Relationship Between Pre- and Post-Orchidectomy Serum Dihydrotestosterone and Prostate Cancer Severity in a Cohort of Nigerian Patients.

Introduction: Prostate cancer (PCa) is the commonest urologic cancer worldwide and the leading cause of male cancer deaths in Nigeria. In Nigeria, orchidectomy remains the primary androgen deprivation therapy. Dihydrotestosterone (DHT) is the active prostatic androgen, but its relationship with PCa severity has not been extensively studied in Africa.

Minimal extra-cardiac atherosclerosis present in young people with sudden cardiac death due to coronary artery disease.

Aim: To define the association between severe coronary artery disease and widespread atherosclerosis in younger individuals.

Methods: Individuals aged 1-50 years with sudden cardiac death (SCD) from 2019-23, autopsy-proven to be due to coronary artery disease, were identified using the state-wide EndUCD registry. Presence of extra-coronary atherosclerosis greater than modified American Heart Association class III was assessed in 5 arterial beds (intra-cerebral vessels, aorta, carotid, renal and femoral arteries).

Place-based household vouchers for locally supplied fruit and vegetables: the Fresh Street pilot cluster randomised controlled trial.

Background: Households in areas of socio-economic deprivation are more likely to consume diets low in fruit and vegetables. Fresh Street is a place-based fruit and vegetable voucher scheme with vouchers redeemable with local independent (non-supermarket) vendors. Paper vouchers are offered to all households in a geographical area regardless of household type, size, or income with no requirement to demonstrate need.

Development and evaluation of a high-fidelity, multi-disciplinary simulation training course for high-consequence infectious diseases using fluorescence visualization.

Background: High-consequence infectious diseases (HCIDs) include contact-transmissible viral haemorrhagic fevers and airborne-transmissible infections such as Middle Eastern Respiratory Syndrome. Assessing suspected HCID cases requires specialized infection control measures including patient isolation, personal protective equipment (PPE), and decontamination. There is need for an accessible course for NHS staff to improve confidence and competence in using HCID PPE outside specialist HCID centres.

Impact of Climate Change on Adolescents' Health Outcomes: An Evidence Gap Map Review.

Background: The evolving impact of climate change on adolescents' health is a pressing global concern. Climate change's effects on their physical, mental, and social well-being worsen unique developmental challenges for adolescents. This study aims to map existing evidence, identify gaps, and highlight research and intervention needs.

Improving the arthritis component of the SLEDAI-2K.

Objective: To propose a new definition for SLEDAI arthritis informed by imaging.

Methods: We performed a planned secondary analysis of observational data from a multicentre study evaluating SLE patients with inflammatory joint pain (swelling not required) using various clinical instruments, laboratory tests and ultrasound. For SLEDAI arthritis, assessors (blinded to ultrasound) were asked which of the glossary terms for arthritis in any version of the SLEDAI drove their decision to score for arthritis.

Maintenance of normothermia in the out-of-hospital setting: A pilot comparative crossover study of a foil blanket versus self-warming blanket.

Introduction: Hypothermia can increase mortality in certain patients. Paramedics apply cotton and foil "space" blankets for warming, yet their effectiveness remains uncertain. This pilot study aimed to evaluate combining cotton blankets with a self-warming blanket versus a combination of cotton blankets and a foil blanket in an out-of-hospital simulation.

Staff and patient experiences of crowding, corridor care and boarding: a rapid review.

The increasing use of healthcare services is leading to issues with hospital overcrowding and this is particularly apparent in emergency departments (EDs). Consequently, patients are being cared for in areas that were not designed for that purpose, such as waiting areas and corridors. This negatively affects nurses' and patients' experiences of care.

Standardized CT KUB Protocols for Nephrolithiasis: A Retrospective Analysis of Radiation Exposure and Cranial Extent Guidelines.

Background and aim Non-contrast computed tomography of kidneys, ureters, and bladder (CT KUB) is the gold standard radiological imaging for nephrolithiasis. It significantly contributes to the total radiation exposure of a population. This is well known to be linked to increased cancer risk over time and as such should be minimized in line with Ionising Radiation (Medical Exposure) Regulations (IR{ME}R).

Optimizing non-invasive vagus nerve stimulation for treatment in stroke.

Stroke remains a leading cause of long-term disability worldwide. There is an unmet need for neuromodulatory therapies that can mitigate against neurovascular injury and potentially promote neurological recovery. Transcutaneous vagus nerve stimulation has been demonstrated to show potential therapeutic effects in both acute and chronic stroke.

Cutaneous vasculitis in systemic lupus erythematosus: epidemiology and risk factors over a 20-year follow-up.

Objectives: Cutaneous vasculitis (CV) is common in SLE, but the epidemiology and risk factors remain unclear. We aimed to identify the trends and risk factors for CV in patients with SLE over a period of 20 years.

Methods: The Birmingham Lupus Cohort is an observational longitudinal cohort of SLE patients.

Barriers faced by surgeons in identifying and managing malnutrition in emergency general surgery: A qualitative study.

Aim: Many patients undergoing emergency surgery are malnourished. Identifying malnutrition is a prerequisite to offering targeted nutritional support. Guidelines exist but little is known regarding exactly how surgeons identify malnutrition, or the barriers that influence surgeons' clinical decision-making.

Sex differences in the intention and decision to use emergency medical services for acute coronary syndrome in Australia: a retrospective study.

Background: Sex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment and reduces in-hospital time to treatment. This study aims to identify factors affecting the intention to call EMS and EMS usage in Australian women and men.

Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study.

Aim: To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy.

Methods: Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases. Multivariable logistic regression analysis was used to examine associations between study characteristics and cricothyroidotomy success.

Pleomorphic Giant Cell Carcinoma and Periurethral Abscess: A Case Report.

Prostate cancer (PCa) is the most common solid malignancy in men in the UK. Pleomorphic giant cell carcinoma (PGCC) is a rare, aggressive variant of prostate adenocarcinoma. PGCC is associated with a poor prognosis and high Gleason-grade characteristics, often occurring in patients with a history of PCa treatment.

Intestinal Injury After Suprapubic Catheterisation: A Scoping Review.

Suprapubic catheterisation (SPC) is a commonly performed urological procedure. Although it is generally safe, SPC-induced bowel injury is a rare but morbid complication. It is described in the literature, but management consensus is lacking.

Initiation of buprenorphine in the emergency department or emergency out-of-hospital setting: A mixed-methods systematic review.

Introduction: People who use substances increasingly access healthcare primarily through emergency medical services (EMS) and emergency departments (EDs). To meet the needs of these patients, EMS and EDs have become access points for medications for opioid use disorder (OUD), specifically buprenorphine. This systematic review aimed to quantify the efficacy of these programs, examining retention in treatment for OUD, rates of re-presentation to ED or EMS, and rates of precipitated withdrawal, as well as summarise clinician and patient perspectives on buprenorphine initiation in these settings.

Development of the post-traumatic stress disorder assessment scale for emergency services.

This paper describes the development and validation of the Post-Traumatic Stress Disorder Assessment Scale for Emergency Services (PASES). The PASES was developed to address the needs of Australia's first National Mental Health and Wellbeing Study of Police and Emergency Services, which covered Police, Ambulance, Fire and Rescue and State Emergency Services personnel. PASES offers several advantages for use in the emergency services sector over other Post-Traumatic Stress Disorder (PTSD) screening scales, including assessment of functional impairment, a dimensional measure of severity which includes identification of sub-threshold cases experiencing distress and impairment, and allowing for experience of cumulative trauma.

Keep Right: Inadvertent Placement of a Temporary Pacing Lead in the Left Ventricle.

Inadvertent lead malposition (ILM) of a temporary pacing wire is a rare complication that can occur during pacemaker insertion. We report a case of a 40-year-old man who presented late following an inferior ST segment elevation myocardial infarction. Temporary cardiac pacing was performed for symptomatic complete heart block.

Spatial and temporal distribution of Ixodes scapularis and tick-borne pathogens across the northeastern United States.

Background: The incidence of tick-borne diseases is increasing across the USA, with cases concentrated in the northeastern and midwestern regions of the country. Ixodes scapularis is one of the most important tick-borne disease vectors and has spread throughout the northeastern USA over the past four decades, with established populations in all states of the region.

Methods: To better understand the rapid expansion of I.

Agreement of point-of-care and laboratory lactate levels among trauma patients and association with transfusion.

Background And Objectives: In the setting of trauma and suspected critical bleeding, indications to commence blood transfusions remain unclear, with high rates of potentially avoidable transfusions. Prehospital blood lactate measurements could help predict the need for blood transfusions. The aim of this study was to compare measurements detected by a point-of-care (POC) lactate device with laboratory measured lactate levels.

Perspectives on cardiopulmonary resuscitation in the frail population: a scoping review.

Frail and elderly persons approaching end of life who suffer cardiac arrest are often subject to rigorous, undignified, and inappropriate resuscitation attempts despite poor outcomes. This scoping review aims to investigate how people feel about the appropriateness of CPR in this population. This review was guided by the PRISMA-ScR methodological framework.