British medical bulletin最新文献

{"title":"Time to bring female genital schistosomiasis out of neglect.","authors":"Olimpia Lamberti, Fiammetta Bozzani, Kita Kiyoshi, Amaya L Bustinduy","doi":"10.1093/bmb/ldad034","DOIUrl":"10.1093/bmb/ldad034","url":null,"abstract":"<p><strong>Background: </strong>Female genital schistosomiasis (FGS) is a chronic gynaecological disease affecting girls and women in sub-Saharan Africa (SSA), caused by the parasite Schistosoma (S.) haematobium. FGS is associated with sexual dysfunction, reproductive tract morbidity and increased prevalence of HIV and cervical precancer lesions.</p><p><strong>Source of data: </strong>Key peer-reviewed published literature.</p><p><strong>Areas of agreement: </strong>FGS screening and diagnosis require costly equipment and specialized training, seldom available in resource-limited settings. FGS surveillance is not included in wider schistosomiasis control strategies. The interplay of FGS with other SRH infections is not fully understood. Integration of FGS within sexual and reproductive health (SRH) control programmes needs to be explored.</p><p><strong>Areas of controversy: </strong>There are no standardized methods for individual or population-based FGS screening and diagnosis, hindering accurate disease burden estimates and targeted resource allocation. Treatment recommendations rely on public health guidelines, without rigorous clinical evidence on efficacy.</p><p><strong>Growing points: </strong>Integrating FGS screening with SRH programmes offers an opportunity to reach at-risk women with limited access to healthcare services. Home-based self-sampling coupled with handheld colposcopes operated by primary healthcare workers show promise for FGS diagnosis and surveillance at scale.</p><p><strong>Areas timely for developing research: </strong>There is growing interest in decentralizing strategies for FGS screening and diagnosis. The accurate predictions on the 'cost-effectiveness' of these approaches will determine their affordability and feasibility within the overburdened health systems in SSA. Clinical trials are needed to optimize FGS treatment. Longitudinal studies can expand on the epidemiological knowledge on co-morbidities and integration within other SRH interventions.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"45-59"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics in Parkinson's disease, state-of-the-art and future perspectives.","authors":"L Trevisan, A Gaudio, E Monfrini, L Avanzino, A Di Fonzo, P Mandich","doi":"10.1093/bmb/ldad035","DOIUrl":"10.1093/bmb/ldad035","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is the second most common neurodegenerative disorder and is clinically characterized by the presence of motor (bradykinesia, rigidity, rest tremor and postural instability) and non-motor symptoms (cognitive impairment, autonomic dysfunction, sleep disorders, depression and hyposmia). The aetiology of PD is unknown except for a small but significant contribution of monogenic forms.</p><p><strong>Sources of data: </strong>No new data were generated or analyzed in support of this review.</p><p><strong>Areas of agreement: </strong>Up to 15% of PD patients carry pathogenic variants in PD-associated genes. Some of these genes are associated with mendelian inheritance, while others act as risk factors. Genetic background influences age of onset, disease course, prognosis and therapeutic response.</p><p><strong>Areas of controversy: </strong>Genetic testing is not routinely offered in the clinical setting, but it may have relevant implications, especially in terms of prognosis, response to therapies and inclusion in clinical trials. Widely adopted clinical guidelines on genetic testing are still lacking and open to debate. Some new genetic associations are still awaiting confirmation, and selecting the appropriate genes to be included in diagnostic panels represents a difficult task. Finally, it is still under study whether (and to which degree) specific genetic forms may influence the outcome of PD therapies.</p><p><strong>Growing points: </strong>Polygenic Risk Scores (PRS) may represent a useful tool to genetically stratify the population in terms of disease risk, prognosis and therapeutic outcomes.</p><p><strong>Areas timely for developing research: </strong>The application of PRS and integrated multi-omics in PD promises to improve the personalized care of patients.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"60-71"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza: cause or excuse? An analysis of flu's influence on worsening mortality trends in England and Wales, 2010-19.","authors":"Lucinda Hiam, Martin McKee, Danny Dorling","doi":"10.1093/bmb/ldad028","DOIUrl":"10.1093/bmb/ldad028","url":null,"abstract":"<p><strong>Background: </strong>England and Wales experienced a stagnation of previously improving life expectancy during the 2010s. Public bodies cited influenza as an important cause.</p><p><strong>Sources of data: </strong>We used data from the Office for National Statistics to examine mortality attributed directly to influenza and to all influenza-like diseases for the total population of England and Wales 2010-19. Several combinations of ICD-10 codes were used to address the possibility of under-counting influenza deaths.</p><p><strong>Areas of agreement: </strong>Deaths from influenza and influenza-like diseases declined between 2010 and 2019, while earlier improvements in mortality from all causes of death were stalling and, with some causes, worsening. Our findings support existing research showing that influenza is not an important cause of the stalling of mortality rates 2010-19.</p><p><strong>Areas of controversy: </strong>Influenza was accepted by many as an important cause of stalling life expectancy for much of the 2010s, while few in public office have accepted austerity as a key factor in the changes seen during that time.</p><p><strong>Growing points: </strong>This adds to the mounting evidence that austerity damaged health prior to COVID-19 and left the population more vulnerable when it arrived.</p><p><strong>Areas for developing timely research: </strong>Future research should explore why so many in public office were quick to attribute the change in trends in overall mortality in the UK in this period to influenza, and why many continue to do so through to 2023 and to deny the key role of austerity in harming population health.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"72-89"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in older people's emergency care use by social care setting: a systematic review of international evidence.","authors":"Kelly Brotherhood, Ben Searle, Gemma Frances Spiers, Camila Caiado, Barbara Hanratty","doi":"10.1093/bmb/ldad033","DOIUrl":"10.1093/bmb/ldad033","url":null,"abstract":"<p><strong>Background: </strong>Older adults' use of social care and their healthcare utilization are closely related. Residents of care homes access emergency care more often than the wider older population; however, less is known about emergency care use across other social care settings.</p><p><strong>Sources of data: </strong>A systematic review was conducted, searching six electronic databases between January 2012 and February 2022.</p><p><strong>Areas of agreement: </strong>Older people access emergency care from a variety of community settings.</p><p><strong>Areas of controversy: </strong>Differences in study design contributed to high variation observed between studies.</p><p><strong>Growing points: </strong>Although data were limited, findings suggest that emergency hospital attendance is lowest from nursing homes and highest from assisted living facilities, whilst emergency admissions varied little by social care setting.</p><p><strong>Areas timely for developing research: </strong>There is a paucity of published research on emergency hospital use from social care settings, particularly home care and assisted living facilities. More attention is needed on this area, with standardized definitions to enable comparisons between studies.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"32-44"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138796940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life of family carers of people living with dementia: review of systematic reviews of observational and intervention studies.","authors":"Déborah Oliveira, Fabiana Araújo Figueiredo da Mata, Aimee Aubeeluck","doi":"10.1093/bmb/ldad029","DOIUrl":"10.1093/bmb/ldad029","url":null,"abstract":"<p><strong>Introduction: </strong>Family members are the primary source of support for the growing number of people living with dementia (PLWD) worldwide. However, caring for a person living with dementia can have detrimental impacts on the carer quality of life (QoL). This review of systematic reviews explored the factors associated with the QoL of family carers of PLWD and interventions aimed at improving their QoL.</p><p><strong>Sources of data: </strong>Several health-related databases (PUBMED, Psychinfo, Google Scholar and COCHRANE) were consulted in November 2022. Nineteen systematic reviews were included, and their methodological quality was assessed via AMSTAR-2.</p><p><strong>Areas of agreement: </strong>Better carer physical and mental health, provision of formal support, relationship quality between carers and PLWD, as well as positive psychological traits were associated with better carer QoL. There is no one-size-fits-all intervention that can improve the QoL of all carers, but promising results were found in most of the interventions.</p><p><strong>Areas of controversy: </strong>There is inconsistency in evidence on the association between the carer age and QoL. The use of a wide range of QoL measures, particularly generic QoL scales, has contributed to inconsistencies when comparing the efficacy of interventions.</p><p><strong>Growing points: </strong>Evidence suggests the need for a person-centred approach to improving carer QoL, considering individual and contextual needs as well as the continuum and progressive nature of dementia care.</p><p><strong>Timely areas for developing research: </strong>Future research should be focused on understanding how to best implement and measure person-centred care approaches to carer QoL, including cost-effectiveness. More qualitative studies are necessary to explore carer negative and positive experiences of QoL.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"1-12"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482037","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}

{"title":"Wharton's jelly and osteoarthritis of the knee.","authors":"Adarsh Aratikatla, Nicola Maffulli, Manu Gupta, Ishana A Potti, Anish G Potty, Ashim Gupta","doi":"10.1093/bmb/ldad030","DOIUrl":"10.1093/bmb/ldad030","url":null,"abstract":"<p><strong>Introduction: </strong>The existing treatment modalities for knee osteoarthritis (OA) do not actually address the pathology. Biological therapies, including those using material derived from perinatal tissues, represent a ground-breaking approach to alleviating the symptoms of OA of the knee.</p><p><strong>Source of data: </strong>Current scientific literature published in PubMed (MEDLINE), Embase and Scopus databases. Trials registered in various clinical trial databases.</p><p><strong>Areas of agreement: </strong>Perinatal tissues including Wharton's jelly (WJ) and associated mesenchymal stem cells (MSCs) can be used for the management of knee OA.</p><p><strong>Areas of controversy: </strong>The efficacy of WJ and associated MSCs in the management of knee OA is still controversial.</p><p><strong>Growing points: </strong>The use of WJ and associated MSCs in the management of knee OA is safe and appears to be effective.</p><p><strong>Areas timely for developing research: </strong>The present published evidence suggests that WJ tissue and associated MSCs offer an encouraging alternative for the management of knee OA. The published in vitro, preclinical and clinical investigations demonstrate the therapeutic potential of WJ and promote further research in this field to provide symptomatic relief to patients suffering from OA, aiming also to regenerate the osteoarthritic hyaline cartilage, with disease-modifying effects. Future adequately powered randomized controlled trials should be undertaken to establish whether WJ is helpful in the management of OA of the knee.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"13-31"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10993459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138796943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction of: Nutrition, adult hippocampal neurogenesis and mental health.","authors":"","doi":"10.1093/bmb/ldae001","DOIUrl":"10.1093/bmb/ldae001","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"90"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569438","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}

{"title":"Reducing the risks of nuclear war: the role of health professionals†.","authors":"Andy Haines, Ira Helfand, Arun Mitra, Tilman Ruff, Chris Zielinski","doi":"10.1093/bmb/ldad019","DOIUrl":"10.1093/bmb/ldad019","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"89-91"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to tackle health inequalities in cardiovascular risks for socioeconomically disadvantaged populations: a rapid review.","authors":"Yu Fu, Ge Yu, Naswa Maulana, Katie Thomson","doi":"10.1093/bmb/ldad025","DOIUrl":"10.1093/bmb/ldad025","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) has shown significant health inequalities for people with low socioeconomic status associated with more risk factors. This review was to synthesize interventions that targeted CVD risks and outcomes among socioeconomically disadvantaged populations and to understand the impact associated with these interventions.</p><p><strong>Sources of data: </strong>Cochrane CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL were searched for records published in the last decade using a systematic search strategy, complemented by screening the reference lists and citation indexes. Nineteen studies were included and a narrative synthesis with the effect direction plot was undertaken in which studies, interventions, participants and outcomes were examined according to the intervention type focusing on behaviours, lifestyle, education, medication and monitoring.</p><p><strong>Areas of agreement: </strong>No universal definition of disadvantaged socioeconomic status was used with common factors relating to racial/ethnic minorities, low income and low or no health insurance. Mixed effects of interventions were reported on clinical outcomes including weight, body mass index, blood pressure, glycated haemoglobin and cholesterol.</p><p><strong>Areas of controversy: </strong>Inconsistent effect was reported due to a large variety of settings, participants and intervention components although they are considered necessary to address the complex health needs of socioeconomically disadvantaged populations.</p><p><strong>Growing points: </strong>There is inadequate evidence to determine whether any of the intervention types are effective in optimising lipids management for socioeconomically disadvantaged populations.</p><p><strong>Areas timely for developing research: </strong>Research is needed with mixed evidence using real world evaluation and lived experience combined with health economic evaluation, on both mental and physical health outcomes.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"22-41"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of clinical trials-is it virtual?","authors":"Cho Ee Ng, Sarah Bowman, Jonathan Ling, Rachael Bagshaw, Angela Birt, Yan Yiannakou","doi":"10.1093/bmb/ldad022","DOIUrl":"10.1093/bmb/ldad022","url":null,"abstract":"<p><strong>Introduction: </strong>Participant recruitment to clinical trials is often sub-optimal. Decentralized clinical trials have the potential to address challenges in traditional site-based clinical trial recruitment.</p><p><strong>Sources of data: </strong>This review is based on recently published literature and the experience of running a large industry-sponsored interventional trial using both traditional and decentralized methods.</p><p><strong>Areas of agreement: </strong>Efficient delivery of clinical trials is essential to continue to provide therapeutic improvements in a timely and cost-efficient way. Clinical trial designs are constantly evolving to achieve effective trial delivery, manage the complexity of new therapeutic algorithms and conform to cultural developments.</p><p><strong>Areas of controversy: </strong>Digitally innovative decentralized clinical trials may be a solution to improve recruitment and retention. Although many trials incorporate digital innovations to reduce patient burden, decentralized clinical trials allow remote access to clinical research, potentially enhancing geographical diversity as well as reducing participant burden.</p><p><strong>Growing points: </strong>Areas for development currently being discussed are developing a 'recruitment platform' that exploits the reach of digital connectivity, automated identification of eligible participants from volunteers, employing technology for remote interaction and exploring the logistic process of delivering the interventions.</p><p><strong>Areas timely for relevant research: </strong>The focus of development must ensure that the overall impact will widen participation and reduce inequalities in healthcare.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"42-57"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185632","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}