Chronic Kidney Disease Following Cardiac Arrest Manifesting as Dyspnoea and Peripheral Oedema in Cardiovascular Multimorbidity: Case Analysis and Brief Literature Review.

Background/aim: Chronic kidney disease (CKD) contributes significantly to morbidity, mortality, and healthcare costs. CKD is not only an independent risk factor for cardiovascular disease (CVD) but also a severe complication for patients with CVD, impacting substantially their prognosis and quality of life.

Case Report: A 79-year-old male with a complex medical history, including asthma, hypertension, myocardial infarction, ischaemic heart disease, and recent atrial fibrillation, presented with new-onset exertional breathlessness and peripheral oedema following cardiac arrest and pacemaker insertion.

A Time-varying Analysis of General Practice Prescribing in the COVID-19 Era: Lessons from Prescription Dynamics in a Pandemic.

Background/aim: Pharmacotherapy is vital in medicine, but inappropriate and inadequate use of medications significantly impacts global mortality and morbidity. Increased prescribing may indicate irrational use or prolonged illness, while decreased prescribing could suggest undertreatment, supply shortages, or the availability of safer and, more effective treatments. The COVID-19 pandemic disrupted health systems, potentially altering prescribing patterns.

Transient Ischaemic Attack in a Patient With Conn Syndrome: A Case Report and Literature Review on the Importance of Identifying Secondary Hypertension.

Background/aim: Transient ischaemic attack (TIA) is characterised by a temporary neurological dysfunction resulting from focal ischaemia in the brain, spinal cord or retina without acute infarction. These episodes typically last less than 24 hours and are significant predictors of subsequent ischaemic strokes. Hypertension is a major risk factor for cerebrovascular events, and primary aldosteronism (PA) is recognised as a common cause of secondary hypertension.

Heart Failure Masked as Pulmonary Embolism in Non-adherent Patient With Atrial Fibrillation: Case Report and Analytical Review of the Literature.

Background/aim: Atrial fibrillation (AF) and heart failure (HF) commonly co-occur, significantly increasing morbidity and mortality. Poorly controlled AF can contribute to complications like HF and is associated with conditions, such as stroke and pulmonary embolism (PE). This report involves a man with AF who had persistent respiratory symptoms and left-sided chest pain, initially suspected to be PE, but eventually diagnosed as HF.

Chest Pain at Rest With Unremarkable ECG and Cardiac Enzymes: Case Study Emphasising the Importance of Clinical Suspicion in the Diagnosis of Coronary Artery Disease.

Background: Coronary artery disease (CAD), primarily caused by atherosclerosis, is a leading cause of death, presenting as angina or myocardial infarction. Advances in cardiac imaging, angiography, and procedures like percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery have improved early detection and management of this condition. This report presents the case of a man who experienced worsening exertional chest pain and discomfort while at rest.

Improving Antimicrobial Stewardship in Acute Sore Throat: Comparison of FeverPAIN and McIsaac Scores with Molecular Point of Care Testing Using Abbott ID NOW.

The diagnosis of streptococcal throat infection is an area where current practice results in significant over-diagnosis of bacterial infection, with the resulting implications for antimicrobial use and resistance. The use of molecular point of care testing (POCT) has previously been shown to alter antibiotic prescribing decisions when compared to Centor scoring. This paper explores the impact of the addition of POCT to clinical assessment using the McIsaac and FeverPAIN scoring systems.

Belongingness in Medical Student Placements: Validation and Pilot Study of the Use of the Exeter Belongingness Assessment Tool in Belgian and English Medical Students.

Background: Belongingness is an important factor in the social development of medical students, and the ability to quantify belongingness in medical students may provide additional metrics by which we can compare different learning environments to help explore differential attainment. Previous studies looking at the measurement of belongingness have demonstrated good internal and external validity for tools designed to measure this facet of student experience. This study aimed to explore the use of the Exeter Belongingness Assessment Tool (EBAT) as one potential source of evidence in the study of student learning experience on clinical placements, which could be used to support quality assurance of clinical learning.

Belongingness in medical students: did it change during lockdown?

Belongingness has been proposed as a potential proxy for legitimate peripheral participation in medical education. Previous studies have shown good internal and external validity for tools designed to measure this variable, with potential use measuring the effectiveness of clinical teaching environments and as a marker of student wellbeing. This study examined changes in belongingness in medical students at the University of Exeter measured in spring 2019 and the equivalent period in 2021, during which COVID-19 related restrictions were in place in the United Kingdom.

Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change.

Accurate clinical diagnosis of patients presenting to primary care settings with acute sore throat remains challenging, often resulting in the over-prescribing of antibiotics. Using point-of-care tests (POCTs) to differentiate between respiratory infections is well-accepted, yet evidence on the application within primary care is sparse. We assessed the application of testing patients ( = 160) from three family practices with suspected Streptococcal infections using rapid molecular tests (ID NOW Strep A2, Abbott).

A Comparative Safety Analysis of Medicines Based on the UK Pharmacovigilance and General Practice Prescribing Data in England.

Background/aim: Adverse drug reactions (ADRs) represent a major concern leading to significant increases in both morbidity and mortality globally. Providing healthcare professionals (HCPs) and patients with real-world data on drug safety is imperative to facilitate informed decision-making. The study aimed to determine the feasibility of creating comparative safety charts for medicines by mapping ADR reporting onto prescribing data.

Development and validation of a tool to measure belongingness as a proxy for participation in undergraduate clinical learning.

Background: 'Participation' in a 'community of practice' is often proposed as a mechanism for clinical learning; however, the use of both terms is variable - ranging from technical to vernacular. Belongingness is a related single concept and development of a tool that measures belongingness may therefore be useful in adding to our understanding of when participation and hence learning takes place in clinical settings.

Methods: After identifying relevant material from the literature, a draft belongingness assessment tool was developed, based on previously published work.

The circularization of amyloid fibrils formed by apolipoprotein C-II.

Amyloid fibrils have historically been characterized by diagnostic dye-binding assays, their fibrillar morphology, and a "cross-beta" x-ray diffraction pattern. Whereas the latter demonstrates that amyloid fibrils have a common beta-sheet core structure, they display a substantial degree of morphological variation. One striking example is the remarkable ability of human apolipoprotein C-II amyloid fibrils to circularize and form closed rings.

Fertilization of mouse oocytes using somatic cells as male germ cells.

Female and male mouse somatic cells were injected into mouse F(1) oocytes. The cells used included cumulus cells (female) and muscle derived fibroblasts (male). The ability of the cells to fertilize oocytes and support embryonic development was examined.