The latest medical research on Hospital
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about hospital gathered by our medical AI research bot.
The selection below is filtered by medical specialty. Registered users get access to the Plexa Intelligent Filtering System that personalises your dashboard to display only content that is relevant to you.
Want more personalised results?
Request AccessRationale and design of Dapagliflozin vErsus SacubiTrIl-valsartaN therapY in Heart Failure with reduced ejection fraction (DESTINY-HF): a pragmatic randomised controlled trial protocol.
BMJ OpenCTRI/2023/12/060772.
This pragmatic randomised controlled trial recruits 100 patients with HFrEF (ejection fraction <40%) of New York Heart Association (NYHA) II-III and allocates them in a 1:1 ratio to the dapagliflozin and sacubitril/valsartan groups. The primary objective is to assess the difference in N-terminal pro-brain natriuretic peptide serum levels at the end of 16 weeks. The secondary efficacy objectives are to assess GDF-15, Kansas City Cardiomyopathy Questionnaire-overall summary score and estimated glomerular filtration rate. Patients will be assessed at baseline, fourth week and 16th week after randomisation. As health technology assessment practices widely differ in countries, cost assessment is a vital factor to consider. The cost needed to treat one cardiovascular event is also compared between both groups. The occurrence of safety events will also be evaluated at each follow-up point.
This pragmatic study aims to compare the efficacy, safety and cost-effectiveness of dapagliflozin versus sacubitril/valsartan in patients with HFrEF in real-world settings. The study aims to provide clinicians with data to make informed decisions regarding the preferred drug class. Additionally, examining the impact of ARNI and SGLT2i on GDF-15 levels could offer better insights into prognosis among patients with HFrEF.
New cancer medicines in Europe 2010-2020: comparison of medicines with or without extensions of indications.
BMJ OpenDuring the last decade, extensions of therapeutic indications have been one of the most common methods to extend the lifecycle of a medical product in the post-authorisation phase and to increase the use and sales of medicines. The aim of this study was to gain understanding of the lifecycle of cancer medicines and especially the role and level of evidence extensions in comparison to first indications.
We identified all new outpatient cancer medicines approved by the European Medicines Agency between 2010 and 2020 and the extensions to their indications. We compared general study design characteristics from the European public assessment reports using critical appraisal tools and clinical added value assessments.
We identified altogether 55 new outpatient cancer medicines, 31 of which had one or more extension(s) of indication and 24 had no extension of indication. In total, there were 57 extensions. The most common extension of indication was a change in the treatment line (35%). Compared with first indications, the overall quality of studies supporting extensions was better in terms of study designs. The proportion of medicines providing CAV was higher in extensions compared with first indication of medicines with and without extensions.
Based on different assessments and perspectives, we found that extensions of indications are a very common and important part of extending the lifecycle of outpatient cancer medicines in Europe. Our findings also suggest that the clinical value of cancer medicines increases with extensions.
Efficacy and mechanism of transcutaneous electrical acupoint stimulation for angina severity in patients with chronic coronary syndromes: study protocol for a multicentre randomised controlled trial.
BMJ OpenChiCTR2400079383.
This study, conducted across two clinical centres, involved 90 participants distributed equally into three groups via simple randomisation (1:1:1 ratio). The research cycle was 28 weeks including a 4-week baseline, 12-week treatment and 12-week follow-up period. All groups will receive basic treatment with the TEAS group additionally receiving 36 sessions of TEAS stimulation over the 12 weeks. The two control groups will either undergo sham TEAS or no additional intervention alongside their basic treatment. The primary outcome is the 6-minute walk test; eight other indicators will serve as secondary outcomes.
Piloting a patient navigation programme for individuals living with dementia, their care partners and members of the care team: protocol for a mixed-methods evaluation.
BMJ OpenThis study has been approved by the research ethics boards at the University of New Brunswick, Université de Moncton, Horizon Health Network and Vitalité Health Network. Knowledge translation activities (eg, presentations at local, national and international conferences; publications for open-access journals; reports and lay summaries) will be undertaken to share the findings from this pilot project with diverse stakeholders, such as decision-makers, health system managers, clinicians and the general public.
This protocol describes the implementation and evaluation plan for a pilot PN programme in New Brunswick (NB) Canada for individuals living with dementia, their care partners and care providers. This project will include two components: (1) an in-person PN programme called Navigating Dementia NB/ Naviguer la démence NB and (2) two virtual peer-to-peer navigational support groups. The PN programme will be codesigned with stakeholders including researchers, patient partners, clinicians and health system managers. Patient navigators will be housed at six primary care sites across the province and the services will be offered in English and French. We will conduct a mixed-methods evaluation to explore the characteristics and experiences of participants who enrol in the PN programme and the navigational support groups, as well as the facilitators and barriers to implementation. Data collection will include navigation charts, Facebook analytics, as well as postintervention surveys, semistructured interviews and focus groups. All participants will provide written informed consent to take part in the intervention and have their data collected for research and evaluation purposes. Demographic data will be analysed using frequency and central tendency measures, while qualitative data from interviews and focus groups will undergo thematic analysis. Content analysis will be used to analyse posts published to the Facebook groups. The evaluation will assess the programme's effectiveness in the short and medium terms, evaluating its ability to achieve the intended outcomes.
Association between physical activity and diabetes control: multiple cross-sectional studies and a prospective study in a population-based, Swiss cohort.
BMJ OpenPhysical activity (PA) is recommended in patients with type 2 diabetes mellitus (T2DM) to improve their glycaemic control. We aimed to assess PA levels among participants with controlled and uncontrolled T2DM.
Three cross-sectional analyses of a prospective cohort conducted in Lausanne, Switzerland. PA levels (sedentary, light, moderate and vigorous) were either self-reported via questionnaire (first and second survey) or objectively assessed using accelerometry (second and third survey). T2DM control was defined as glycaemia <7.0 mmol/L or glycated haemoglobin <6.5% (48 mmol/mol).
Data from 195 (30.3% women), 199 (30.1% women) and 151 (44.4% women) participants with T2DM were analysed in the first (2009-2012), second (2014-2017) and third (2018-2021) surveys. Approximately half of the participants did not have controlled glycaemia. Using subjective data, over 90% (first survey) and 75% (second survey) of participants reported moderate and vigorous PA >150 min/week. After multivariable adjustment, no differences were found regarding all types of self-reported PA levels between controlled and uncontrolled participants. Objective assessment of PA led to considerable differences according to the software used: 90% and 20% of participants with moderate and vigorous PA >150 min/week, respectively. After multivariable adjustment, no differences were found for all PA levels between controlled and uncontrolled participants, irrespective of the analytical procedure used. Using glycated haemoglobin, almost two-thirds of participants were considered as uncontrolled, and no differences were found for objectively assessed PA between controlled and uncontrolled participants.
No differences in PA levels were found between participants with controlled and uncontrolled T2DM.
Grasping rehabilitation using motor imagery with or without neurofeedback after tetraplegia: a study protocol for a bicentric randomised controlled trial.
BMJ OpenNCT03190863 (ClinicalTrials.gov).
We will perform a bicentric, assessor-blinded, randomised controlled study. During rehabilitation, 21 inpatients with C6-C7 tetraplegia will be allocated to MI with neurofeedback (MI training with graphical display on a computer screen based on mu (8-13 Hz) and beta (18-25 Hz) frequency rhythms measured with 32-channel electroencephalography), MI alone (only MI training) and control (watching movies and visualisation of geometric shapes). All participants will receive three 45-min training sessions per week for 5 weeks.The primary outcome measure will be wrist extension angle immediately after the intervention during tenodesis grasp measured with a 3D motion analysis system (VICON). Secondary outcomes will include a range of measures: kinematic, grip strength, upper limb range of motion, upper limb strength (manual muscle test and hand-held dynamometer measure), dexterity (box and block test, 9-hole peg test, Jebsen test, capabilities of upper extremity questionnaire), quality of life (WHOQOL-Bref), daily life autonomy (Quadriplegic Index of Function), MI capacity and brain reorganisation (magnetoencephalography only available in Lyon, n=15). We will measure all outcomes five times: during weeks 1, 3 and 5 (baseline), week 11 (immediately after the intervention end) and week 18 (8 weeks after the intervention end).
Profiles and associated factors of prenatal psychological symptoms and their association with health-related quality of life among pregnant women: a cross-sectional study.
BMJ OpenTo cluster prenatal psychological symptoms into different profiles and investigate prenatal psychological symptoms' sociodemographic, health-related and pregnancy-related factors. Furthermore, health-related quality of life was compared across prenatal psychological symptom profiles.
This study's primary outcome was the creation of latent profiles of prenatal psychological symptoms. These were represented by the coexisting symptoms of three common psychological disorders: depression measured using the eight-item Patient Health Questionnaire, anxiety measured using the Generalised Anxiety Disorder-7 and stress measured using the Pregnancy Stress Rating Scale. Secondary outcomes included potential sociodemographic, health-related and pregnancy-related factors associated with prenatal psychological symptoms, which were measured using a researcher-designed information sheet, and health-related quality of life, measured using the 5-Level EuroQol 5-Dimension questionnaire.
Prenatal psychological symptoms were classified into three latent profiles using latent profile analysis: low (62.9%), moderate (31.3%) and severe (5.8%). Factors associated with the severity of prenatal psychological symptoms included age, relationship with partner, relationship with mother-in-law, history of gynaecological diseases, history of dysmenorrhoea, stage of pregnancy, unplanned pregnancy, severity of vomiting symptoms and abnormal pregnancy indicators. Moreover, an inverse association was identified between the severity of prenatal psychological symptoms and health-related quality of life.
Considering the high prevalence of prenatal psychological symptoms and their adverse effects on health-related quality of life, the assessment of prenatal psychological symptoms should be integrated into prenatal healthcare and made routine practice. Investigating the relevant associated factors would be beneficial for identifying vulnerable individuals.
Perioperative mortality of caesarean section in North-West Ethiopia: a prospective cohort study.
BMJ OpenThis study aimed to assess 7-day perioperative maternal mortality and risk factors at Tibebe Ghion Specialized Hospital.
Perioperative death measured from intraoperative time to the seventh day following caesarean section.
The most frequent indication for caesarean section was failure to progress, followed by fetal distress and elective caesarean delivery, accounting for 40.04%, 24.72% and 20.43% of all cases, respectively. The 7-day perioperative maternal mortality rate was 1.83%. Maternal bleeding (adjusted relative risk (ARR) = 11.80; 95% CI 1.12, 124.08) and not using the WHO surgical safety checklist (ARR = 6.88; 95% CI 3.14, 15.07) were independently associated with increased risk of 7-day perioperative mortality.
In this study, mortality after caesarean section was higher than in high-income countries. Implementation of targeted interventions focusing on the prevention and management of maternal bleeding, along with the consistent use of the WHO surgical safety checklist, could potentially contribute to improving the overall safety and outcomes of caesarean sections.
Is disinformation more likely to spread? A fuzzy-set qualitative comparative analysis of emerging infectious diseases on China's short video platform.
BMJ OpenThis study aimed to develop a model for the dissemination of information on emerging infectious diseases (EIDs) by identifying the specific features of mpox (monkeypox)-related short video content that encourages public sharing.
Focusing on Douyin (TikTok in mainland China), this study collected data from the top 500 most popular short videos using 'monkeypox' as the keyword from 1 May 2022 to 31 October 2022. Under the guidance of the health belief model, the videos were coded using two sets of conditional variables: information type variables and information content variables. The information type variables distinguish between fact-checking information and disinformation. Regarding information content variables, this study integrated the features of audiovisual media with the needs of the Chinese public, introducing efficacy information. The study then used fuzzy-set qualitative comparative analysis to analyse the correlation and consistency between the video contents and the level of public sharing, which was the outcome variable. Subsequently, a Poisson regression model was estimated to verify their significance on video-sharing volume.
The results showed that there were three configurations of short video content related to mpox which could trigger a high level of sharing among the general public. It was found that the number of fact-checked cases in the most widely disseminated short videos of mpox was 21.8:1 compared with the number of disinformation cases. Therefore, it can be concluded that fact-checked information was more likely to spread than disinformation in the case of an outbreak of EIDs on China's short video platforms. Based on the analysis of the three configurations, we also found that they separately formed three paths of the short video communication model, and each path had a more significant variable playing a central role. We named each pathway after the core variable: authoritative source path, personal efficacy path and disinformation path.
This study developed a model for information dissemination of EIDs and found that fact-checked content was more likely to spread on Chinese short video platforms instead of disinformation. It also explored public demand for guidance on EIDs precautions.
Do relationships between ambient temperature and serious adverse health outcomes vary among users of different antidiabetes drugs? A retrospective cohort study of US Medicaid beneficiaries with type 2 diabetes.
BMJ OpenPrior studies demonstrate that some untoward clinical outcomes vary by outdoor temperature. This is true of some endpoints common among persons with diabetes, a population vulnerable to climate change-associated health risks. Yet, prior work has been agnostic to the antidiabetes drugs taken by such persons. We examined whether relationships between ambient temperature and adverse health outcomes among persons with type 2 diabetes (T2D) varied by exposure to different antidiabetes drugs.
We linked US Medicaid to US Department of Commerce data that permitted us to follow individuals longitudinally and examine health plan enrolment, healthcare claims, and meteorological exposures-all at the person-day level. We mapped daily temperature from weather stations to Zone Improvement Plan (ZIP) codes, then assigned a t-max to each person-day based on the residential ZIP code. Among prespecified subcohorts of users of different pharmacologic classes of antidiabetes drugs, we calculated age and sex-adjusted occurrence rates for each outcome by t-max stratum. We used modified Poisson regression to assess relationships between linear and quadratic t-max terms and each outcome. We examined effect modification between t-max and a covariable for current exposure to a specific antidiabetes drug and assessed significance via Wald tests.
We identified ∼3 million persons with T2D among whom 713 464 used sulfonylureas (SUs), dipeptidyl peptidase-4 inhibitors (DPP-4is), meglitinides, or glucagon-like peptide 1 receptor agonists (GLP1RAs). We identified a positive linear association between t-max and serious hypoglycaemia among non-insulin users of glimepiride and of glyburide but not glipizide (Wald p value for interaction among SUs=0.048). We identified an inverse linear association between t-max and DKA among users of the DPP-4i sitagliptin (p=0.016) but not the GLP1RA exenatide (p=0.080). We did not identify associations between t-max and sudden cardiac arrest among users of SUs, meglitinides, exenatide, or DPP-4is.
We identified some antidiabetes drug class-specific and agent-specific differences in the relationship between ambient temperature and untoward glycaemic but not arrhythmogenic, safety outcomes.
Effectiveness of digital health exercise interventions on muscle function and physical performance in older adults with possible, confirmed or severe sarcopenia: a protocol for a systematic review.
BMJ OpenThe findings of the systematic review will be shared through publishing in a peer-reviewed journal and presentation at appropriate conferences. Since we will not be using specific patient data, ethical approval is unnecessary.
Searching will be performed in the following 11 databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, WOS, Scopus, CBM, CNKI, WANFANG and VIP) for published trials and 2 trial registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) for unpublished trials. Google Scholar will be used to find grey literature. The criterion of inclusion will be clinical trials involving digital health exercise interventions in older adults (≥60 years) diagnosed with sarcopenia (possible, confirmed or severe sarcopenia). For data synthesis, we will use a summary table to show the major characteristics of selected trials and a summary graph to demonstrate the risk of bias for each outcome using RoB 2, which will be further discussed in a narrative synthesis. The possibility of meta-analysis for quantitative data will be assessed according to the homogeneity analysis of the trials, using the methods of fixed or random effects model. If meta-analysis is possible, subgroup analysis and sensitivity analysis will be performed as well. Publication bias will be assessed through the use of the funnel plot and Egger's linear regression test when an adequate number of trials are available. Finally, the Grading of Recommendations, Assessment, Development and Evaluation approach will be used to classify the certainty of evidence body into four categories (high, moderate, low and very low).
CRD42024516930.
Pattern of hospital admissions and costs associated with acute rheumatic fever and rheumatic heart disease in Australia, 2012-2017.
Australian Health ReviewObjectiveThis study aims to describe the pattern and trends in acute rheumatic fever (ARF)/rheumatic heart disease (RHD)-related hospitalisations a...
