Mechanical insufflation-exsufflation use in neuromuscular disease: a single centre cohort study.

Introduction: Mechanical insufflation-exsufflation (MIE) is a commonly used therapy to augment secretion clearance in individuals with neuromuscular disease. There are no clear evidence-based guidelines on the settings that should be used in different diagnostic groups and how they should be titrated. We report on the settings used in the largest cohort of individuals using domiciliary MIE in the literature.

Interest and barriers to research in obstetric haematology - findings from a national survey in the United Kingdom.

Introduction: In 2021, the steering committee members of British Society of Haematology Obstetric Haematology Special Interest Group noted difficulties in opening research studies. This led to the development of a survey to further evaluate this issue.

Method: An electronic survey was distributed to all members of the British Society of Haematology Obstetric Haematology Special Interest Group and to relevant specialty leads of the National Institute for Health and Care Research Clinical Research Network for further dissemination within these networks.

Efficacy and Safety of Epicutaneous Immunotherapy in Peanut-Allergic Toddlers: Open-Label Extension to EPITOPE.

Background: The pivotal phase 3 EPITOPE trial, a 12-month, double-blind, placebo-controlled study of epicutaneous immunotherapy with the VIASKIN® patch containing 250 μg peanut protein (VP250) previously reported significant treatment response vs placebo in peanut-allergic toddlers aged 1-through-3 years.

Objective: To assess interim efficacy and safety of VP250 from the first year of the EPITOPE open-label extension (OLE) study.

Methods: Eligible participants enrolled in the OLE study for up to 3 years of total treatment with annual double-blind, placebo-controlled food challenges (DBPCFC) and safety assessments; here we report the first year OLE (Year 2) results.

2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.

Clinical practice guidelines consolidate and evaluate all pertinent evidence on a specific topic available at the time of their formulation. The goal is to assist physicians in determining the most effective management strategies for patients with a particular condition. These guidelines assess the impact on patient outcomes and weigh the risk-benefit ratio of various diagnostic or therapeutic approaches.

Hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric cancer with peritoneal metastasis - Joint analysis of European GASTRODATA and American national cancer database.

Introduction: Palliative chemotherapy is the current standard among advanced gastric cancer (GC) patients with peritoneal metastasis (PM), while the role of gastrectomy with cytoreductive surgery and HIPEC remains unclear. The current study aimed to assess treatment outcomes among GC patients with PM undergoing gastrectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) using multinational cancer registries.

Methods: The analysis (2012-2022) included stage IV GC patients with PM undergoing gastrectomy and HIPEC from the European GASTRODATA Registry (EU cohort) and the American National Cancer Database (NCDB, U.

Commentary: Tolvaptan for Autosomal Dominant Polycystic Kidney Disease (ADPKD) - an update.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) affects up to 70 000 people in the UK and the most common inherited cause of end-stage kidney disease (ESKD). It is generally a late-onset multisystem disorder characterised by bilateral kidney cysts, liver cysts and an increased risk of intracranial aneurysms. Approximately 50% of people with ADPKD reach ESKD by age 60.

Matrix mechano-sensing at the invasive front induces a cytoskeletal and transcriptional memory supporting metastasis.

The extracellular matrix (ECM) controls tumour dissemination. We characterise ECM organization in human and mouse tumours, identifying three regions: tumour body, proximal invasive front and distal invasive front. Invasive areas show increased matrix density, fibre thickness, length, and alignment, with unique radial fibre orientation at the distal invasive front correlating with amoeboid invasive features.

Thoracoabdominal Asynchrony in Very Severe COPD: Clinical and Functional Correlates During Exercise.

Introduction: Patients with severe Chronic Obstructive Pulmonary Disease (COPD) often experience breathlessness and exercise limitations due to expiratory flow limitation. Pulmonary rehabilitation programmes, including exercise with non-invasive ventilation (NIV) or high-flow nasal therapy (HFT), aims to improve quality of life and exercise tolerance. This study investigates the relationship between thoracoabdominal asynchrony (TAA) during supported (NIV and HFT) and unsupported (conventional oxygen therapy - COT) exercise and clinical and functional parameters in severe COPD patients awaiting lung transplantation.

Tumor Biomechanics Quantified Using MR Elastography to Predict Response to Neoadjuvant Chemotherapy in Individuals with Breast Cancer.

Purpose To evaluate the ability of MR elastography (MRE) to noninvasively quantify tissue biomechanics and determine the added diagnostic value of biomechanics for predicting response throughout neoadjuvant chemotherapy (NAC). Materials and Methods In this prospective study (between September 2020 and August 2023; registration no. NCT03238144), participants with breast cancer scheduled to undergo NAC underwent five MRE scans at different time points alongside clinical dynamic contrast-enhanced MRI (DCE MRI).

Effectiveness of infrastructural interventions to improve access to safe drinking water in Latin America and the Caribbean on the burden of diarrhoea in children <5 years: a systematic literature review and narrative synthesis.

Globally, Latin America and the Caribbean (LAC) has one of the lowest rates of equitable access to safely managed drinking water. This systematic literature review assessed the effectiveness of infrastructure interventions to provide equitable access to safely managed drinking water in LAC on the burden of diarrhoea in children <5 years. The review was conducted in February 2024 using Ovid MEDLINE, Embase, Global Health, and the Cochrane Library with inclusion criteria: quantitative study designs of intervention effectiveness on burden of diarrhoea in children; conducted in LAC; studies published since 1 January 2000; and full-text available in English.

Can we use integrated total pelvic floor ultrasound as a screening tool in defaecatory pelvic floor dysfunction? A prospective evaluation of the accuracy of integrated total pelvic floor ultrasound compared with defaecation proctography.

Aim: Pelvic floor dysfunction is common and includes symptoms such as urinary incontinence, pelvic pain, faecal incontinence, obstructive defaecation syndrome symptoms and pelvic organ prolapse. It is investigated with defaecation proctography (DP) and integrated total pelvic floor ultrasound (TPFUS). Whilst DP is currently the gold standard, TPFUS is efficient and less invasive, offering additional sphincter function assessment.

An implementation facilitation intervention to improve the musculoskeletal X-ray reporting by radiographers across London.

Background: The National Healthcare Service (NHS) radiology service delivery in London is representative of the current pressures and challenges faced in England of Musculoskeletal (MSK) X-ray reporting workforce shortages, and national turnaround time (TATs) targets. The implementation project evaluated facilitation as a strategy to achieve the NHS England 50% target for all MSK X-rays to be reported by radiographers.

Methods: The project was an eight-month multi-centre (n = 5 London NHS Trusts) study applying the Promoting Action on Research Implementation in Health Services (PARIHS) framework with embedded mixed-methods evaluation.

IgG4-related disease causing dacryoadenitis, bronchial stenosis and lobar collapse.

Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic fibroinflammatory disease that can affect almost any organ in the body. The most common sites of IgG4-RD include the salivary glands, orbits and lacrimal glands, pancreas, biliary tree, retroperitoneum and thyroid. Immunoglobulin G4-related lung disease (IgG4-RLD) can occur in isolation or as a component of multisystem disease.

Classification of Fibroepithelial Lesions of the Breast in Core Needle Biopsy With Implications for Further Management.

Fibroepithelial lesions (FELs) of the breast represent a diverse group of biphasic tumors with varying morphologies and clinical behavior. The classification of FELs is mainly based on a constellation of diagnostic criteria, and intralesional heterogeneity is not uncommon. Therefore, reporting FELs in a core needle biopsy (CNB) with limited tissue material can be challenging as not all the features may be represented for assessment.

The state-of-the-art in cardiac MRI reconstruction: Results of the CMRxRecon challenge in MICCAI 2023.

Cardiac magnetic resonance imaging (MRI) provides detailed and quantitative evaluation of the heart's structure, function, and tissue characteristics with high-resolution spatial-temporal imaging. However, its slow imaging speed and motion artifacts are notable limitations. Undersampling reconstruction, especially data-driven algorithms, has emerged as a promising solution to accelerate scans and enhance imaging performance using highly under-sampled data.

Current opinion: an overview of sickle cell disease and chronic pain and perioperative considerations.

Purpose: This review aims to provide the practicing anesthesiologist with information on the pathophysiology, physiology, and management of patients with sickle cell disease. This includes the evaluation of common intraoperative management issues as well as perioperative concerns related to the disease. This review will also discuss the outpatient care of sickle cell patients concerning disease-modifying agents and chronic pain management.

Use of doravirine-based regimens in clinical practice in Europe: a real-life retrospective observational study.

Objectives: We evaluated antiviral effectiveness and safety of doravirine (DOR)-based regimens in people with HIV (PWH) in routine clinical practice.

Design: A retrospective, noninterventional study across 16 sites in five European countries [United Kingdom (UK), France, Spain, Belgium, Netherlands].

Methods: The study was conducted in both treatment-experienced and treatment-naive PWH who either switched to, or initiated DOR-containing antiretroviral therapy (ART).

Treatment of Myeloproliferative Neoplasms With Janus Kinase Inhibitors: A Meta-Analysis of Cardiovascular Safety.

Background: Janus kinase inhibitors (JAKis) are an integral aspect of the management of myeloproliferative neoplasms (MPNs). Part of the clinical benefit derived from JAKis may be due to reductions in thrombosis, a potentially life-threatening complication of MPNs. However, evidence has emerged of adverse cardiovascular effects secondary to JAKis.