Assessing and Improving the Documentation of Large-Volume Paracentesis Procedures in a Tertiary Hospital: A Quality Improvement Project.

Inconsistent documentation of large-volume paracentesis (LVP) procedures in a tertiary hospital presents risks to patient safety and procedural quality. This study aimed to improve the completeness and accuracy of LVP documentation through the implementation of a structured checklist, developed in alignment with the British Society of Gastroenterology (BSG) Safety Toolkit. The intervention was conducted over three Plan-Do-Study-Act (PDSA) cycles and involved multidisciplinary collaboration, the integration of Local Safety Standards for Invasive Procedures (LocSSIPs) into the Clinical Record System (CRS), and targeted training for staff.

Efficacy of Anti-Vascular Endothelial Growth Factor (VEGF) Therapy for Age-Related Macular Degeneration.

Anti-vascular endothelial growth factor (VEGF) drugs are used for various diseases with abnormal proliferation of blood vessels. The use of these drugs in wet age-related macular degeneration (AMD) has proven to be highly effective. Various factors contribute to the efficacy of these drugs in different settings.

The translational potential of inflammation-induced skin blister human models in exploring the pathogenesis of periodontitis and its systemic health implications.

Periodontitis is a highly prevalent chronic disease. Despite decades of extensive research on the topic, a complete understanding of its immunopathogenesis, especially when linked to other inflammatory comorbidities, is lacking. human and animal experiments have shown the host inflammatory response's crucial role in both the disease's onset and its systemic implications.

Impact of Race on the Outcomes of Retinoblastoma Treated With Primary Enucleation: A Global Study of 1426 Patients.

Background: To evaluate the clinical presentation, pathological features and outcomes of retinoblastoma based on the race of origin in a global cohort of patients.

Methods: Retrospective collaborative study of 1426 patients who underwent primary enucleation for retinoblastoma.

Results: Patients were grouped into Caucasians (n = 231, 16%), Asians (n = 841, 59%), Hispanics (n = 226, 16%), Arabs (n = 96, 7%) and Others (Africans, African Americans, Indigenous Australians; n = 32, 2%) cohorts.

Impact of pulmonary vein isolation on atrial arrhythmias in patients with typical atrial flutter: systematic review and meta-analysis of randomized clinical trials.

Aims: Cavotricuspid isthmus (CTI) ablation is the current ablation treatment for typical atrial flutter (AFL). However, post-ablation atrial tachyarrhythmias, mostly in the form of atrial fibrillation (AF), are frequently observed after CTI ablation. We aimed to evaluate the effectiveness and safety of concomitant or isolated pulmonary vein isolation (PVI) in patients with typical AFL scheduled for ablation.

Medical ambivalence and Long Covid: The disconnects, entanglements, and productivities shaping ethnic minority experiences in the UK.

Structural violence - related to 'isms' like racism, sexism, and ableism - pertains to the ways in which social institutions harm certain groups. Such violence is critical to institutional indifference to the plight of ethnic minority people living with long-term health conditions. With only emergent literature on the lived experiences of ethnic minorities with Long Covid, we sought to investigate experiences around the interplay of illness and structural vulnerabilities.

Limb Salvage Versus Amputation: A Review of Variables Influencing the Assessment and Decision-Making in Complex Limb Fracture Management.

Complex limb injuries are combination injuries that involve all components of a limb's tissue, such as skin, bone with its surrounding soft tissue cover, and neurovascular elements. Complex limb trauma often has a background of a significant mechanism of injuries such as high-velocity road traffic accidents, ballistic injuries, industrial accidents, and other major mechanisms of injuries which involve high amounts of energy transfer through these tissue layers. These injuries pose a major challenge to trauma and orthopaedic surgeons.

Massive Bilateral Haemorrhagic Prepatellar Bursitis: A Case Report.

Prepatellar bursitis is a common cause of anterior knee pain. We present an unusual case of massive bilateral traumatic haemorrhagic prepatellar bursitis managed with surgical excision and describe our operative findings. The patient presented with large bilateral knee swellings which had been present for six years following a fall onto both knees.

The impact of psoriatic arthritis on quality of life: a systematic review.

Background: Psoriatic arthritis (PsA) is a chronic inflammatory condition that can affect individuals of all ages. Patients may experience a range of physical and psychological issues.

Objective: To examine the impact of PsA on an individual's quality of life (QoL) and physical function.

Perception of Telemedicine and Remote Learning Following the COVID-19 Pandemic: A Health Education England Survey of London Obstetrics and Gynaecology Trainees.

Purpose: To determine the level of uptake of telemedicine among postgraduate obstetrics and gynaecology (O&G) trainees in London, and how they perceive its impact on their training.

Methods: A mixed-methods survey aimed at exploring trainee perspectives of telemedicine use in clinical practice and its implications for training. Study participants were O&G specialist doctors on the London (UK) training programme.

Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.

Atrial fibrillation (AF) remains the most common cardiac arrhythmia worldwide and is associated with significant morbidity and mortality. The European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) have recently released the 2024 guidelines for the management of AF. This review highlights 10 novel aspects of the ESC/EACTS 2024 Guidelines.

The NHS England Jewish BRCA Testing Programme: overview after first year of implementation (2023-2024).

Background: The NHS Jewish BRCA Testing Programme is offering germline and genetic testing to people with ≥1 Jewish grandparent. Who have an increased likelihood of having an Ashkenazi Jewish (AJ) founder germline pathogenic variant (gPV) compared with the general population.Testing is offered via a self-referral, home-based saliva sampling pathway, supported by a genetic counsellor telephone helpline.

The Efficacy of Biodegradable Temporising Matrix for Upper Limb Reconstruction: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis is to assess the efficacy of the biodegradable temporising matrix (BTM) (NovoSorb; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) in the reconstruction of complex upper extremity wounds. The authors conducted a systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines assessing the efficacy of BTM in complex upper extremity wound reconstruction. The primary outcome measures were successful BTM integration and the proportion of wounds healed.

East London Project: a participatory mixed-method evaluation on how removing enforcement could affect sex workers' safety, health and access to services in East London.

Background: Sex workers' risk of violence and ill-health is shaped by their work environments, community and structural factors, including criminalisation.

Aim: We evaluated the impact of removing police enforcement on sex workers' safety, health and access to services.

Design: Mixed-methods participatory study comprising qualitative research, a prospective cohort study, mathematical modelling and routine data collation.

A pragmatic approach to recognize intrapartum chorioamnionitis.

Chorioamnionitis is a significant contributor to non-hypoxic fetal compromise, increasing the risk of neonatal encephalopathy and cerebral palsy. This paper highlights the limitations of traditional diagnostic methods for chorioamnionitis, which rely on histopathology, microbiology, and clinical signs, and emphasizes the importance of recognizing the fetal inflammatory response using intrapartum cardiotocography (CTG). By understanding the physiological pathways of inflammation, clinicians can identify characteristic CTG patterns.

A Systematic Review of Multimodal Analgesic Effectiveness on Acute Postoperative Pain After Adult Cardiac Surgery.

Aim: To synthesise the best available empirical evidence about the effectiveness of multimodal analgesics on pain after adult cardiac surgery.

Design: A systematic review with meta-analysis.

Methods: Indexed full-text papers or abstracts, in any language, of randomised controlled trials of adult patients undergoing cardiac surgery investigating multimodal postoperative analgesic regimen effect on mean level of patient-reported pain intensity at rest.

Diagnostic interobserver variability of atypia assessment in columnar cell lesions among a group of expert breast pathologists in the United Kingdom and the Republic of Ireland, on behalf of the UK national coordinating committee for breast pathology.

Aims: Atypical ductal hyperplasia and flat epithelial atypia (FEA) have defined diagnostic criteria, yet there is variation in the interpretation of these criteria, particularly when the atypia is present in a background of columnar cell lesions (CCLs). This study focuses upon cases which are especially challenging or difficult to classify reproducibly according to existing criteria.

Methods And Results: Thirteen breast pathology experts were asked to classify 10 challenging cases with CLLs as atypical or non-atypical.

The London Regional Major Trauma System: A Literature Review of Epidemiology and Current and Future Challenges.

Trauma has been one of the world's most common causes of death among younger age groups. In the UK, a lack of an organized and streamlined approach was reported in the management of traumatic injuries and patients involved in trauma cases in the UK. Therefore, a major trauma network system was devised to address these issues in line with other trauma systems around the world.

Rational approach to fetal heart rate monitoring and management during the second stage of labor.

Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.

Detection and treatment of developmental dysplasia of the hip in infants: updates and recommendations.

Purpose Of Review: Developmental dysplasia of the hip (DDH) is common and is a source of potentially avoidable morbidity through childhood and adult life. Despite progress over the past century, there is a wide variation in policy, practice and outcomes between countries. This review considers information from a geographically wide range of locations to evaluate the impact of these variations and understand how these variations arise.

Corrigendum to "Genetic Variants of Are Major Determinants of Kidney Failure in People of African Ancestry With HIV" [ Volume 7, Issue 4, April 2022, Pages 786-796].

[This corrects the article DOI: 10.1016/j.ekir.

Exploring How the Kidney BEAM Physical Activity Digital Health Intervention Improved Mental Health-Related Quality of Life for People Living With Kidney Disease.

Introduction: The Kidney BEAM randomized controlled trial reported clinically meaningful and statistically significant improvements in mental health-related quality of life (HRQoL), physical function (sit-to-stand-60, but not the physical component of HRQoL) and patient activation after a 12-week physical activity digital health intervention (DHI). This study explores factors that contributed to the effectiveness of Kidney BEAM through mixed methods analyses.

Methods: Quantitative data analysis was obtained from the recently published primary manuscript.

Feasibility of relaxation along a fictitious field in the 2nd rotating frame (T) mapping in the human myocardium at 3 T.

Purpose: Evaluate the feasibility of quantification of Relaxation Along a Fictitious Field in the 2nd rotating frame (RAFF2) relaxation times in the human myocardium at 3 T.

Methods: mapping was performed using a breath-held ECG-gated acquisition of five images: one without preparation, three preceded by RAFF2 trains of varying duration, and one preceded by a saturation prepulse. Pixel-wise maps were obtained after three-parameter exponential fitting.