Scottish Medical Journal最新文献

英文中文

Multicentric analysis of the perceptions and knowledge of digital health amongst undergraduate medical students 本科医学生对数字健康认知和知识的多中心分析

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-03-03 DOI: 10.1177/00369330221080749

Mohamed Nauzan Mohamed Nazeer, H. Baig, A. Subeh, Q. Khan, Saad Atif Majeed, Mohammad Ashraf

Introduction Digital health (DH) is continuously evolving by use of information and communications technology to improve healthcare provision, thereby reshaping systems and clinical practices. Recent studies identified an overwhelming lack of awareness of DH within the profession. This study aimed to analyse student perceptions and knowledge of DH to assess confidence in its use to develop greater DH awareness and literacy. Methods Students enrolled in undergraduate medical degrees were invited to take part in an online survey assessing aspects of DH including demography, familiarity, attitudes, level of knowledge and confidence. Anonymised data was collated and subsequently analysed to review DH awareness. Results A total of 143 students participated from nine British universities with 28.7% of respondents admitting low levels of familiarity of DH concepts. Students anticipated negative repercussions of DH including reduced data security (42.7%) and deterioration in doctor-patient relationship (30%); while improvements in healthcare access and health-outcomes are expected by 89.5% and 68.5%, respectively. 71.4% of participants believed they had minimal experience of exposure to DH and 76% believed they did not possess the necessary skills to utilise DH. Only 3.5% of students had some exposure to DH teaching during their course. Conclusion There is an important requirement to address the lack of knowledge and exposure of students to DH, particularly as the world targets the COVID-19 pandemic. DH is forming the basis of the ‘new normal’ in healthcare, however the full potential of DH cannot be achieved unless there is an increase in its teaching incorporated into medical school curricula.

引言数字健康（DH）通过利用信息和通信技术不断发展，以改善医疗服务，从而重塑系统和临床实践。最近的研究发现，该行业普遍缺乏对DH的认识。本研究旨在分析学生对DH的看法和知识，以评估对其使用的信心，从而提高DH意识和识字率。方法邀请医学本科生参加一项在线调查，评估DH的人口学、熟悉度、态度、知识水平和信心等方面。对匿名数据进行了整理和分析，以审查卫生署的认识。结果共有143名来自英国9所大学的学生参加了调查，其中28.7%的受访者承认对DH概念的熟悉程度较低。学生预计DH的负面影响，包括数据安全性降低（42.7%）和医患关系恶化（30%）；而医疗保健可及性和健康结果的改善预计分别为89.5%和68.5%。71.4%的参与者认为他们接触DH的经验很少，76%的人认为他们不具备使用DH的必要技能。只有3.5%的学生在课程中接触过DH教学。结论解决学生对DH缺乏知识和接触的问题是一项重要要求，特别是在全球应对新冠肺炎大流行的情况下。卫生署正在形成医疗保健“新常态”的基础，但除非将其教学纳入医学院课程，否则卫生署的全部潜力无法实现。

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引用次数: 2

Extra-peritoneal Laparoscopic Resection of Benign Prostate Adenoma >150 CC with preservation of posterior wall of prostatic urethra: Dundee Technique and early outcomes. 保留前列腺尿道后壁的腹腔镜下> 150cc良性前列腺腺瘤切除术:Dundee技术及早期结果

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 Epub Date: 2021-12-23 DOI: 10.1177/00369330211068123

Hollie A Clements, Ghulam Nabi

Background: There are limited options for men with large benign prostates (>150cc) and bladder outflow obstruction due to benign prostatic hyperplasia (BPH). Management options include surgery (open or minimal access) and endoscopic procedures. There is a paucity of literature on outcomes for prostates >150cc.

Methods: In this case series we describe a step-by-step, illustrated, modified extra-peritoneal technique of laparoscopic prostatectomy with preservation of the posterior prostatic urethra. This involves creation of extra-peritoneal space, transverse incision of prostate capsule, progressive adenoma dissection, resection, and closure of the capsule.

Results: Ten patients underwent this procedure between 2015 and 2019. The mean age was 72.4 years and mean prostate size was 215.5cc. Mean procedure duration was 200 min and there were no intraoperative complications. Most patients were discharged on postoperative day 1. Mean intraoperative blood loss was 120 ml with no patient requiring blood transfusion. At follow up (mean 37 months) no patients had residual symptoms of BPH.

Conclusion: We describe a novel extraperitoneal laparoscopic technique for benign prostates of >150cc with very good outcomes. The transferability of this technique to centres with laparoscopic expertise at minimal extra cost and future adaptability in the robotic setting are some of the advantages of this technique.

背景:对于大良性前列腺(>150cc)和由良性前列腺增生(BPH)引起的膀胱流出梗阻的男性，选择有限。治疗方案包括手术(开放或最小通道)和内窥镜手术。关于前列腺>150cc的预后文献很少。方法:在这个病例系列中，我们描述了一步一步，说明，改良的腹膜外腹腔镜前列腺切除术技术，保留前列腺后尿道。这包括创造腹膜外间隙，横向切开前列腺包膜，渐进式腺瘤清扫、切除和包膜闭合。结果:2015年至2019年期间，有10名患者接受了该手术。平均年龄为72.4岁，平均前列腺大小为215.5cc。平均手术时间200分钟，无术中并发症。大多数患者在术后第1天出院。术中平均失血量为120 ml，无患者需要输血。随访(平均37个月)无患者出现前列腺增生残余症状。结论:我们描述了一种新的腹腔外腹腔镜技术，用于>150cc的良性前列腺，效果非常好。该技术以最小的额外成本转移到具有腹腔镜专业知识的中心，并且未来在机器人环境中的适应性是该技术的一些优点。

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引用次数: 1

A call to introduce newborn screening for spinal muscular atrophy (SMA) in Scotland. 呼吁在苏格兰引入新生儿脊髓性肌萎缩症(SMA)筛查。

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 Epub Date: 2022-02-11 DOI: 10.1177/00369330221078994

Thomas H Gillingwater, Catherine McWilliam, Iain Horrocks, Kenneth McWilliam, Mark Hamilton, Elaine Fletcher, Nicola Williams, Sarah Smith, Simon H Parson

The recent development of three effective therapies for patients with spinal muscular atrophy (SMA) – Nusinersen (Spinraza), Onasemnogene abeparvovec (Zolgensma) and Risdiplam (Evrysdi) - arguably represents one of the great medical achievements of the 21 st century. 1 These treatments, which all work via restoring levels of the SMN protein, have revolutionised the outlook for patients with an otherwise incurable, and mostly fatal, condition. However, all three treat-ments come at a signi ﬁ cant ﬁ nancial cost For example, Zolgensma (often referred to as “ the world ’ s most expensive drug ” ) has a list price of nearly £1.8m per dose. Moreover, a large body of pre-clinical research, supported by emerging data from patient clinical trials, makes clear that the effective-ness of all current SMA therapies is largely determined by how early therapy can be delivered. 1,2 Thus, pre-symptomatic treatment of patients results in signi ﬁ cantly better outcomes both in terms of patient bene ﬁ ts and ﬁ nancial return on investment - than starting treatment after symptom onset. If then follows identify SMA patients onset hence exists:

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引用次数: 1

Evaluation of lung cancer biomarkers profile for the decision of targeted therapy in EBUS-TBNA cytological samples. 评估EBUS-TBNA细胞学样本中肺癌生物标志物谱以决定靶向治疗。

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 Epub Date: 2022-02-11 DOI: 10.1177/00369330221078995

Aslıhan Gürün Kaya, Aydın Çiledağ, Serhat Erol, Miraç Öz, Deniz Doğan Mülazımoğlu, Özlem Işık, Hilal Özakıncı, Fatma Çiftçi, Elif Şen, Koray Ceyhan, Akın Kaya, Demet Karnak, Gökhan Çelik, Savaş İsmail

Background: Guidelines recommend performing biomarker tests for epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), BRAF and ROS proto-oncogene-1(ROS1) genes and protein expression of programmed death ligand-1(PD-L1) in patients with non-small lung cell carcinoma (NSCLC). Studies reported that endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) can provide sufficient material for cancer biomarker analyses, but there are still concerns about the subject.

Aim: The purpose of the study was to assess the adequacy of EBUS-TBNA for testing lung cancer biomarkers.

Methods: We retrospectively reviewed patients with NSCLC whose EBUS-TBNA was analysed for EGFR, ALK, ROS-1, BRAF and PD-L1 expression between December 2011 and December 2020.

Results: A total of 394 patients were enrolled in the study. EGFR mutation and ALK fusion were the most common studied biomarkers. EBUS-TBNA adequacy rate for biomarker tests was found 99.0% for EGFR, 99.1 for ALK, 97.2% for ROS1, 100% for BRAF and 99.3% for PD-L1 testing. Multivariate analysis revealed the histological type, history of treatment for NSCL, size, or 18-fluorodeoxyglucose uptake of sampled lesion did not show any association with TBNA adequacy for biomarker testing.

Conclusion: EBUS-TBNA can provide adequate material for biomarker testing for EGFR, ALK, ROS-1, BRAF and PD-L1 expression.

背景:指南推荐在非小肺细胞癌(NSCLC)患者中进行表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)、BRAF和ROS原癌基因-1(ROS1)基因和程序性死亡配体-1(PD-L1)蛋白表达的生物标志物检测。有研究报道，支气管内超声-经支气管针吸法(EBUS-TBNA)可以为癌症生物标志物分析提供足够的材料，但仍存在一些问题。目的:本研究的目的是评估EBUS-TBNA检测肺癌生物标志物的充分性。方法:回顾性分析2011年12月至2020年12月期间EBUS-TBNA检测EGFR、ALK、ROS-1、BRAF和PD-L1表达的非小细胞肺癌患者。结果:共有394名患者入组研究。EGFR突变和ALK融合是最常见的生物标志物。EGFR的EBUS-TBNA充分率为99.0%，ALK为99.1%，ROS1为97.2%，BRAF为100%，PD-L1为99.3%。多变量分析显示，组织学类型、非典型鳞状细胞白血病的治疗史、大小或样本病变的18-氟脱氧葡萄糖摄取与生物标志物检测的TBNA充分性没有任何关联。结论:EBUS-TBNA可为EGFR、ALK、ROS-1、BRAF、PD-L1等生物标志物的检测提供充足的材料。

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引用次数: 3

Robotic Millin's Prostatectomy: Revisiting an age-old technique for treating benign prostate hyperplasia in large glands 机器人米林前列腺切除术:重访治疗大腺体良性前列腺增生的古老技术

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 DOI: 10.1177/00369330221080750

Venkata Rm Kusuma, D. Moschonas, M. Perry, K. Patil

The surgical management of large benign prostates above 100 ml remains a challenge. Various guidelines recommend Holmium laser enucleation of the prostate (HOLEP), Bipolar TURP, Thulium laser VapoEnucleation Prostate (ThuVEP), and open prostatectomy for gland size more than 80ml. 1 – 3 Open prostatectomy is less favoured due to increased transfusion rates, complications, and prolonged hospital stay. 4 As a result, the experience in open Millin ’ s prostatectomy has dwindled with most of the procedures being done by minimally invasive methods. Although laser enucleation of the prostate is established as a standard treatment option, the limitations are the steep learning curve, limited availability of the equipment, and prolonged stress urinary incontinence. 5

大于100毫升的大型良性前列腺的外科治疗仍然是一个挑战。各种指南推荐钬激光前列腺去核术(HOLEP)，双极TURP，铥激光前列腺去核术(ThuVEP)，以及腺体大小超过80ml的开放式前列腺切除术。1 - 3由于输血率、并发症和住院时间延长，开放性前列腺切除术不太受欢迎。结果，开放式米林前列腺切除术的经验减少了，大多数手术都是通过微创方法完成的。虽然激光前列腺摘除是一种标准的治疗选择，但其局限性是学习曲线陡峭，设备的可用性有限，以及长期的压力性尿失禁。5

引用次数: 1

Scottish Cardiac Society 30^th Annual General Meeting Friday 24^th September 2021. 苏格兰心脏病学会第 30 届年度大会 2021 年 9 月 24 日星期五。

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 DOI: 10.1177/00369330211066529

引用次数: 0

Integrated bioinformatic analysis of key biomarkers and signalling pathways in psoriasis. 银屑病关键生物标志物和信号通路的综合生物信息学分析。

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 Epub Date: 2022-02-11 DOI: 10.1177/00369330221078993

Suwei Tang, Wencheng Jiang, Ping Xu, Shaoqiong Xie, Mingxia Wang, Chunjie Gao, Jiajing Lu, Yang Yang

Background and aims: Psoriasis is a relatively common autoimmune inflammatory skin disease with a chronic etiology. Since psoriasis is still incurable, it is necessary to identify the molecular mechanisms of psoriasis. The present study was designed to detect novel biomarkers and pathways associated with psoriasis incidence, and provide new insights into treatment of psoriasis.

Methods and results: Differentially expressed genes (DEGs) associated with psoriasis in the Gene Expression Omnibus (GEO) database were identified, and their functional roles and interactions were then annotated and evaluated through GO, KEGG, and gene set variation (GSVA) analyses. In total 197 psoriasis-related DEGs were identified and found to primarily be associated with the NOD-like receptor, IL-17, and cytokine-cytokine receptor interaction signalling pathways. GSVA revealed significant differences between normal and lesional groups (P < 0.05), while PPI network analyses identified CXCL10 as the hub gene with the highest degree value, whereas IRF7, IFIT3, OAS1, GBP1, and ISG15 were promising candidate genes for the therapeutic treatment of psoriasis.

Conclusion: The findings of the present integrated bioinformatics may enhance our understanding of the molecular events occurring in psoriasis, and these candidate genes and pathways together may prove to be therapeutic targets for psoriasis.

背景和目的：银屑病是一种比较常见的自身免疫性炎症皮肤病，病因是慢性的。由于银屑病仍无法治愈，因此有必要确定银屑病的分子机制。本研究旨在检测与银屑病发病相关的新型生物标志物和通路，并为银屑病的治疗提供新的见解：在基因表达总库（GEO）数据库中确定了与银屑病相关的差异表达基因（DEGs），然后通过GO、KEGG和基因组变异（GSVA）分析对其功能作用和相互作用进行了注释和评估。共鉴定出 197 个与银屑病相关的 DEGs，发现它们主要与 NOD 样受体、IL-17 和细胞因子-细胞因子受体相互作用信号通路有关。GSVA显示正常组和皮损组之间存在明显差异（P＜0.05），而PPI网络分析则发现CXCL10是程度值最高的枢纽基因，而IRF7、IFIT3、OAS1、GBP1和ISG15则是有望用于银屑病治疗的候选基因：结论：本综合生物信息学研究的结果可能会加深我们对银屑病分子事件的理解，这些候选基因和通路可能会被证明是银屑病的治疗靶点。

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Scottish Paediatric Society St Andrew's Day Paediatic Symposium 2020. 2020年苏格兰儿科学会圣安德鲁日儿科研讨会

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 DOI: 10.1177/00369330211068774

引用次数: 0

ABSTRACT SUBMISSION - Autumn Meeting - 29 October 2021. 提交摘要-秋季会议-2021年10月29日

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 DOI: 10.1177/00369330221074572

引用次数: 0

Scottish Paediatric Society Summer Meeting 2021. 苏格兰儿科学会2021年夏季会议

IF 2.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Scottish Medical Journal

Pub Date : 2022-02-01 DOI: 10.1177/00369330211068776

引用次数: 0

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