A proof-of-concept analysis of data from the first NHS clinic for young adults with comorbid cannabis use and psychotic disorders.

Background: Cannabis use severely affects the outcome of people with psychotic disorders, yet there is a lack of treatments. To address this, in 2019 the National Health Service (NHS) Cannabis Clinic for Psychosis (CCP) was developed to support adults suffering from psychosis to reduce and/or stop their cannabis use.

Aims: Examine outcome data from the first 46 individuals to complete the CCP's intervention.

Comparison of Laboratory Confirmed Drugs in Acute Recreational Drug Toxicity Presentations to an Urban Hospital in London, UK, 2016/17 versus 2019/20.

Introduction: Novel Psychoactive Substance (NPS) use is increasingly prevalent and is often associated with severe acute recreational drug toxicity (ARDT). 258 UK deaths were attributed to NPS use in 2021. Confirmatory testing which identifies NPS is limited by expense and timeliness.

Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio-an experimental study.

Background: Ventilator-induced lung injury (VILI) is one of the side effects of mechanical ventilation during ARDS; a prerequisite for averting it is the quantification of its risk factors associated with a given ventilatory setting. Many clinical variables have been proposed as predictors of VILI, of which driving pressure is the most widely used. In this study, we compared the performance of driving pressure, four times the driving pressure added to respiratory rate (4DPRR) and mechanical power ratio.

Rethinking ARDS classification: oxygenation impairment fails to predict VILI risk.

Purpose: The selection and intensity of respiratory support for ARDS are guided by PaO/FiO. However, ventilator-induced lung injury (VILI) is linked to respiratory mechanics and ventilator settings. We explored whether the VILI risk is related to ARDS severity based on oxygenation.

Does inhaler adherence really matter in severe asthma?

Inhaled therapies, primarily the inhaled corticosteroid (ICS), have been the cornerstone of asthma treatment since the 1960s. They have been shown to reduce symptom burden, morbidity and mortality, and potentially avoid unnecessary and unscheduled healthcare. However, some people have severe asthma, defined by an inability to gain or maintain consistent disease control despite appropriate use of high dose ICS-containing inhalers.

Prolonged weaning from mechanical ventilation: who, what, when and how?

Weaning from invasive mechanical ventilation is an important part of the management of respiratory failure patients. Patients can be classified into those who wean on the first attempt (simple weaning), those who require up to three attempts (difficult weaning) and those who require more than three attempts (prolonged weaning). The process of weaning includes adequately treating the underlying cause of respiratory failure, assessing the readiness to wean, evaluating the response to a reduction in ventilatory support, and eventually liberation from mechanical ventilation and extubation or decannulation.

The Multichannel Intraoesophageal Impedance Transit Concept.

Introduction/aims The multichannel intraoesophageal impedance transit (MIIT) is a new clinical concept that is being introduced to measure the oesophageal transit during a 24-hour multichannel impedance-pH (MII-pH) study. Methods MIIT was tested in a case-control study between January 2020 and December 2023. A laboratory test was first conducted to determine the saline baseline impedance (SBI) using MII-pH catheters.

Impact of CT-angiography derived plaque characteristics on cardiac events in patients with a negative invasive fractional flow reserve.

Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque.

REsolution of Symptoms afTer Oesophago-gastric cancer REsection delphi (RESTOREd)-standardizing the definition, investigation and management of gastrointestinal symptoms and conditions after surgery.

Background: Oesophago-gastric cancer surgery negatively affects quality of life with a high postoperative symptom burden. Several conditions that may be diagnosed and treated after surgery are recognised. However, consensus regarding their definition and management is lacking.

Mini-endoscopic combined intrarenal surgery (mini-ECIRS) for complex urolithiasis.

Introduction: To miniaturize endourological procedures, mini-Endoscopic Combined Intrarenal Surgery (mini-ECIRS) has emerged as a promising alternative in the treatment of complex kidney and ureteral stones. To date, some data available in the literature have shown good outcomes regarding effectiveness and safety. This study aimed to evaluate the results and postoperative complications of mini-ECIRS in our series.

A pain research strategy for Europe: A European survey and position paper of the European Pain Federation EFIC.

Background: Pain is the leading cause of disability and reduced quality of life worldwide. Despite the increasing burden for patients and healthcare systems, pain research remains underfunded and under focused. Having stakeholders identify and prioritize areas that need urgent attention in the field will help focus funding topics, reduce 'research waste', improve the effectiveness of pain research and therapy and promote the uptake of research evidence.

Treatments for RYR1-related disorders.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To analyse the benefits and harms of pharmacological or other interventions (e.g.

Core elements of the perioperative medicine for older people undergoing surgery (POPS) model of care.

Purpose: Hospital surgical services that utilise the approach of the perioperative medicine for older people undergoing surgery (POPS) model of care improve outcomes for older people contemplating and undergoing surgery. Complex models of care like POPS may be difficult to implement without understanding the elements that comprise that model of care. Logic models can be used to aid implementation by visually depicting theoretical relationships between the elements of the model of care.

Wound imaging software and digital platform to assist review of surgical wounds using patient smartphones: The development and evaluation of artificial intelligence (WISDOM AI study).

Introduction: Surgical patients frequently experience post-operative complications at home. Digital remote monitoring of surgical wounds via image-based systems has emerged as a promising solution for early detection and intervention. However, the increased clinician workload from reviewing patient-submitted images presents a challenge.

Prostate-specific antigen kinetics in Asian patients with metastatic castration-sensitive prostate cancer treated with apalutamide in the TITAN trial: A post hoc analysis.

Objective: In the TITAN trial of patients with metastatic castration-sensitive prostate cancer (mCSPC), deep and rapid prostate-specific antigen (PSA) decline with apalutamide plus androgen deprivation therapy (ADT) was associated with longer overall survival (OS), radiographic progression-free survival (rPFS), time to PSA progression (TTPP), and time to castration resistance (TTCR) compared with no decline (all p < 0.0001). This post hoc analysis evaluated PSA kinetics in the Asian subpopulation.

Trends and variation in issuance of high-cost narcolepsy drugs by NHS England organisations and regions from 2019 to 2022.

Clinicians and people with narcolepsy report varied access to higher-cost narcolepsy treatments in England associated with variations in national and local commissioning. There are no publicly available data quantifying use of these drugs to support policy decisions. We therefore aimed to describe national, regional and local prescribing trends for higher-cost narcolepsy drugs using new national databases.

The impact of long axial field of view (LAFOV) PET on oncologic imaging.

The development of long axial field of view (LAFOV) positron emission tomography coupled with computed tomography (PET/CT) scanners might be considered the biggest step forward in PET imaging since it became a mainstream clinical modality. Despite increased capital and maintenance costs and data storage requirements, the improvement in image quality, significantly faster acquisition times and lower radiopharmaceutical administered activities, allow a high quality and more efficient clinical service. This step change in technology overcomes some of the limitations of standard short axial field of view scanners.

CHIME Syndrome in a Child With Homozygous PIGL p.Leu167Pro Variant.

CHIME syndrome is a variable condition characterized by ichthyosiform dermatosis, accompanied by intellectual disability, ocular colobomas, ear anomalies, and heart defects. It is an autosomal recessive condition caused by biallelic pathogenic variants in the PIGL gene. Until now, all reports of individuals affected with CHIME syndrome showed the PIGL c.

Physiological Assessment of ECCOR on the Work of Breathing in Exacerbations of COPD.

Rationale: The impact of extracorporeal carbon dioxide removal (ECCOR) on work of breathing and aeration in exacerbations of chronic obstructive pulmonary disease (AECOPD) is poorly understood.

Objectives: The study explores the impact of non-invasive ventilation (NIV) and ECCOR on respiratory drive, effort and distribution of ventilation in AECOPD.

Methods: Patients enrolled in a randomised controlled study of the addition of ECCOR to NIV compared with NIV underwent oesophageal pressure measurement, electrical impedance tomography and parasternal electromyography.