Open Window Mapping of Accessory Pathways: A Literature Review and Practical Guide.

Catheter ablation is the treatment of choice for patients with symptomatic accessory pathways (APs) causing recurrent atrioventricular reciprocating tachycardia or in situations where APs conduct rapidly, posing a risk of sudden cardiac death. Conventional AP mapping relies on point-by-point assessment of local electrograms looking closely for pathway electrograms or early atrial or ventricular electrograms, which may be challenging and time consuming. Recently, open window mapping (OWM) using 3D navigational systems has emerged as a novel technique to help localise and ablate APs.

Protecting patients and learners: educational leadership on the fringes.

The development of high-quality clinicians takes place through immersion in clinical practice facilitated by educational supervisors with appropriate capabilities and organisational support to undertake the role. Learners give feedback on the quality of their learning experience on placement, which provides insights about the quality of clinical care received by patients.In this article, we explore the role of educational leaders in engaging with learner feedback about patient care, the challenges and tensions this generates, and the path through resolution.

Invasive Detection of Coronary Microvascular Dysfunction: How It Began, and Where We Are Now.

The landscape of interventional cardiology is ever evolving. Contemporary practice has shifted from a stenosis-centred approach to the total characterisation of both the epicardial and microcirculatory vessels. Microcirculatory dysfunction plays an important role in the pathophysiology of acute and chronic coronary syndromes, and characterisation of the microcirculation has important clinical consequences.

Early Experience of Undertaking Robotic Assisted Total Mesorectal Excision in Rectal Resections, Avoiding a Diverting Stoma: Key eHancement of the Anastomosis for No Stoma Technique - A Case Series.

Anastomotic leak is a feared complication in rectal cancer surgery, and a proximal diverting stoma to protect the rectal anastomosis is used to minimize its impact. We evaluated a novel technique that uses the da Vinci® robotic platform (Intuitive Surgical) to reinforce the colorectal anastomosis and rectal staple line with sutures, and rectal resection and assessment of the anastomotic perfusion, using our Portsmouth protocol. During robotic rectal cancer surgery, we used indocyanine green to determine the level of transection and check the vascularity of the circular anastomosis.

Oncological outcomes of open, laparoscopic and robotic colectomy in patients with transverse colon cancer.

Background: Literature concerning surgical management of transverse colon cancer is scarce, since many key trials excluded transverse colon cancer. The aim of this study was to evaluate clinical and oncological outcomes comparing open, laparoscopic and robotic transverse colon cancer resection.

Methods: Consecutive patients who underwent elective surgery for transverse colon cancer between December 2005 and July 2021 were included.

Can Interventional Cardiologists Help Deliver the UK Mechanical Thrombectomy Interventional Programme for Patients with Acute Ischaemic Stroke? A Discussion Paper from the British Cardiovascular Interventional Society Stroke Thrombectomy Focus Group.

There is a willingness among UK interventional cardiologists to contribute to provision of a 24/7 mechanical thrombectomy (MT) service for all suitable stroke patients if given the appropriate training. This highly effective intervention remains unavailable to the majority of patients who might benefit, partly because there is a limited number of trained specialists. As demonstrated in other countries, interdisciplinary working can be the solution and an opportunity to achieve this is outlined in this article.

Orthotopic bladder substitution: Surgical aspects and optimization of outcomes.

Objectives: Orthotopic bladder substitution (OBS) is a management option for urinary diversion in men and women undergoing cystectomy. The aim of the procedure is to provide a functional continent urinary reservoir of adequate capacity, compliance and low pressure. We have provided a narrative review of the existing literature and highlighted areas where improvement and standardization can be recommended.

RT-qPCR Detection of SARS-CoV-2: No Need for a Dedicated Reverse Transcription Step.

Reverse transcription of RNA coupled to amplification of the resulting cDNA by the polymerase chain reaction (RT-PCR) is one of the principal molecular technologies in use today, with applications across all areas of science and medicine. In its real-time, fluorescence-based usage (RT-qPCR), it has long been a core technology driving the accurate, rapid and sensitive laboratory diagnosis of infectious diseases. However, RT-qPCR protocols have changed little over the past 30 years, with the RT step constituting a significant percentage of the time taken to complete a typical RT-qPCR assay.

Glycoprotein Acetyls: A Novel Inflammatory Biomarker of Early Cardiovascular Risk in the Young.

Background Low-grade inflammation in the young may contribute to the early development of cardiovascular disease. We assessed whether circulating levels of glycoprotein acetyls (GlycA) were better able to predict the development of adverse cardiovascular disease risk profiles compared with the more commonly used biomarker high-sensitivity CRP (C-reactive protein). Methods and Results A total of 3306 adolescents and young adults from the Avon Longitudinal Study of Parents and Children (mean age, 15.

RT-qPCR Diagnostics: The "Drosten" SARS-CoV-2 Assay Paradigm.

The reverse transcription quantitative polymerase chain reaction (RT-qPCR) is an established tool for the diagnosis of RNA pathogens. Its potential for automation has caused it to be used as a presence/absence diagnostic tool even when RNA quantification is not required. This technology has been pushed to the forefront of public awareness by the COVID-19 pandemic, as its global application has enabled rapid and analytically sensitive mass testing, with the first assays targeting three viral genes published within days of the publication of the SARS-CoV-2 genomic sequence.

An epidemiological study of a patient population, triage category allocations and principal diagnosis within the emergency centres of a private healthcare group in the Emirate of Dubai, United Arab Emirates.

Aim: To describe, compare and correlate the number of patients seen, their demographics, triage category allocations and principal diagnosis in four emergency centres; to better understand the patient population and triage practices in this setting.

Design: An observational, cross-sectional, epidemiological study.

Methods: Electronic medical records were retrospectively evaluated from patients triaged in each of the four emergency centres over six months.

Recovery of Absolute Coronary Blood Flow and Microvascular Resistance After Chronic Total Occlusion Percutaneous Coronary Intervention: An Exploratory Study.

Background This study aimed to investigate longitudinal physiological changes in the recanalized coronary chronic total occlusion (CTO) vessel and its dependent myocardium after successful percutaneous coronary intervention (PCI). Methods and Results In this pilot study, 25 patients scheduled for elective CTO PCI with viable myocardium and angiographically visible collaterals were included. Absolute coronary blood flow and absolute microvascular resistance were measured invasively using continuous thermodilution.

Emergency centre triage category allocations and their associated patient flow timeframes in a private healthcare group in the Middle East.

Aims And Objectives: To identify and describe triage category allocations and their associated patient pathway timeframes in four emergency centres of a large private healthcare group in the United Arab Emirates.

Background: The classification of patients in accordance with their acuity level is a complex task that requires quick and accurate allocation. Triage system categories have predetermined timeframes in which patients should be seen by a physician or treatment initiated for the best possible outcome.

The nursing work environment and quality of care: Content analysis of comments made by registered nurses responding to the Essentials of Magnetism II scale.

Aim: To report a qualitative study of themes Registered Nurses raised spontaneously about their work environment, in a cross-sectional survey study when responding to the Essentials of Magnetism II (EOMII) scale.

Design: Qualitative descriptive survey.

Methods: At the end of the EOMII scale, a free form text section was included asking nurses to add comments about their ward/work environment Of the 247 nurses who completed the EOMII scale, 30% ( = 75) provided comments.

The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China.

Background/aims: To examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China.

Methods: A total of 199 consecutive patients with diabetes (mean age = 57 years, SD = 11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients' records.

Tar yield and composition from poultry litter gasification in a fluidised bed reactor: effects of equivalence ratio, temperature and limestone addition.

Air gasification of poultry litter was experimentally investigated in a laboratory scale bubbling fluidised bed gasifier. Gasification tests were conducted at atmospheric pressure using silica sand as the bed material. This paper examines the effect of the equivalence ratio (ER) in the range of 0.

100 Steps of a DIEP Flap-A Prospective Comparative Cohort Series Demonstrating the Successful Implementation of Process Mapping in Microsurgery.

Background: The demand to improve the efficiency of microsurgical breast reconstruction is driven by increasing number of breast cancer and risk reducing cases, and the concurrent requirement for hospitals to cut costs. Businesses have successfully used process mapping as a tool to improve efficiency; however, process mapping has been sparsely used in surgery. This prospective cohort study has used process mapping to break down the individual components of a deep inferior epigastric artery perforator (DIEP) flap operation into a template of 100 streamlined steps.

Reliable, resilient and sustainable water management: the Safe & SuRe approach.

Global threats such as climate change, population growth, and rapid urbanization pose a huge future challenge to water management, and, to ensure the ongoing reliability, resilience and sustainability of service provision, a paradigm shift is required. This paper presents an overarching framework that supports the development of strategies for reliable provision of services while explicitly addressing the need for greater resilience to emerging threats, leading to more sustainable solutions. The framework logically relates global threats, the water system (in its broadest sense), impacts on system performance, and social, economic, and environmental consequences.

Lymphomas Associated with Breast Implants: A Review of the Literature.

Background: Recently there have been concerns raised about anaplastic large cell lymphoma (ALCL) associated with breast implants.

Objectives: The main aim of this article was to review and analyze the published literature specifically for hematopoietic malignancies associated with breast implants and postulate a hypothesis for their etiology and pathogenesis.

Methods: The PubMed database was searched using key words "lymphoma" and "breast implants" for published papers and abstracts on implant-associated hematopoietic malignancies.