Brit J Hosp Med
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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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Spontaneous pneumothorax is an increasingly common clinical presentation, the management of which, until recent years, had remained unchanged for decades. A recent surge in pneumothorax research has produced the largest randomised controlled trials in the field yet and has revolutionised the management of spontaneous pneumothorax. ⋯ In this review, we discuss recent advances in the management of pneumothorax and the evidence underpinning contemporary guidelines. We aim to equip physicians with the knowledge to engage their patients in the decision-making process regarding their pneumothorax, whilst keeping patient safety and patients' own preferences at the centre of their care.
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Kawasaki disease (KD), which is also known as cutaneous mucosal lymph node syndrome, is an acute, self-limiting, necrotizing vasculitis with unclear cause that primarily affects small- and medium-sized blood vessels and most commonly affects children aged 6 months to 5 years. Currently, diagnosis is based primarily on typical clinical symptoms. ⋯ After a series of clinical laboratory and imaging examinations and marked improvement of symptoms after treatment with intravenous immunoglobulin (IVIG), IKD was considered as the diagnosis. When children present with jaundice and fever, physicians should consider KD as a possible diagnosis to ensure early detection and treatment of the disease.
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Aims/Background Chronic renal failure (CRF) is the eventual outcome shared by various progressive renal diseases, posing a serious threat to the physical health of patients. CRF patients are required to undergo hemodialysis (HD), which imposes heavy psychological and mental burdens for most individuals. This study explores the effects of Internet Plus-based continuous nursing on the compliance of CRF patients with HD. ⋯ After 6 months of follow-up, the scores of KDTA and SF-36 in the observation group were significantly higher than those in the routine group (p < 0.001). The incidence of HD complications in the observation group (7.41%) was significantly lower than that in the routine group (21.52%) (p < 0.05). Conclusion Internet Plus-based continuous nursing can effectively improve treatment adherence, self-management behaviors as well as quality of life in patients, and reduce the incidence of HD complications.
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Aims/Background Coronary heart disease (CHD) and atrial fibrillation (AF) exhibit a close relationship, yet the existing body of research predominantly relies on observational study methodologies, posing challenges in establishing causal relationships. The objective of our study is to investigate the causal linkages between coronary atherosclerosis (CAAs), angina pectoris, myocardial infarction (MI), and AF. Methods This study utilizes a two-sample Mendelian randomization (TSMR) methodology, leveraging genetic variation as a means of evaluating causality. ⋯ Results The results of our study suggest a genetic predisposition in which CAAs, angina, and MI may enhance susceptibility to AF, while AF may reciprocally elevate the risk of CAAs. Conclusion In light of these findings, it is recommended that patients with CHD undergo regular cardiac rhythm monitoring, and that patients with AF receive anticoagulant and antiplatelet therapy whenever feasible. This study posits a practical implication for clinical practice.