British journal of hospital medicine最新文献

{"title":"A Retrospective Comparative Study of Sodium Ferulate Combined With Methylcobalamin for Oxaliplatin-Induced Peripheral Neuropathy in Patients With Colorectal Cancer.","authors":"Baojun Min, Li Wan, Hongyong He, Jie Chen, Zhonglu Jian, Rong Chen","doi":"10.31083/BJHM55138","DOIUrl":"10.31083/BJHM55138","url":null,"abstract":"<p><strong>Aims/background: </strong>Oxaliplatin-induced peripheral neuropathy (OIPN) is a common dose-limiting toxic effect of oxaliplatin-based chemotherapy for colorectal cancer (CRC), severely affecting patients' quality of life and treatment adherence. Currently, effective therapeutic options for OIPN are limited. This study aimed to investigate the clinical efficacy and safety of sodium ferulate combined with methylcobalamin in the treatment of OIPN in CRC patients.</p><p><strong>Methods: </strong>In this retrospective cohort study, 280 CRC patients diagnosed with OIPN following oxaliplatin-based chemotherapy at Qianxi People's Hospital between January 2020 and December 2024 were enrolled. Based on treatment regimen, patients were assigned to an observation group (sodium ferulate combined with methylcobalamin, <i>n</i> = 152) or a control group (methylcobalamin alone, <i>n</i> = 128). All patients received basic nursing care. Treatment duration was 8 weeks for both groups. Outcomes compared between groups included National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) neurotoxicity grading, nerve conduction velocity (NCV), and quality of life (QoL) scores assessed before treatment, at 4 weeks, and at 8 weeks post-treatment. Clinical efficacy was evaluated after 8 weeks, and changes in hematological parameters and liver/kidney function indicators were monitored.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the two groups (<i>p</i> > 0.05). While no significant difference in neurotoxicity grading was observed at 4 weeks (<i>p</i> > 0.05), the observation group demonstrated significantly better NCI-CTCAE grades than the control group at 8 weeks (<i>p</i> < 0.05). NCV assessments revealed that motor and sensory NCVs of the median and common peroneal nerves in the observation group were significantly improved compared to both baseline levels and the control group at 4 and 8 weeks (<i>p</i> < 0.05). After 8 weeks, the overall clinical efficacy rate was significantly higher in the observation group (89.47%) than in the control group (67.97%) (<i>p</i> < 0.05). QoL scores across all functional domains (physical, role, cognitive, emotional, and social) were significantly better in the observation group compared to the control group at 8 weeks (<i>p</i> < 0.05). Hematological and liver/kidney function parameters remained within normal ranges and showed no significant intergroup differences post-treatment (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The combination of sodium ferulate and methylcobalamin is superior to methylcobalamin monotherapy in alleviating the severity of neurotoxicity, improving nerve conduction function, enhancing clinical efficacy, and promoting quality of life in CRC patients with OIPN, with a comparable safety profile. It represents a promising clinical treatment option for OIPN.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55138"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396083","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 Updates in IgG4-Related Pancreatic and Hepatobiliary Disease.","authors":"Hoyun Lee, Rodrigo Vieira Motta, Emma L Culver","doi":"10.31083/BJHM55132","DOIUrl":"10.31083/BJHM55132","url":null,"abstract":"<p><p>Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibro-inflammatory immune-mediated condition. The Pancreato-Hepato-Biliary subtype is the most frequent phenotype. The subtype encompasses immunoglobulin G4 (IgG4)-related pancreatitis (autoimmune pancreatitis type 1), IgG4-related cholangitis, IgG4-related hepatopathy and IgG4-related cholecystitis. The condition is characterised by multi-organ involvement and unpredictable recurrent disease flares, which lead to organ damage and failure in the absence of early recognition and adequate treatment. It is associated with a 2-fold increase in mortality and higher incidences of malignancies, such as solid-organ tumours and lymphoma. Diagnostic delays result from the lack of awareness and the absence of a single diagnostic test, leading to multiple generalist and specialist visits prior to the initiation of therapy. There have been major advances in the management of IgG4-RD to include a move to more targeted therapies. This includes the novel cluster of differentiation 19 (CD19)-depletion therapy inebilizumab, which has been approved in the United States, Europe and Japan for the treatment of IgG4-RD. This review highlights crucial diagnostic clues and emerging therapeutic advances in the evolving field of the Pancreato-Hepato-Biliary subtype of IgG4-RD.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55132"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395818","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":"Obstetric Medicine and Intensive Care: Maternal Critical Illness in Practice.","authors":"Juliet Bottle, Charlotte Frise","doi":"10.31083/BJHM55139","DOIUrl":"10.31083/BJHM55139","url":null,"abstract":"<p><p>Pregnant and postpartum women make up a small proportion of intensive care unit (ICU) admissions, but they require distinct, carefully adapted approaches to care. This review outlines these challenges and proposes general principles to address them, emphasising consultant-level multidisciplinary input and alignment with national standards for service organisation and escalation of care. Pregnancy-related physiological changes affect haemodynamics, ventilation, and renal function-all of which have implications for monitoring, treatment thresholds, and drug selection. The practical aspects of organ support are discussed, as well as imaging and contrast safety. It is emphasised that maternal stabilisation and timely critical diagnosis should take priority, and that pregnant women must not be disadvantaged in their access to life-saving interventions. The conditions that may lead to critical illness in obstetric patients are reviewed, with a discussion of the current evidence and clinical practice. Attention to psychological well-being and lactation support is underscored as an essential component of holistic recovery and long-term outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55139"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396063","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":"Meeting Young People Where They Are: Approaching Communication With Young People and Practical Tips to Engage Them in Their Care.","authors":"Rebecca J Nock, Rachel S Tattersall","doi":"10.31083/BJHM53741","DOIUrl":"10.31083/BJHM53741","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"53741"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396049","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":"Case Report: Legionella Necrotising Pneumonia in a Diabetic Patient-A Clue to Co-Infection?","authors":"Ami Schattner, Ina Dubin, Livnat Uliel","doi":"10.31083/BJHM55140","DOIUrl":"10.31083/BJHM55140","url":null,"abstract":"<p><strong>Aims/background: </strong>Computerised tomography findings in patients with <i>Legionella</i> pneumonia usually demonstrate airspace consolidation and/or ground glass opacities (GGO). Associated necrosis, abscess formation, or cavitation are usually limited to patients who are clearly immunocompromised.</p><p><strong>Case presentation: </strong>We report a recent patient who was immunocompetent, other than controlled type 2 diabetes, and had hospital-acquired severe <i>Legionella</i> pneumonia. The patient was found to have pulmonary necrosis and bacterial co-infection with <i>Acinetobacter</i>.</p><p><strong>Results: </strong>The patient underwent endotracheal intubation and mechanical ventilation, and was treated with intravenous azithromycin and colistin. However, the patient's condition continued to deteriorate, and she eventually died from multiple organ failure.</p><p><strong>Conclusion: </strong>The unusual appearance of necrotising pneumonia in Legionnaires' disease patients without frank immunosuppression may signify a co-infection with other microorganisms, which must be sought.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55140"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395844","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":"Effectiveness of a Bobath Concept-Based Nursing Model on Neurological Function and Independence in Daily Living After Arteriovenous Malformation Resection: A Retrospective Study.","authors":"Fen Zhang, Xiaoxue Xu, Ling Zhang","doi":"10.31083/BJHM55137","DOIUrl":"10.31083/BJHM55137","url":null,"abstract":"<p><strong>Aims/background: </strong>Arteriovenous malformation (AVM) resection may result in postoperative neurological deficits and reduced capacity to perform daily activities. This study aims to investigate the impact of a Bobath concept-based nursing model on neurological function and independence in daily living following AVM resection.</p><p><strong>Methods: </strong>We retrospectively included 91 brain AVM patients who underwent AVM resection at The Fourth Hospital of Hebei Medical University between April 2024 and April 2025. Based on the nursing model provided, patients were divided into a Bobath care group (n = 45) and a routine care group (n = 46). Neurological function, motor performance, health-related quality of life, hospital stay duration, postoperative complications, and nursing satisfaction were assessed preoperatively and postoperatively.</p><p><strong>Results: </strong>Compared with the routine care group, the Bobath care group exhibited significantly lower National Institutes of Health Stroke Scale (NIHSS) scores and improved modified Rankin Scale (mRS) scores postoperatively (<i>p</i> < 0.05). Fugl-Meyer Assessment (FMA) scores for upper and lower limb motor function, as well as total motor mobility, were higher in the Bobath care group (<i>p</i> < 0.05). Length of hospital stay and recovery milestones were reduced (<i>p</i> < 0.05). 36-Item Short Form Health Survey (SF-36) physical and mental health domain scores improved more markedly in the Bobath care group (<i>p</i> < 0.05). Complication rates were lower (<i>p</i> < 0.05), and patient satisfaction was higher (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The Bobath concept-based nursing model improves neurological function, motor ability, and quality of life in patients undergoing AVM resection. It also reduces complications, shortens hospitalization, and improves rehabilitation outcomes, indicating significant clinical value for postoperative AVM care. Further multicenter and prospective studies are needed to validate its long-term efficacy.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55137"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395929","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 Empowerment-Based Rehabilitation on Patients Following Lumbar Disc Herniation Surgery: A Retrospective Cohort Study.","authors":"Xin Zhang, Xia Yang","doi":"10.31083/BJHM50685","DOIUrl":"10.31083/BJHM50685","url":null,"abstract":"<p><strong>Aims/background: </strong>Lumbar disc herniation is a common chronic musculoskeletal condition requiring long-term postoperative rehabilitation. However, implementation of existing nursing models is often discontinuous and they are generally not patient-centered. This study aimed to explore the effects of a continuous rehabilitation intervention program based on empowerment theory on pain severity, lumbar function, self-efficacy and quality of life in postoperative patients with lumbar disc herniation from the perspective of internal medicine and chronic disease management.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Cangnan County Hospital of Traditional Chinese Medicine, including 147 patients who underwent single-level lumbar discectomy between January 2023 and June 2025. The patients underwent single-level lumbar discectomy of lumbar disc prolapse and were divided into a control group (n = 75) and an intervention group (n = 72). The control group received routine nursing and health education postoperatively. On the basis of routine nursing, the intervention group received continuous rehabilitation intervention based on empowerment theory for 3 months. The intervention program consisted of three core components: (1) in-hospital empowerment; (2) post-discharge empowerment support (1-12 weeks after surgery); (3) digital empowerment support via the WeChat platform. The effects of the intervention were evaluated before and 3 months after the intervention using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), General Self-Efficacy Scale (GSES), and 36-Item Short Form Health Survey (SF-36).</p><p><strong>Results: </strong>Baseline characteristics were comparable between the two groups (all <i>p</i> > 0.05). After the intervention, the intervention group showed significantly greater improvements than the control group, with significantly lower median VAS score (3.00 vs. 4.00, <i>p</i> < 0.001) and median ODI score (28.00 vs. 32.00, <i>p</i> = 0.005), as well as significantly higher median GSES score, SF-36 Bodily Pain (BP) score, and Role-Physical (RP) score (all <i>p</i> < 0.001). The overall nursing satisfaction rate was also significantly higher in the intervention group (93.06% vs. 78.67%, <i>p</i> = 0.013).</p><p><strong>Conclusion: </strong>The empowerment-based continuous rehabilitation intervention was associated with lower pain, better lumbar function, enhanced self-efficacy, and improved quality of life in postoperative patients with lumbar disc herniation, offering a patient-centered strategy for long-term rehabilitation management from the perspective of internal medicine and chronic disease care.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"50685"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396078","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 Surgical Training: A Comprehensive Update on Simulation, Assessment, and Emerging Innovations.","authors":"Rushabh Shah, Yash Verma, Daniyal Ashraf, Umar Shifas, Kai Yuen Wong","doi":"10.31083/BJHM55134","DOIUrl":"10.31083/BJHM55134","url":null,"abstract":"<p><p>Artificial intelligence (AI) is reshaping surgical education. This article summarises recent developments across simulation, assessment and recruitment. It also examines the barriers and governance challenges of implementation, and considers emerging technologies such as digital twins, generative AI and intra-operative decision-support that are likely to shape the future of surgical training.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55134"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395614","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":"Diagnostic Value of SCC-Ag Combined With CYFRA 21-1 in Predicting Long-Term Lymph Node Metastasis After Cervical Cancer Surgery.","authors":"Kaizhen Xu, Guilan Zhang","doi":"10.31083/BJHM55133","DOIUrl":"10.31083/BJHM55133","url":null,"abstract":"<p><strong>Aims/background: </strong>Lymph node metastasis (LNM) is an important prognostic factor of cervical cancer, significantly impacting patient outcomes and treatment strategies. Current methods for predicting LNM after surgery are limited, necessitating the identification of reliable biomarkers. This study aimed to evaluate the diagnostic value of serum squamous cell carcinoma antigen (SCC-Ag) combined with cytokeratin fragment 21-1 (CYFRA 21-1) for identifying long-term LNM after cervical cancer surgery.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted on 138 patients with primary cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy between May 2020 and May 2023. Patients were followed up for at least two years post-surgery, with a focus on their LNM status. Serum SCC-Ag and CYFRA 21-1 levels were measured using an electrochemiluminescence immunoassay analyzer. Patients were classified into two groups based on the presence of LNM detected during follow-up: without LNM and with LNM groups. The cohort was further divided into a training set (<i>n</i> = 85) and a test set (<i>n</i> = 53). Univariate and multivariate logistic regression analysis identified significant predictors, which were used to construct a nomogram diagnostic model. Model performance was evaluated using calibration curves, receiver operating characteristic curve analysis, and decision curve analysis.</p><p><strong>Results: </strong>Elevated serum SCC-Ag and CYFRA 21-1 levels were observed in patients with LNM compared to those without. Multivariate logistic regression identified both of these markers as independent predictors of long-term LNM (all <i>p</i> < 0.05). The constructed nomogram model integrating these markers demonstrated high discriminatory power, with an area under the curve of 0.869 in the training set and 0.861 in the test set.</p><p><strong>Conclusion: </strong>Serum SCC-Ag and CYFRA 21-1 levels may serve as valuable biomarkers for predicting long-term LNM after cervical cancer surgery. A nomogram model integrating these markers provides enhanced diagnostic accuracy and could potentially guide personalized treatment strategies.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55133"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395926","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":"Methotrexate Neurological Toxicities: Current State-of-the-Art.","authors":"Abbie Wilson, Christina Halsey","doi":"10.31083/BJHM55135","DOIUrl":"10.31083/BJHM55135","url":null,"abstract":"<p><p>Methotrexate is a highly effective anti-folate drug, used for a range of oncological and inflammatory conditions. Toxic effects of methotrexate on the bone marrow, mucosa, liver and kidneys are widely appreciated; however, clinicians may be less familiar with neurotoxic side-effects. Neurotoxicity is primarily reported in those receiving high-dose or intrathecal methotrexate; however, it may occur in patients receiving low-dose treatment. Symptoms range from acute headache/somnolence, sub-acute onset of seizures/stroke-like symptoms, to long-term cognitive and behavioural difficulties. Stroke-like symptoms occur several days after administration when the patient may be out of the hospital, meaning that acute care providers must be able to recognise and appropriately manage these conditions. The mechanism by which methotrexate causes neurotoxicity remains poorly understood, and although some treatments and preventative agents have been identified, they lack robust evidence at present, representing a key area for future research. This article aims to provide a state-of-the-art review of methotrexate neurotoxicity, which will increase physician awareness of this condition, its presentation, and to highlight evidence and research gaps relating to treatment and prevention.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 6","pages":"55135"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396102","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}