Morecambe Bay Medical Journal

Editorial

2024-04-06T10:46:21+01:00

Closing Chapter: Three Years with the Morecambe Bay Medical Journal

2024-04-06T10:22:48+01:00

Prevalence, patterns, and impacts of multimorbidity on adverse clinical outcomes in chronic kidney disease: A systematic review

2024-04-10T10:40:29+01:00

Background: Multimorbidity is the concurrent presence of two or more long-term health conditions in the same individual. It fragments healthcare delivery and affects quality of life. Chronic kidney disease (CKD) often occurs with multimorbidity. The prevalence of CKD is rising; however, there is a lack of evidence on the prevalence, patterns, and impacts of multimorbidity on adverse clinical outcomes in patients with CKD.

Methods: This was a systematically conducted literature review. A search was conducted in EMBASE, MEDLINE, CINAHL, and SCOPUS (2019-2023). The main search terms were “chronic kidney disease” and “multimorbidity.” The eligibility criteria were observational studies with adult participants with all stages of CKD (CKD stages 1-5, including those on renal replacement therapy). The exposure was multimorbidity quantified by measures. All-cause mortality, kidney disease progression, hospitalisation, and cardiovascular events were outcomes. The Joanna Briggs Institute (JBI) checklist was used for the risk of bias assessment. Due to heterogeneity in design and methods, Jennie Popay’s narrative synthesis was used for data synthesis.

Results: Of 6879 papers, nine papers met the inclusion criteria. Most studies included participants with all stages of CKD (CKD stage 1-5). The prevalence of multimorbidity ranged from 86.6% to 99.1%. Hypertension was the most prevalent comorbidity. The combination of concordant multimorbidity (hypertension, diabetes, and cardiovascular diseases) was highly prevalent. Multimorbidity was significantly associated with mortality, cardiovascular events, kidney disease progression, and hospitalisation. While older people had more multimorbidity burdens, younger patients with CKD were at a higher risk of death from multimorbidity. Severe CKD with clusters of cardiovascular diseases, diabetes, chronic pain, and depression was significantly associated with all-cause mortality.

Conclusion: There are associations between multimorbidity and adverse clinical outcomes in patients with CKD. However, there is a lack of data on Black, Asian, and Minority Ethnic participants from low- and middle-income countries. Further research is needed to investigate the high prevalence of chronic pain and depression in chronic kidney disease.

A critical exploration of the impact of gender disparities on female students and decision-making regarding specialisation whilst at medical school

2024-04-06T23:31:00+01:00

Measles outbreaks: why vaccination hesitancy must be confronted head-on

2024-04-06T23:30:42+01:00

Pleomorphic dermal sarcoma: a case report

2024-04-06T23:30:32+01:00

A pleomorphic dermal sarcoma (PDS) is considered a rare and poorly understood neoplasm of the skin.1 This has features similar to atypical fibroxanthoma (AFX).1 As well as the baseline similar characteristics to an AFX, a PDS also exhibits features of an infiltrative growth pattern which allows invasion of the subcutis, tumour necrosis and the possibility of lymphovascular invasion.2 These are more aggressive features than the more extensively reported AFX. There is a degree of metastatic potential associated with a PDS and hence early diagnosis and management with the appropriate multi-disciplinary team (MDT) is important to optimise the clinical prognosis. This case report will discuss a relatively rare diagnosis of a patient presenting with a PDS on the scalp and his management within the Oral and Maxillofacial Surgical (OMFS) Department, including consideration of his overall palliative care. Here, we will discuss the social, medical and physical implications of this diagnosis as well as considering the overall determinants of his quality of life (QoL).

Histopathology quiz

2024-04-06T10:34:36+01:00

Comparing patient and community representation in the NHS in South Cumbria, 1974-82

2024-04-06T23:30:23+01:00

The separation of Westmorland and Furness from Cumbria created the newest Healthwatch in England, launched on 18th October 2023. Squeezed between regulators, local authority scrutiny, and democratic organisational accountability, Healthwatch occupies an awkward position as both patient and consumer champion in the National Health Service (NHS). This awkwardness is amplified by Cumbria’s geography, which has distinct historical communities with differing service priorities to the north and south. Within the south, these are divided between west and east. This paper uses the creation of separate South West and South East Community Health Councils (CHCs) from 1974 until their unification in 1982 as South Cumbria to explore patient and community representation in the NHS.

The neurogenesis diet and lifestyle: Upgrade your brain, upgrade your life

2024-04-06T10:45:16+01:00

Centenary, Bicentenary and Quatercentenary

2024-04-06T10:39:33+01:00