Unravelling the cardio-renal-metabolic-foot connection in people with diabetes-related foot ulceration: a narrative review.

Diabetes-related foot ulceration (DFU), a serious but preventable complication of diabetes, is a leading cause of hospitalisation, lower extremity amputation and disability worldwide. People with DFU have a greater burden of cardiovascular risk factors, heart failure and chronic kidney disease, resulting in over two-fold higher risk of cardiovascular death compared with people with diabetes without DFU. Here, we propose a "cardio-renal-metabolic-foot" connection in people with diabetes based on shared pathophysiological mechanisms linking DFU with cardiovascular and renal disease.

Safety, tolerability and pharmacokinetics of subcutaneous cefazolin as an alternative to intravenous administration.

Background: Subcutaneous (SC) administration of antibiotics is a practical alternative to IV administration. Cefazolin is widely used for skin and soft tissue infections and other complex infections by IV administration.

Methods: In this prospective, cross-over self-controlled study, a single dose of SC cefazolin was administered to 15 stable inpatients established on IV cefazolin as part of their management plan.

Quantifying radiation exposure in the radiological investigation of non-arthritic hip pain.

Radiological investigations are essential for evaluating underlying structural abnormalities in patients presenting with non-arthritic hip pain. The aim of this study is to quantify the radiation exposure associated with common radiological investigations performed in assessing patients presenting with non-arthritic hip pain. A retrospective review of our institutional imaging database was performed.

Investigating the effect of cochlear implant usage metrics on cortical auditory-evoked potential responses in adult recipients post-implantation.

Introduction: This study examines the effect of cochlear implant (CI) device usage metrics on post-operative outcomes in unilateral CI recipients. The primary objective is to investigate the relationship between CI usage frequency (average daily CI use) and duration (total years of CI use) on electrically evoked cortical auditory-evoked potential (eCAEP) response peak latency (ms) and amplitude (μV).

Methods: Adult CI users ( = 41) who previously exhibited absent acoustically evoked CAEP responses participated in the study.

Indian Trial of Tranexamic acid in Spontaneous Intracerebral Haemorrhage (INTRINSIC TRIAL) Study Protocol.

Rationale: Early mortality in intracerebral haemorrhage (ICH) is due to haematoma volume (HV) expansion and there are no effective treatments available other than reduction in blood pressure. Tranexamic acid (TXA) a hemostatic drug which is widely available and safe can be a cost-effective treatment for ICH, if proven efficacious.

Hypothesis: Administration of TXA in ICH patients when given within 4.

Towards Metaclinical Medicine - The Non-Human Physician as Our Destiny.

Medicine, and human healing more generally, have been constantly evolving for millennia as part of humanity's persistent efforts to heal its injuries and diseases, to maintain wellbeing, and to delay the inevitable: death. The philosophy underlying medicine has always been closely intertwined with the prevailing ideas in each historical period. Prejudices, religious beliefs, even magical herbs, as well as rational thought and advanced sciences, make up the fabric of over 2,000 years of western medicine.

Isolated Lateral Extra-Articular Tenodesis for Ongoing Instability Following Anterior Cruciate Ligament (ACL) Reconstruction with an Intact Graft is Effective and Has Low Surgical Morbidity.

The management of persisting instability following anterior cruciate ligament reconstruction (ACLR) includes isolated lateral extra-articular tenodesis (LEAT). The present study investigates the outcomes following isolated LEAT to address ongoing instability following ACLR without LEAT. Patients with ongoing symptomatic instability following ACLR with a radiologically intact and well-positioned graft who underwent an isolated LEAT between January 2017 and March 2022 were retrospectively recruited.

Safety, tolerability and pharmacokinetics of subcutaneous meropenem as an alternative to intravenous administration.

Background: Subcutaneous delivery of antibiotics is a practical alternative to IV administration. Meropenem is commonly used to treat infections caused by resistant Gram-negative organisms.

Methods: This was a prospective, crossover self-controlled study in 11 stable inpatients established on meropenem.

Theranostics, Advanced Cancer, and The Meaning of Life.

There is an unmet need to recognize and address the psychosocial and spiritual support of the rapidly growing population of cancer survivors living with advanced metastatic disease which is essentially incurable. Palliative chemotherapy may do more harm than good. The role of the physician in the provision of a supportive, compassionate relationship of mutual trust is critical in the exploration of spirituality and the meaning of life for each individual patient.

The Experiences and Perceptions of Telehealth in Patients Living With Advanced Chronic Obstructive Pulmonary Disease: A Qualitative Evidence Synthesis.

Aim: To systematically identify, appraise and synthesise qualitative research evidence which examined the impact of telehealth on the experiences and perceptions of patients living with advanced chronic obstructive pulmonary disease, to inform the development of patient-centred telehealth.

Design: Qualitative evidence synthesis.

Database Searches: CINAHL, Cochrane, Embase, PUBMED, MEDLINE, EThOS, Web of Science, PsycINFO, Lenus, DART, RIAN and ProQuest were searched for primary qualitative studies undertaken between 2008 and 2023.

Serological responses to target Streptococcus pyogenes vaccine antigens in patients with proven invasive beta-haemolytic streptococcal infections.

Background: Rising incidence of invasive beta-haemolytic streptococcal (iBHS) infections has prompted consideration of vaccination as a preventative strategy for at-risk populations. The benefits of a vaccine targeting Lancefield group A (Streptococcus pyogenes; Strep A) would increase if cross-species immunity against Lancefield groups C/G (Streptococcus dysgalactiae subspecies equisimilis; SDSE) and B (Streptococcus agalactiae; GBS) was demonstrated.

Methods: A prospective, observational study of adult patients with iBHS infections due to Strep A, SDSE or GBS.

Impact of quality of care on outcomes in survivors of stroke with aphasia: A linked registry and hospital data observational study.

Background: The impact of hospital care quality on patient outcomes in post-stroke aphasia remains unclear. We investigated the impact of nationally-endorsed acute stroke treatments on outcomes post-stroke, by aphasia status.

Methods: Patient-level data from the Australian Stroke Clinical Registry (2009-2013) linked to national deaths, hospital emergency presentations and admissions data were used.

Minimum intraoperative testing battery for cochlear implantation: the international practice trend.

Purpose: In cochlear implantation (CI) surgery, there are a wide variety of intraoperative tests available. However, no clear guide exists on which tests must be performed as the minimum intraoperative testing battery. Toward this end, we studied the usage patterns, recommendations, and attitudes of practitioners toward intraoperative testing.

Extended scope audiology clinic - a review of its outcomes and re-presentation to the ear nose and throat service.

Objective: To evaluate the role of Extended Scope (ES) audiologists in managing adult Ear Nose and Throat (ENT)/Otology waitlists and analyse patient re-presentation rate to the ENT service within 12 months of being discharged from the clinic.

Design: A retrospective cohort study assessing the efficacy of ES audiologists, measuring the discharge rate from ENT waitlists, the rate of escalation to ENT care, and the rate and reasons for any re-presentations to care.

Study Sample: 394 adult patients.

The inter-relationship between Helicobacter pylori infection, dementia and mortality in type 2 diabetes: The Fremantle Diabetes Study Phase I.

Background: Given sparse relevant data, the aim of this study was to determine whether Helicobacter pylori infection, including cytotoxin-associated gene-A (CagA) producing strains, is associated with dementia in type 2 diabetes (T2DM).

Methods: Longitudinal data from 1115 participants in the community-based Fremantle Diabetes Study Phase I (mean age 64.0 years, 48.

Anticoagulation in device-detected atrial fibrillation with or without vascular disease: a combined analysis of the NOAH-AFNET 6 and ARTESiA trials.

Background And Aims: The optimal antithrombotic therapy in patients with device-detected atrial fibrillation (DDAF) is unknown. Concomitant vascular disease can modify the benefits and risks of anticoagulation.

Methods: These pre-specified analyses of the NOAH-AFNET 6 (n = 2534 patients) and ARTESiA (n = 4012 patients) trials compared anticoagulation with no anticoagulation in patients with DDAF with or without vascular disease, defined as prior stroke/transient ischaemic attack, coronary or peripheral artery disease.

Anticoagulation in Patients With Device-Detected Atrial Fibrillation With and Without a Prior Stroke or Transient Ischemic Attack: The NOAH-AFNET 6 Trial.

Background: Short and rare episodes of atrial fibrillation (AF) are commonly detected using implanted devices (device-detected AF) in patients with prior stroke or transient ischemic attack (TIA). The effectiveness and safety of oral anticoagulation in patients with prior stroke or TIA and device-detected AF but with no ECG-documented AF is unclear.

Methods And Results: This prespecified analysis of the NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes) trial with post hoc elements assessed the effect of oral anticoagulation in patients with device-detected AF with and without a prior stroke or TIA in the randomized, double-blind, double-dummy NOAH-AFNET 6 trial.

European Society of Cardiology: the 2023 Atlas of Cardiovascular Disease Statistics.

This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the 2021 report in presenting cardiovascular disease (CVD) statistics for the ESC member countries. This paper examines inequalities in cardiovascular healthcare and outcomes in ESC member countries utilizing mortality and risk factor data from the World Health Organization and the Global Burden of Disease study with additional economic data from the World Bank. Cardiovascular healthcare data were collected by questionnaire circulated to the national cardiac societies of ESC member countries.

Undertaking a structured assessment of a hard-to-heal wound.

A thorough, holistic wound assessment is essential to identify the aetiology of a hard-to-heal wound and formulate a diagnosis, which will underpin the treatment plan. This article describes the fundamental elements of assessing a patient with a hard-to-heal wound holistically, including taking a patient history, performing a clinical examination and investigations, and considering the patient's physical, psychological, spiritual and social needs. The author also outlines the aspects of the TIMERS (tissue, infection/inflammation, moisture, edge, regeneration and social factors) wound assessment tool in detail, and explains some of the challenges associated with accurately assessing a wound.