Identifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic approaches and screening tools.

Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.

Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults.

Skull Base Chordoma and Chondrosarcoma: Neuroradiologist's Guide to Diagnosis, Surgical Management, and Proton Beam Therapy.

Skull base chordomas and chondrosarcomas are distinct types of rare, locally aggressive mesenchymal tumors that share key principles of imaging investigation and multidisciplinary care. Maximal safe surgical resection is the treatment choice for each, often via an expanded endoscopic endonasal approach, with or without multilayer skull base repair. Postoperative adjuvant radiation therapy is frequently administered, usually with particle therapy such as proton beam therapy (PBT).

Prevalence of Incidental Extraspinal Findings on MR Imaging of the Lumbar Spine in Adults: A Systematic Review and Meta-analysis.

Background: Low back pain is common worldwide. MR imaging may identify extraspinal findings that are not related to the proposed clinical question. The prevalence of extraspinal incidental findings and their clinical significance has not been well-established.

Comparison of electrodiagnostic findings in acute traumatic versus chronic non-traumatic ulnar neuropathy at the elbow.

Introduction/aims: A common concept is that traumatic nerve injuries are more likely axonal, and that compressive neuropathies are more likely demyelinating. The purpose of this study was to compare traumatic versus non-traumatic ulnar neuropathy at the elbow (UNE) to look for electrodiagnostic differences between the two groups.

Methods: A retrospective 3 year review of UNE patients at two academic health science centers was conducted.

Smoking status and mortality outcomes following percutaneous coronary intervention.

Objective: The aim of this study was to assess the impact of smoking on short (30-day) and intermediate (30-day to 6-month) mortality following percutaneous coronary intervention (PCI).

Background: The effect of smoking on mortality post-PCI is lacking in the modern PCI era.

Methods: This was a retrospective analysis of prospectively collected data comparing short- and intermediate-term mortality amongst smokers, ex-smokers and non-smokers.

Is follow-up echocardiogram mandatory after a STEMI?

Current guidelines do not advise follow-up echocardiograms after ST-segment elevation myocardial infarction (STEMI), unless the left ventricular ejection fraction is ≤40%. We present an interesting case of left ventricular pseudo-aneurysm-diagnosed 6 months after index STEMI presentation. Follow-up echocardiogram was performed in her case, due to jaw pain during routine haemodialysis.

The early dynamic of ECG in Takotsubo syndrome presenting with ST-elevation: A comparison with age and gender-matched ST-elevation myocardial infarction.

Background: Takotsubo syndrome mimics acute myocardial infarction (MI) at presentation.

Objectives: To explore differences in ECG time-course that could further help distinguish the two conditions.

Methods: Serial ECG's (day 0-4) of 27 acute takotsubo and 37 MI patients, all presenting with anterior ST-elevation, were analysed for detailed morphology and timing of de/re-polarisation.

An observational study to justify and plan a future phase III randomized controlled trial of metformin in improving overall survival in patients with inoperable pancreatic cancer without liver metastases.

Purpose: Metformin has plausible direct and indirect anti-cancer properties against pancreatic adenocarcinoma cells. However, metformin may only be efficacious in patients with inoperable pancreatic ductal adenocarcinoma (PDAC) without liver metastases. Absorption may be decreased by gastrointestinal symptoms and proton pump inhibitors (PPIs).

Compartment syndrome: Neuromuscular complications and electrodiagnosis.

Compartment syndrome (CS) is a treatable condition characterized by elevated intracompartmental pressure and may be acute or chronic in nature. Sustained elevated compartment pressure can lead to ischemia and necrosis of muscle as well as injury to peripheral nerves, creating a deficit that may be neuropathic, myopathic, or mixed. While electrodiagnostic assessments are of limited utility in the diagnosis of acute/traumatic CS, they can assist with prognosticating return of function after surgical fasciotomy or in clarifying the injury pattern in cases in which a traumatic injury results in subsequent neuromuscular deficits.

Atrial fibrillation case finding in over 65 s with cardiovascular risk factors - Results of initial Scottish clinical experience.

Background: Atrial fibrillation (AF) is a major preventable risk factor for stroke and may be silent in elderly individuals who are at especially high risk. This paper describes the first phase of implementation of a clinical AF detection programme in a community setting. Objectives were (i) to determine the feasibility of using a handheld ECG recording system for AF detection among individuals aged 65 years or more, who have cardiovascular risk factors.

Myocardial and Systemic Inflammation in Acute Stress-Induced (Takotsubo) Cardiomyopathy.

Background: Acute stress-induced (takotsubo) cardiomyopathy can result in a heart failure phenotype with a prognosis comparable with that of myocardial infarction. In this study, we hypothesized that inflammation is central to the pathophysiology and natural history of takotsubo cardiomyopathy.

Methods: In a multicenter study, we prospectively recruited 55 patients with takotsubo cardiomyopathy and 51 age-, sex-, and comorbidity-matched control subjects.

Metformin as an Adjunctive Therapy for Pancreatic Cancer: A Review of the Literature on Its Potential Therapeutic Use.

Pancreatic ductal adenocarcinoma has the worst prognosis of any cancer. New adjuvant chemotherapies are urgently required, which are well tolerated by patients with unresectable cancers. This paper reviews the existing proof of concept data, namely laboratory, pharmacoepidemiological, experimental medicine and clinical trial evidence for investigating metformin in patients with pancreatic ductal adenocarcinoma.

Persistent Long-Term Structural, Functional, and Metabolic Changes After Stress-Induced (Takotsubo) Cardiomyopathy.

Background: Takotsubo cardiomyopathy is an increasingly recognized acute heart failure syndrome precipitated by intense emotional stress. Although there is an apparent rapid and spontaneous recovery of left ventricular ejection fraction, the long-term clinical and functional consequences of takotsubo cardiomyopathy are ill-defined.

Methods: In an observational case-control study, we recruited 37 patients with prior (>12-month) takotsubo cardiomyopathy, and 37 age-, sex-, and comorbidity-matched control subjects.

Effect of hip and knee position on nerve conduction in the common fibular nerve.

Introduction: The aim of this study was to measure the influence that hip and knee position have on routine fibular motor nerve conduction studies.

Methods: Healthy subjects under age 40 were recruited (n = 24) to have fibular nerve conduction studies completed in various positions, using hip extension-knee extension as a control.

Results: A mean increase in conduction velocity of 2.

Implantation of subcutaneous implantable cardioverter defibrillators in Europe: results of the European Heart Rhythm Association survey.

Aims: The purpose of this European Heart Rhythm Association (EHRA) survey is to provide an overview of the current use of subcutaneous cardioverter defibrillators (S-ICDs) across a broad range of European centres.

Methods And Results: A questionnaire was sent via the internet to centres participating in the EHRA electrophysiology research network. Questions included standards of care and policies used for patient management, indications, and techniques of implantation of the S-ICDs.

Structural and electrical cardiac abnormalities are prevalent in asymptomatic adults with myotonic dystrophy.

Objective: Cardiac disease accounts for a large burden of premature mortality and morbidity in patients with type 1 myotonic dystrophy (MD). However, little is known about structural cardiac abnormalities particularly in asymptomatic patients with MD. We sought to describe the prevalence and extent of structural cardiac abnormalities in patients with MD and to assess their association with functional, electrical, biochemical and genetic disturbances.

Phenotype-driven molecular autopsy for sudden cardiac death.

A phenotype-driven approach to molecular autopsy based in a multidisciplinary team comprising clinical and laboratory genetics, forensic medicine and cardiology is described. Over a 13 year period, molecular autopsy was undertaken in 96 sudden cardiac death cases. A total of 46 cases aged 1-40 years had normal hearts and suspected arrhythmic death.

Management of patients with ventricular tachycardia in Europe: results of the European Heart Rhythm Association survey.

The purpose of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in the management of ventricular tachycardia (VT). The data are based on an electronic questionnaire sent to the members of the EHRA Research Network. Responses were received from 31 centres in 16 countries.

Right ventricular septal pacing as alternative for failed left ventricular lead implantation in cardiac resynchronization therapy candidates.

Aims: To compare the effects on left ventricular (LV) function of right ventricular (RV) septal pacing vs. cardiac resynchronization therapy (CRT) in patients with an indication for the latter. Cardiac resynchronization therapy is an effective therapy in patients with drug-refractory heart failure.

EuroEco (European Health Economic Trial on Home Monitoring in ICD Patients): a provider perspective in five European countries on costs and net financial impact of follow-up with or without remote monitoring.

Aim: Remote follow-up (FU) of implantable cardiac defibrillators (ICDs) allows for fewer in-office visits in combination with earlier detection of relevant findings. Its implementation requires investment and reorganization of care. Providers (physicians or hospitals) are unsure about the financial impact.

Prescribers' practice of assessing arrhythmia risk with QT-prolonging medications.

Aims: This study aimed to assess prescribers' monitoring for arrhythmic risk with QT-prolonging medications (LQT drugs).

Methods: Over a 6-month period, all inpatients under the care of Cardiologists (Cohort A) and General Physicians (Cohort B) at Aberdeen Royal Infirmary who were prescribed drugs with known risk of Torsades de Pointes (TdP) were identified. Admission and repeat electrocardiograms (ECG) after 48 h of commencing a LQT drug were examined.

Utility of the Pulmonary Vein Ablation Catheter for Electrical Isolation of A Left Sided Vena Cava Triggering Atrial Fibrillation.

A persistent left sided vena cava (LSVC) can trigger atrial fibrillation. A 41 year old man with paroxysmal atrial fibrillation (PAF) and LSVC had all four pulmonary veins and his LSVC electrically isolated from the left atrium with the Pulmonary Vein Ablation Catheter (PVAC). At follow up patient described no further episodes of AF.