British journal of hospital medicine最新文献

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Application Value of Deep Learning-Based AI Model in the Classification of Breast Nodules. 基于深度学习的人工智能模型在乳腺结节分类中的应用价值
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-15 DOI: 10.12968/hmed.2025.0078
Shaogang Zhi, Xiaoxia Cai, Wei Zhou, Peipei Qian
{"title":"Application Value of Deep Learning-Based AI Model in the Classification of Breast Nodules.","authors":"Shaogang Zhi, Xiaoxia Cai, Wei Zhou, Peipei Qian","doi":"10.12968/hmed.2025.0078","DOIUrl":"https://doi.org/10.12968/hmed.2025.0078","url":null,"abstract":"<p><p><b>Aims/Background</b> Breast nodules are highly prevalent among women, and ultrasound is a widely used screening tool. However, single ultrasound examinations often result in high false-positive rates, leading to unnecessary biopsies. Artificial intelligence (AI) has demonstrated the potential to improve diagnostic accuracy, reducing misdiagnosis and minimising inter-observer variability. This study developed a deep learning-based AI model to evaluate its clinical utility in assisting sonographers with the Breast Imaging Reporting and Data System (BI-RADS) classification of breast nodules. <b>Methods</b> A retrospective analysis was conducted on 558 patients with breast nodules classified as BI-RADS categories 3 to 5, confirmed through pathological examination at The People's Hospital of Pingyang County between December 2019 and December 2023. The image dataset was divided into a training set, validation set, and test set, and a convolutional neural network (CNN) was used to construct a deep learning-based AI model. Patients underwent ultrasound examination and AI-assisted diagnosis. The receiver operating characteristic (ROC) curve was used to analyse the performance of the AI model, physician adjudication results, and the diagnostic efficacy of physicians before and after AI model assistance. Cohen's weighted Kappa coefficient was used to assess the consistency of BI-RADS classification among five ultrasound physicians before and after AI model assistance. Additionally, statistical analyses were performed to evaluate changes in BI-RADS classification results before and after AI model assistance for each physician. <b>Results</b> According to pathological examination, 765 of the 1026 breast nodules were benign, while 261 were malignant. The sensitivity, specificity, and accuracy of routine ultrasonography in diagnosing benign and malignant nodules were 80.85%, 91.59%, and 88.31%, respectively. In comparison, the AI system achieved a sensitivity of 89.36%, specificity of 92.52%, and accuracy of 91.56%. Furthermore, AI model assistance significantly improved the consistency of physicians' BI-RADS classification (<i>p</i> < 0.001). <b>Conclusion</b> A deep learning-based AI model constructed using ultrasound images can enhance the differentiation between benign and malignant breast nodules and improve classification accuracy, thereby reducing the incidence of missed and misdiagnoses.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483089","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}
引用次数: 0
Bidirectional Causal Relationship Between Myopia and Neurodegenerative Diseases: Two-Sample Mendelian Randomization Analyses. 近视与神经退行性疾病的双向因果关系:双样本孟德尔随机化分析。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-18 DOI: 10.12968/hmed.2025.0183
Yuanyuan Fan, Zhijie Wang, Mengai Wu, Li Lin, Lifeng Chen, Bin Zheng
{"title":"Bidirectional Causal Relationship Between Myopia and Neurodegenerative Diseases: Two-Sample Mendelian Randomization Analyses.","authors":"Yuanyuan Fan, Zhijie Wang, Mengai Wu, Li Lin, Lifeng Chen, Bin Zheng","doi":"10.12968/hmed.2025.0183","DOIUrl":"https://doi.org/10.12968/hmed.2025.0183","url":null,"abstract":"<p><p><b>Aims/Background</b> Myopia is highly prevalent in certain neurodegenerative diseases (NDDs), and both conditions demonstrate genetic susceptibility. This study investigated the potential bidirectional causal relationships between myopia and four NDDs, Parkinson's disease (PD), Alzheimer's disease (AD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS), using Mendelian randomization (MR). We aimed to determine whether myopia contributes to the risk of NDDs and vice versa. <b>Methods</b> We analyzed data from two independent, large-scale genome-wide association study (GWAS) cohorts on myopia, comprising 212,571 participants in the first cohort (finn-b-H7_MYOPIA) and 95,619 in the second (GCST009521). GWAS summary statistics for the four NDDs, encompassing 589,439 samples, were also incorporated. Bidirectional MR was employed to investigate causal relationships between myopia and each of the four NDDs. The inverse variance-weighted (IVW) method served as the primary analytical approach. Sensitivity analyses, including MR-Egger regression, weighted median, weighted mode, and simple mode, were conducted to assess the robustness of the findings. Horizontal pleiotropy was evaluated using the MR-Egger regression intercept test and the Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) global test, while heterogeneity was assessed via Cochran's Q test. Leave-one-out analyses were conducted to evaluate the influence of individual single nucleotide polymorphisms (SNPs). Odds ratios (ORs) with 95% confidence intervals (CIs) were reported, and statistical significance was set at <i>p</i> < 0.05. <b>Results</b> MR analyses identified no evidence of a causal relationship between myopia and refractive error and increased risk of any of the four NDDs (all <i>p</i> > 0.05). Similarly, none of the NDDs were associated with an increased risk of myopia or refractive error (all <i>p</i> > 0.05). Sensitivity analyses revealed no SNPs with significant influence on the causal associations (all <i>p</i> > 0.05), supporting the robustness of the findings. <b>Conclusion</b> This study provides no evidence of a bidirectional causal relationship between myopia and the four NDDs among individuals of European ancestry. Future research should extend beyond direct causal inference to investigate potential mediating biological mechanisms.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483181","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}
引用次数: 0
Enabling Vaccine Uptake: Strategies for the Public Health Sector. 促进疫苗吸收:公共卫生部门战略。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-05 DOI: 10.12968/hmed.2024.0669
Kirsty Emery, Jaspriya Dhaliwal, Rebecca Light, Matthias Eberl, Sheena M Cruickshank
{"title":"Enabling Vaccine Uptake: Strategies for the Public Health Sector.","authors":"Kirsty Emery, Jaspriya Dhaliwal, Rebecca Light, Matthias Eberl, Sheena M Cruickshank","doi":"10.12968/hmed.2024.0669","DOIUrl":"https://doi.org/10.12968/hmed.2024.0669","url":null,"abstract":"<p><p>Safe and effective vaccines have been instrumental in controlling and mitigating some of the most contagious and devastating diseases throughout history, ranging from smallpox, polio and diphtheria to measles, flu and coronavirus disease 2019 (COVID-19). Despite their proven success, vaccination rates often fall short of the World Health Organisation's recommendations, facing persistent challenges. This review explores strategies to enhance vaccine uptake, with a particular focus on the UK context, by examining potential barriers, effective interventions and the vital role of various stakeholders. Boosting vaccine uptake requires a comprehensive approach that tackles issues such as vaccine hesitancy, improves accessibility, builds public trust, and utilises effective communication. By implementing targeted strategies, public bodies, scientists and healthcare professionals can work together to improve vaccination rates and safeguard communities against preventable diseases. Continuous evaluation and adaptation of these strategies are crucial to ensure their effectiveness and relevance in addressing the evolving challenges of vaccine uptake.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483186","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}
引用次数: 0
Evaluation of the Association of the Total Cholesterol-to-High-Density Lipoprotein Cholesterol Ratio and Triglyceride-Glucose Index With Coronary Artery Disease and Their Diagnostic Utility. 评价总胆固醇-高密度脂蛋白胆固醇比值和甘油三酯-葡萄糖指数与冠状动脉疾病的关系及其诊断价值。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-13 DOI: 10.12968/hmed.2024.1038
Na Qu, Qian Li, Xin Bai, Ruixiao Wang
{"title":"Evaluation of the Association of the Total Cholesterol-to-High-Density Lipoprotein Cholesterol Ratio and Triglyceride-Glucose Index With Coronary Artery Disease and Their Diagnostic Utility.","authors":"Na Qu, Qian Li, Xin Bai, Ruixiao Wang","doi":"10.12968/hmed.2024.1038","DOIUrl":"https://doi.org/10.12968/hmed.2024.1038","url":null,"abstract":"<p><p><b>Aims/Background</b> This study aimed to examine the relationship between coronary heart disease (CHD) severity, the triglyceride-glucose (TyG) index, and the total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio while also assessing their diagnostic significance. A deeper understanding of the pathophysiology of CHD enables early detection, more precise screening of high-risk groups, and the development of more targeted treatment plans. <b>Methods</b> A total of 196 patients with suspected acute coronary syndrome (ACS) were included in this retrospective study, of whom 134 were diagnosed with CHD. Clinical, laboratory and coronary angiography (CAG) data were collected. CHD patients were classified into low-, medium-, and high-risk groups according to their Synergy Between Percutaneous Coronary Intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) scores. The correlations and clinical relevance of the TyG index and TC/HDL-C ratio were further examined by stratifying patients into single-, dual-, and multi-vessel groups according to the number of lesions. A <i>p</i>-value < 0.05 was considered statistically significant. <b>Results</b> Relative to non-CHD patients, CHD patients were significantly older and exhibited higher levels of TC, Triglycerides (TG), TyG index, and TC/HDL-C ratio (<i>p</i> < 0.05). Both the TyG index and TC/HDL-C ratio were independently associated with the risk of coronary atherosclerosis in univariate and multivariate logistic regression analyses (<i>p</i> < 0.05). The multi-vessel disease group had significantly higher TyG index and TC/HDL-C ratio values compared to the single- and dual-vessel groups (<i>p</i> < 0.05). Additionally, SYNTAX scores showed a significantly positive correlation with both indices (<i>p</i> < 0.05). The area under the curve (AUC) values for the TC/HDL-C ratio and TyG index were 0.918 and 0.893, respectively, both significantly greater than 0.5 (<i>p</i> < 0.05). <b>Conclusion</b> The TC/HDL-C ratio and TyG index are associated with the risk of CHD, with their values rising as coronary artery disease severity progresses. These indices may serve as valuable tools for predicting clinical severity in patients with coronary artery lesions.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483187","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}
引用次数: 0
The Clinical and Economic Value of Follow-on Biologics: Biosimilars, Biobetters, and Bioparallels. 后续生物制剂的临床和经济价值:生物类似药、生物改良药和生物平行药。
IF 1.8 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-04 DOI: 10.12968/hmed.2024.1036
Ivo Abraham, Ansam Nail Beddor, Karen Michelle MacDonald
{"title":"The Clinical and Economic Value of Follow-on Biologics: Biosimilars, Biobetters, and Bioparallels.","authors":"Ivo Abraham, Ansam Nail Beddor, Karen Michelle MacDonald","doi":"10.12968/hmed.2024.1036","DOIUrl":"10.12968/hmed.2024.1036","url":null,"abstract":"<p><p>The advent of biosimilars into the market of biologic treatments less than 20 years ago in Europe and about 10 years ago in the United States heralded a period of rapid and profound changes in biological therapies. While biosimilars where the first disruptors to the biologics market and some lingering concerns have been addressed, they have since been joined by biobetters and bioparallels in a powerful aggregate of follow-on biologics (FOB) competing with originators biologics. Biobetters are drugs derived from existing biological agents, either by design or by coincidence, with improved pharmacological properties or outcomes. Bioparallels are distinct biologic agents in established classes of biological therapeutics (for instance, Programmed Death 1 (PD-1) inhibitors) that mainly compete on price without the burden of demonstrating equivalence in efficacy and safety. Lingering clinical concerns about biosimilars have been addressed. The economic dynamics of a biologics market that includes lower-priced FOBs continues to be demonstrated, especially how the cost-efficiencies from treatment with FOBs enable expanded patient access to and patient equity in biological therapy on a budget-neutral basis. However, this must be considered within a broader context of potential excess FOB capacity in countries with relatively well-funded healthcare systems, the commoditization of FOBs, and associated downward pricing pressures. Positively, however, is how this excess FOB capacity can be parlayed into increased access to biological therapeutics in low- and middle-income countries.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483196","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}
引用次数: 0
Effect of the Preoperative Application of Esketamine on Stress Indicators in Paediatric Patients Undergoing Bronchoalveolar Lavage Under General Anaesthesia. 术前应用艾氯胺酮对全麻支气管肺泡灌洗患儿应激指标的影响。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-18 DOI: 10.12968/hmed.2025.0306
Jizheng Zhang, Jiaming Zheng, Xiaohua Sun, Yi Li, Wanlu Ren
{"title":"Effect of the Preoperative Application of Esketamine on Stress Indicators in Paediatric Patients Undergoing Bronchoalveolar Lavage Under General Anaesthesia.","authors":"Jizheng Zhang, Jiaming Zheng, Xiaohua Sun, Yi Li, Wanlu Ren","doi":"10.12968/hmed.2025.0306","DOIUrl":"https://doi.org/10.12968/hmed.2025.0306","url":null,"abstract":"<p><p><b>Aims/Background</b> To explore the effect of the preoperative administration of esketamine on stress indices in paediatric patients undergoing bronchoalveolar lavage (BAL) under general anaesthesia. <b>Methods</b> A retrospective cohort study was conducted to collect clinical data from children undergoing BAL under general anaesthesia in Tianjin Hospital of Tianjin University between February 2021 and January 2024. The patients were divided into two groups: the reference group (taking no preoperative medications) and the study group (receiving preoperative esketamine). The baseline variables of the two groups were balanced using the 1:1 nearest neighbour matching method of propensity score matching (PSM), and the outcome indicators of the matched cohorts were compared. <b>Results</b> A total of 168 patients were included, including 86 in the reference group and 82 in the study group. After PSM, 46 cases in each group were successfully matched. Results showed that all postoperative stress indicators in the study group were significantly lower than those in the reference group (<i>p</i> < 0.001). The Paediatric Anaesthesia Emergence Delirium (PAED) scores and Face, Legs, Arms, Crying, Consolability (FLACC) scale scores of the children in the study group were significantly lower than those in the reference group (<i>p</i> < 0.01). There was no significant difference in the overall incidence of perioperative adverse reactions between the two groups (<i>p</i> > 0.05). <b>Conclusion</b> The preoperative application of esketamine can reduce the stress response in paediatric patients undergoing BAL under general anaesthesia. This effect is beneficial for enhancing the outcome of surgical treatment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483184","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}
引用次数: 0
Effects and Underlying Mechanism of Vitamin D Combined With rhGH and GnRH-a Therapy on the Growth and Development of Girls With Central Precocious Puberty. 维生素D联合rhGH和GnRH-a治疗对中枢性性早熟女童生长发育的影响及其机制
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-13 DOI: 10.12968/hmed.2024.1016
Haiying Fang, Huiqin Wang, Hongxian Lv
{"title":"Effects and Underlying Mechanism of Vitamin D Combined With rhGH and GnRH-a Therapy on the Growth and Development of Girls With Central Precocious Puberty.","authors":"Haiying Fang, Huiqin Wang, Hongxian Lv","doi":"10.12968/hmed.2024.1016","DOIUrl":"https://doi.org/10.12968/hmed.2024.1016","url":null,"abstract":"<p><p><b>Aims/Background</b> Vitamin D plays a crucial role in regulating puberty development. Furthermore, it is closely associated with the onset and progression of precocious puberty. Therefore, this study aimed to investigate the effects of vitamin D supplementation on growth and development in girls with central precocious puberty (CPP) undergoing recombinant human growth hormone (rhGH) combined with gonadotropin-releasing hormone analogues (GnRH-a) therapy and to analyze its underlying mechanisms. <b>Methods</b> This retrospective study analyzed the clinical data from 100 CPP girls who received rhGH combined with GnRH-a in Jinhua Maternal and Child Health Care Hospital between June 2020 and December 2022. Study participants were divided into the vitamin D supplementation group (VitD group, <i>n</i> = 43) and the non-supplementation group (non-VitD group, <i>n</i> = 57) according to whether vitamin D was supplemented during treatment. Growth and development indicators, including bone age/chronological age (BA/CA), predicted adult height (PAH), Tanner stage, sex hormone levels, and bone mineral density (BMD) of the left heel were compared between the two groups before treatment and 12 months after treatment. <b>Results</b> After 12 months of treatment, the VitD group demonstrated a significantly reduced BA/CA ratio compared to the non-VitD group (<i>p</i> = 0.002). The VitD group had a significantly higher PAH than the non-VitD group (<i>p</i> = 0.009). Furthermore, the comparison of the Tanner stage between the two groups showed a statistically significant difference (<i>p</i> = 0.033). Additionally, the estradiol (E<sub>2</sub>), GnRH excitation test-follicle stimulating hormone (FSH) peak value and GnRH excitation test-luteinizing hormone (LH) peak value were significantly lower in the VitD group than in the non-VitD group (<i>p</i> < 0.001, <i>p</i> = 0.014, <i>p</i> < 0.001). Moreover, the BMD of the left heel in the VitD group significantly increased to that of the non-VitD group following 12 months of treatment (<i>p</i> = 0.005). <b>Conclusion</b> Supplementation of vitamin D during rhGH combined with GnRH-a treatment further enhances the growth and development of CPP girls. This positive impact may be due to its crucial role in inhibiting the growth of breast epithelial cells, reducing sex hormone levels, and reducing treatment-induced BMD.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483185","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}
引用次数: 0
Lean Management and Integrated Care in Europe: An Effective Mix for a Health System. 欧洲的精益管理和综合护理:卫生系统的有效组合。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-04 DOI: 10.12968/hmed.2025.0019
Livio Garattini, Marco Badinella Martini
{"title":"Lean Management and Integrated Care in Europe: An Effective Mix for a Health System.","authors":"Livio Garattini, Marco Badinella Martini","doi":"10.12968/hmed.2025.0019","DOIUrl":"10.12968/hmed.2025.0019","url":null,"abstract":"<p><p>A rational organization of health care services has become a major problem for European countries. Here, we summarize the concepts of lean management (LM) and integrated care (IC) and discuss the major issues to be resolved to make them effective. LM is a systematic approach for reducing waste in a procedure by considering any type of work to be the sum of several processes. The strength of LM lies in involving all employees into a problem-solving approach. IC implies a positive approach against the fragmentation of service provision in order to undermine the silos generated within health services. The success of LM and IC depends on how three major problems will be faced: their holistic application, some baseline training on management and organization provided to health professionals, and the full support of health managers. Future analysis on the organization of health systems should focus on how to improve healthcare services by a full collaboration between health workers.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483193","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}
引用次数: 0
Prevalence and Risk Factors of Preeclampsia in Pregnant Women With Gestational Diabetes Mellitus. 妊娠期糖尿病孕妇先兆子痫的患病率及危险因素
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-20 DOI: 10.12968/hmed.2024.0990
Yufeng Ye, Liuyan Zhang, Yonggui Han, Xialei Yu
{"title":"Prevalence and Risk Factors of Preeclampsia in Pregnant Women With Gestational Diabetes Mellitus.","authors":"Yufeng Ye, Liuyan Zhang, Yonggui Han, Xialei Yu","doi":"10.12968/hmed.2024.0990","DOIUrl":"https://doi.org/10.12968/hmed.2024.0990","url":null,"abstract":"<p><p><b>Aims/Background</b> Pregnant women with gestational diabetes mellitus (GDM) are at an increased risk of developing preeclampsia, a condition that not only threatens maternal and fetal safety but also compromises organ function. This study aimed to determine the prevalence of preeclampsia among pregnant women with GDM in China and to identify its associated risk factors. <b>Methods</b> A total of 212 GDM patients who underwent prenatal care and delivery at Beilun District People's Hospital between September 2020 and September 2024 were included in the study. Participants were divided into a preeclampsia group (PE group) and a non-preeclampsia group (Non-PE group) based on the presence or absence of preeclampsia. Clinical and demographic data were extracted from the medical record system and compared between the two groups. Univariate and multivariate analyses were conducted to identify factors influencing the occurrence of preeclampsia. Receiver operating characteristics (ROC) curves were used to evaluate the predictive efficacy of statistically different indicators. <b>Results</b> Among the 212 GDM patients, 60 developed preeclampsia (PE group), while 152 did not (Non-PE group), resulting in a preeclampsia prevalence of 28.30% (60/212). Multivariate logistic regression analysis identified high systolic blood pressure (SBP) (<i>p</i> < 0.001), high diastolic blood pressure (DBP) (<i>p</i> = 0.002), elevated body mass index (BMI) (<i>p</i> < 0.001), increased glycated hemoglobin (HbA1c) (<i>p</i> = 0.007), and high blood urea nitrogen (BUN) (<i>p</i> = 0.017) as independent risk factors for preeclampsia in GDM patients. The predictive value for preeclampsia was assessed using ROC curve analysis. When BMI was ≥23.205 kg/m<sup>2</sup>, the area under the curve (AUC) was 0.695 [<i>p</i> < 0.001, 95% CI (0.612, 0.778)], with a sensitivity of 0.683 and specificity of 0.632. For HbA1c ≥5.550%, the AUC was 0.665 [<i>p</i> < 0.001, 95% CI (0.583, 0.747)], with a sensitivity of 0.617 and specificity of 0.658. When BUN was ≥4.250 mmol/L, the AUC was 0.692 [<i>p</i> < 0.001, 95% CI (0.612, 0.772)], with a sensitivity of 0.550 and specificity of 0.763; The combined prediction model of these three parameters yielded an AUC of 0.826 [<i>p</i> < 0.001, 95% CI (0.759, 0.892)], with a sensitivity of 0.783 and specificity of 0.803. <b>Conclusion</b> The prevalence of preeclampsia was significantly higher among patients with GDM. In addition to blood pressure, BMI, HbA1c, and BUN levels are key factors associated with preeclampsia risk and may be used together to assist in predicting GDM patients with preeclampsia. It is necessary to pay more attention to the high-risk groups of preeclampsia and formulate targeted health management strategies to reduce the risk of preeclampsia and improve maternal and neonatal outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483194","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}
引用次数: 0
Bilateral Primary Breast Cancer: A Case of Synchronous Diagnosis and Management of Ductal Carcinoma In Situ and Invasive Ductal Carcinoma. 双侧原发性乳腺癌:导管原位癌与浸润性导管癌同步诊断与治疗一例。
IF 1 4区 医学
British journal of hospital medicine Pub Date : 2025-06-25 Epub Date: 2025-06-24 DOI: 10.12968/hmed.2024.1013
Yan Wang, Yong Chen, Bo Zhang, Xianfu Liu
{"title":"Bilateral Primary Breast Cancer: A Case of Synchronous Diagnosis and Management of Ductal Carcinoma <i>In Situ</i> and Invasive Ductal Carcinoma.","authors":"Yan Wang, Yong Chen, Bo Zhang, Xianfu Liu","doi":"10.12968/hmed.2024.1013","DOIUrl":"https://doi.org/10.12968/hmed.2024.1013","url":null,"abstract":"<p><p><b>Aims/Background</b> Bilateral breast cancer (BBC) is an uncommon subtype of breast cancer which occurs either synchronously or metachronously. Synchronous BBC with distinct histological types in the left and right breasts is particularly rare. <b>Case Presentation</b> This report presents a case of a 57-year-old female patient diagnosed with bilateral primary breast cancer, characterized by ductal carcinoma <i>in situ</i> (DCIS) in one breast and invasive ductal carcinoma (IDC) in the other. The patient initially sought medical attention due to a palpable mass and pain in her left breast, leading to a diagnosis confirmed through imaging studies and biopsy. The patient was treated with three cycles of neoadjuvant therapy, followed by a modified radical mastectomy on the left breast and a lumpectomy on the right breast. Postoperatively, the patient received endocrine therapy and radiotherapy, with no evidence of recurrence observed to date. <b>Conclusion</b> Further research and clinical advancements are necessary to optimize treatment and care strategies for patients with bilateral breast cancer, ensuring that their unique therapeutic needs are effectively addressed.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 6","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483182","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}
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