British medical bulletin最新文献

High-volume injections in Achilles tendinopathy: a systematic review. 跟腱病的大容量注射：系统性综述。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae015

Rifat Hassan, Daryl Poku, Nafisa Miah, Nicola Maffulli

{"title":"High-volume injections in Achilles tendinopathy: a systematic review.","authors":"Rifat Hassan, Daryl Poku, Nafisa Miah, Nicola Maffulli","doi":"10.1093/bmb/ldae015","DOIUrl":"10.1093/bmb/ldae015","url":null,"abstract":"Introduction: Achilles tendinopathy (AT) is common, particularly in runners. High-volume injections (HVIs) may be beneficial in the management of AT compared to other conservative management options, including exercise regimens, platelet-rich plasma (PRP) injections, and extracorporeal shockwave therapy. The published research on the effectiveness of HVI in the treatment of AT was evaluated in this systematic review.Sources of data: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed when conducting this systematic review. The electronic databases PubMed, Embase, Cochrane, Web of Science, CINAHL, and OVID were thoroughly searched, from inception to 13 September 2023, for articles assessing HVI for AT.Areas of agreement: A total of 10 studies with 460 participants met the inclusion criteria. HVI typically consisted of saline, local anaesthetic, and corticosteroids. HVI combined with corticosteroids demonstrated immediate and long-term improvements in ankle function. Compared to HVI without corticosteroids, HVI with corticosteroids exhibited greater, early improvements in pain and function, with no significant differences at later follow-up points. Significant reductions in tendon thickness and neovascularity were also found with HVI treatment over time.Areas of controversy: No adverse events were reported with HVI, despite the use of corticosteroids.Growing points: HVI is an effective and safe modality, particularly in the short term, to significantly reduce pain and discomfort in the Achilles tendon, especially when supplemented with corticosteroids.Areas timely for developing research: More robust randomized controlled trials, with longer-term follow-ups and homogeneity, are needed to fully establish its efficacy for AT.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"35-47"},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

From the archive-Vol 152, Issue 1.

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae017

Avi A Weinbroum

引用次数: 0

Bone-patellar tendon-bone, hamstring, and quadriceps tendon autografts for anterior cruciate ligament reconstruction in skeletally immature patients: a systematic review. 骨-髌腱-骨、腘绳肌腱和股四头肌腱自体移植物用于骨骼不成熟患者的前交叉韧带重建：系统性综述。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae011

Filippo Migliorini, Federico Cocconi, Luise Schäfer, Raju Vaishya, Daniel Kämmer, Nicola Maffulli

{"title":"Bone-patellar tendon-bone, hamstring, and quadriceps tendon autografts for anterior cruciate ligament reconstruction in skeletally immature patients: a systematic review.","authors":"Filippo Migliorini, Federico Cocconi, Luise Schäfer, Raju Vaishya, Daniel Kämmer, Nicola Maffulli","doi":"10.1093/bmb/ldae011","DOIUrl":"10.1093/bmb/ldae011","url":null,"abstract":"Introduction: Historically, anterior cruciate ligament (ACL) ruptures in the paediatric age group were managed conservatively with bracing, casting, activity modification, and physical therapy. However, most of these patients had to reduce their sports activities, and secondary damages to the affected knee were prevalent.Source of data: Published scientific literature in Embase, Web of Science, PubMed, and Google Scholar databases.Areas of agreement: ACL reconstruction in children with open physes patients is debated. Any damage to the physes around the knee could lead to growth abnormalities and axial deviation of the knee.Areas of controversy: Different grafts are available and suitable for ACL reconstruction in skeletally immature patients; however, which graft performs better remains unclear.Growing points: This systematic review compared bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts for ACL reconstruction in skeletally immature patients. The joint laxity, Patient-reported outcome measures (PROMs), return to sport, and complications were compared.Areas timely for developing research: In skeletally immature patients, HT, BPTB, and QT autografts for ACL reconstruction yielded good outcomes. Comparative studies are strongly required to establish the most suitable autograft.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"16-27"},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

New developments in the diagnosis and management of motor neuron disease. 运动神经元疾病诊断和管理的新进展。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae010

David O'Brien, Pamela J Shaw

{"title":"New developments in the diagnosis and management of motor neuron disease.","authors":"David O'Brien, Pamela J Shaw","doi":"10.1093/bmb/ldae010","DOIUrl":"10.1093/bmb/ldae010","url":null,"abstract":"Introduction: Motor neuron disease (MND) is a devastating neurodegenerative disease characterized by progressive muscle weakness.Sources of data: PubMed, MEDLINE, and Cochrane databases were searched for articles to March 2024. Searches involved the terms 'motor neuron disease' or 'amyotrophic lateral sclerosis' and 'epidemiology', 'diagnosis', 'clinical', 'genetic', 'management', 'treatment', or 'trial'.Areas of agreement: Evidence-based management involves riluzole, multidisciplinary care, provision of noninvasive ventilation and gastrostomy, and symptomatic treatments. Tofersen should be offered to treat SOD1-MND.Areas of controversy: Edaravone and Relyvrio are approved treatments in the USA, but insufficient evidence was found to support approval in the UK and Europe.Growing points: The discovery of neurofilaments as MND biomarkers, growth of platform trials and development of novel therapies provide optimism for more powerful neuroprotective therapies.Areas timely for developing research: Further work should focus on the elucidation of environmental causes of MND, gene-environment interactions, and advanced cellular models of disease.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"4-15"},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Pediatric wrist fractures: variations in management across countries. An evidence-based summary of evidence. 小儿腕部骨折：各国在处理上的差异。循证证据摘要。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae014

Luca Labianca, Cosma Calderaro, Nicola Maffulli

{"title":"Pediatric wrist fractures: variations in management across countries. An evidence-based summary of evidence.","authors":"Luca Labianca, Cosma Calderaro, Nicola Maffulli","doi":"10.1093/bmb/ldae014","DOIUrl":"10.1093/bmb/ldae014","url":null,"abstract":"Introduction: Fractures of the distal radius are common in pediatric population, with considerable variation in the management of pediatric wrist fractures across different countries. It is crucial to consider the different approaches to conservative management and surgical intervention. The decision on the appropriate treatment method often depends on the type and severity of the fracture, as well as the available healthcare resources and expertise in each country. This article tries to identify these variations, so the various healthcare systems can work toward implementing best practices in the management of pediatric wrist fractures on a global scale.Source of data: Published peer-reviewed articles identified in electronic databases, including PubMed Scopus and Google Scholar.Areas of agreement: The management of pediatric wrist fractures can differ significantly among countries given the high variability in healthcare resources and cultural practices.Areas of controversy: The management of pediatric wrist fractures can be challenging in certain countries, especially in developing regions with limited resources.Growing points: Challenges such as long therapeutic delays, lack of appropriate anesthesia, and the absence of fluoroscopy can complicate the treatment process. Randomized controlled clinical trials (RCTs) are vital in providing high-quality evidence to guide clinical decision-making, especially in the field of pediatric wrist fractures.Areas timely for developing research: Efforts to support and prioritize the conduct and dissemination of RCTs in pediatric wrist fracture management can ultimately lead to more consistent, effective, and evidence-based care for children with wrist fractures worldwide.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"28-34"},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

'In this Issue' Volume 152. 本期 "第 152 卷。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-12 DOI: 10.1093/bmb/ldae018

Nicola Maffulli

引用次数: 0

The athletes heart-from acute stimulus to chronic adaptation.

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-07 DOI: 10.1093/bmb/ldae021

Joseph D Maxwell, David Oxborough

{"title":"The athletes heart-from acute stimulus to chronic adaptation.","authors":"Joseph D Maxwell, David Oxborough","doi":"10.1093/bmb/ldae021","DOIUrl":"https://doi.org/10.1093/bmb/ldae021","url":null,"abstract":"Introduction: The complex phenomenon of the athlete's heart (AH) describes the chronic physiological structural and functional adaptation secondary to repeated exposure of an acute exercise stimulus.Sources of data: This narrative review is based on published evidence.Areas of agreement: Highly trained athletic individuals frequently display cardiac parameters which are suggestive of an AH and can exceed the traditional 'normal' limits.Area of controversy: The physiological processes underpinning the extent of cardiac adaption and how this is closely linked to exercise type, but also sex, ethnicity, and body size.Growing points: Since its seminal description by Morganroth and colleagues in 1975, our understanding of the AH has evolved in tandem with improvements in cardiac imaging techniques alongside the exploration of more diverse athletic populations. This narrative review aims to provide a balanced discussion of the multi-factorial nature of structure and function of the AH with specific reference to the unique physiological exercise stimuli.Areas timely for developing research: Despite great interest in cardiac adaptations across a broad spectrum of athletic populations, future research designs should consider the use of new and novel imaging techniques to enhance our understanding of the acute cardiovascular responses which ultimately mediates such adaptations, especially in athletic populations underrepresented in the literature.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Obesity: ethical issues.

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-05 DOI: 10.1093/bmb/ldae022

Christopher Mayes, Jane Williams

引用次数: 0

Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review. 骨骼不成熟患者的同种异体移植与自体移植前交叉韧带重建：系统性综述。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-12-05 DOI: 10.1093/bmb/ldae020

Filippo Migliorini, Marco Pilone, Luise Schäfer, Francesca Alzira Bertini, Riccardo Giorgino, Nicola Maffulli

{"title":"Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review.","authors":"Filippo Migliorini, Marco Pilone, Luise Schäfer, Francesca Alzira Bertini, Riccardo Giorgino, Nicola Maffulli","doi":"10.1093/bmb/ldae020","DOIUrl":"https://doi.org/10.1093/bmb/ldae020","url":null,"abstract":"Introduction: Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common.Areas of agreement: Evidence of ACL reconstruction using allografts in children with open physes is limited.Areas of controversy: Whether the outcomes of ACL allograft reconstruction in children and adolescents with open physes are superior to autograft ACL reconstruction is unclear, with contrasting evidence.Source of data: In October 2024, the Web of Science, PubMed, and Embase were accessed with no additional filters. Only clinical investigations evaluating ACL reconstruction in children or adolescents with open physes were eligible. Only studies reporting a minimum length of 24 months of follow-up were included.Areas timely for developing research: Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Percutaneous repair of the Achilles tendon with one knot offers equivalent results as the same procedure with two knots. A comparative prospective study. 用一个绳结经皮修复跟腱与用两个绳结修复跟腱的效果相当。前瞻性对比研究。

IF 6.7 2区医学

British medical bulletin Pub Date : 2024-11-29 DOI: 10.1093/bmb/ldae019

Nicola Maffulli, George Christidis, Nikolaos Gougoulias, Panagiotis Christidis, Daryl Poku, Rifat Hassan, Filippo Migliorini, Francesco Oliva

{"title":"Percutaneous repair of the Achilles tendon with one knot offers equivalent results as the same procedure with two knots. A comparative prospective study.","authors":"Nicola Maffulli, George Christidis, Nikolaos Gougoulias, Panagiotis Christidis, Daryl Poku, Rifat Hassan, Filippo Migliorini, Francesco Oliva","doi":"10.1093/bmb/ldae019","DOIUrl":"https://doi.org/10.1093/bmb/ldae019","url":null,"abstract":"Purpose: The present prospective comparative study included patients with acute Achilles tendon rupture (ATR) who underwent percutaneous repair with one knot compared to percutaneous repair with two knots.Methods: All patients underwent the procedure under local anesthesia. A total of 29 patients underwent percutaneous repair with two knots (Group A), and 33 patients underwent percutaneous repair with one knot (Group B). All patients were treated by a single surgeon between 2019 and 2021 and were followed prospectively for 24 months.Results: Patients' characteristics at baseline were similar between the two groups, except for age [38.0(15.0) vs 32.0(15.0) years, P = 0.028]. The procedure took longer for the two knots technique [19.0(4.0) vs 13.0(3.0) min, P < 0.001]. The Achilles tendon total rupture score was not different between the two techniques (90.7 ± 3.26 vs 90.5 ± 2.18, P = 0.737), as was the elongation of the gastrosoleus-Achilles tendon complex measured by the Achilles tendon resting angle [-1.0(2.0) vs - 1.0(2.0), P < 0.380]. The calf circumference of the injured and non-injured leg did not differ between the groups. Plantarflexion strength of the operated leg was significantly weaker than the non-operated leg in both groups. The European Foot and Ankle Society and patient reported outcome measures score by Piedade et al. scores were not statistically significant different between the two groups. No patient experienced a re-rupture, a venous thrombo-embolism episode, or injury to the sural nerve.Conclusion: The modified technique offered similar objective and subjective outcome measures, in addition to reduced operative time.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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