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.

Case report: Vedolizumab in Oral Crohn's disease: the downsides of a gut-specific therapy for a multi-site disease.

Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease which can affect any area of the gastrointestinal tract, including oral tissues. The complex nature of this disease demands interdisciplinary management, especially when both intestinal and oral manifestations are present.

Case: This report presents the case of a 28-year-old male patient with oral, ileo-caecal and peri-anal CD managed jointly between Gastroenterology and Oral Medicine.

Effect of Proximal Blood Flow Arrest During Endovascular Thrombectomy (ProFATE): A Multicenter, Blinded-End Point, Randomized Clinical Trial.

Background: The effect of temporary blood flow arrest during endovascular thrombectomy for acute ischemic stroke is uncertain due to the lack of evidence from randomized controlled trials. We aimed to investigate whether temporary blood flow arrest during endovascular thrombectomy using a balloon guide catheter improves intracranial vessel recanalization compared with nonflow arrest.

Methods: The ProFATE trial (Proximal Blood Flow Arrest During Endovascular Thrombectomy) was a multicenter, randomized, participant- and outcome-blinded trial at 4 thrombectomy centers in the United Kingdom.

Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI).

Purpose: Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI aimed to develop a Core Outcome Set (COS) for daily monitoring of GI function to improve consistency and comparability in future studies in critically ill patients.

Combined chest wall perforator flap and synchronous fat grafting for partial breast reconstruction.

Chest wall perforator flaps (CWPFs) have been a well-recognised surgical option for volume replacement following breast conservation surgery (BCS). However, the flap volume can sometimes be limited, which may adversely affect the aesthetic outcome or even disqualify the patient from having BCS. We report the first case of hybrid partial breast reconstruction using immediate autologous fat injection into CWPF.

Clinical approach to palpitations in pregnancy.

Palpitations are common in pregnancy and warrant investigation. Palpitations may be caused by non-cardiac and cardiac causes. Patients with structural or functional abnormalities or inherited cardiovascular disease are more likely to develop arrhythmia, especially during pregnancy when the mother's body undergoes extensive physiological adaptations, which further contribute to an increased arrhythmia risk.

CD19-targeting chimeric antigen receptor T-cell therapy is safe and effective for intra-cardiac B cell non-Hodgkin lymphoma.

Introduction: Chimeric antigen receptor T-cell (CAR-T) therapy is highly effective in B-cell blood cancers, but there is limited data on its safety and efficacy in intra-cardiac lymphoma, due to the potential risks of cardiotoxicity and pseudo-progression.

Discussion: We discuss four high-risk cases that were managed with a multi-disciplinary approach, including baseline cardiac risk assessment and surveillance with multimodal cardiac imaging and serum cardiac biomarkers, elective supportive care in the intensive care unit, and early treatment of cytokine release syndrome.

Conclusion: CAR-T therapy can be effective and safe in the treatment of B-cell blood cancers with intra-cardiac disease.

A New Diagnosis of Ulcerative Colitis on a Background of Diversion Colitis Following Hartmann's Procedure for Perforated Diverticula.

Ulcerative colitis (UC) is a chronic immune-mediated intestinal condition. This case report describes an 82-year-old woman who was newly diagnosed with UC. Two years prior, she had multiple admissions for abdominal pain and rectal bleeding, initially diagnosed as diverticulitis.

Leucocyte telomere length and conduction system ageing.

Background: Deterioration of the cardiac conduction system is an important manifestation of cardiac ageing. Cellular ageing is accompanied by telomere shortening and telomere length (TL) is often regarded as a marker of biological ageing, potentially adding information regarding conduction disease over and above chronological age. We therefore sought to evaluate the association between leucocyte telomere length (LTL) on two related, but distinct aspects of the cardiac conduction system: ECG measures of conduction (PR interval and QRS duration) and incident pacemaker implantation in a large population-based cohort.

Whole Gut Motility Patterns in Patients with Chronic Nausea and Vomiting.

Chronic nausea and vomiting (N/V) disorders are common in clinical practice. Our primary aim was to compare total and segmental gastrointestinal transit times as well as gastric contraction patterns in patients with chronic N/V syndrome to those of healthy volunteers (HVs). In the patient group, our secondary aim was to explore how symptoms and motility patterns were affected by a serotonin HT receptor agonist (Prucalopride).

Influence of CReatine Supplementation on mUScle Mass and Strength After Stroke (ICaRUS Stroke Trial): A Randomized Controlled Trial.

Background/objectives: The acute phase of stroke is marked by inflammation and mobility changes that can compromise nutritional status. This study was a randomized, double-blind, placebo-controlled trial evaluating the effectiveness of creatine supplementation for older people during seven days of hospitalization for stroke compared to usual care.

Method: The primary outcome measures were changes in functional capacity, strength, muscle mass, and muscle degradation.

Identifying potential predictors of surgical site infection risk following cardiac surgery: a scoping review.

Objectives: This scoping review was undertaken to identify risk predictions models and preoperative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high-risk of SSI, and therefore guide a national SSI prevention strategy.

Methods: A scoping review to systematically identify and map out existing research evidence on preoperative predictors of SSI was conducted in two stages.

Decreased cardio-respiratory information transfer is associated with deterioration and a poor prognosis in critically ill patients with sepsis.

Assessing illness severity in the ICU is crucial for early prediction of deterioration and prognosis. Traditional prognostic scores often treat organ systems separately, overlooking the body's interconnected nature. Network physiology offers a new approach to understanding these complex interactions.