Biggest shake-up in health and social care leadership in a generation to improve patient care: comment from report coauthor Dame Linda Pollard.

The Health and Social Care Secretary Sajid Javid has welcomed the publication of an independent review of health and adult social care leadership, led by General Sir Gordon Messenger and Dame Linda Pollard-and, in what will be the biggest shake-up in health and social care leadership in a generation, is accepting all seven transformative recommendations they have put forward.

Referral for Dietary Intervention in Celiac Disease Is Low among Gastroenterologists and Primary Care Providers.

Background: Strict adherence to a gluten-free diet is the only known effective treatment for celiac disease currently. Multiple organizations recommend follow-up with a dietitian and guideline-directed management after diagnosis. Few studies have evaluated follow-up post diagnosis.

Acute Esophageal Necrosis Secondary to a Paraesophageal Hernia.

Acute esophageal necrosis (AEN) or "black esophagus" is a rare clinical entity caused by necrosis of distal esophageal mucosa stemming from esophageal ischemia. Possible etiologies are broad but most commonly include possible triggers of low-flow vascular states in the esophagus, including infections, broad-spectrum antibiotic use, and gastric volvulus, among others. Patients most commonly present clinically with acute onset hematemesis and melena.

Castleman flare or COPD exacerbation- can biomarkers override availability bias?

Effective treatments for human herpes virus 8 (HHV-8) associated multicentric Castleman disease (MCD) have led to prolonged survival for this complex systemic lymphoproliferative inflammatory disease. Nonetheless, significant challenges remain for the recognition of disease exacerbations, particularly when overlapping with common comorbid conditions. We present a case of a 60-year-old man with a 22-year history of MCD, current advanced COPD, and medication-controlled HIV.

Clostridium difficile Infection of a Total Hip Arthroplasty: Case Report and Review of the Literature.

Case: We describe the case of an 85-year-old woman who presented with worsening right hip pain after a conversion hip replacement. Subsequent imaging demonstrated a gas-containing collection in the lateral thigh. She was taken to the operating room for irrigation and debridement, where intraoperative cultures returned positive for Clostridium difficile.

STEMI: rare initial presentation of a mediastinal mass supplied by the RCA.

In the setting of severe septic shock, a 70-year-old woman had an ST segment myocardial infarction with ST elevations in the inferolateral leads. On cardiac catheterisation, no obstructive pathology was noted. Chest imaging revealed a large mediastinal mass measuring 8.

Alveolar recruitment strategy improves arterial oxygenation after cardiopulmonary bypass.

Atelectasis occurs during general anaesthesia. This is partly responsible for the impairment of gas exchange that occurs peri-operatively. During cardiopulmonary bypass, this atelectasis is exacerbated by the physical collapse of the lungs.

No response to trigger agents in a malignant hyperthermia-susceptible patient.

Malignant hyperthermia susceptibility is an inherited disorder, where a life-threatening condition can result from exposure to a trigger agent or agents. Succinylcholine and volatile anaesthetic agents are well established to be trigger agents in anaesthetic practice. We describe a case of a previously investigated malignant hyperthermia-susceptible patient who did not declare his status and was exposed to both succinylcholine and isoflurane, without any detectable reaction.

Measurement of CP-violating asymmetries in B0 decays to CP eigenstates.

We present measurements of time-dependent CP-violating asymmetries in neutral B decays to several CP eigenstates. The measurement uses a data sample of 23x10(6) Upsilon(4S)-->BbarB decays collected by the BABAR detector at the PEP-II asymmetric B Factory at SLAC. In this sample, we find events in which one neutral B meson is fully reconstructed in a CP eigenstate containing charmonium and the flavor of the other neutral B meson is determined from its decay products.

Work-heat tolerance of distance runners.

Physical training in a cool environment by subjects not previously trained improves their work-heat tolerance, but can not replace heat acclimatization to the standard heat stress conditions employed by a variety of investigators. This is attributed to the inability of these subjects to sustain prolonged work at high metabolic rates. Thus, they are not maintaining high core body temperatures long enough to bring about an adaptive change to heat.