Progressive Symptoms in an Older Patient Recently Diagnosed With Coeliac Disease and Rapid Progression to Enteropathy-Associated T-cell Lymphoma (EATL).

Coeliac disease (CD) is an immune-mediated condition that causes damage to the small intestine upon gluten consumption by genetically susceptible individuals. To determine whether there is an active coeliac disease or the presence of additional pathologies, patients must undergo regular evaluations, including repeat endoscopy. In this analysis, we present a case study of a 75-year-old woman from England who was diagnosed with coeliac disease later in life.

Epidemiology and Management of Pediatric Fractures in Malawi.

Background: Pediatric fractures are common in Malawi, and surgical care, when needed, remains inaccessible to many. Understanding which children in Malawi receive surgery or nonsurgical treatment would help set priorities for trauma system development.

Methods: We used multivariate logistic regression to evaluate associations between surgical treatment and age, sex, school enrollment, injury mechanism, fracture type, open fracture, referral status, hospital of presentation, delayed presentation (≥2 days), healthcare provider, and inpatient vs outpatient treatment.

Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis.

Background: Factors predisposing to increased mortality with COVID-19 infection have been identified as male sex, hypertension, obesity, and increasing age. Early studies looking at airway diseases gave some contradictory results. The purpose of our study was to determine global variation in studies in patients hospitalized with COVID-19 in the prevalence of COPD and asthma; and to determine whether the presence of asthma or COPD affected mortality in the same hospital population.

Acquired brain injury (ABI) survivors' experience of occupation and activity during their inpatient stay: a scoping review.

Purpose: This review aimed to characterise and map: (1) what type of evidence and what dominant study characteristics are available regarding acquired brain injury (ABI) survivors' experience of occupation and activity in hospital? (2) How are occupation and activity conceptualised in the literature? (3) How are ABI survivors experiencing occupation and activity while in hospital? (4) What factors create barriers or opportunities for engagement in occupations or activity in hospital? (5) Are there any knowledge gaps identified?

Materials And Methods: A scoping review was conducted examining literature published between 2017 and 2022. Relevant studies were systematically retrieved from electronic databases.

Results: Thirty-four publications were included.

Using a consensus meeting to enhance fracture care education in low income countries.

Background: A key strategy to building surgical capacity in low income countries involves training care providers, particularly in the interventions highlighted by the Lancet Commission for Global Surgery, including the management of open fractures. This is a common injury, especially in areas with a high incidence of road traffic incidents. The aim of this study was to use a nominal group consensus method to design a course on open fracture management for clinical officers in Malawi.

Efficacy of antifibrotic drugs, nintedanib and pirfenidone, in treatment of progressive pulmonary fibrosis in both idiopathic pulmonary fibrosis (IPF) and non-IPF: a systematic review and meta-analysis.

Background: Research questions To compare the efficacy of nintedanib and pirfenidone in the treatment of progressive pulmonary fibrosis; and to compare the efficacy of anti-fibrotic therapy (grouping nintedanib and pirfenidone together) in patients with IPF versus patients with progressive lung fibrosis not classified as IPF.

Study Design And Methods: A search of databases including MEDLINE, EMBASE, PubMed, and clinicaltrials.gov was conducted.

Peer assessment after clinical exposure (PACE): an evaluation of structured peer support for staff in emergency care.

Background: There is an increasing body of evidence that identifies psychological stressors associated with working in emergency medicine. Peer Assessment After Clinical Exposure (PACE) is a structured programme designed to support staff following traumatic or chronic work-related stressful exposure. The first author of this study created the PACE programme and implemented it in one emergency department (ED).

Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma.

Aim: The study assesed trabeculectomy survival in advanced open angle glaucoma (OAG).

Methods: This is a retrospective longitudinal study in advanced OAG undergoing primary trabeculectomy. Clinical and demographic parameters were recorded.

A Review of UK-based National and International Scientific Meeting Published Abstracts in Response to the Draft NICE Aortic Aneurysm Guidelines.

Background: UK National Institute for Health and Care Excellence (NICE) draft clinical guidelines (CG) (2018) regarding aortic aneurysm repair were disputed internationally. We aim to appraise the academic response to the draft CG in terms of quantity and scientific quality by reviewing published conference abstracts from three major national and international, UK meetings.

Methods: Abstracts related to aortic practice from The Vascular Societies Annual Scientific Meeting, British Society for Endovascular Therapy (BSET) & Charing Cross (CX) meetings from 2019 were reviewed for methodology, sample size, data collection period, scientific quality and conclusions that supported or conflicted the draft guideline.

The economic burden of open tibia fractures: A systematic review.

Background: Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment.

Methods: All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials.

The Malawi Orthopaedic Association/AO Alliance guidelines and standards for open fracture management in Malawi: a national consensus statement.

Background: Open fractures are common injuries in Malawi that pose a large burden on the healthcare system and result in long-term disability.

Aim: Establishing a multiprofessional agreement on the management of open fractures in Malawi from a consensus meeting.

Methods: AO Alliance convened a consensus meeting to build an agreement on the management of open fractures in Malawi.

Systematic review of patient reported outcomes from open tibia fractures in low and middle income countries.

Background: Open tibia fractures are a common cause of admission following road traffic accidents in low and middle income countries (LMICs), resulting in substantial mortality and disability. It is important to summarise the clinical course of this injury using patient reported scores in order to assess best treatment in LMICs.

Objectives: To summarise the disability after sustaining an open tibia fracture in LMICs METHODS: All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials.

Onlay bone grafts from iliac crest: a retrospective analysis.

This study was performed to address the outcomes of patients treated with onlay grafts from the iliac crest to augment the deficient jaw. The results of 173 consecutive patients who underwent bone grafting prior to implant surgery are presented. The grafts were taken from the anterior iliac crest to repair alveolar bone deficiencies that were too large to be corrected using intraoral bone grafts.

The UK Neovascular AMD Database Report 3: inter-centre variation in visual acuity outcomes and establishing real-world measures of care.

PurposeInternational variations in visual acuity (VA) outcomes of eyes treated for neovascular age-related macular degeneration (nAMD) are well-documented, but intra-country inter-centre regional variations are not known. These data are important for national quality outcome indicators. We aimed to determine intra-country and inter-centre regional variations in outcomes for treatment of nAMD.

The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis--a guide to treatment.

Background: The Beit CURE (BC) classification is a radiographic classification used in childhood chronic haematogenous osteomyelitis. The aim of this study is to assess correlation between this classification and the type and extent of treatment required.

Methods: We present a retrospective series of 145 cases of childhood chronic haematogenous osteomyelitis classified using the BC classification.

Acute response and chronic stimulus for cardiac structural and functional adaptation in a professional boxer.

The individual response to acute and chronic changes in cardiac structure and function to intense exercise training is not fully understood and therefore evidence in this setting may help to improve the timing and interpretation of pre-participation cardiac screening. The following case report highlights an acute increase in right ventricular (RV) size and a reduction in left ventricular (LV) basal radial function with concomitant increase at the mid-level in response to a week's increase in training volume in a professional boxer. These adaptations settle by the second week; however, chronic physiological adaptation occurs over a 12-week period.

First metatarsophalangeal arthrodesis for hallux valgus.

Arthrodesis of the first metatarsophalangeal joint is a reliable operation in the treatment of selected cases of hallux valgus. It corrects deformity of hallux valgus and metatarsus primus varus, leading to good functional results with a low complication rate. It is a technique well suited to patients with hallux valgus associated with degenerative changes or severe deformity, and those for whom primary hallux valgus surgery has failed.

Distal Tibial Fracture Fixation with Locking Compression Plate (LCP) Using the Minimally Invasive Percutaneous Osteosynthesis (MIPO) Technique.

Background: Treatment of distal tibial fractures has always been a challenge. Distal tibia is more superficial, with less soft tissue coverage and blood supply. Therefore, operative treatment can lead to complications.

Insulin resistance, the metabolic syndrome, and incident cardiovascular events in the Framingham Offspring Study.

The metabolic syndrome and insulin resistance have been related to incident cardiovascular disease (CVD), but it is uncertain if metabolic syndrome predicts CVD independent of insulin resistance. Our study sample included 2,898 people without diabetes or CVD at baseline. Metabolic syndrome was defined by the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria.

Carcinoid tumours of the larynx.

The larynx is a rare site of origin of neuroendocrine carcinomas. They can be divided into typical, atypical and small cell tumours on the basis of their histopathological differentiation. The tumour histology and prognosis correlate closely.

Congenital brachial palsy: incidence, causes, and outcome in the United Kingdom and Republic of Ireland.

Objectives: To determine the incidence and study the causes and outcome of congenital brachial palsy (CBP).

Design: Active surveillance of newborn infants using the British Paediatric Surveillance Unit notification system and follow up study of outcome at 6 months of age.

Setting: The United Kingdom and Republic of Ireland.

Reducing hospital readmissions for people with heart failure.

With an ageing population and more people surviving heart attacks there are increasing numbers of people living with heart failure. Readmissions to hospital are often prolonged and costly. A number of nurse-led schemes have been successful in tackling the preventable causes of hospital readmissions and helping patients achieve a better quality of life in the community.