British medical bulletin
-
British medical bulletin · Mar 2022
Considerations for the implementation of machine learning into acute care settings.
Management of patients in the acute care setting requires accurate diagnosis and rapid initiation of validated treatments; therefore, this setting is likely to be an environment in which cognitive augmentation of the clinician's provision of care with technology rooted in artificial intelligence, such as machine learning (ML), is likely to eventuate. ⋯ Well-resourced Learning Health Systems are likely to exploit ML technology to gain the fullest benefits for their patients. How these clinical advantages can be extended to patients in health systems that are neither well-endowed, nor have the necessary data gathering technologies, needs to be urgently addressed to avoid further disparities in healthcare.
-
British medical bulletin · Mar 2022
Review'The WOW factors': comparing workforce organization and well-being for doctors, nurses, midwives and paramedics in England.
High rates of poor mental health in healthcare staff threatens the quality and sustainability of healthcare delivery. Multi-factorial causes include the nature and structure of work. We conducted a critical review of UK NHS (England) data pertaining to: doctors, nurses, midwives and paramedics. ⋯ Multi-level systems approaches to well-being are required that consider intersectionality and structural differences between professions; together with inter-professional national databases to facilitate monitoring.
-
British medical bulletin · Dec 2021
Meta AnalysisDiagnosis and epidemiology of winged scapula in breast cancer patients: A systematic review and meta-analysis.
Winged scapula (WS) is a critical complication of axillary surgery in patients treated for breast cancer, and is associated with pain, impairment of the upper extremity's function and poor performance in daily activities. ⋯ Further studies should aim for objective diagnostic tests, especially when the condition is not evident.
-
British medical bulletin · Dec 2021
ReviewTreatment strategies for mosaic overgrowth syndromes of the PI3K-AKT-mTOR pathway.
Mosaic overgrowth syndromes (OS) are a proteiform ensemble of rare diseases displaying asymmetric overgrowth involving any tissue type, with degrees of severity ranging from isolated malformation to life-threatening conditions such as pulmonary embolism. Despite discordant clinical presentations, all those syndromes share common genetic anomalies: somatic mutations of genes involved in cell growth and proliferation. The PI3K-AKT-mTOR signaling pathway is one of the most prominent regulators of cell homeostasis, and somatic oncogenic mutations affecting this pathway are responsible for mosaic OS. This review aims to describe the clinical and molecular characteristics of the main OS involving the PI3K-AKT-mTOR pathway, along with the treatments available or under development. ⋯ OS are a dynamic, expanding field of research. Studies focusing on the identification of genetic anomalies and their pharmacological inhibition are needed.
-
British medical bulletin · Dec 2021
ReviewTranslational aspects of novel findings in genetics of male infertility-status quo 2021.
Male factor infertility concerns 7-10% of men and among these 40-60% remain unexplained. ⋯ Di-/oligogenic causes, structural and common variants implicated in multifactorial inheritance may explain the 'hidden' genetic factors. It is also critical to understand how the recently identified diverse genetic factors of infertility link to general male health concerns across lifespan and how the clinical assessment could benefit from this knowledge.