Conserve or Reverse? Outcomes of Conservative treatment versus Reverse Shoulder Arthroplasty in displaced 3- & 4-part proximal humeral fractures in patients over 60 years.

Background: The optimal treatment of 3- and 4-part proximal humeral fractures in older adults remains controversial. This aim of this study was compare patient reported outcomes following reverse shoulder arthroplasty (RSA) or non-operative management in patients over 60 years old.

Methods: A retrospective review was undertaken of patients following 3- or 4-part proximal humeral fractures treated with RSA or non-operative treatment with minimum 2-year follow-up.

'What is 'wellbeing' to doctors in training, and how do we improve it? Results of a quantitative survey and thematic analysis of internal medicine trainees.

Introduction: The wellbeing of medical trainees has come into sharp focus in recent years, particularly since the COVID-19 pandemic. Workforce pressures are well documented, as is the need to retain staff. There are a number of initiatives to try and improve the wellbeing of staff, including the introduction of wellbeing and education dellows for stage 1 internal medicine trainees in some regions.

An update on the pharmacotherapy of gout.

Introduction: Gout is a common form of acute inflammatory arthritis caused by the deposition of monosodium urate crystals within synovium of joints. This leads to severe pain, reducing quality of life for patients with this condition.

Areas Covered: This review summarizes the treatment of both acute flares of gout and urate-lowering therapy based on guidance from various major international societies.

Retinal fluid quantification using a novel deep learning algorithm in patients treated with faricimab in the TRUCKEE study.

Background: Investigate retinal fluid changes via a novel deep-learning algorithm in real-world patients receiving faricimab for the treatment of neovascular age-related macular degeneration (nAMD).

Methods: Multicenter, retrospective chart review and optical coherence tomography (OCT) image upload from participating sites was conducted on patients treated with faricimab for nAMD from February 2022 to January 2024. The Notal OCT Analyzer (NOA) algorithm provided intraretinal, subretinal and total retinal fluid for each scan.

Wide variation in shape of hypoplastic left ventricles undergoing recruitment and biventricular repair: A statistical shape modeling study.

Background: Patients with hypoplastic left ventricles (LV) who undergo volume-loading procedures (recruitment, biventricular [BIV] repair) are at risk for adverse outcomes, including heart failure and death. We investigated pre-BIV LV shape as a predictor of outcome after BIV repair in patients with hypoplastic LVs.

Methods: Baseline and post-recruitment cardiac magnetic resonance imaging and computed tomography data were analyzed in patients with hypoplastic LV (<50 mL/m).

The patient perspective on the environmental impact of inhalers.

Introduction: Increasing the proportion of low-carbon inhalers prescribed within the NHS forms a central part of net-zero policy. Yet, the patients' perspective on this strategy has not been determined. We aimed to establish if environmental issues are important to respiratory patients and whether this may influence inhaler choice.

'More like a partnership': A qualitative evaluation of Communication Coaching for Sonographers (CCS) in obstetric ultrasound.

Introduction: Sonographers are required to deliver unexpected news to expectant parents in real time during obstetric ultrasound scans. The complexity of these interactions requires sonographers to conduct the clinical task while communicating their findings and managing the expectant parent's response within the designated appointment time. Communication coaching for sonographers (CCS) is a tailored intervention that has previously been associated with improvements in confidence and news delivery practice.

Increased memory confidence and delusions in Alzheimer's disease: a preliminary study.

There is uncertainty about whether delusion formation in Alzheimer's disease (AD) can be explained by false memories. "Metamemory," the ability to self-evaluate memory and identify memory errors, is impaired in people with delusions in schizophrenia. Our objective was to investigate whether false memory and metamemory were associated with delusions in AD.

The effect of breed on ivermectin residues in the edible tissues of cattle and the estimated withdrawal period.

This study analyzed the residue depletion kinetics of ivermectin (IVM) in Nelore and crossbred (Nelore x Angus) cattle aiming to compare the profiles between the breeds and evaluate the residue levels at the injection site. IVM 1%, at a dose of 0.2 mg/kg, was administered the subcutaneous route, and tissue samples were collected on different days post administration for analysis by LC-MS/MS.

Estrous cycle regulates cephalic mechanical sensitivity and sensitization of the trigemino-cervical complex in a female rat model of chronic migraine.

The higher incidence of migraines in women compared with men has led to the inclusion of female animals in pain research models. However, the critical role of the hormonal cycle is frequently overlooked, despite its clear correlation with migraine occurrences. In this study, we show in a rat model of migraine induced by repeated dural infusions of an inflammatory soup (IS) that a second IS (IS2) injection performed in proestrus/estrus (PE, high estrogen) female rats evokes higher cephalic mechanical hypersensitivities than when performed in metestrus/diestrus (MD, low estrogen) or ovariectomized (OV) rats.

The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis.

Unlabelled: Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.

Methods: We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes.

Ocular toxicities of FDA-approved antibody drug conjugates.

Antibody-drug conjugates (ADCs) are an emerging field of cancer treatments that are becoming more widespread in their use. However, there are potential ocular toxicities associated with these drugs that ophthalmologists need to be aware of to better maintain ocular health as patients undergo rigorous medical treatment for their conditions. While many ADCs have been approved by the Food and Drug Administration (FDA), many subsequent reports have been published regarding additional ocular side effects these drugs may cause.

Pulmonary Embolism and Right Ventricular Dysfunction: Mechanism and Management.

Pulmonary embolism (PE) occurs when thrombi from deep vein thrombosis dislodge and obstruct pulmonary arteries, raising pulmonary artery pressure and straining the right ventricle. This strain can lead to right ventricular dysfunction (RVD), characterized by reduced cardiac output, impaired contractility, and potential development of chronic thromboembolic pulmonary hypertension. Clinically, PE may present with symptoms such as dyspnea, pleuritic chest pain, and tachycardia.

Comment on Chatwin et al. Waves of Precision: A Practical Guide for Reviewing New Tools to Evaluate Mechanical In-Exsufflation Efficacy in Neuromuscular Disorders. 2024, , 2643.

We read with interest the paper published by Chatwin et al [...

The use of Reflectance Confocal Microscopy to diagnose Basal Cell Carcinoma in the United Kingdom: A Prospective Observational Trial at a Single Centre.

Background: Previous work with Reflectance Confocal Microscopy (RCM) imaging has shown high sensitivity and specificity for Basal Cell Carcinoma (BCC), but to date there have been few studies on a UK cohort.

Objectives: The study hypothesised that RCM could be used prospectively to accurately diagnose BCC in a private UK secondary care, single clinician setting. The study assessed the potential for RCM to be used as a routine diagnostic procedure.

Care coordinator delivered method of levels therapy to improve engagement and other outcomes in early psychosis (CAMEO): protocol for a feasibility cluster-randomised controlled trial.

Background: Rates of disengagement from early intervention in psychosis (EIP) services are high. Care coordinators make up the largest staff group in EIP services and have the most frequent and sustained contact with service users. The quality of relationships between service users and care coordinators plays a central role in determining the effectiveness of EIP services.