Aims/Background: Congenital dermatological diseases (CDD), a complex group of inherited or developmental skin disorders, pose challenges in their management owing to their genetic nature, clinical variability, and socioeconomic impact. Despite the growing body of research, gaps remain in our understanding of research trends, collaborative networks, and translational advancements in this field. This bibliometric study evaluates CDD research over the last three decades (1995–2024) to identify its key developments and Emerging Themes. Methods: A comprehensive bibliometric analysis was conducted using the Scopus database (October 2024), owing to its extensive peer-reviewed coverage and reliable citation tracking. A multistep search strategy was used to refine the dataset and ensure its relevance. Bibliometrix and VOSviewer were used for quantitative and network-based analyses, highlighting publication trends, author impacts, and thematic structures. Results: CDD research expanded significantly between 1995 and 2024, with 17,984 publications and the majority being published in the last decade. The average age of the documents was 11.6 years, reflecting sustained engagement. Author metrics (h-index, g-index, and m-index) identified leading contributors, while co-authorship and collaboration networks revealed global research dynamics. The co-word analysis outlined the evolving thematic framework, including trends in diagnostic tools and therapeutic innovations. Conclusion: This study provided a structured overview of CDD research and identified critical gaps in its diagnosis, treatment strategies, and interdisciplinary collaboration. Understanding these trends can inform clinical decision-making, enhance early diagnosis, and support the development of targeted therapies, ultimately improving patient outcomes.
Multiple myeloma is a haematological malignancy of plasma cells, typically characterised by a monoclonal immunoglobulin protein detectable in the blood. Myeloma requires treatment when it affects specific end-organs, including lytic bone disease. The accurate detection of bone disease is therefore crucial in the diagnosis and management of myeloma, and advanced imaging with whole-body magnetic resonance imaging or positron emission tomography is now recommended as the standard of care. For patients with non-secretory myeloma and those with extramedullary disease, imaging is the only way to monitor response to treatment and to detect relapse. Whilst there are challenges in delivering advanced imaging modalities to patients with myeloma, the clinical and financial advantages mean that improving access should be a priority. This review discusses the importance of advanced imaging in the management of myeloma across its disease course, and outlines current barriers and potential future directions in this rapidly evolving field.
The metabolic and inflammatory burden of cardiac surgery results in increased protein catabolism, elevated energy expenditure and thereby a consequent increased risk of postoperative complications. Therefore, it is imperative to optimise nutritional status preoperatively and postoperatively to ameliorate these effects on wound healing, immune function, and recovery of the myocardium, in addition to other clinical outcomes. Despite its benefits, structured perioperative nutritional care is rarely undertaken. In this narrative review, we will summarise contemporary literature (2017-2026) and international guideline recommendations to outline phase-specific nutritional strategies for patients undergoing cardiac surgery. In the early postoperative period, early initiation of enteral nutrition, adequate protein provision (1.2-2.0 g/kg/day), and careful fluid and glycaemic management are critical to attenuate catabolic stress and reduce complications. During hospital recovery and discharge to home, emphasis should shift towards caloric adequacy, micronutrient optimisation-particularly vitamins C and D, zinc, and iron-and management of medication-related gastrointestinal effects. In the long-term phase, adoption of cardioprotective dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets supports secondary prevention and cardiovascular risk reduction. Elderly patients who are sarcopenic, individuals with diabetes mellitus or chronic kidney disease (CKD), overweight individuals and people on anticoagulation warrant special consideration. Integrating nutritional assessment and intervention into Enhanced Recovery After Cardiac Surgery (ERACS) pathways may help improve recovery trajectories and reduce morbidity. Further high-quality research should be conducted to define procedure-specific and individualised nutritional protocols in the cardiac surgical population.
AIMS/BACKGROUND:Whole-body computed tomography (WBCT) is central to major trauma assessment, but appropriate justification and reporting depend on adequate clinical information at the time of request. The Royal College of Radiologists (RCR) 2024 major trauma guidance recommends six minimum data elements for trauma WBCT requests. This quality improvement project aimed to improve documentation compliance and reduce inappropriate WBCT requests at a district general hospital. METHODS:A completed audit cycle was undertaken. Consecutive adult trauma patients undergoing WBCT were identified in a baseline audit (Cycle 1; n = 100, September-December 2024) and a post-intervention re-audit (Cycle 2; n = 100, September-December 2025). Three interventions were introduced: educational feedback to Department of Radiology and Department of Emergency Medicine staff, an RCR-derived electronic request proforma embedded within CareFlow Electronic Patient Record (EPR), and real-time radiologist feedback. Primary outcomes were compliance with the six RCR minimum dataset standards and the proportion of requests meeting RCR WBCT criteria. RESULTS:Baseline compliance varied across documentation domains. In Cycle 1, documentation rates were 74% for mechanism of injury, 94% for primary survey findings, 7% for haemodynamic status, 5% for preceding investigations, 13% for past medical history, and 0% for trauma team leader contact details. Following intervention, mechanism documentation improved to 100% (p < 0.001), haemodynamic status to 93% (p < 0.001), and trauma team leader contact details to 92% (p < 0.001). Primary survey documentation remained high at 97% (p = 0.306). Past medical history increased to 18% (p = 0.329), while preceding investigations remained low at 4% (p = 1.000). Requests meeting RCR WBCT criteria increased from 57% to 96% (p < 0.001), while non-compliant requests fell from 43% to 4%. This represented 39 potentially avoidable scans and approximately 780 mSv of theoretically avoided radiation exposure per 100 requests. CONCLUSION:A theory-informed intervention combining education, a mandatory electronic proforma, and real-time radiologist feedback substantially improved trauma WBCT request documentation and reduced inappropriate requests. Embedding minimum datasets into electronic requesting systems is a low-cost, scalable strategy to support compliance with the Ionising Radiation (Medical Exposure) Regulations [IR(ME)R] 2017, as amended in 2020, and radiation stewardship.
AIMS/BACKGROUND:The Central Sterile Supply Department (CSSD) is a critical component of hospital infection control, and the quality of its work directly impacts patient safety. Given that traditional training models struggle to accommodate differences in staff competency levels, this study aimed to investigate the effectiveness of a tiered training model in CSSD personnel management. METHODS:A retrospective analysis was conducted using the same group of staff members. Traditional standardized training was implemented during the control period (2024), while tiered training based on job competency was implemented during the observation period (2025). Based on competency assessments, staff were categorized into basic, proficient, core, and management & guidance levels, and targeted training courses were implemented accordingly. The effectiveness of the tiered training model was evaluated by comparing knowledge levels, core skills, work quality indicators (including process quality, outcome quality, and service efficiency), as well as internal and external satisfaction between the two periods. RESULTS:During the observation period, staff knowledge scores were significantly higher than those in the control period (81.86 ± 5.23 vs. 70.71 ± 8.52, p < 0.001), and scores for various operational skills also improved significantly (p < 0.001). Process and outcome quality indicators, including cleaning qualification rate and sterilization qualification rate, showed significant improvements (p < 0.05). Service efficiency indicators, including retrieval time, preparation, and replenishment times, were also significantly reduced (p < 0.001). Additionally, internal and external training and service satisfaction scores were significantly higher during the observation period (p < 0.05). CONCLUSION:The tiered training model can effectively improve the knowledge and technical competencies of CSSD staff, enhance work quality and service efficiency, and increase internal and external satisfaction. This model represents a precise and efficient personnel training and management strategy that accommodates differences in staff capabilities and may have potential for widespread application in the future.
