Brit J Hosp Med
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Postgraduate leadership fellowships are becoming more popular among doctors-in-training. The author completed a one-year leadership fellowship with the Health Education England (HEE), East Midlands. A personal reflective approach was used to present the experiences of the author following the completion of the fellowship programme. ⋯ Personal benefits for the author were seen in the areas of improved leadership skills; completion of a postgraduate academic qualification; improvement of teaching skills; and honing of major trauma clinical skills. Furthermore, the literature review showed that there was high grade evidence from two randomised controlled trials, for the impact of such programmes in obstetrics/gynaecology simulation, and on team leadership for major trauma resuscitation. In addition, three systematic reviews reported positive impacts of such programmes at an individual level for participants' attitudes, knowledge and skills, with minimal evidence for the overall impacts on healthcare institutions.
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Meta Analysis
The Effect of Probiotics on Obesity with Comorbid Depression: A Systematic Review and Meta-Analysis.
Aims/Background Obesity and depression frequently co-occur, and the relationship between them is bidirectional. Being obese or overweight increases the risk of depression, and conversely, depression increases the risk of obesity or overweight. Emerging clinical research has shown that probiotics may be effective in treating obesity and associated depression. ⋯ Conclusion Overall, probiotics did not improve depressive symptoms in obesity. However, beneficial effects were observed with the Edinburgh Postnatal Depression Scale and short-term use of probiotic. Additional rigorous randomized controlled trials are warranted to elucidate the therapeutic potential of probiotics for obesity-related depression.
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Coeliac disease is a common autoimmune disorder that affects nearly 1% of the general population. Current diagnostic strategies involve active case finding, serological tests, and endoscopy with biopsies. However, many patients with coeliac disease remain undiagnosed due to a wide gap between clinical guidelines and real-world practice in the diagnosis of adult coeliac disease. This highlights the need for increased education, training, and targeted quality-improvement interventions to optimise the diagnosis of coeliac disease.
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Case Reports
Intrauterine Device Completely Encapsulated by Fibrous Tissue in a Postmenopausal Woman: A Case Report.
A 54-year-old woman, who had been menopausal for over two years and had an Intrauterine Device (IUD) in place for over twenty years, requested a removal of the IUD. The IUD was found to be embedded during the removal process. ⋯ For postmenopausal women with IUDs, early removal is recommended to minimise complications. Hysteroscopic examination should be the first choice for the rare complication of embedded IUDs covered with fibrous tissue, with hysteroscopic removal as the preferred treatment.
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Comparative Study
Comparative Predictive Modeling for PICC Line Complications in Oncology: A Retrospective Study.
Aims/Background Peripherally inserted central catheter (PICC) are increasingly used in cancer treatment, offering significant therapeutic benefits while also posing risks for complications such as infection, thrombosis, and catheter migration. Effective prediction and management of these complications are crucial to optimizing patient outcomes and reducing healthcare costs. Methods This retrospective study analyzed PICC line insertion in 266 cancer patients implemented from January 2019 to December 2023 at a regional healthcare facility in China. ⋯ A tailored nomogram was developed for clinical use, enabling personalized risk evaluation. Conclusion The study underscores the utility of LASSO logistic regression in the personalized risk evaluation of PICC line complications, recommending its integration into clinical practice. The tailored nomogram provides a practical tool for clinicians to enhance care customization for patients requiring PICC lines, thereby improving treatment outcomes and patient safety.