Spot protein-creatinine ratio and spot albumin-creatinine ratio in the assessment of pre-eclampsia: a diagnostic accuracy study with decision-analytic model-based economic evaluation and acceptability analysis.

Background: The National Institute for Health and Care Excellence (NICE) guidelines highlighted the need for 'large, high-quality prospective studies comparing the various methods of measuring proteinuria in women with new-onset hypertensive disorders during pregnancy'.

Objectives: The primary objective was to evaluate quantitative assessments of spot protein-creatinine ratio (SPCR) and spot albumin-creatinine ratio (SACR) in predicting severe pre-eclampsia (PE) compared with 24-hour urine protein measurement. The secondary objectives were to investigate interlaboratory assay variation, to evaluate SPCR and SACR thresholds in predicting adverse maternal and fetal outcomes and to assess the cost-effectiveness of these models.

How to use… Hip examination and ultrasound in newborns.

Developmental dysplasia of the hip (DDH) ranges from a clinically detectable dislocation of the hip to radiologically diagnosed hip abnormalities. It is caused by both antenatal and postnatal factors. The Neonatal and Infant Physical Examination Screening Programme recommends that newborns should undergo a hip ultrasound (USS) when risk factor or clinical features suggestive of DDH are present.

Safety of corticosteroid injection for carpal tunnel syndrome.

Unlabelled: The risks of corticosteroid injection for carpal tunnel syndrome, principally intraneural injection and tendon rupture, are known only from anecdotal reports. The literature does not allow an accurate estimate of their incidence or that of lesser side effects such as local pain. We have encountered only four serious complications in 9515 injections.

GFR estimation based on standardized creatinine and cystatin C: a European multicenter analysis in older adults.

Background: Although recommended by the Kidney Disease Improving Global Outcomes, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPICR) creatinine equation was not targeted to estimate glomerular filtration rate (eGFR) among older adults. The Berlin Initiative Study (BIS1CR) equation was specifically developed in older adults, and the Lund-Malmö revised (LMRCR) and the Full Age Spectrum (FASCR) equations have shown promising results in older adults. Our aim was to validate these four creatinine equations, including addition of cystatin C in a large multicenter cohort of Europeans ≥70 years.

Use of optokinetics based OKCSIB protocol in restoring mobility in primary progressive MS.

The case is of a mid-40s patient who developed progressive muscle weakness and loss of mobility over 6 weeks due to primary progressive multiple sclerosis. 2.5 days before admission, she became bed bound with weakness of 1/5 on the Oxford scale.

Data on the relation between renal biomarkers and measured glomerular filtration rate.

The data presented in this article are related to the research article entitled "The Diagnostic Value of Rescaled Renal Biomarkers Serum Creatinine and Serum Cystatin C and their Relation with Measured Glomerular Filtration Rate" (Pottel et al. (2017) [1]). Data are presented demonstrating the rationale for the normalization or rescaling of serum cystatin C, equivalent to the rescaling of serum creatinine.

Acute kidney injury in acute-on-chronic liver failure: where does hepatorenal syndrome fit?

Renal dysfunction occurs in 25% to 50% of patients with cirrhosis admitted to the hospital with an acute episode of hepatic decompensation and may be due to underlying chronic kidney disease, an acute deterioration, or both. An acute deterioration in renal function in cirrhotic patients is now collectively referred to as acute kidney injury (AKI), which has been subclassified into different grades of severity that identify prognostic groups. Acute-on-chronic liver failure is characterized by acute hepatic and/or extrahepatic organ failure driven by a dysregulated immune response and systemic inflammatory response.

Pain in elite athletes-neurophysiological, biomechanical and psychosocial considerations: a narrative review.

Pain is a common problem among elite athletes and is frequently associated with sport injury. Both injury and pain interfere with peak performance. Pain management should be based on the physiological, anatomical and psychosocial influences on the individual's pain and is not equivalent to injury management, which focuses on musculoskeletal recovery and return-to-play.

International Olympic Committee consensus statement on pain management in elite athletes.

Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes.

Identifying barriers to help-seeking for non-motor symptoms in people with Parkinson's disease.

Non-motor symptoms of Parkinson's disease have a significant impact on quality of life. Despite this, many non-motor symptoms remain unreported by patients and consequently untreated. This study explored barriers to help-seeking using two theoretical frameworks, the Common Sense Model of illness perception and Theoretical Domains Framework.

Acute kidney injury and critical limb ischaemia associated with the use of the so called "legal high" 3-fluorophenmetrazine.

Until the law in the United Kingdom (UK) changed in May 2016 so called "legal highs" or "new psychoactive substances" were freely available in high street shops across the UK. Following prohibition these drugs are still easily purchased illegally via the internet. We report a case of a patient who self-administered 3-fluorophenmetrazine intravenously with catastrophic consequences.

Preventing Episodic Migraine With Caloric Vestibular Stimulation: A Randomized Controlled Trial.

Objective: To evaluate the safety and efficacy of a novel solid-state, caloric vestibular stimulation (CVS) device to provide adjuvant therapy for the prevention of episodic migraine in adult migraineurs.

Background: Migraine causes significant disability in ∼12% of the world population. No current migraine preventive treatment provides full clinical relief, and many exhibit high rates of discontinuation due to adverse events.

Pneumococcal pulmonary valve endocarditis.

Pulmonary valve endocarditis is an rare type of infective endocarditis (IE). Streptococcus pneumoniae is a pathogen that is uncommonly associated with IE. A 50 year-old man was referred to us to an incidental echocardiographic finding of a pulmonary valve vegetation.

Results of the first interim analysis of the RAPPER II trial in patients with spinal cord injury: ambulation and functional exercise programs in the REX powered walking aid.

Background: The RAPPER II study investigates the feasibility, safety and acceptability of using the REX self-stabilising robotic exoskeleton in people with spinal cord injury (SCI) who are obligatory wheelchair users. Feasibility is assessed by the completion of transfer into the REX device, competency in achieving autonomous control and completion of upper body exercise in an upright position in the REX device. Safety is measured by the occurrence of serious adverse events.

The diagnostic value of rescaled renal biomarkers serum creatinine and serum cystatin C and their relation with measured glomerular filtration rate.

Background: Serum creatinine (Scr) is the major contributing variable in glomerular filtration rate (GFR) estimating equations. Serum cystatin C (ScysC) based GFR estimating (eGFR)-equations have also been developed. The present study investigates the relation between 'rescaled' levels of these renal biomarkers (with reference interval of [0.

A retrospective study comparing the loss of anchorage following the extraction of maxillary first or second premolars during orthodontic treatment with fixed appliances in adolescent patients.

Introduction: This retrospective study assessed the difference in anchorage loss using 3D superimposition of study models between cases treated with extraction of maxillary first premolars and maxillary second premolars carried out in orthodontic specialist practice.

Method: Sixty subjects who have undergone extractions of either maxillary first or second premolars as part of their orthodontic treatment were selected. Eligibility criteria included patients with a Class I, mild Class II or III malocclusions, mild-to-moderate crowding with no anchorage reinforcement.

Resource Use and Real-World Outcomes for Ranibizumab Treat and Extend for Neovascular Age-Related Macular Degeneration in the UK: Interim Results from TERRA.

Introduction: Ranibizumab is an inhibitor of vascular endothelial growth factor-A (anti-VEGF) approved for the treatment of neovascular age-related macular degeneration (nAMD). The treat and extend (T&E) regimen can potentially reduce the burden of clinic visits compared with a pro re nata (PRN) regimen. Retrospective, interim analyses of clinical effectiveness, treatment and resource use patterns were conducted using real-world data in England and Wales from the TERRA study.

YouTube™ as an information resource for orthognathic surgery.

Objective: To investigate video content on YouTube™ related to orthognathic surgery.

Materials And Methods: YouTube™ was searched using the terms: orthognathic surgery; orthodontic surgery; jaw surgery; jaw corrective surgery. Inclusion criteria included English language; primary content orthognathic surgery and acceptable audio-visual quality.