Adverse Effects of Intraparenchymal and Peritumoral Application of Isosulfan Blue Dye in Sentinel Lymph Node Mapping in Breast Cancer: A Systematic Review and Meta-Analysis.

We investigate the evidence for adverse effects of intraparenchymal and peritumoral application of isosulfan blue dye in sentinel lymph node (SLN) mapping in breast cancer patients. A meta-analysis on the adverse effects of intraparenchymal and peritumoral application of isosulfan application in SLN mapping was conducted using Medline and Embase databases up to 2023. Procedure-based adverse reactions were divided into three grades: Grade I (allergic skin reactions), Grade II (hypotension) and Grade III (requiring vasopressor support).

Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study.

Introduction: Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long-term outcomes such as cardiovascular disease. The purpose of this study was to determine the association between GDM and subsequent cardiovascular disease during a period of rising gestational diabetes diagnosis in England. Specifically, associations were compared before and after 2008, when national guidelines supporting risk factor-based screening were introduced.

Long-term trends in educational inequalities in alcohol-attributable mortality, and their impact on trends in educational inequalities in life expectancy.

Background: Previous studies on socio-economic inequalities in mortality have documented a substantial contribution of alcohol-attributable mortality (AAM) to these inequalities. However, little is known about the extent to which AAM has contributed to time trends in socio-economic inequalities in mortality.

Objective: To study long-term trends in educational inequalities in AAM and assessed their impact on trends in educational inequalities in life expectancy in three European countries.

The Determinants of Long-Term Outcomes After Colorectal Cancer Surgery: A Literature Review.

Colorectal cancer (CRC) is a common malignancy associated with high mortality. Surgical care is an effective colorectal cancer management technique, and it is therefore crucial that a review of the determinants of patients' long-term outcomes after CRC surgery is conducted. This article aims to provide healthcare professionals and policymakers with insights into the determinants of long-term outcomes following CRC surgery while acknowledging the interconnected impact of the early recovery and post-operative periods.

Management of Scapula Fractures at a Level 1 Trauma Centre in the United Kingdom.

Background Scapular fractures, an uncommon injury that can be brought on by a high-energy mechanism because of its proximity to the pectoral and shoulder muscles, are frequently linked to fatal injuries. This study aimed to compare surgical versus conservative treatment of scapular fractures and the results of treated patients. Methods The traumatic scapular fracture patients in this cross-sectional study (n = 391) were treated at a major trauma centre (level 1) in the United Kingdom between 2012 and 2018.

Assessing the Current State of USA-Based Disaster Medicine Fellowships.

Objectives: This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.

Methods: Two separate surveys were sent to USA-based DM program directors and alumni.

Sex workers and their stories: using timelines as a creative method in research involving underserved populations.

Background: Researchers may often find it challenging to gather data with underserved populations, even when using traditional qualitative methods. They may also be at risk of further entrenching the hegemony of the dominant narrative, silencing participants' experiences and further marginalising and excluding those most in need. Timelines and other creative methods are useful, sensitive tools that combine flexibility and malleability with an ethical appeal, such as feminist ethics of care.

Psoriasis and dementia: A population-based matched cohort study of adults in England.

Objective: Evidence for an association between psoriasis and dementia is limited and conflicting. We aimed to investigate the association using large and representative population-based data and describe risk by dementia subtype and over time.

Methods: We compared dementia risk between people with and without psoriasis using an age-, sex- and primary care practice-matched cohort of adults aged ≥40 years from the Clinical Practice Research Datalink Aurum in England (1997-2021) linked to hospital admissions data, analysed with stratified Cox regression.

The composition of England's single-qualification OMFS posts: a descriptive analysis of foundation year and dental core training posts.

Postgraduate exposure to oral and maxillofacial surgery (OMFS) for medical and dental graduates differs significantly. To our knowledge, the availability and opportunities provided by these single-qualification posts have not previously been explored. We investigated the number of OMFS posts available for foundation year (FY) doctors and dental core trainees (DCTs) by using information from UK foundation schools and analysing data from Health Education England (HEE) and the UK Foundation Programme Office (UKFPO).

Janus-kinase inhibitor use in immune-mediated inflammatory diseases beyond licensed indications: A scoping review.

Introduction: The use of janus kinase inhibitors (JAKi's) in immune-mediated inflammatory conditions (IMIDs) beyond licence is expanding rapidly. The aim of this scoping review was to identify and present the available evidence on the efficacy of JAKi's in all conditions without marketing authorisation.

Methods: Through a detailed literature search we identified studies including 5 or more patients that assessed the use of any JAKi for any efficacy outcome .

High hydrostatic pressure modulates the digestive properties of rice starch-gallic acid composites by boosting non-inclusion complexation.

Influencing the starch postprandial glycemia via interventions that are sourced from natural plant materials has gained attention recently. Amylose present in starch is reported to form complexes with small ligands such as gallic acid (GA) through a conformational change that are digested slowly and contribute to the formation of resistant starch. In this study, the molecular interactions, multi-scale structure and in vitro digestion properties of normal neat rice starch and rice starch-GA composites (2, 5 % w/v) obtained either by high hydrostatic pressure (HHP) or thermal (T) treatment were compared.

Incidence trends in ischaemic and non-ischaemic heart failure in people with and without type 2 diabetes, 2000-2019: An observational study in England.

Aim: To investigate trends in ischaemic and non-ischaemic heart failure (HF) in adults with type 2 diabetes and without diabetes between 1st January 2000 and 31st December 2019 in England.

Methods: We used the Clinical Practice Research Datalink datasets, linked to the Hospital Episode Statistics and Office for National Statistics to estimate sex-specific crude and age-standardised rates of incident ischaemic and non-ischaemic HF up to 10 years per calendar year of diabetes diagnosis and diabetes status.

Results: In a cohort of 735,810 individuals, 5,073 ischaemic (2,038 in people with type 2 diabetes and 3,035 in those without) and 16,501 non-ischaemic (6,358 and 10,143, respectively) HF events were recorded during a median follow-up of 10 years.

Teaching Guatemalan Lay Midwives Acupressure: Outcomes and Lessons Learned.

Purpose: Lay midwives attend most births at home in Guatemala facing many challenges with limited resources. Current research demonstrates that acupressure can reduce preterm contractions and encourage post-term labor. Sharing acupressure techniques with lay midwives could improve birth outcomes in Guatemala.

Natural History of Symptoms in Patients With Esophagogastric Junction Outflow Obstruction Using Standardized Surveys.

Background Our aim was to assess the clinical presentation and outcomes of patients with a manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO) using standardized symptom surveys and comparison to a cohort who were referred for manometry but who had a normal study. Methods We followed a cohort of adult patients without a mechanical obstruction who underwent high-resolution manometry at our medical center from 9/12/19 to 10/4/21 for 16 months. Results Thirty-seven patients with EGJOO (age: 60.

Mapping the landscape of lineage-specific dynamic regulation of gene expression using single-cell transcriptomics and application to genetics of complex disease.

Single-cell transcriptome data can provide insights into how genetic variation influences biological processes involved in human biology and disease. However, the identification of gene-level associations in distinct cell types faces several challenges, including the limited reference resource from population scale studies, data sparsity in single-cell RNA sequencing, and the complex cell state pattern of expression within individual cell types. Here we develop genetic models of cell type specific and cell state adjusted gene expression in mid-brain neurons in the process of specializing from induced pluripotent stem cells.

The study protocol of a double-blind randomized controlled trial of EMDR and multifocal transcranial current stimulation (MtCS) as augmentation strategy in patients with fibromyalgia.

Background: Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma.

Tackling the primary healthcare workforce crisis: time to talk about health systems and governance-a comparative assessment of nine countries in the WHO European region.

Background: Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify capacities that may help respond effectively to the HCWF crisis in health system contexts.

Methods: A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England.

The management of splanchnic vein thrombosis in acute pancreatitis: a global DELPHI consensus study.

Background: Splanchnic vein thrombosis (SpVT) occurs in 17%-23 % of acute pancreatitis cases. Serious sequelae include hepatic and bowel ischaemia. However, management with therapeutic anticoagulation remains controversial due to potential bleeding risk.

Developing the allied health professionals workforce within mental health, learning disability and autism inpatient services: rapid review of learning from quality and safety incidents.

Background: Allied health professionals (AHPs) in inpatient mental health, learning disability and autism services work in cultures dominated by other professions who often poorly understand their roles. Furthermore, identified learning from safety incidents often lacks focus on AHPs and research is needed to understand how AHPs contribute to safe care in these services.

Methods: A rapid literature review was conducted on material published from February 2014 to February 2024, reporting safety incidents within adult inpatient mental health, learning disability and autism services in England, with identifiable learning for AHPs.

General practice chlamydia testing: qualitative study of staff approaches using behavioural change theory.

Background: Chlamydia is the most diagnosed bacterial sexually transmitted infection in England, but opportunistic testing remains low in general practice despite high prevalence among young people. Attempts to increase testing have been met with little success; therefore, there is a need to explore why rates remain low and how this may be improved.

Aim: To explore general practice staff perceptions of opportunistic chlamydia testing, including barriers, facilitators, interventions, and policies, using the Behaviour Change Wheel (BCW).

General Practice chest x-ray rate is associated with earlier lung cancer diagnosis and reduced all-cause mortality: a retrospective observational study.

Background: Evidence on whether general practice rates of investigation in symptomatic patients using chest x-ray (CXR) affects outcomes is equivocal.

Aim: Determine if there is an association between rates of general practice (GP) requested CXR and lung cancer outcomes.

Design And Setting: Retrospective observational study (England) Methods: Cancer registry data for patients diagnosed with lung cancer 2014-2018 was linked to data on GP CXRs 2013-2017.

A Time-varying Analysis of General Practice Prescribing in the COVID-19 Era: Lessons from Prescription Dynamics in a Pandemic.

Background/aim: Pharmacotherapy is vital in medicine, but inappropriate and inadequate use of medications significantly impacts global mortality and morbidity. Increased prescribing may indicate irrational use or prolonged illness, while decreased prescribing could suggest undertreatment, supply shortages, or the availability of safer and, more effective treatments. The COVID-19 pandemic disrupted health systems, potentially altering prescribing patterns.

Novel pathways for headache via neurology same day emergency care: admission avoidance, prevention of lumbar punctures and reduced length of stay in hospital.

There are various models for acute neurology services in the UK, with considerable variation in practice. Patients are often admitted unnecessarily for neurology review, leading to delay in diagnosis and treatment. Alternative models, such as the Neurology Same Day Emergency Care service (Neuro-SDEC) at University College London Hospital provide a pathway that can prevent admissions and streamline patient care.