A Rare Case of Isolated Diverticular Disease of the Appendix Combined With Uncomplicated Appendicitis.

The differential diagnoses for patients presenting with right iliac fossa pain are broad, with appendicitis almost always on the top of the list. Although rare, diverticulosis of the appendix, complicated by inflammation, should be considered in these patients. We report a case of a middle-aged female with right iliac fossa pain with a high inflammatory marker.

PANORAMA: A 2021 Clinician Survey of Treatment Approaches for People With New Diagnoses of Relapsing-Remitting Multiple Sclerosis in the United Kingdom.

Background: The PANORAMA survey aimed to assess current treatment practice for individuals with new diagnoses of relapsing-remitting multiple sclerosis (RRMS) in the United Kingdom and to explore variations in treatment approaches with an emphasis on escalation vs early high-efficacy treatment (HET) and treatment goals.

Methods: Health care professionals (HCPs) from the UK treating patients with RRMS took part in interviews facilitated by a structured questionnaire. Data were analyzed descriptively using quantitative or qualitative methods, as appropriate.

Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning.

Individuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms.

Accidental Organophosphate Poisoning in a Patient Due to a Bed Bug Pesticide in the United Kingdom: A Case Report.

Organophosphate (OP) compounds, developed during World War II, are a group of chemicals used as pesticides, insecticides and herbicides. As irreversible inhibitors of the enzyme acetylcholinesterase (AChE), they reduce anti-cholinesterase activity and therefore increase acetylcholine (ACh) levels at the neuromuscular junction (NMJ). Diazinon, the OP leading to the patient's symptoms in this report, is an amber-brown liquid that was once the most widely used insecticide in the United States of America.

A Case of Lumbosacral Radiculoplexus Neuropathy: A Rare Complication of Diabetes Mellitus.

Diabetic lumbosacral radiculoplexus neuropathy, also known as diabetic lumbosacral plexopathy or diabetic amyotrophy, is a rare complication of diabetes mellitus. Due to its varied clinical presentation and wide differential, it may pose a diagnostic quandary in assessing patients with proximal asymmetrical lower limb weakness. We present the case of a 74-year-old female patient with a recent onset of falls and aim to discuss the aetiology, differentials, and treatment modalities in diabetic plexopathy.

Transcranial Magnetic Stimulation-Electroencephalography (TMS-EEG) in Neurosurgery: Unexplored Path Towards Personalized Brain Surgery.

Transcranial Magnetic Stimulation-Electroencephalography (TMS-EEG) is a non-operative technique that allows for magnetic cortical stimulation (TMS) and analysis of the electrical currents generated in the brain (EEG). Despite the regular utilization of both techniques independently, little is known about the potential impact of their combination in neurosurgical practice. This scoping review, conducted following PRISMA guidelines, focused on TMS-EEG in epilepsy, neuro-oncology, and general neurosurgery.

Functional Neurological Disorder and Autism Spectrum Disorder: A Complex and Potentially Significant Relationship.

Introduction: Functional neurological disorder (FND) and autism spectrum disorder (ASD) are two complex neuropsychiatric conditions that have been historically classified within psychiatric domains, resulting in a lack of extensive research, insufficient clinical recognition, and persistent societal stigma. In recent years, there has been an increasing recognition among professionals and affected individuals of their possible overlap. This review explores the potential clinical and mechanistic overlap between FND and ASD, with particular attention to shared symptoms across sensory, motor, and psychiatric domains.

Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery: a prospective cohort study.

Purpose: Low intraabdominal pressure (IAP) during laparoscopy is associated with improved post-operative outcomes across a variety of surgical specialties. A prospective cohort study was undertaken to assess post-operative outcomes in patients undergoing laparoscopic colorectal surgery (LCRS) with low (8mmHg) versus conventional (15mmHg) IAP.

Methods: A prospective real-world observational study of patients undergoing LCRS in a single-centre, between June 2020 and June 2023 was performed.

Improving Patient Care and Streamlining Follow-Up: Compliance With National Institute for Health and Care Excellence (NICE) Guidelines for Pediatric Distal Radius Buckle Fractures.

Introduction: Torus fractures, also known as buckle fractures, are among the most common types of fractures seen in children who present to the emergency department (ED). These injuries usually occur when a child falls onto an outstretched hand, resulting in the compression and buckling of the dorsal cortex of the radius while the volar cortex remains intact. These fractures generally have a good prognosis and heal well with simple immobilization with a low risk of complications.

Ambulatory management of acute uncomplicated diverticulitis (AmbUDiv study): a multicentre, propensity score matching study.

Introduction: Recent studies have suggested that ambulatory management is feasible for acute uncomplicated diverticulitis (AUD); however, there is still no consensus regarding the most appropriate management settings. This study presents a multi-centre experience of managing patients presenting with AUD, specifically focusing on clinical outcomes and comparing ambulatory treatment with in-patient management.

Methods: A retrospective multi-centre study was conducted across four hospitals in the UK and included all adult patients with computed tomography (CT) confirmed (Hinchey grade 1a) acute diverticulitis over a 12-month period (January - December 2022).

MSK ultrasound imaging-assisted clinical examination.

Musculoskeletal disorders are a significant global health concern, affecting over 1.71 billion individuals worldwide, with a considerable impact on quality of life and economic burden due to healthcare costs and productivity losses. In the United Kingdom, approximately one-third of the population suffers from musculoskeletal disorders, underscoring the need for effective diagnostic and management strategies.

Spontaneous Cerebrospinal Fluid Rhinorrhea in Pre-operative Pituitary Adenoma: A Report of Two Cases.

Pituitary macroadenomas are neuroendocrine tumors residing in the base of the skull. First-line therapies for prolactin-secreting adenomas (prolactinoma) include medical treatment with dopamine agonists and neurosurgical intervention. Cerebrospinal fluid (CSF) rhinorrhea is a well-known complication following skull base tumor treatment; however, spontaneous CSF rhinorrhea as the initial presenting feature of such tumors is rare.

Comprehensive Analysis of Purpura Fulminans as an Uncommon Postoperative Complication: A Case Series.

Background: Acute infectious purpura fulminans (AIPF) is a rare but potentially fatal postoperative complication characterised by rapidly progressing disseminated intravascular coagulation (DIC), widespread purpura, and multi-organ dysfunction. Despite its severe and critical outcomes, the literature on this condition in the postoperative context is limited.

Objectives: This study aimed to analyse and evaluate the incidence, clinical presentation, laboratory findings, management strategies, and outcomes of postoperative AIPF in patients who underwent various surgical procedures.

Evaluating the Confidence of Non-specialty Doctors Working in Trauma and Orthopedics in Performing Knee Arthrocentesis Through Simulation-Based Teaching.

Introduction Acute monoarthropathies that present in emergency settings include septic arthritis, where urgent joint arthrocentesis is the diagnostic gold standard. Literature indicates low confidence among trainee doctors in performing knee aspirations. Simulation-based teaching can be used to supplement procedural skills training and improve their confidence in performing such procedures.

CBCT (Cone-Beam CT)-Based Online Adaptive Radiotherapy in the Post-operative Oesophageal Cancer Patient.

We present a case of a patient having cone-beam CT (CBCT)-based online adaptive radiotherapy (oART) on Ethos Therapy after oesophagectomy and gastric pull-up. This case report aims to demonstrate that daily oART is a viable treatment option for post-oesophagectomy patients. The patient's radiotherapy plan was generated on the Ethos system using an eight-field intensity-modulated radiation therapy (IMRT) plan imported from the Eclipse planning system.

Enterocolic Lymphocytic Phlebitis Masquerading as a Malignant Stricture in the Caecum: A Case Report and Literature Review.

Enterocolic lymphocytic phlebitis (ELP) is an idiopathic form of venous inflammation that is limited to the gastrointestinal tract. It is characterised by inflammation of the veins with no involvement of the arteries. Usually, it presents with gastrointestinal symptoms such as abdominal pain, and imaging may suggest malignancy.

Protocol club: a social learning framework for the research delivery workforce.

Background: 'Protocol club' is a learning activity underpinned by social learning theory that is designed 'by the research delivery workforce, for the research delivery workforce'. A protocol club meets regularly to critique the feasibility and deliverability of publicly available study protocols.

Aim: To describe a proof-of-concept protocol club aimed at addressing the training needs of a research delivery workforce at two NHS England trusts.