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Impact of sarcopenia on outcomes of bladder cancer undergoing radical cystectomy: A systematic review and meta-analysis. 肌肉疏松症对接受根治性膀胱切除术的膀胱癌患者预后的影响:系统回顾与荟萃分析。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1177/00369330241234690
Fanyi Qin, Jiacheng Wu

Objective: To provide synthesized evidence on the association between sarcopenia and risk of mortality, recurrence and postoperative complications in patients with bladder cancer and undergoing radical cystectomy (RC).

Methods: Only studies with observational design that investigated the association between sarcopenia and outcomes of interest among patients with bladder cancer undergoing RC were included. The outcomes of interest were mortality, recurrence, and postoperative complications. The systematic search was conducted using three large databases, that is, PubMed, EMBASE, and Scopus. A random effects model was used for the analysis and pooled effect sizes were reported as odds ratio (OR) or hazards ratio (HR) along with 95% confidence intervals (CIs).

Results: A total of 21 studies with 4997 patients were included. Compared to non-sarcopenic subjects, those with sarcopenia had increased risk of all-cause mortality (HR 1.45, 95% CI: 1.32, 1.61), cancer-specific mortality (HR 1.74, 95% CI: 1.49, 2.03) and a lower recurrence free survival (HR 1.84, 95% CI: 1.30, 2.62). Patients with sarcopenia also had higher risk of developing complications within 90 days postoperatively (OR 1.77, 95% CI: 1.23, 2.55).

Conclusion: Sarcopenia among patients with bladder cancer and managed using RC is associated with adverse survival outcomes and an increased risk of postoperative complications.

摘要提供有关肌肉疏松症与接受根治性膀胱切除术(RC)的膀胱癌患者的死亡率、复发率及术后并发症风险之间关系的综合证据:仅纳入了对接受根治性膀胱切除术的膀胱癌患者中肌肉疏松症与相关结果之间关系进行调查的观察性设计研究。相关结果包括死亡率、复发率和术后并发症。系统性检索使用了三个大型数据库,即 PubMed、EMBASE 和 Scopus。分析采用随机效应模型,汇总效应大小以几率比(OR)或危险比(HR)以及 95% 置信区间(CI)的形式报告:结果:共纳入了 21 项研究,4997 名患者。与非肌肉疏松症患者相比,肌肉疏松症患者的全因死亡率(HR 1.45,95% CI:1.32,1.61)、癌症特异性死亡率(HR 1.74,95% CI:1.49,2.03)和无复发生存率(HR 1.84,95% CI:1.30,2.62)均有所增加。肌肉疏松症患者在术后90天内出现并发症的风险也更高(OR 1.77,95% CI:1.23,2.55):膀胱癌患者中的肌肉疏松症与不良的生存结果和术后并发症风险增加有关。
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引用次数: 0
Challenges and expectations of international medical graduates moving to the UK: An online survey. 移居英国的国际医学毕业生面临的挑战和期望:在线调查。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 Epub Date: 2024-02-19 DOI: 10.1177/00369330241229922
Jenni Lane, Nitin Shrotri, Bhaskar K Somani

Introduction: International medical graduates (IMGs) account for 41% of the UK doctor's workforce but often work in isolated roles, receive minimal constructive feedback regarding their work and offered limited opportunities for career progression. We conducted a survey researching the views of IMGs or doctors from ethnic minority backgrounds on the support given to them.

Methods: A survey was carried out on physician demographics, grade and date of first NHS appointment, familiarity and support offered in NHS, induction and study leave, Professional and Linguistic Assessments Board exams and General Medical Council (GMC) referrals. It was drafted via surveymonkey.co.uk platform and circulated via relevant closed medical groups.

Results: A total of 173 IMGs and 16 British trained doctors (controls) took the survey. In the IMGs first job, there was no dedicated supervisor, mentor, induction, shadowing period and study leave for 56%, 86%, 52%, 59% and 52%, respectively. Suggestions given for improvements included teaching sessions, mentors, work orientation, supernumerary period and paid induction by 80%, 78%, 76%, 61% and 41% respectively. While 59% of participants knew of another IMG referred to the GMC, the primary reasons given were lack of knowledge of NHS, bias, communication difficulties and cultural differences.

Conclusion: This paper reflects the views of doctors regarding the support given to IMGs during their first NHS appointment and subsequent jobs in the NHS. IMGs require a focused and detailed induction, mentorship, educational and clinical supervision throughout their transition to the NHS.

简介国际医学毕业生(IMGs)占英国医生队伍的 41%,但他们往往从事孤立的工作,很少得到有关其工作的建设性反馈,而且职业发展机会有限。我们开展了一项调查,研究 IMG 或少数民族背景医生对他们所获支持的看法:调查内容包括医生的人口统计学特征、级别和首次在 NHS 任职的日期、对 NHS 提供的支持的熟悉程度、入职培训和学习假、专业和语言评估委员会考试以及医学总会(GMC)的转诊情况。问卷通过 surveymonkey.co.uk 平台起草,并通过相关封闭式医疗小组分发:共有 173 名 IMG 和 16 名英国受训医生(对照组)参加了调查。在 IMG 的第一份工作中,没有专职主管、导师、入职培训、实习期和学习假的分别占 56%、86%、52%、59% 和 52%。80%、78%、76%、61%和41%的参与者提出的改进建议包括教学课程、导师、工作指导、编外期和带薪入职培训。59%的参与者知道有另一名 IMG 被转介到 GMC,他们给出的主要原因是缺乏对 NHS 的了解、偏见、沟通困难和文化差异:本文反映了医生们对 IMG 首次在 NHS 任职及随后在 NHS 工作期间所提供支持的看法。IMG在过渡到国家医疗服务系统的整个过程中,需要有针对性的、详细的入职培训、指导、教育和临床监督。
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引用次数: 0
The effect of virtual reality glasses applied during intrauterine device insertion on pain, anxiety and satisfaction: Randomized controlled study. 放置宫内节育器时使用虚拟现实眼镜对疼痛、焦虑和满意度的影响:随机对照研究。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 Epub Date: 2024-03-06 DOI: 10.1177/00369330241234688
Tuğba Öz, Nurdan Demirci

Background and aim: This study was carried out to determine the effect of the use of "virtual reality glasses," on anxiety, pain, and satisfaction level in order to reduce anxiety and pain during intrauterine device (IUD) insertion, which is a painful and stressful procedure for women and to divert attention to increase satisfaction.

Methods: This randomized controlled study in the gynecology clinic of a state hospital with 80 women who were accepted to participate in the study. Data were collected using structured patient information form, numerical pain rating scale, state-trait anxiety inventory, patient satisfaction evaluation form, and virtual reality glasses.

Results: Post-procedural pain scores in the control group after IUD application were higher than post-procedural pain in the virtual reality group. Measurements of post-procedure anxiety in the control group were higher than measurements of post-procedural in the virtual reality group. Satisfaction levels of women with virtual reality glasses during IUD insertion were also found to be high.

Conclusions: It was determined that the use of virtual reality glasses, one of the methods of distraction during IUD insertion, was effective in reducing pain and anxiety and increasing patient satisfaction.

背景和目的:本研究旨在确定使用 "虚拟现实眼镜 "对焦虑、疼痛和满意度的影响,以减轻妇女在宫内节育器(IUD)植入过程中的焦虑和疼痛,因为这对妇女来说是一个痛苦而紧张的过程,并转移注意力以提高满意度:这项随机对照研究在一家州立医院的妇科诊所进行,共有 80 名妇女被接受参与研究。采用结构化患者信息表、疼痛评分量表、状态-特质焦虑量表、患者满意度评估表和虚拟现实眼镜收集数据:结果:使用宫内节育器后,对照组的术后疼痛评分高于虚拟现实组。对照组的术后焦虑测量值高于虚拟现实组的术后焦虑测量值。使用虚拟现实眼镜的妇女在宫内节育器植入过程中的满意度也很高:结论:虚拟现实眼镜是宫内节育器植入过程中分散注意力的方法之一,使用虚拟现实眼镜能有效减轻疼痛和焦虑,提高患者满意度。
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引用次数: 0
Generating evidence, reporting implementation of innovations through use of technology in healthcare: Core purposes of multidisciplinary journal. 通过在医疗保健领域使用技术来生成证据、报告创新的实施情况:多学科期刊的核心宗旨。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 DOI: 10.1177/00369330241252024
Ghulam Nabi
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引用次数: 0
Scottish Society of Physicians 65th Annual Meeting. 苏格兰医师协会第 65 届年会。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 DOI: 10.1177/00369330231225894
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引用次数: 0
Patient information videos via QR codes: An innovative and sustainable approach in ophthalmology. 通过 QR 码播放患者信息视频:眼科领域的创新和可持续方法。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-01 Epub Date: 2024-03-01 DOI: 10.1177/00369330241236945
Sirjhun Patel, Wei Han Ong, Caroline Cobb, Stewart Gillan

Background: We explore an innovative approach by transforming patient information leaflet (PILs) into Quick Response (QR) code linked patient information videos (PIVs) in ophthalmology. Our objectives are to assess the subjective utility of a PIV on glaucoma and analyse the use of QR codes as a delivery method.

Methods: A prospective study was conducted in Ninewells Hospital, NHS Tayside. A glaucoma PIV was created and linked to a QR code provided to 130 glaucoma patients. Pre- and post-video questionnaires evaluated the patients' perception of using a QR code and subjective improvement in their understanding of glaucoma.

Results: Out of 102 responses collected, 55% of patients had no prior experience with QR codes. However, 81% of patients were able to watch the PIV. The average view duration of the video was 3:26, with 82.5% view retention. Statistically significant improvement in glaucoma knowledge was observed across all six areas questioned (p < 0.001) using a 5-point Likert scale. Overall, 70% of patients preferred PIVs over PILs, and 77% acknowledged that PIVs could be a sustainable alternative.

Conclusion: QR codes for delivering PIVs were well-received, with patients finding them easy to use. Our PIV on glaucoma effectively enhanced patients' understanding of the condition.

背景:我们探索了一种创新方法,将眼科患者信息宣传单(PIL)转化为与快速反应(QR)代码链接的患者信息视频(PIV)。我们的目标是评估 PIV 在青光眼方面的主观效用,并分析使用 QR 码作为传递方法的情况:方法:在泰赛德国家医疗服务系统的尼尼韦尔斯医院开展了一项前瞻性研究。制作了青光眼 PIV,并与提供给 130 名青光眼患者的 QR 码相链接。视频播放前和播放后的问卷调查评估了患者对使用 QR 码的感知以及对青光眼理解的主观改进:在收集到的 102 份答复中,55% 的患者以前没有使用过二维码。然而,81% 的患者能够观看 PIV。视频的平均观看时长为 3:26,观看保留率为 82.5%。据统计,患者在所有六个方面的青光眼知识都有了明显的提高(p 结论:青光眼知识的提高是一个长期的过程:用于提供 PIV 的 QR 码广受欢迎,患者认为它们易于使用。我们关于青光眼的 PIV 有效地提高了患者对青光眼的认识。
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引用次数: 0
Retraction notice 撤稿通知
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-04-24 DOI: 10.1177/00369330241240826
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引用次数: 0
Reboot coaching programme: a mixed-methods evaluation assessing resilience, confidence, burnout and depression in medical students. 重新启动指导方案:一种评估医学生恢复力、信心、倦怠和抑郁的混合方法评估。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2023-12-05 DOI: 10.1177/00369330231213981
Judith Johnson, Lucy Pointon, Rebecca Talbot, Rebecca Coleman, Luke Budworth, Ruth Simms-Ellis, Katharina Vogt, Dialechti Tsimpida, Chandra Shekha Biyani, Reema Harrison, Gloria Cheung, Colin Melville, Vijay Jayagopal, William Lea

Background: Poor mental health in medical students is a global concern. Effective interventions are required, which are tailored towards the training-related stressors medical students experience. The Reboot coaching programme is an online, tailored intervention based on cognitive-behavioural principles.

Aims: To evaluate whether the Reboot coaching programme tailored for medical students was feasible and associated with improvements in mental health outcome indicators.

Methods: Medical students participated in two group online workshops and a one-to-one coaching call with a Reboot-trained licensed psychological therapist. Participants provided data at: baseline (T1), post-workshops (T2), post-coaching call (T3) and 4-month follow-up (T4). Outcome measures included resilience, confidence, burnout and depression. Feedback was provided regarding the workshops at T2.

Results: 115 participants (93/80.9% women; mage = 23.9; SD = 2.8) were recruited, 83 (72.2%) completed all intervention elements and 82 (71.3%) provided T4 data, surpassing recruitment and retention targets. There were significant improvements following baseline in resilience (ps < .001), confidence (ps < .001), burnout (ps < .001) and depression (ps ≤ .001). Most participants agreed the workshops imparted useful skills (n = 92; 99%) and would recommend Reboot to others (n = 89; 95.6%).

Conclusions: Existing interventions have produced mixed results regarding their effectiveness in improving medical students' mental health. Reboot is a feasible intervention in this group which is associated with improvements in resilience, confidence, burnout and depression. Further controlled studies of Reboot are now needed.

背景:医学生心理健康状况不佳是一个全球关注的问题。需要针对医学生所经历的与训练有关的压力源进行有效的干预。Reboot辅导计划是一种基于认知行为原则的在线定制干预。目的:评价为医学生量身定制的Reboot指导方案是否可行,并与心理健康结局指标的改善有关。方法:医学生参加了两个小组在线研讨会和一个一对一的电话辅导与重启培训的执业心理治疗师。参与者在基线(T1)、工作坊后(T2)、辅导后电话(T3)和4个月随访(T4)时提供数据。结果测量包括恢复力、信心、倦怠和抑郁。就二号大楼的工作坊提供意见。结果:115名参与者(93/80.9%为女性;法师= 23.9;SD = 2.8)例,83例(72.2%)完成了所有干预要素,82例(71.3%)提供了T4数据,超过了招募和保留目标。恢复力与基线相比有显著改善(ps ps ps ps≤0.001)。大多数参与者认为讲习班传授了有用的技能(n = 92;99%),并会向其他人推荐Reboot (n = 89;95.6%)。结论:现有的干预措施在改善医学生心理健康方面的效果好坏参半。在这个群体中,重新启动是一种可行的干预措施,它与恢复力、信心、倦怠和抑郁的改善有关。现在需要对Reboot进行进一步的对照研究。
{"title":"Reboot coaching programme: a mixed-methods evaluation assessing resilience, confidence, burnout and depression in medical students.","authors":"Judith Johnson, Lucy Pointon, Rebecca Talbot, Rebecca Coleman, Luke Budworth, Ruth Simms-Ellis, Katharina Vogt, Dialechti Tsimpida, Chandra Shekha Biyani, Reema Harrison, Gloria Cheung, Colin Melville, Vijay Jayagopal, William Lea","doi":"10.1177/00369330231213981","DOIUrl":"10.1177/00369330231213981","url":null,"abstract":"<p><strong>Background: </strong>Poor mental health in medical students is a global concern. Effective interventions are required, which are tailored towards the training-related stressors medical students experience. The Reboot coaching programme is an online, tailored intervention based on cognitive-behavioural principles.</p><p><strong>Aims: </strong>To evaluate whether the Reboot coaching programme tailored for medical students was feasible and associated with improvements in mental health outcome indicators.</p><p><strong>Methods: </strong>Medical students participated in two group online workshops and a one-to-one coaching call with a Reboot-trained licensed psychological therapist. Participants provided data at: baseline (T1), post-workshops (T2), post-coaching call (T3) and 4-month follow-up (T4). Outcome measures included resilience, confidence, burnout and depression. Feedback was provided regarding the workshops at T2.</p><p><strong>Results: </strong>115 participants (93/80.9% women; <i>m</i>age = 23.9; <i>SD </i>= 2.8) were recruited, 83 (72.2%) completed all intervention elements and 82 (71.3%) provided T4 data, surpassing recruitment and retention targets. There were significant improvements following baseline in resilience (<i>ps </i>< .001), confidence (<i>ps </i>< .001), burnout (<i>ps </i>< .001) and depression (<i>ps </i>≤ .001). Most participants agreed the workshops imparted useful skills (n = 92; 99%) and would recommend Reboot to others (n = 89; 95.6%).</p><p><strong>Conclusions: </strong>Existing interventions have produced mixed results regarding their effectiveness in improving medical students' mental health. Reboot is a feasible intervention in this group which is associated with improvements in resilience, confidence, burnout and depression. Further controlled studies of Reboot are now needed.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"10-17"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Statins and BCG response: Is there more to the story? 他汀类药物和卡介苗反应:还有更多故事吗?
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 DOI: 10.1177/00369330231221234
Amanda A Myers, Ashish M Kamat
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引用次数: 0
HMG co-reductase expression and response to intravesical Bacillus Calmette-Guérin in patients with high grade non-muscle invasive urinary bladder cancer receiving statins. 接受他汀类药物治疗的高级别非肌肉浸润性膀胱癌患者HMG共还原酶表达及对膀胱内卡介苗-谷氨酰胺的反应
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2023-11-13 DOI: 10.1177/00369330231213935
Jamie Krishnan, Andrew Symington, Neil Kernohan, Suan Bray, Allison Robertson, Ghulam Nabi

Background: Cardiovascular disease affects over 7 million people in the UK and statins are often prescribed to mitigate cardiovascular risks. The effect of statins on a number of cancers is debated and their effect on Bacillus Calmette-Guérin (BCG) responsiveness in non-muscle invasive urinary bladder cancer (NMIBC) is not fully understood.

Aims: This study aims to explore the difference in HMG Co-A reductase (HMGCR) expression in NMIBC on immunochemistry in BCG responders and non-responders while on statins.

Method: Three hundred and thirty-two cases of intravesical BCG treatment for high-risk NMIBC between November 2003 and December 2017 were identified. Patients taking statins for at least 12 months before the diagnosis of NIMBC and with a follow-up of at least 5 years were included. They were divided into BCG responders and non-responders. Tumour tissue from these patients was immunohistochemically stained and quantitative image analysis carried out to assess and compare HMGCR expression in the groups.

Results & conclusion: This study showed a differential expression of HMGCR in responders vs. non-responders to BCG for high-risk NMIBC on statins. This data should form the basis of a further research and multi-centre study in a larger cohort, using HMGCR as a biomarker of response in patients on statins.

背景:在英国,心血管疾病影响着超过700万人,他汀类药物经常被用于降低心血管风险。他汀类药物对许多癌症的影响存在争议,其对非肌肉浸润性膀胱癌(NMIBC)中卡介苗(BCG)反应性的影响尚不完全清楚。目的:本研究旨在探讨卡介苗应答者和他汀类药物无应答者NMIBC免疫化学中HMG Co-A还原酶(HMGCR)表达的差异。方法:对2003年11月至2017年12月间采用卡介苗膀胱内治疗高危NMIBC病例332例进行分析。患者在确诊NIMBC前服用他汀类药物至少12个月,随访至少5年。他们被分为卡介苗应答者和无应答者。对这些患者的肿瘤组织进行免疫组织化学染色,并进行定量图像分析,以评估和比较各组HMGCR的表达。结果与结论:本研究显示,在接受他汀类药物治疗的高危NMIBC患者中,HMGCR在卡介苗应答者和无应答者中存在差异表达。这些数据应该成为进一步研究和更大队列多中心研究的基础,使用HMGCR作为他汀类药物患者反应的生物标志物。
{"title":"HMG co-reductase expression and response to intravesical Bacillus Calmette-Guérin in patients with high grade non-muscle invasive urinary bladder cancer receiving statins.","authors":"Jamie Krishnan, Andrew Symington, Neil Kernohan, Suan Bray, Allison Robertson, Ghulam Nabi","doi":"10.1177/00369330231213935","DOIUrl":"10.1177/00369330231213935","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease affects over 7 million people in the UK and statins are often prescribed to mitigate cardiovascular risks. The effect of statins on a number of cancers is debated and their effect on Bacillus Calmette-Guérin (BCG) responsiveness in non-muscle invasive urinary bladder cancer (NMIBC) is not fully understood.</p><p><strong>Aims: </strong>This study aims to explore the difference in HMG Co-A reductase (HMGCR) expression in NMIBC on immunochemistry in BCG responders and non-responders while on statins.</p><p><strong>Method: </strong>Three hundred and thirty-two cases of intravesical BCG treatment for high-risk NMIBC between November 2003 and December 2017 were identified. Patients taking statins for at least 12 months before the diagnosis of NIMBC and with a follow-up of at least 5 years were included. They were divided into BCG responders and non-responders. Tumour tissue from these patients was immunohistochemically stained and quantitative image analysis carried out to assess and compare HMGCR expression in the groups.</p><p><strong>Results & conclusion: </strong>This study showed a differential expression of HMGCR in responders vs. non-responders to BCG for high-risk NMIBC on statins. This data should form the basis of a further research and multi-centre study in a larger cohort, using HMGCR as a biomarker of response in patients on statins.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"3-9"},"PeriodicalIF":2.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156342","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
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Scottish Medical Journal
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