High-dose vs. Low-dose Proton Pump Inhibitors post-endoscopic hemostasis in patients with bleeding peptic ulcer. A meta-analysis and meta-regression analysis.

Background/aims: Present meta-analysis aims to evaluate studies of low- versus high-dose proton pump Inhibitors (PPI) post-endoscopic hemostasis, including the newly published randomized controlled trials (RCTs) and to conclude whether low-dose PPI can generate the comparable results as high-dose PPI.

Materials And Methods: To identify suitable trials, the electronic databases PubMed, Medline, Cochrane Library, and the Embase were used. All RCTs concerning low- versus high-dose PPI administration post-endoscopic hemostasis published until December 2016 were identified.

Emerging/changing fashion trends and their impact on conduct of anaesthesia.

One of the innate features of human behaviour is to enhance personal image in order to look different from the rest of the crowd and to satisfy a need for individualism. People use different dress codes, body makeup and artificial gadgets to improve their personal and physical appearance. The main motive behind all these efforts is personal satisfaction, to appear attractive to others and to overcome phobias and complexes.

Man behind the laryngoscopy is important.

Tracheal intubation is the most fundamental and effective resuscitation skill in many emergency situations. It is also performed to facilitate various surgical procedures and mechanical ventilation in critically ill patients. Tracheal intubation is also one of the most commonly taught clinical skills.

Management of symptomatic knee osteoarthritis in obesity: a survey of orthopaedic surgeons' opinions and practice.

Introduction: The aim of this survey was to explore knee surgeons' opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity.

Methods: Questionnaires were sent electronically to all consultant members of the British Association for Surgery of the Knee.

Results: The response rate was 52%.

Experiences of Patients with Mental Illness' Interactions with Medical Students: A Systematic Review.

Objectives: Mental health is a key area for learning within undergraduate medical education. Given the nature of mental illness, interactions may have the potential to uniquely affect patients. This study set out to systematically review studies reporting experiences and perceptions of patients with mental illness' clinical interactions with medical students.

Skin closure following fractured neck of femur surgery: a survey of orthopaedic surgeons' practices.

Introduction: Surgical intervention for patients presenting with a fractured neck of femur is common, however the best method of skin closure remains unclear. It has been suggested that the use of metallic skin clips in the closure of hip wounds may increase the rate of surgical site infections, however there are few high quality studies evaluating this.

Methods: We designed a survey to assess surgeons preferred skin closure method and their reasons for choosing it.

A JAFROC study of nodule detection performance in CT images of a thorax acquired during PET/CT.

Purpose: Two types of CT images (modalities) are acquired in PET/CT: for attenuation correction (AC) and diagnosis. The purpose of the study was to compare nodule detection and localization performance between these two modalities.

Methods: CT images, using both modalities, of an anthropomorphic chest phantom containing zero or more simulated spherical nodules of 5, 8, 10 and 12 mm diameters and contrasts -800, -630 and 100 HU were acquired.

Gefitinib and EGFR Gene Copy Number Aberrations in Esophageal Cancer.

Purpose The Cancer Esophagus Gefitinib trial demonstrated improved progression-free survival with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib relative to placebo in patients with advanced esophageal cancer who had disease progression after chemotherapy. Rapid and durable responses were observed in a minority of patients. We hypothesized that genetic aberration of the EGFR pathway would identify patients benefitting from gefitinib.

A rare case of primary ovarian carcinoid.

We present a rare case in an elderly Caucasian lady of primary ovarian carcinoid tumor, causing symptoms of the carcinoid syndrome and severe carcinoid heart disease. Carcinoid tumors are the commonest neuroendocrine tumors, the majority of which are found in the gastrointestinal tract and lungs. Ovarian carcinoids represent only 0.

Relationship between circulating microRNA-30c with total- and LDL-cholesterol, their circulatory transportation and effect of statins.

Background: Small non-coding microRNAs (miR) have important regulatory roles and are used as biomarkers of disease. We investigated the relationship between lipoproteins and circulating miR-30c, evaluated how they are transported in circulation and determined whether statins altered the circulating concentration of miR-30c.

Methods: To determine the relationship between lipoproteins and circulating miR-30c, serum samples from 79 subjects recruited from a lipid clinic were evaluated.

Portal Supply and Venous Drainage of the Caudate Lobe in the Healthy Human Liver: Virtual Three-Dimensional Computed Tomography Volume Study.

Objective: The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe.

Methods: Extrahepatic (provided by the first-order branches) versus intrahepatic (provided by the second- to third-order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3-D liver maps in 140 potential live liver donors.

Effect of reconstruction methods and x-ray tube current-time product on nodule detection in an anthropomorphic thorax phantom: A crossed-modality JAFROC observer study.

Purpose: To evaluate nodule detection in an anthropomorphic chest phantom in computed tomography (CT) images reconstructed with adaptive iterative dose reduction 3D (AIDR(3D)) and filtered back projection (FBP) over a range of tube current-time product (mAs).

Methods: Two phantoms were used in this study: (i) an anthropomorphic chest phantom was loaded with spherical simulated nodules of 5, 8, 10, and 12 mm in diameter and +100, -630, and -800 Hounsfield units electron density; this would generate CT images for the observer study; (ii) a whole-body dosimetry verification phantom was used to ultimately estimate effective dose and risk according to the model of the BEIR VII committee. Both phantoms were scanned over a mAs range (10, 20, 30, and 40), while all other acquisition parameters remained constant.

Is Performance-Based Progress Testing in Psychiatry Feasible?

Objective: The aim of this study was to explore if competency-based progress tests for postgraduate psychiatry are reliable, if they are able to discriminate trainees at different levels of training, and if they are able to demonstrate improvement of trainees' skills from 3 years of data.

Methods: Psychiatry trainees in the North Western Deanery, UK, were invited to participate in the annual progress test. The progress test simulated the Clinical Assessment of Skills and Competencies (CASC) exam, the final postgraduate examination for psychiatry trainees.

A Rare Variant of Pancreatic Sarcoidosis: Diagnostic Challenge.

Unlabelled: Pancreatic sarcoidosis is one of the variant of systemic sarcoidosis which is extremely rare in literature and opined as an enigma. Hence, its diagnosis is very challenging as its presentation mimics pancreatic carcinoma. In view of a better understanding, we are presenting a case of pancreatic sarcoidosis to emphasize the above.

Symphysiotomy.

The place of symphysiotomy, as an alternative to Caesarean section (CS), in the management of established obstructed labour in low- and middle-income, resource-poor countries (LMICs), is reviewed. It is suggested that it does have a very definite place, especially in mothers of low age and parity, in circumstances where medical facilities are limited, where antenatal care and hospital delivery are not assured in a future pregnancy, and in cultures where it is important to the woman that a vaginal delivery is achieved.

Implementing NICE obesity guidance for staff: an NHS trust audit.

Background: The UK National Institute of Health and Clinical Excellence (NICE) has produced guidelines (CG43) on preventing and managing overweight and obesity, which apply to the National Health Service (NHS) as an employer.

Aims: To record in an NHS trust baseline assessment and management of obesity by its occupational health (OH) service staff, with reference to the standards in CG43, enabling deficiencies to be identified and improvements to be recommended as a benchmark for future measurement.

Methods: Criteria relevant to OH in CG43 were identified and data were collected from trust policies, interviews with managers, questionnaires to OH staff, examination of OH resources and case notes of staff attending OH.

Indigenous ethnopsychiatry in the north-west of England: the case of 'Barrow Man'.

This paper describes the appearance and subsequent disappearance of 'Barrow Man' and uses anthropological and social psychological theory to examine the socio-cultural, psychological and economic conditions for the existence of the phenomenon. It argues that these conditions were the result of both specific local labour market circumstances and of the effects of global political changes, and argues that to talk about 'Barrow Man' as if it was a psychiatric diagnosis was to identify a moral construct as a mental disorder. It also argues that at the same time the phenomenon was expressive of certain core values that were not readily acknowledged in everyday clinical practice and that it might therefore best be understood as an institutional category.

Gefitinib for oesophageal cancer progressing after chemotherapy (COG): a phase 3, multicentre, double-blind, placebo-controlled randomised trial.

Background: Evidence is scarce for the effectiveness of therapies for oesophageal cancer progressing after chemotherapy, and no randomised trials have been reported. We aimed to compare gefitinib with placebo in previously treated advanced oesophageal cancer.

Methods: For this phase 3, parallel, randomised, placebo-controlled trial, eligible patients were adults with advanced oesophageal cancer or type I/II Siewert junctional tumours, histologically confirmed squamous-cell carcinoma or adenocarcinoma, who had progressed after chemotherapy, with WHO performance status 0-2, and with measurable or evaluable disease on CT scan.

A free-response evaluation determining value in the computed tomography attenuation correction image for revealing pulmonary incidental findings: a phantom study.

Rationale And Objectives: The purpose of this study was to compare lesion-detection performance when interpreting computed tomography (CT) images that are acquired for attenuation correction when performing single photon emission computed tomography/computed tomography (SPECT/CT) myocardial perfusion studies. In the United Kingdom, there is a requirement that these images be interpreted; thus, it is necessary to understand observer performance on these images.

Materials And Methods: An anthropomorphic chest phantom with inserted spherical lesions of different sizes and contrasts was scanned on five different SPECT/CT systems using site-specific CT protocols for SPECT/CT myocardial perfusion imaging.

Living with a powered wheelchair: exploring children's and young people's experiences.

Purpose: The study aimed to explore the lived experiences of children and young people who use an Electric Powered Indoor/Outdoor wheelchair (EPIOC).

Method: To allow for the individual lived experiences of the children to be explored, an exploratory study was designed using Interpretative Phenomenological Analysis (IPA). Nine children aged 7-16 years were recruited and their views explored through semi-structured interviews.

Campylobacter fetus sepsis in an immunocompetent patient with haematological complication.

Campylobacter fetus sepsis is rare, especially among young, immunocompetent patients. We present the case of a 43-year-old man with a history of ulcerative colitis who was diagnosed with C fetus bacteraemia with endovascular manifestation. The patient was found to have a low vitamin K level and a high international normalised ratio, and developed deep vein thrombosis.