Brit J Hosp Med
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Randomized Controlled Trial
Efficacy of General Magnetic Therapy and Motor-Evoked Potential-Guided Precision Magnetic Therapy in Patients with Overactive Bladder: A Randomized Controlled Trial.
Aims/Background Overactive bladder (OAB) is a prevalent chronic condition affecting approximately 12% of adults, with incidence increasing with age. While pharmacological and behavioural therapies are standard treatments, their efficacy is often limited by side effects and poor adherence. This study aimed to compare the therapeutic effects of precision magnetic stimulation guided by motor-evoked potential with general magnetic therapy in patients with OAB. ⋯ While there were no significant differences between the two magnetic stimulation methods in terms of OABSS scores, urgent urination, nocturnal urination, or maximum bladder volume, precision magnetic therapy showed greater efficacy in reducing urination frequency and improving initial bladder volume. These findings suggest that precision magnetic therapy offers an enhanced therapeutic benefit. Clinical Trial Registration Chinese Clinical Trial Registry (ChiCTR2400087888).
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Aims/Background Research evidence has demonstrated a significant association between hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF), but the causality and pattern of this link remain unexplored. Therefore, this study investigated the causal relationship between HCM and AF using a two-sample and bidirectional Mendelian randomization (MR) approach. Additionally, this assessed the role of cardiovascular proteins (CPs) associated with cardiovascular diseases between HCM and AF by applying a two-step MR analysis. ⋯ Moreover, Two-step MR analyses indicated that 5 CPs were causally associated with HCM; 12 CPs with AF and 1 CP (Melusin) with both HCM and AF. Additionally, Melusin was observed as a protective factor for both HCM and AF and may serve as a mediator variable for these two conditions (mediation effect 0.0004, mediation ratio 5.5178%, 95% CI: 5.4624-5.5731). Conclusion HCM may increase the risk of developing AF, with Melusin serving as a mediator for this risk.
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The burdens of cardiovascular (CV) diseases and cardiotoxic side effects of cancer treatment in oncology patients are increasing in parallel. The European Society of Cardiology (ESC) 2022 Cardio-Oncology guidelines recommend the use of standardized risk stratification tools to determine the risk of cardiotoxicity associated with different anticancer treatment modalities and the severity of their complications. The use of the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) is essential for assessing risk prior to starting cancer treatment, and validation of these methods has been performed in patients receiving anthracyclines, human epidermal receptor 2 (HER2)-targeted therapies and breakpoint cluster region-abelson oncogene locus (BCR-ABL) inhibitors. ⋯ This review summarizes the key points of risk stratification in these patients. The steps include identifying the target population, assessing nonmodifiable and modifiable CV risk factors, reviewing previous oncologic therapies and CV histories, and performing baseline investigations. In summary, this review aims to provide general physicians with a simple 7-step guide that will help steer and navigate them through cardiac risk evaluation of potentially cardiotoxic oncologic treatment strategies.
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Advanced life support certification has traditionally been the gold standard of resuscitation training for doctors and has been shown to improve outcomes from cardiac arrest. In 2021, Health Education England removed named courses from mandatory Foundational Programme competencies, which has resulted in capping of reimbursement and reduced access to courses. This represents a drop in educational standards which is particularly concerning when the medical school curriculum has been shown to deliver inconsistent, poor-quality resuscitation training. Here we review the benefits and negatives of life support training, looking at both junior and senior clinicians with differing educational requirements.
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Aims/Background Atopic dermatitis (AD) is a common chronic inflammatory skin disorder globally. Crisaborole, a nonsteroidal topical phosphodiesterase 4 inhibitor (PDE4i), has been utilized in treating AD. Crisaborole regulates the production of inflammatory cytokines, which are usually overactive among AD patients. ⋯ Furthermore, the safety profiling of the treatments was insignificant, demonstrating no statistical difference in the treatment-emergent adverse events (TEAEs) between the two groups with high heterogeneity (OR 0.53, 95% CI 0.14 to 1.98; I2 = 99%; p = 0.35). Conclusion Crisaborole demonstrates substantial efficacy in treating mild to moderate AD compared to vehicle therapies, as it reduces the signs and symptoms of the disease. Furthermore, crisaborole is well tolerated and has an acceptable safety profile in treating mild to moderate AD patients.