Diagnosis and management of dilated cardiomyopathy: a systematic review of clinical practice guidelines and recommendations.

Dilated cardiomyopathy (DCM) is extensively discussed in numerous expert consensus documents and international guidelines, with differing recommendations. To support clinicians in daily practice and decision-making, we conducted a systematic review of key guidelines and recommendations concerning the diagnosis and clinical management of DCM. Our research encompassed MEDLINE and EMBASE databases for relevant articles published, as well as the websites of relevant scientific societies.

Predicting success with reduced dosing frequency of tralokinumab in patients with moderate-to-severe atopic dermatitis.

Background: Approved tralokinumab maintenance dosing regimens for treatment of moderate-to-severe atopic dermatitis (AD) include 300 mg every two weeks (Q2W) and every four weeks (Q4W), that clinicians may consider for patients who achieved clear or almost clear skin at Week 16 with initial Q2W dosing.

Objectives: To identify predictive factors associated with maintained response after switching to tralokinumab Q4W, evaluate recapture of treatment response after relapse on Q4W, and assess treatment-emergent immunogenicity with tralokinumab Q4W.

Methods: These post hoc analyses utilized machine learning to identify predictive factors for maintained treatment response at Week 52 using data from the Week 16 responder population (ie, patients who met Investigator's Global Assessment of clear/almost clear skin [IGA 0/1] and/or ≥75% improvement in Eczema Area and Severity Index (EASI-75) at Week 16 with tralokinumab Q2W monotherapy) of the phase 3 ECZTRA 1 and 2 trials.

London Major Trauma System: a review of an organised trauma system and the challenges it faces.

London Major Trauma System (LMTS) was the first organised trauma system in the United Kingdom. It was created in 2010 in response to multiple reviews that suggested a large number of deaths from trauma may have been preventable. LMTS has all the features of a modern organised trauma system, including regionalisation, integration of care, transfer services, trauma teams, and a world leading research service.

Gonadotropin therapy for mini-puberty induction in male infants with hypogonadotropic hypogonadism: a systematic review.

Context: Congenital hypogonadotropic hypogonadism (CHH) is defined as an isolated deficiency of gonadotropin hormones. Mini-puberty, a transient postnatal activation of the hypothalamic-pituitary-gonadal axis in healthy infants, provides a window of opportunity to diagnose and treat CHH. Currently, in male infants with CHH, testosterone is used to increase phallus size.

Integration of genetic testing into diagnostic pathways for cardiomyopathies: a clinical consensus statement by the ESC Council on Cardiovascular Genomics.

In the modern era, cardiologists managing patients and families with cardiomyopathies need to be familiar with every stage of the diagnostic pathway from clinical phenotyping to the prescription and interpretation of genetic tests. This clinical consensus statement from the ESC Council for Cardiovascular Genomics aims to promote the integration of genetic testing into routine cardiac care of patients with cardiomyopathies, as recommended in the 2023 ESC guidelines for cardiomyopathies. The document describes the types of genetic tests currently available and provides advice on their prescription and for counselling after the return of genetic findings, including the approach in patients and families with variants of unknown significance.

Explainable Artificial Intelligence in Paediatric: Challenges for the Future.

Background: Explainable artificial intelligence (XAI) emerged to improve the transparency of machine learning models and increase understanding of how models make actions and decisions. It helps to present complex models in a more digestible form from a human perspective. However, XAI is still in the development stage and must be used carefully in sensitive domains including paediatrics, where misuse might have adverse consequences.

Reframing assisted dying through the civil law: possibilities and challenges for the UK.

Background: Current proposals for assisted dying in the UK are based on embedding it within a medical, healthcare model. This model is revealing challenges in safeguarding, monitoring and the impact on healthcare.

Objective: To explore if a different model is a safer, pragmatic and realistic alternative.

Human papillomavirus genotype and cycle threshold value from self-samples and risk of high-grade cervical lesions: A post hoc analysis of a modified stepped-wedge implementation feasibility trial.

Background: Human papillomavirus (HPV) testing of self-collected vaginal samples has potential to improve coverage of cervical screening programmes, but current guidelines mostly require those HPV positive on a self-sample to attend for routine screening.

Methods And Findings: A pragmatic modified stepped-wedge implementation feasibility trial was conducted at primary care practices in England. Individuals aged 25 to 64 years who were at least 6 months overdue for cervical screening could provide a self-collected sample.

Effects of cladribine on intrathecal and peripheral B and plasma cells.

Introduction: Cladribine is a deoxyadenosine analogue that can penetrate the blood-brain barrier. It is used to treat multiple sclerosis (MS). However, the mechanistic understanding of the effect of this highly effective therapy on B cells and plasma cells in the central nervous system compartment is limited.

Neonatal intracranial pathologies on ultrasound imaging in sub-Saharan Africa: a systematic review and meta-analysis.

Annually, 30 million children are affected by newborn conditions, most in low-income countries, with long-term implications for survivors. We aimed to evaluate neonatal intracranial pathologies identifiable on cranial ultrasound (CUS) in sub-Saharan Africa (SSA). This systematic review and meta-analysis explored the spectrum of neonatal intracranial pathology, in nine databases, using the Joanna Briggs Institute Systematic Review Tools.

Clinical Assessment and Factors Influencing Treatment Strategy and Outcomes in Complex Limb Injuries.

Complex limb injuries are high-energy injuries that may threaten limb viability and confer significant morbidity and mortality. Prompt clinical assessment and decision-making are critical to determining the optimal management strategy, i.e.

Coronary angiography: a review of the state of the art and the evolution of angiography in cardio therapeutics.

Traditionally, coronary angiography was restricted to visual estimation of contrast-filled lumen in coronary obstructive diseases. Over the previous decades, considerable development has been made in quantitatively analyzing coronary angiography, significantly improving its accuracy and reproducibility.  Notably, the integration of artificial intelligence (AI) and machine learning into quantitative coronary angiography (QCA) holds promise for further enhancing diagnostic accuracy and predictive capabilities.

Retinal morphology across the menstrual cycle: insights from the UK Biobank.

Oestradiol and progesterone levels are higher in menstruating women than men of the same age, and their receptors are present in their neurosensory retina and retinal pigment epithelium. However, the impact of this hormonal environment on retinal physiology in women remains unclear. Using self-reported menstrual cycle phases as a surrogate for fluctuating hormonal levels, we investigated associations with retinovascular indices on colour fundus photograph and retinal thickness in optical coherence tomography across regularly menstruating women in the UK Biobank.

Effect and safety of intravenous iron compared to oral iron for treatment of iron deficiency anaemia in pregnancy.

Rationale: Intravenous iron is increasingly used to treat iron-deficient anaemia (IDA) in pregnancy. A previous network meta-analysis suggested that intravenous irons have a greater effect on haematological parameters than oral irons; however, the impact on serious pregnancy complications such as postpartum haemorrhage (PPH) or the need for blood transfusion was unclear. Since then, several new randomised controlled trials (RCTs) have been conducted.

Holistic approaches to living well with endometriosis.

Unlabelled: Endometriosis is a common chronic non curable neuro-inflammatory condition, which can cause endometriosis-related pelvic pain (ERPP). Sufferers may struggle with side effects and/or risks from conventional medical and surgical treatments, or not get pain relief. Increasing numbers of endometriosis patients wish to explore holistic management with fewer side effects, however it is important that medical professionals maintain an evidence-based practice for recommended treatments.

Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom.

Aim: Sub30 study is an open-label, prospective, single-arm feasibility study with the primary objective of assessing the logistics, feasibility, and safety of ECPR delivery in a pre-hospital setting for refractory out-of-hospital cardiac arrest patients in London, United Kingdom.

Results: Forty-three eligible patients were identified by London Ambulance Service over 27 trial recruitment days during a 13-month study period resulting in the despatch of the pre-hospital ECPR team to 18 patients. Five patients met full criteria and were cannulated for ECPR.

Cisplatin- or Carboplatin-Based Chemotherapy Plus Pembrolizumab in Advanced Urothelial Cancer: Exploratory Analysis From the Phase 3 KEYNOTE-361 Study.

Introduction: KEYNOTE-361 evaluated first-line pembrolizumab with and without platinum-based chemotherapy versus chemotherapy alone in advanced or metastatic urothelial carcinoma. The primary end points of progression-free survival (PFS) or overall survival (OS) were not met. Exploratory analysis of efficacy by platinum agent (cisplatin or carboplatin) is reported.

Surgical identification of brain tumour margins through impedance monitoring and electrocorticography and the potential for their combined use: A systematic review.

Context: Primary central nervous system tumours have poor survival outcomes. Surgery, the first-line treatment, presents technical limitations, such as visualising the whole tumour border. Intracranial impedance monitoring and electrocorticography techniques provide insights into the local field potential characteristics, resistance and capacitance properties of brain tissue.