Treatment Strategies for Proximal Deep Vein Thrombosis: A Network Meta-analysis of Randomised Controlled Trials.

Objective: To investigate the outcomes of treatment strategies for proximal and iliofemoral deep vein thrombosis (DVT).

Methods: Randomised controlled trials (RCTs) investigating outcomes of catheter directed thrombolysis (CDT), ultrasound assisted CDT (USCDT), percutaneous aspiration thrombectomy (PAT), and best medical therapy (BMT) for proximal DVT from 2000 onwards were considered. MEDLINE, EMBASE, and CINAHL were searched using the Healthcare Databases Advanced Search interface developed by the National Institute for Health and Care Excellence.

A microbiome and metabolomic signature of phases of cutaneous healing identified by profiling sequential acute wounds of human skin: An exploratory study.

Profiling skin microbiome and metabolome has been utilised to gain further insight into wound healing processes. The aims of this multi-part temporal study in 11 volunteers were to analytically profile the dynamic wound tissue and headspace metabolome and sequence microbial communities in acute wound healing at days 0, 7, 14, 21 and 28, and to investigate their relationship to wound healing, using non-invasive quantitative devices. Metabolites were obtained using tissue extraction, sorbent and polydimethylsiloxane patches and analysed using GCMS.

Electrical stimulation disrupts biofilms in a human wound model and reveals the potential for monitoring treatment response with volatile biomarkers.

Management of biofilm infections relies on time-consuming laboratory techniques and monitoring treatment by subjective clinical evaluations. Due to these limitations, there is a need to explore alternative strategies. The aims of this study were to assess the feasibility of using volatile organic compound (VOC) biomarkers to monitor treatment response and measure anti-biofilm efficacy of electrical stimulation (ES) in vitro and in human cutaneous wound biofilm models.

Validation of biofilm formation on human skin wound models and demonstration of clinically translatable bacteria-specific volatile signatures.

Biofilms are major contributors to delayed wound healing and there is a need for clinically relevant experimental models to assess theranostics. Microorganisms release volatile organic compounds (VOCs) and the ability to identify these in infected cutaneous wounds could lead to efficient non-invasive diagnosis. The aims here were to develop and assess bacterial biofilm formation and identify their VOC profiles in an in vitro model and validate in human ex vivo incisional and excisional cutaneous wound models.

Volatile organic compound detection as a potential means of diagnosing cutaneous wound infections.

Chronic cutaneous wound infections and surgical site infections (SSIs) present a huge burden on the healthcare system and can lead to increased morbidity and mortality. Current diagnostic methods of identifying and confirming infection involve culture-based and molecular methods. Both techniques are time-consuming and delays commonly lead to untargeted empirical treatment.

Pre-operative predictors of poor outcomes in patients undergoing surgical lower extremity revascularisation - Retrospective cohort study.

Background: Surgical lower extremity revascularisation (LER) can lead to poor outcomes that include delayed hospital discharge, in-hospital mortality, major amputations and readmissions. The aim of this study was to identify pre-operative predictors associated with these poor clinical outcomes.

Materials And Methods: All patients (n = 635; mean age 69; male 67.

Cutaneous wound biofilm and the potential for electrical stimulation in management of the microbiome.

Infection contributes significantly to delayed cutaneous wound healing, which impacts patient care. External application of electrical stimulation (ES) has beneficial effects on wound repair and regeneration. The majority of studies to date have explored ES in relation to planktonic microorganisms, yet evidence indicates that bacteria in chronic wounds reside as antibiotic-resistant polymicrobial biofilms, which contribute to impairing wound healing.

The efficacy of electrical stimulation in lower extremity cutaneous wound healing: A systematic review.

Current gold standard lower extremity cutaneous wound management is not always effective. Cutaneous wounds generate a "current of injury" which is directly involved in wound healing processes. Application of exogenous electrical stimulation has been hypothesised to imitate the natural electric current that occurs in cutaneous wounds.

Whole genome microarray data of chronic wound debridement prior to application of dermal skin substitutes.

Clinical consensus is that debridement is necessary for successful application of dermal skin substitutes (DSS) to chronic wounds. The aim here was to identify commonly expressed genes associated with wound healing in untreated acute wounds and chronic wounds treated with wound debridement followed by DSS. Cutaneous biopsies were taken at two time points from untreated acute and chronic wounds and from chronic wounds treated with DSS following debridement.

The efficacy of electrical stimulation in experimentally induced cutaneous wounds in animals.

Background: Complicated cutaneous wounds and their subsequent management can be a clinical challenge in veterinary medicine. There is still an unmet need for an ideal wound healing therapy that is able to stimulate efficiency and quality of repair. Skin wounds generate large and persistent endogenous electric currents and fields termed the "current of injury".

Single-Center Experience Following the Introduction of a Percutaneous Endovascular Aneurysm Repair First Approach.

We evaluated our experience following the introduction of a percutaneous endovascular aneurysm repair (pEVAR) first approach using Perclose Proglide assessing efficacy, complications, and identification of factors that could predict failure. A retrospective cohort study on patients over a 2-year period following the introduction of a pEVAR first approach was performed. The primary end point was defined as successful deployment and access site hemostasis.

Anatomic Variation of Rami Communicantes in the Upper Thoracic Sympathetic Chain: A Human Cadaveric Study.

Background: Hyperhidrosis is secondary to over activation of the sympathetic nervous system and surgical sympathectomy is the treatment of choice when other modalities have failed. This study investigated anatomic variation in the upper thoracic sympathetic chain and associated rami communicantes among cadaveric specimens. It considers the implications of these findings on surgical techniques to treat hyperhidrosis.

Carotid endarterectomy for critical stenosis prior to cardiac surgery: Should it be done? A retrospective cohort study.

Introduction: Stroke remains a major cause of morbidity and mortality after cardiac surgery affecting 2% of patients. Extra-cranial carotid artery disease has been implicated in the aetiology of post cardiac surgery stroke. The aim of the study was to evaluate and compare the morbidity and mortality in patients undergoing cardiac surgery with or without staged carotid endarterectomy (CEA) in a tertiary referral centre.

The Role of Neuromediators and Innervation in Cutaneous Wound Healing.

The skin is densely innervated with an intricate network of cutaneous nerves, neuromediators and specific receptors which influence a variety of physiological and disease processes. There is emerging evidence that cutaneous innervation may play an important role in mediating wound healing. This review aims to comprehensively examine the evidence that signifies the role of innervation during the overlapping stages of cutaneous wound healing.

Surgical management of a symptomatic extracranial internal carotid artery aneurysm and coexisting carotid body tumor.

Treatment of carotid body tumors and extracranial carotid artery aneurysms are well documented in the literature as separate entities. As distinct pathologies, they present technical difficulties with high complication rates. No patients with simultaneous carotid body tumors and extracranial internal carotid artery aneurysms have been reported.

Resolution of carotid stenosis pre-carotid intervention: A case for selective preoperative duplex ultrasound.

Introduction: Spontaneous resolution of carotid stenosis is a phenomenon that has been described in literature in the past. At present it is not routine practise to scan patients prior to carotid endarterectomy surgery within the UK.

Presentation Of Case: A 58 year old female presented to hospital with a history of sudden onset headache and left sided weakness.

Amyand's hernia with a periappendicular abscess.

We present a rare case of a perforated vermiform appendix presenting as a strangulated inguinal hernia. An 89-year-old man presented to the surgical assessment unit with a 1-week history of progressively worsening abdominal pain, fever and a tender mass in the right iliac fossa. A diagnosis of strangulated inguinal hernia was made.

A rare case of a pure testicular seminoma presenting 7 years after a pineal germinoma.

Pure testicular seminomas occurring in patients with previous intracranial germ cell tumours are extremely rare. We present such a case. A 37-year-old gentleman presented to urology after previously being treated for a pineal germinoma with steroids and radiotherapy.