Brit J Hosp Med
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Aims/Background Arterial spin labelling (ASL) is a non-invasive magnetic resonance imaging (MRI) method. ASL techniques can quantitatively measure cerebral perfusion by fitting a kinetic model to the difference between labelled images (tag images) and ones which are acquired without labelling (control images). ASL functional MRI (fMRI) provides quantitative perfusion maps by using arterial water as an endogenous tracer instead of depending on vascular blood oxygenation level. ⋯ Conclusion The 4-block pulsed functional ASL (fASL) presents accurate and reliable activation, with minimal time-on-task effect and little adverse impact of time, in participants engaging in visually guided saccade and fixation tasks. Despite having lower sensitivity than BOLD fMRI, ASL can determine accurate activation location. Although the time-on-task effects affect the observation for the sensitivity of ASL over task time, it is suggested that ASL fMRI may provide a powerful method for pinpointing the time-on-task effect over a long period of time.
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Locally Employed Doctors (LEDs) are defined as any doctor below consultant grade, appointed within a UK National Health Service (NHS) Trust, who are not working within a national training scheme. They are a cohort significantly increasing in numbers. International Medical Graduates (IMGs) are overseas-qualified doctors who contribute to more than 30% of the workforce-related deficit in the number of UK-qualified doctors required to meet NHS requirements. ⋯ The Royal College of Physicians (RCP) recently produced new guidance stating the basic principle that all doctors should be considered as being in training. LEDs are junior doctors with educational needs, yet they do not receive the same opportunities as their training-grade equivalents. Moving forward, we would advocate a UK-wide process which will help the NHS develop a strong and cohesive workforce, whether they are locally or nationally employed.
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Aims/Background Child and adolescent psychiatric inpatient admissions out-of-area or to adult wards are frequently discussed in the national media. No previous systematic reviews have investigated the impact of such admissions. Methods Systematic searches of MEDLINE, Embase, CINAHL, PsycINFO, PsycArticles, King's Fund, Google Scholar, The Health Foundation, Social Care Online, Cochrane Library, Royal College of Psychiatrists, Web of Science and Econ light databases were conducted alongside grey literature searches. ⋯ For studies of admissions of under-18s to adult psychiatric wards the most commonly reported impact was on length of stay. Opinions from staff and young people of these types of admissions were mostly negative. Conclusion Further studies looking at the full range of impacts of these admissions over the long term are needed.
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Aims/Background Peripheral nerve injury affects some people with multiple myeloma; this condition can be brought on by the disease itself or by the treatments they receive. Such a complication increases patients' financial burden, causes treatment to be interrupted or delayed, and reduces treatment efficacy. However, opinions regarding the risk factors for peripheral neuropathy are currently divided. ⋯ We discovered that PN was strongly correlated with age, haemoglobin, and levels of creatinine (p = 0.039, p = 0.045, and p = 0.030, respectively). Conclusion Age, haemoglobin and creatinine levels are associated with the occurrence of PN. Investigation of the incidence and risk factors of multiple myeloma-associated PN can provide a better theoretical basis for the selection of treatment options and the enhancement of patient well-being and satisfaction.
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Aims/Background The present study aimed to assess the capability of biomarkers, including inflammatory indicators, anaemic markers, lipid markers, and renal function indices, to differentiate between different stages of chronic kidney disease (CKD). Expected to provide a new strategy for monitoring the development of CKD and stratified treatment management, providing valuable insights for future biomarker studies to explore early detection of CKD. Methods The changes in inflammatory markers (interferon gamma [IFN-γ], interleukin [IL]-17A, IL-10, IL-6, IL-4, IL-2, IL-1 and white blood cells [WBC]), lipid markers (high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], and triglyceride [TG]), indicators of kidney injury (serum creatinine [Scr] and blood urea nitrogen [BUN]) in 451 patients with different stages of CKD were examined. ⋯ Furthermore, it was discovered that the blood levels of IL-6 (p = 0.012), BUN (p < 0.001), and Hb (p < 0.001) were risk factors associated with the stages of CKD. Conclusion Serum levels of IL-6, BUN and Hb have been associated with the progression of CKD. Using a combination of serum biomarkers is a potential strategy for tracking the development of CKD, facilitating stratified management and early intervention.