Pancreaticopleural fistula: a rare aetiology of pleural effusion.

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis, which clinically presents as a pleural effusion and often with an absence of typical abdominal symptoms associated with pancreatic disease.We describe a man in his early 50s who presented to the emergency department with pleuritic chest pain and progressive breathlessness with a history of alcohol excess. Chest X-ray demonstrated a bilateral pleural effusion with a dark red amylase-rich exudate on needle aspiration, necessitating a chest drain insertion.

Clinical application of capsule sponge testing in symptomatic reflux disease: a national prospective cohort study.

Background: Capsule sponge testing, using an oesophageal cell collection device with biomarkers, was implemented nationally across Scotland in 2020 for symptomatic reflux patients referred to secondary care for non-urgent endoscopy. The aim was to use capsule sponge testing as a triage tool to reduce pressures on the endoscopy service during COVID-19, focus endoscopy resources on those most likely to have pathology and streamline the patient pathway. This prospective cohort study presents the first real-world results and evaluates the clinical application of capsule sponge testing in symptomatic reflux disease based on endoscopic biopsy results.

Oesophageal cell collection device and biomarker testing to identify high-risk Barrett's patients requiring endoscopic investigation.

Background: Barrett's oesophagus surveillance places significant burden on endoscopy services yet is vital to detect early cancerous change. Oesophageal cell collection device (OCCD) testing was introduced across Scotland for Barrett's surveillance in response to the COVID-19 pandemic. This national pragmatic retrospective study presents the CytoSCOT programme results and evaluates whether OCCD testing is successfully identifying high-risk Barrett's patients requiring urgent endoscopy.

A comparison of radiographically determined periapical healing and tooth survival outcomes of root canal (re)treatment performed in two care pathways within the United Kingdom Armed Forces.

Aims: To compare radiographic periapical healing and tooth survival outcomes of root canal (re)treatment performed within two care pathways (Routine Dental Care and Referred Treatment Pathway), in the United Kingdom Armed Forces (UKAF), and determine the effects of endodontic complexity on outcomes.

Methodology: This retrospective cohort study included 1466 teeth in 1252 personnel who received root canal (re)treatment between 2015 and 2020. General Dental Practitioners treated 661 teeth (573 patients) (Routine cohort), whilst Dentists with a Special Interest treated 805 teeth (678 patients) (Referred cohort).

National adoption of an esophageal cell collection device for Barrett's esophagus surveillance: impact on delay to investigation and pathological findings.

High quality Barrett's esophagus surveillance is crucial to detect early neoplastic changes. An esophageal cell collection device (OCCD) was introduced as a triage tool for Barrett's surveillance. This study aims to evaluate whether the Scottish OCCD program (CytoSCOT) has reduced delays to Barrett's surveillance, and whether delayed surveillance negatively impacts endoscopic pathology.

Diagnosis, treatment, and outcome of patients with oesophagogastric cancer during the COVID-19 pandemic: national study.

Background: The national response to COVID-19 has had a significant impact on cancer services. This study investigated the effect of national lockdown on diagnosis, management, and outcomes of patients with oesophagogastric cancers in Scotland.

Methods: This retrospective cohort study included consecutive new patients presenting to regional oesophagogastric cancer multidisciplinary teams in National Health Service Scotland between October 2019 and September 2020.

Eight-year retrospective study investigating tooth survival after primary non-surgical root canal treatment in a UK military cohort.

Introduction: Root canal treatment (RCT) plays an important role in preserving the dentition by deferring other invasive treatments. Data on tooth survival and predictive factors for tooth loss after RCT in the military cohort are lacking. This investigation aimed to determine the proportion of teeth surviving in an 8-year period after RCT and identify potential predictive factors for tooth loss in a UK military cohort.

The development of a restorative Managed Clinical Network within the defence primary healthcare organisation.

The United Kingdom Armed Forces introduced a Managed Clinical Network to transform care provision for military patients referred with complex restorative treatment needs. This article discusses the processes that underpinned this transformation of service, from assessment of populations needs to implementation of clinical delivery.

Disruption and bactericidal indices depicted in polygonal graphs to show multiple outcome effects of root canal irrigant supplements on single- and dual-species biofilms.

Objectives: The aims of this study were to (1) investigate the relative time-dependent disruption and bactericidal effects of detergent-type surfactants on single- or dual-species biofilms of root canal isolates and (2) to examine the utility of polygonal graphs for depiction of biofilm disruption and cell killing.

Materials And Methods: Single-species biofilms of Streptococcus sanguinis, Enterococcus faecalis, Fusobacterium nucleatum and Porphyromonas gingivalis were grown on nitro-cellulose membranes for 72 h and immersed in Tween®80, cetyltrimethylammoniumbromide (CTAB), and sodium dodecyl sulphate (SDS) for 1-, 5- or 10-min (n = 3 per test). The number of viable and non-viable bacteria "disrupted" from the biofilm and those "remaining-attached" was determined using a viability stain in conjunction with fluorescence microscopy.

Dental care provision to UK military personnel serving on Operation Herrick in Afghanistan. Part 2: aetiology and management.

Aims: To evaluate the nature of tooth-related morbidity in military personnel deployed on Operation Herrick and to compare the management of dental emergencies to that in non-deployed personnel.

Method: Data were collected prospectively for UK Service personnel on Operation Herrick (OpH) during an 18-month period and measured against prospectively collected 'home base' (HB) control data.

Results: Molar teeth were responsible for 64.

Dental care provision to UK military personnel serving on Operation Herrick in Afghanistan. Part 1: access to dental care.

Aims: To assess factors influencing access to dental care and to determine the true level of dental morbidity experienced by UK military personnel serving on Operation Herrick.

Methods: Data on dental emergencies were collected prospectively over an 18-month period. Deployed personnel were divided into those co-located with a dental centre and those not co-located.

The efficacy of supplementary sonic irrigation using the EndoActivator system determined by removal of a collagen film from an ex vivo model.

Aim: To evaluate the efficacy of sonic irrigation (EndoActivator ) using various polymer tips and power settings in a stained collagen ex vivo model.

Methodology: The root canals of fifty human, straight single-rooted extracted teeth were prepared to size 40, .08 taper.

Role of Heart Rate Variability in Predicting Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.

Introduction: Early recognition of post-ERCP pancreatitis (PEP) would help deliver an appropriate discharge plan following ERCP. Functioning of the autonomic nervous system can be measured using non-invasive heart rate variability techniques (HRV) and provides quantitative information about the modulation of cardiac vagal and sympathetic activity. Pain evoked sympathetic activation is a well-known phenomenon, as exhibited in those suffering PEP.

Pre- and post-operative management of dental implant placement. Part 2: management of early-presenting complications.

Despite morbidity factors that include pain and complications with healing, there is currently little available guidance regarding optimal pre-and post-operative protocols for dental implant placement. While the first paper of this two-part series discussed the management of post-operative pain, the second instalment reviews pre- and post-operative means of managing early complications associated with dental implant placement.

Pre- and post-operative management of dental implant placement. Part 1: management of post-operative pain.

Although dental implant placements have high success rates and a low incidence of morbidity, post-operative pain and complications with the healing process have been reported. There is little guidance available regarding optimal pre- and post-operative management of dental implant placement. This first paper discusses the mechanisms of pain associated with dental implant placement and offers guidance to clinicians on optimal pre- and post-operative pain management regimes.

Vitamin D deficiency as a suspected causative factor in the failure of an immediately placed dental implant: a case report.

Aim: To discuss the influence of Vitamin D deficiency in the osseointegration process of a dental implant by way of a case report.

Summary: A 29-year-old soldier attended clinic with a fractured mandibular premolar (tooth 44) that was traumatised following head trauma related to the detonation of an Improvised Explosive Device (IED) whilst serving on operational duty. The tooth was deemed unsalvageable and was extracted with immediate placement of a dental implant.

Whose Rights Count? Negotiating Practice, Policy, and Legal Dilemmas Regarding Infant-Parent Contact When Infants are in Out-of-Home Care.

This article takes a human rights perspective with a view to articulating the infant's perspective when the infant has been subjected to abuse, neglect, or both and is reliant on the state to ensure his or her health and well-being. When a young child is removed from parental care, important and often difficult decisions have to be made about subsequent contact between child and parent. We consider a number of dilemmas which may arise for practitioners when they are assisting child welfare decision makers in relation to contact, and acknowledge the limited empirical follow-up studies of the impact of child welfare practice and legal decisions on infant outcomes.

A feasibility randomised controlled trial of the New Orleans intervention for infant mental health: a study protocol.

Child maltreatment is associated with life-long social, physical, and mental health problems. Intervening early to provide maltreated children with safe, nurturing care can improve outcomes. The need for prompt decisions about permanent placement (i.

B-type natriuretic peptide predicts postoperative cardiac events and mortality after elective open abdominal aortic aneurysm repair.

Objective: The aim of this study was to determine if a single preoperative B-type natriuretic peptide (BNP) level correlated with perioperative cardiac events, cardiac death, and all-cause mortality in elective open abdominal aortic aneurysm (AAA) repair in the short term, intermediate term, and long term.

Methods: A prospective, 2-year multicenter observational cohort study in the three vascular units in Glasgow was performed. All patients who were admitted for elective open AAA repair were recruited.

Risk stratification scores in elective open abdominal aortic aneurysm repair: are they suitable for preoperative decision making?

Objectives: Risk indices help quantify the risk of cardiovascular events and death prior to making decisions about prophylactic AAA repair. This paper aims to study the predictive capabilities of 5 validated indices.

Design And Methods: A prospective observational multi-centre cohort study from August 2005 to September 2007 in Glasgow recruited 106 consecutive patients undergoing elective open AAA repair.

B-type natriuretic peptide predicts long-term survival after major non-cardiac surgery.

Background: The prediction of long-term survival after surgery is complex. Natriuretic peptides can predict short-term postoperative cardiac morbidity and mortality. This study aims to determine the long-term prognostic significance of preoperative B-type natriuretic peptide (BNP) concentration after major non-cardiac surgery.