Advanced thymic epithelial tumour resection: vascular resection and reconstruction strategy.

Background: Thymic epithelial tumors (TETs) represent the predominant primary malignancy of the anterior mediastinum, often necessitating complex surgical interventions due to their invasive nature. The prognosis of advanced TET relies significantly on achieving complete resection with microscopically clear margins (R0). This frequently entails resection and reconstruction of major vascular structures like the superior vena cava (SVC) and brachiocephalic veins, and in some cases, extra pleural pneumonectomy (EPP).

Imagining Futures: Evaluation of a blended programme of dialectical behaviour therapy and the creative arts for young women with a history of self-harm.

Objectives: To evaluate an arts-enhanced dialectical behavioural therapy skills group for managing emotions and self-harm, implemented via an innovative public sector/third sector partnership to increase access to care.

Design: This is a pilot mixed-methods study.

Methods: To assess participant experience in the 'Imagining Futures' programme, we examined self-report questionnaires and qualitative focus group interviews using framework analysis.

An index of the initial blood pressure response to angiotensin II treatment and its association with clinical outcomes in vasodilatory shock.

Background: No standardized index exists to assess cardiovascular responsiveness to angiotensin-II. We hypothesized that a standardized index of initial blood pressure response to angiotensin-II treatment would be associated with clinical outcomes.

Methods: Using data from the Angiotensin Therapy for High Output Shock (ATHOS-3) trial, we developed an Angiotensin-II Initial MAP Response Index of Treatment Effect (AIMRITE) defined as (MAP at hr1 - MAP at baseline)/study drug dose.

Lessons learned from a candidate gene study investigating aromatase inhibitor treatment outcome in breast cancer.

The role of germline genetics in adjuvant aromatase inhibitor (AI) treatment efficacy in ER-positive breast cancer is poorly understood. We employed a two-stage candidate gene approach to examine associations between survival endpoints and common germline variants in 753 endocrine resistance-related genes. For a discovery cohort, we screened the Breast Cancer Association Consortium database (n ≥ 90,000 cases) and retrieved 2789 AI-treated patients.

Genes Associated With Hypertrophic Cardiomyopathy: A Reappraisal by the ClinGen Hereditary Cardiovascular Disease Gene Curation Expert Panel.

Background: Hypertrophic cardiomyopathy (HCM) is an inherited cardiac condition affecting ∼1 in 500 and exhibits marked genetic heterogeneity. Previously published in 2019, 57 HCM-associated genes were curated providing the first systematic evaluation of gene-disease validity.

Objectives: The authors report work by the Clinical Genome Resource Hereditary Cardiovascular Disease (HCVD) Gene Curation Expert Panel (GCEP) to reappraise the clinical validity of previously curated and new putative HCM genes.

Content Validity of Patient-Reported Outcome Measures Developed for Assessing Disease-Specific Quality of Life in Children With Sinonasal Disease: A Systematic Review.

Objectives: Paediatric sinonasal disease is prevalent worldwide, giving rise to substantial healthcare costs and morbidity. However, there is a lack of sinus-specific patient-reported outcome measures (PROMs) tailored for children. This study aimed to evaluate existing PROMs against established validation criteria to determine whether a paediatric-specific, validated instrument for assessing sinonasal disease currently exists.

Evolving trends in lung cancer risk factors in the ten most populous countries: an analysis of data from the 2019 Global Burden of Disease Study.

Background: Amid shifting tobacco policies and escalating air pollution levels, Lung Cancer (LC) risk factors have changed notably. Continuous assessment of these risk factors is necessary. This study compares trends in tobacco, air pollution, and asbestos-associated Age-Standardized Mortality Rates (ASMR) from Trachea, Bronchus, and Lung (TBL) Cancer across the top ten most populated countries (2023 censuses) and globally.

Management of Echocardiography Requests for the Detection and Follow-Up of Heart Valve Disease: A Consensus Statement From the British Heart Valve Society.

Background: In the aftermath of the Covid19 pandemic and lockdowns, there has been a growing population awaiting transthoracic echocardiograms for potential valvular heart disease. Conducting comprehensive echocardiograms for all individuals may no longer be practical, leading to substantial delays in obtaining the necessary scans. This paper explores an alternative approach, suggesting the consideration of dedicated and shorter scans specifically for patients suspected of having valvular heart disease.

Large-scale genome-wide association analyses identify novel genetic loci and mechanisms in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is an important cause of morbidity and mortality with both monogenic and polygenic components. Here, we report results from a large genome-wide association study and multitrait analysis including 5,900 HCM cases, 68,359 controls and 36,083 UK Biobank participants with cardiac magnetic resonance imaging. We identified 70 loci (50 novel) associated with HCM and 62 loci (20 novel) associated with relevant left ventricular traits.

Evaluation of polygenic scores for hypertrophic cardiomyopathy in the general population and across clinical settings.

Hypertrophic cardiomyopathy (HCM) is an important cause of morbidity and mortality, with pathogenic variants found in about a third of cases. Large-scale genome-wide association studies (GWAS) demonstrate that common genetic variation contributes to HCM risk. Here we derive polygenic scores (PGS) from HCM GWAS and genetically correlated traits and test their performance in the UK Biobank, 100,000 Genomes Project, and clinical cohorts.

A postzygotic GNA13 variant upregulates the RHOA/ROCK pathway and alters melanocyte function in a mosaic skin hypopigmentation syndrome.

The genetic bases of mosaic pigmentation disorders have increasingly been identified, but these conditions remain poorly characterised, and their pathophysiology is unclear. Here, we report in four unrelated patients that a recurrent postzygotic mutation in GNA13 is responsible for a recognizable syndrome with hypomelanosis of Ito associated with developmental anomalies. GNA13 encodes Gα, a subunit of αβγ heterotrimeric G proteins coupled to specific transmembrane receptors known as G-protein coupled receptors.

A survey of cone beam computed tomography use amongst endodontic specialists in the United Kingdom.

Introduction: The aim of this study was to investigate the applications of cone beam computed tomography (CBCT) amongst endodontic specialists in the United Kingdom (UK) via an online survey.

Methods: An online invitation to take part in the survey was sent out to 306 specialist endodontists registered on the UK specialist register. The survey consisted of a series of questions associated with demographics, access and use of CBCT, utilization of dose optimization parameters, and frequency of use in different clinical scenarios.

Management of Primary Bladder Neck Obstruction and Dysfunctional Voiding in Young Men: A Systematic Review and Meta-analysis.

Background And Objective: Management of young men with primary bladder neck obstruction (PBNO) and dysfunctional voiding (DV) is challenging. We systematically reviewed evidence on diagnostic strategies and treatment outcomes in men aged 18-50 yr with PBNO or DV.

Methods: We conducted a comprehensive bibliographic search on the Embase, Medline, and Cochrane Library databases in July 2024.

Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients With Bacteremia: A Post Hoc Analysis of the CAMERA2 Randomized Clinical Trial.

Introduction: Classification of patients with bacteremia as complicated versus uncomplicated is based on a combination of clinical and microbiologic variables. Whether daily body temperature and common laboratory tests such as C-reactive protein (CRP) and white blood cell (WBC) can improve risk stratification algorithms is unclear.

Methods: We conducted a post hoc secondary analysis of the CAMERA2 trial, which enrolled hospitalized adult patients with methicillin-resistant bacteremia and prospectively collected daily body temperature and peripheral blood WBC and CRP.

Electrocardiographic imaging metrics to predict the risk of arrhythmia in patients with ischemic cardiomyopathy.

Background: The leading cause of death in patients with ischemic cardiomyopathy is sudden cardiac death caused by ventricular arrhythmias. Accurate determination of arrhythmic risk in these patients is vital to allow clinicians to take appropriate preventive measures.

Objective: To review and summarize the literature on electrocardiographic imaging (ECGi) metrics that could be used to predict arrhythmic risk in patients with ischemic cardiomyopathy.

EUFOREA meeting on defining disease states in allergic rhinitis: towards a unified language in AR.

Allergic rhinitis (AR), the most prevalent immunological disease, affects approximately 400 million individuals globally and can significantly impact quality of life (QoL). Despite nearly 25 years of guidelines, AR remains largely under- diagnosed, suboptimally treated and poorly controlled. In the light of new knowledge and treatment options, there is a necessity to update or revise fundamental AR definitions to facilitate communication across diverse specialties engaged in its treatment and to improve patient care.

Parent-led ear health checks at home for children with complex needs pilot-project: a new approach to improving access to ear health.

Objective: To assess the acceptability of parent-delivered ear health checks at home for children with complex needs.

Design: A multi-method service level evaluation of a modified ear check pathway. Qualitative and quantitative data were collected via interviews, Likert scale questions, and otoscopy and tympanometry acceptance data.

Epidemiological trends of mechanically ventilated acute respiratory distress syndrome in the twenty-first century: a nationwide, population-based retrospective study.

Purpose: Acute respiratory distress syndrome (ARDS) is a prevalent respiratory condition associated with significant mortality. Current literature on ARDS epidemiology reports a wide range of incidence (7.2-78.

The use of clinical teaching associates (CTAs) in teaching male intimate examination to medical students: A randomised controlled trial.

Introduction: Genital examinations are challenging for medical students to learn in part due to practice opportunities. In an attempt to address this, we introduced clinical teaching associates (CTAs) who teach third year medical students and allow male intimate examinations to be practiced on themselves.

Materials And Methods: A single-blinded parallel-group RCT was conducted, recruiting 96 students.

Statistical Heterogeneity in Oral Health Meta-Analyses.

Providing the summary effect size and its uncertainty, a prediction interval, and a measure of statistical heterogeneity constitute good reporting practices in meta-analyses. Popular statistical heterogeneity measures comprise the and statistics. However, researchers often rely unduly on the statistic, using naive categorizations to gauge the extent of heterogeneity, leading to misuses of the meta-analysis models, deficiencies in reporting, and misleading conclusions.