REPAIRS Delphi: A UK and Ireland Consensus Statement on the Management of Infected Arterial Pseudoaneurysms Secondary to Groin Injecting Drug Use.

Objective: Consensus guidelines on the optimal management of infected arterial pseudoaneurysms secondary to groin injecting drug use are lacking. This pathology is a problem in the UK and globally, yet operative management options remain contentious. This study was designed to establish consensus to promote better management of these patients, drawing on the expert experience of those in a location with a high prevalence of illicit drug use.

The "standard story" of anti-Māori talk in Pae Ora (Healthy Futures) Bill submissions.

Aim: To review some common patterns of race talk in a sample of submissions made to the Pae Ora (Healthy Futures) Bill. This bill proposed a structural reform of the health system in Aotearoa New Zealand to address long-standing health inequities experienced by Māori, the Indigenous peoples, and other priority populations.

Method: In a sample of 3,000 individual submissions made in late 2021, we found 2,536 explicit references to race.

A critical Tiriti analysis of Te Pae Tata: the Interim New Zealand Health Plan.

The current health reforms in Aotearoa New Zealand are being described as "transformational". Political leaders and Crown officials maintain the reforms embed a commitment to Te Tiriti o Waitangi, address racism and promote health equity. These claims are familiar and have been used to socialise previous health sector reforms.

A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill.

Aim: The Pae Ora (Healthy Futures) Bill is the framework for a reformed health system intended to embed Te Tiriti o Waitangi and centre equity. The Bill is informed by the Wai 2575 Health Kaupapa Waitangi Tribunal Inquiry and the Health and Disability System Review, both of which established an urgent mandate to transform the health sector. This desktop review explores to what extent the proposed Bill is likely to uphold Te Tiriti.

The Needle and the Damage Done: A Retrospective Review of the Health Impact of Recreational Intravenous Drug Use and the Collateral Consequences for Vascular Surgery.

Background: The UK has one of the highest rates of recreational drug use and consequent deaths in Europe. Scotland is the "Drug deaths capital of Europe." Intravenous drug use can result in limb- and life-threatening pathology.

A critical analysis of te Tiriti o Waitangi application in primary health organisations in Aotearoa New Zealand: Findings from a nationwide survey.

Primary health is at the forefront of efforts to address health inequities. Effective primary health care keeps people well and improves longevity and quality of life. The persistence of health inequities, particularly between Indigenous peoples and non-Indigenous peoples globally, suggests that there is a need to strengthen policy and practise.

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real-world outcomes.

Background And Aims: NHS Tayside is a health board in Scotland which serves around 400 000 residents. Approximately, 2761 are estimated to be persons who inject drugs (PWID), and therefore at risk of infections such as hepatitis C (HCV) and HIV. There are few studies exploring mechanisms and success of eliminating HCV in HIV co-infected PWID using real-world data.

Strength-limiting damage and its mitigation in CAD-CAM zirconia-reinforced lithium-silicate ceramics machined in a fully crystallized state.

Objectives: The objective was to explore how clinically relevant machining process and heat treatment influence damage accumulation and strength degradation in lithium silicate-based glass ceramics machined in the fully crystallized state.

Methods: A commercial zirconia-reinforced lithium silicate (ZLS) glass ceramic with a fully developed microstructure (Celtra® Duo) was studied. Disk-shaped specimens (nominal 10 mm diameter and 1 mm thickness) were fabricated either using a CAD-CAM process, creating a clinically relevant dental restoration surface, or were sectioned from water-jet cut cylindrical blocks with their critical surfaces consistently polished.

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.

Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19.

Design, Setting, And Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin.

Pupil Cycle Time Distinguishes Migraineurs From Subjects Without Headache.

Migraine is a neurological disorder characterized by paroxysms of head pain accompanied by trigeminovascular system activation and autonomic dysfunction. Diagnosis is currently based on clinical diagnostic criteria. Though physiological differences exist between migraineurs and non-headache controls, true physiological biomarkers have been elusive, especially for the full clinical spectrum of migraine, inclusive of chronic, episodic, and probable migraine.

Fungal diseases at the medical front door.

Fungal diseases are an increasingly recognized cause of mortality worldwide and often pose diagnostic challenges. This article focuses on common fungal diseases as they may present in the acute medical unit, looking at the initial investigation and management of four common diseases: Pneumocystis jirovecii pneumonia, cryptococcal meningitis, candidaemia and allergic bronchopulmonary aspergillosis. There is an increase in morbidity and mortality if these conditions are not correctly diagnosed and thus appropriate therapy is delayed.

Can intravenous antifungal therapy be safely used in the outpatient parenteral antimicrobial therapy (OPAT) setting?

Outpatient parenteral antimicrobial therapy (OPAT) is an established treatment option for patients with a variety of infections who require a period of intravenous therapy, are clinically stable, and do not require continuous monitoring. Many patients with fungal infections require prolonged therapy due to resistance or intolerance to oral antifungal agents. Despite the widespread use of OPAT by infection specialists, antifungal agents appear infrequently used in this setting.

Strength-limiting damage in lithium silicate glass-ceramics associated with CAD-CAM.

Objective: The fabrication of all-ceramic restorations using Computer Aided Design and Computer Aided Manufacturing (CAD-CAM) most commonly involves subtractive machining which results in strength-limiting, surface and sub-surface damage in the resultant prosthesis. The objective was to explore how clinically relevant machining-process variables, and material variables, affect damage accumulation in lithium silicate glass-ceramics.

Methods: Three commercial lithium silicate glass-ceramics (IPS e.

Engineering Approaches to Assessing Hydration Status.

Dehydration is a common condition characterized by a decrease in total body water. Acute dehydration can cause physical and cognitive impairment, heat stroke and exhaustion, and, if severe and uncorrected, even death. The health effects of chronic mild dehydration are less well studied with urolithiasis (kidney stones) the only condition consistently associated with it.

Oral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: an observational study.

Objectives: British Thoracic Society guidelines recommend clarithromycin in addition to beta-lactam antibiotics for patients with community-acquired pneumonia and CURB-65 score 2-5. Intravenous therapy is commonly used but there are few data on whether oral therapy is equally effective.

Methods: This observational study used propensity matching to compare two groups of patients with moderate to severe community-acquired pneumonia (CURB-65 score 2-5) treated with oral ( = 226) or intravenous ( = 226) clarithromycin on admission.

Cardiovascular disease as a complication of community-acquired pneumonia.

Purpose Of Review: Here, we review the incidence, prognosis, potential mechanisms and therapeutic implications of cardiovascular disease in community-acquired pneumonia (CAP).

Recent Findings: Recent evidence suggests that a large proportion of deaths from CAP are attributable to cardiovascular disease, including sudden cardiac death, acute myocardial infarction (MI), arrhythmias and cardiac failure. Up to one-third of patients with CAP may experience cardiovascular complications within 30 days of hospital admission, while data also suggest that CAP managed in the community is associated with increased risk of acute MI.

MRSA: treating people with infection.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin, as well as to other beta-lactam antibiotics, including flucloxacillin, beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection, particularly in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. About 8% of S aureus in blood cultures in England, Wales, and Northern Ireland is resistant to methicillin.

Structure determination from XAFS using high-accuracy measurements of x-ray mass attenuation coefficients of silver, 11 keV-28 keV, and development of an all-energies approach to local dynamical analysis of bond length, revealing variation of effective thermal contributions across the XAFS spectrum.

We use the x-ray extended range technique (XERT) to experimentally determine the mass attenuation coefficient of silver in the x-ray energy range 11 kev-28 kev including the silver K absorption edge. The results are accurate to better than 0.1%, permitting critical tests of atomic and solid state theory.

Necrotizing soft tissue infections in intravenous drug users: a vascular surgical emergency.

Objective: To assess the short and long-term outcomes of necrotizing soft tissue infection (NSTI) in intravenous drug users (IVDU) in a regional vascular centre.

Methods: This was a retrospective analysis of all IVDUs with NSTI admitted to the regional vascular surgical unit between January 2009 and July 2014. Clinical outcome measures were interval between admission and surgery, length of ITU/HDU and hospital stays, post-operative complications, in hospital and one year mortality.