Contraception for women over 40: A comprehensive guide.

Background: Women in their 40s experience significant reproductive health changes, requiring personalised contraception to avoid unintended high-risk pregnancies and adapt to changing health conditions.

Objective: This article examines optimal contraceptive choices for women in their 40s, considering effectiveness, ease of use, non-contraceptive benefits, side effects, contraindications and re-evaluation or discontinuation timings.

Discussion: Contraceptive choices for women in their 40s vary depending on their family planning status, underlying health conditions and risk factors.

Drinking motives link positive and negative life events to problematic alcohol use during the COVID-19 pandemic: a longitudinal study.

Purpose: Stressful life events are associated with problematic drinking, and alcohol misuse has been exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. While coping motives may account for this association, positive life events (PLEs) and enhancement motives are understudied. To address these gaps, we examined the associations of history of alcohol use disorder (AUD), negative life events (NLEs), and PLEs with problematic alcohol use and tested coping and enhancement motives as mediators.

Dynamics of Splenic Transient Elastography in Patients With Alcohol Use Disorder.

Introduction: Splenic stiffness (SS) measurement (SSM) is an evolving noninvasive assessment to evaluate portal hypertension. Studies with respect to SSM in patients with alcohol use disorder are limited.

Methods: We studied patients seeking treatment for alcohol use disorder in an inpatient treatment protocol at the National Institutes of Health and parsed SSM into 3 groups based on degree of change.

Diet quality from early pregnancy through 1-y postpartum: a prospective cohort study.

Background: Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined.

Objectives: This study investigated diet quality from early pregnancy through 1 y postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States.

Methods: Participants completed 24-h dietary recalls at 6 study visits (each pregnancy trimester and 6 wk, 6 mo, and 1 y postpartum) (n = 383).

Central nervous system involvement in Erdheim-Chester disease: a magnetic resonance imaging study.

Purpose: To characterize brain MR imaging findings in a cohort of 58 patients with ECD and to evaluate relationship between these findings and the BRAF pathogenic variant.

Methods: ECD patients of any gender and ethnicity, aged 2-80 years, with biopsy-confirmed ECD were eligible to enroll in this study. Two radiologists experienced in evaluating ECD CNS disease activity reviewed MRI studies.

Faecal immunochemical test (FIT) based prioritisation of new patient symptomatic cases referred for colorectal investigation.

Aim: Quantitative faecal haemoglobin (fHb) measurement by faecal immunochemical test (FIT) is a powerful biomarker for colorectal cancer (CRC) and is incorporated in referral, prioritisation and triage protocols for symptomatic cases in other countries. We report our use of FIT to prioritise new patient symptomatic cases referred for colorectal investigation.

Method: Cases referred for investigation of new colorectal symptoms who were aged ≥50 years (≥40 years Māori/Pacific peoples), who would otherwise be triaged to non-urgent colonoscopy, were asked to provide a stool sample for FIT.

Body Composition, Vascular Health, Cardiorespiratory Fitness, Lung Function, Muscle Architecture, and Physical Activity in People with Young Onset Dementia: A Case-Control Study.

Background: Body composition, blood pressure, estimated maximal oxygen uptake (VO), lung function, physical activity, muscle architecture, and endothelial function had not previously been examined in people with young onset dementia. Therefore, the study measured these variables in a young onset dementia group, compared them to age-matched controls.

Methods: Estimated VO (via the Astrand-Rhyming test), body composition, blood pressure, lung function (via spirometry), muscle architecture (via ultrasonography), and endothelial function (via flow-mediated dilation) were assessed.

Implementing a Peer Support Program for Second Victims.

The second victim phenomenon describes the distress frequently experienced by health care providers after an unintentional medical error or unexpected adverse event. However, few health care institutions have initiatives that proactively address this phenomenon. The pilot project discussed in this article aimed to create a peer support program for health care providers experiencing the second victim phenomenon.

Persistent Autonomic and Immunologic Abnormalities in Neurologic Post-Acute Sequelae of SARS-CoV2 Infection.

Objectives: After acute coronavirus disease-2019 (COVID-19), people often experience fatigue, "brain fog," or other central neurologic symptoms (neuro-post-acute SARS-CoV2, or "Neuro-PASC"). In this observational study we evaluated whether abnormalities noted on initial evaluation persist after at least another year.

Methods: Neuro-PASC research participants who had undergone comprehensive inpatient testing at the NIH Clinical Center returned after at least 1 year for follow-up assessments including symptoms rating scales, MRI, lumbar puncture for tests of the CSF, physiologic recordings during the Valsalva maneuver and head-up tilting (with serial plasma catechols and cardiac Doppler ultrasound during the tilting), blood volume measurement, skin biopsies to examine sympathetic innervation, and blood sampling for neuroendocrine and immunologic measures.

NICE guidelines in the Sunderland RACPC cohort study: one size does not fit all.

At least 5% of GP and accident and emergency (A&E) attendances are undifferentiated chest pain. Rapid access chest pain clinics (RACPC) offer urgent guideline-directed management of suspected cardiac chest pain. The National Institute for Health and Care Excellence (NICE) recommends computed tomography coronary angiography (CTCA) as a first-line investigation.

Developing critical enquiry, capacity, capability and confidence in the health and care workforce.

Background: Health and care staff have limited opportunities to design, deliver and lead critical enquiry activities.

Aims: To explore barriers and enablers of building capacity, capability and confidence of these practitioners who wish to undertake critical enquiry activity.

Methods: A realist conceptual framework including the development of middle range theory allowed analysis of the scholarship process and outcomes.

Guest Editorial - Shifting Dynamics: ICU Admissions in Denmark during the First Wave of the COVID-19 Pandemic.

The advent of the SARS-CoV-2 pandemic brought unprecedented challenges to healthcare systems worldwide. As the virus spread across continents, hospitals faced a surge in patient admissions, particularly to intensive care units (ICUs). Understanding the impact of the pandemic on the sickest patients admitted to hospital is crucial for enhancing preparedness for future outbreaks.

LASER assisted soft tissue procedures for orthodontic treatment.

Light Amplified Stimulated Emission of Radiation (LASER) therapy has been the subject of numerous researches as an auxiliary method in orthodontic practice. Therefore, it is of interest to assess the clinical evaluation of laser assisted soft tissue procedures for orthodontic treatment. The soft tissue surgical procedures carried out were aestheticre-contouring, gingivectomy, maxillary frenectomy, operculectomy and surgical exposure of impacted canines.

Patient-reported outcomes and functional assessments of patients with Alkaptonuria in a 3-year Nitisinone treatment trial.

Alkaptonuria is a rare disorder of tyrosine catabolism caused by deficiency of homogentisate 1,2-dioxygenase that leads to accumulation of homogentisic acid (HGA). Deposition of HGA-derived polymers in connective tissue causes progressive arthropathy of the spine and large joints, cardiac valvular disease, and genitourinary stones beginning in the fourth decade of life. Nitisinone, a potent inhibitor of the upstream enzyme, 4-hydroxyphenylpyruvate dioxygenase, dramatically reduces HGA production.