Reviewing the Possible Rare Reasons for Normal Parathyroid Hormone, Vitamin D and Serum Calcium Levels in a Patient With Severe Osteoporosis and Radiologic Parathyroid Adenoma: A Case Report.

Literature evidence describing a seeming de novo occurrence of severe osteoporosis accompanied by the presence of parathyroid adenoma with normal serum parathormone level (PTH), normal serum vitamin D, and serum calcium levels is rare; hence, this case report. In the absence of raised parathormone levels and the demonstration of the presence of parathyroid adenoma, the hypothesis that the authors were left with was that could certain forms of parathyroid adenoma express factors or active substances with severe osteoclastic activity. Or, could certain expressed PTH molecules in parathyroid adenoma scenarios prove difficult to assay using conventional study methods? We have reviewed the literature in a bid to provide answers to these possible uncommon scenarios.

Evaluating ChatGPT's Diagnostic Accuracy in Detecting Fundus Images.

Introduction Artificial intelligence is rapidly advancing in healthcare. Ophthalmology, with its reliance on imaging for diagnosis and management, has the potential to benefit from this technology. Deep learning models are currently used in image analysis in ophthalmology.

Core elements of the perioperative medicine for older people undergoing surgery (POPS) model of care.

Purpose: Hospital surgical services that utilise the approach of the perioperative medicine for older people undergoing surgery (POPS) model of care improve outcomes for older people contemplating and undergoing surgery. Complex models of care like POPS may be difficult to implement without understanding the elements that comprise that model of care. Logic models can be used to aid implementation by visually depicting theoretical relationships between the elements of the model of care.

Understanding care-seeking and subsequent pregnancy loss in the second trimester of pregnancy - A multicentre audit.

Objective: This study aimed to increase understanding of the signs and symptoms that lead pregnant people to seek hospital care in the second trimester of pregnancy. In addition, we aimed to describe management and follow up, to record pregnancy outcomes, and to gather information about symptoms and signs related to second trimester pregnancy loss.

Methods: This prospective audit in seven geographically dispersed sites across the UK collected data over two weeks (7th March-20th March 2022 inclusive) on all unscheduled secondary care attendances between 14 and 21 completed weeks' gestation.

Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections? A systematic review and meta-analysis of randomized controlled trials.

Anastomotic leaks are a significant complication in colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) has been suggested as a method to reduce the risk. This meta-analysis aims to evaluate the effect of ICG-FA on reducing anastomotic leaks in colorectal surgery.

Atypical Takotsubo Post-Natural Delivery: A Guideline-Based Approach for Diagnosing Takotsubo Cardiomyopathy.

Since its first description in 1990, Takotsubo cardiomyopathy (TC) has continued to puzzle physicians and scientists alike as the mechanisms behind the characteristic unique left ventricular dysfunction that marks the condition and its relation to the intense emotional and physiological stressors that usually precede it have remained not fully understood. Since then, several different variants of the condition have been described that do not conform to the conventional narrative of a post-menopausal disease that only affects women of a certain age and is triggered by a preceding event. Of these variants, atypical Takotsubo, which does not assume the typical characteristic apical ballooning that marks the condition has been linked with a younger age group and a more neurological trigger.

Quality of life in advanced-stage, asymptomatic, non-bulky follicular lymphoma treated with rituximab shows significant improvement compared with watchful-waiting.

Traditionally, patients with asymptomatic, advanced-stage follicular lymphoma were managed with a watchful-waiting approach until disease progression. The 'Watch and Wait' Phase-3 randomised international trial examined whether rituximab could delay the need for treatment and the effect on quality of life (QoL). In this article, we present the long-term results of the QoL aspect of the trial.

A Comprehensive Review of Recent Trends in Posterior Malleolus Fracture Management.

Posterior malleolus fractures (PMFs) are challenging injuries around the ankle that can lead to poor clinical outcomes as they can compromise ankle stability. Although there has been an evolution in the principles of management of PMFs, their optimal treatment remains controversial. This review article aims to provide an in-depth account of the management of PMF, thereby providing a better understanding of these complex cases hence resulting in improving patient outcomes.

Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study.

Introduction: Feeding via a misplaced nasogastric tube (NGT) is a common but preventable cause of patient harm. The aim of this study was to determine the accuracy of diagnostic radiographers' assessment of NGT position on chest radiographs (CXRs) and safe-to-feed decisions.

Methods: A multi-case, multi-reader study was conducted using an online image interpretation platform.

Understanding the long-term impact of the COVID-19 pandemic on non-muscle-invasive bladder cancer outcomes: 12-Month follow-up data from the international, prospective COVIDSurg Cancer study.

Objective: The objective of this study was to report the 12-month oncological outcomes for patients with non-muscle-invasive bladder cancer (NMIBC) within the prospective, international COVIDSurg Cancer study.

Patients And Methods: Eligible patients were aged ≥18 years and scheduled for elective surgical management of NMIBC with curative intent (transurethral resection of bladder tumour [TURBT] or bladder biopsy) from 21 January to 14 April 2020. The primary outcome was disease recurrence within 12 months of previous elective TURBT/bladder biopsy.

Comparative Outcomes of Percutaneous K-Wires Versus Plate Fixation in the Treatment of Distal Radius Fractures: A Focus on Stability in Osteoporotic Patients and Both-Bone Distal End Fractures.

Background Distal radius fractures (DRFs) are commonly treated with percutaneous K-wire or plate fixation. The relative efficacy and stability of these methods, particularly in osteoporotic patients and in cases involving both distal radius and ulna fractures, remain subjects of clinical debate. Objective This study aims to compare the outcomes of percutaneous K-wire fixation versus plate fixation in patients with distal end radius fractures, focusing on postoperative stability in osteoporotic conditions and both-bone distal end fractures.

Analysis of Serum and Synovial Inflammatory Markers in Periprosthetic Joint Infections: A Narrative Review.

Periprosthetic joint infection (PJI) is considered a rare but devastating complication after total joint arthroplasty (TJA). The problem lies in the fact that there is a paucity of "gold standard" diagnostic tests that make the diagnosis of PJI extremely challenging. Recently, there have been increasing evidence-based guidelines that have been introduced to standardise the approach to a patient with a suspected PJI.

Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma: The PROACT Clinical Trial.

Background: Cardiotoxicity is a concern for cancer survivors undergoing anthracycline chemotherapy. Enalapril has been explored for its potential to mitigate cardiotoxicity in cancer patients. The dose-dependent cardiotoxicity effects of anthracyclines can be detected early through the biomarker cardiac troponin.

Prospective randomized evaluation of the sustained impact of assistive artificial intelligence on anesthetists' ultrasound scanning for regional anesthesia.

Objectives: Ultrasound-guided regional anesthesia (UGRA) relies on acquiring and interpreting an appropriate view of sonoanatomy. Artificial intelligence (AI) has the potential to aid this by applying a color overlay to key sonoanatomical structures.The primary aim was to determine whether an AI-generated color overlay was associated with a difference in participants' ability to identify an appropriate block view over a 2-month period after a standardized teaching session (as judged by a blinded assessor).

National audit of patient reported experience of radical cystectomy for bladder cancer pathways.

Objective: The objective of this study was to measure and describe the national patient experience of radical cystectomy (RC) pathways in the UK using the validated Cystectomy-Pathway Assessment Tool (C-PAT).

Patients And Methods: A cohort of 1081 patients who underwent RC for bladder cancer, between 1 January 2021 and 31 July 2022 at 33 UK cystectomy centres, returned completed C-PAT responses. SPSS was employed for data summary statistics, including median, interquartile range, Mann Whitney U test or Chi-square test with a 95% confidence interval to assess statistical significance between potentially associated variables.

Evaluation of the Effectiveness of Virtual Telephone Consultations Against Traditional Face-to-Face Consultations in Spine Surgery Using an Objective Metric.

Introduction: Coronavirus disease 2019 (COVID-19) proved to be a catalyst in the paradigm change from face-to-face (F2F) to virtual consultations in trauma and orthopaedics. This study evaluates the efficacy of telephone consultations versus F2F reviews in an elective spine clinic.

Methods: In this retrospective study, the clinic letters from elective spinal clinics were conducted over one month.

An International Survey of the Diagnosis and Management of Ménière's Disease Amongst Otolaryngology Consultants.

Ménière's Disease (MD) is a disease that may be difficult to diagnose and manage. Our UK survey showed variability in the practice of UK Otolaryngology consultants. We hence surveyed Otolaryngology consultants internationally, to assess their confidence levels in diagnosing MD, their use of the AAO-HNS guidelines and current diagnostic and treatment modalities.

Feasibility and Safety of a Home-based Electroencephalogram Neurofeedback Intervention to Reduce Chronic Neuropathic Pain: A Cohort Clinical Trial.

Objective: To evaluate the feasibility, safety, and potential health benefits of an 8-week home-based neurofeedback intervention.

Design: Single-group preliminary study.

Setting: Community-based.