b&gt;Results&lt;/b&gt; In the training set, 36 cases (21.95%) showed poor therapeutic effects, while 24 cases (34.29%) in the validation set exhibited poor treatment response. There was no significant difference in clinical data between the two groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Univariate analysis showed significant differences (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) across several factors, such as fever duration, cough severity, presence of pulmonary wet rales, white blood cell count, C-reactive protein (CRP) levels, Mycoplasma antibody titers, and Mycoplasma nucleic acid test findings among different treatment groups. Logistic regression analysis revealed prolonged fever duration, severe cough, presence of wet rales in the lungs, high white blood cell count, high CRP levels, high Mycoplasma antibody titers, and positive Mycoplasma nucleic acid test as independent risk factors of poor efficacy for azithromycin sequential treatment (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The Concordance index (C-index) of the column chart model was 0.804 in the training set and 0.861 in the validation set. The average absolute errors of the predicted and actual values were 0.129 and 0.081, respectively. The Hosmer-Lemeshow test results were χ&lt;sup&gt;2&lt;/sup&gt; = 10.288, &lt;i&gt;p&lt;/i&gt; = 0.245 for the training set and χ&lt;sup&gt;2&lt;/sup&gt; = 7.922, &lt;i&gt;p&lt;/i&gt; = 0.441 for the validation set, suggesting good model calibration. The ROC curve analysis revealed that the area under the ROC curve (AUC) for predicting the poor efficacy of azithromyc","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483189","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}