Expedited Conveyance of Out-of-Hospital-Cardiac Arrest patients with STEMI and shockable rhythms to Cardiac Arrest Centres - A Feasibility Pilot Study of the British Cardiovascular Intervention Society conveyance algorithm.

Background And Aims: Guidelines suggest non-traumatic out-of-hospital cardiac arrest (OHCA) be conveyed to cardiac arrest centres (CAC). We hypothesised that (a) a pre-hospital conveyance algorithm based on initial presenting rhythm following OHCA is feasible and (b) that would demonstrate survival advantage.

Methods: This observational pilot study included all consecutive patients with OHCA from suspected cardiac aetiology from the county of Essex, United Kingdom from April 2022-April 2023.

Apical periodontitis microbiome association with salivary and serum inflammatory burden.

Aims: Apical Periodontitis (AP) involves complex interactions between the root canal microbiome and the host immune response, with potential risk of local and systemic inflammatory burden, however there is no evidence available regarding correlation between microbiome and inflammatory marker levels. This study aims to identify the microbiome of saliva, intracanal and blood samples in AP subjects and investigate the correlation between intracanal and blood microbiomes with serum inflammatory biomarker levels, and salivary microbiomes with salivary inflammatory biomarker levels.

Methodology: Saliva, Intracanal and blood samples were collected from AP patients undergoing root canal retreatment.

Motor-sparing regional anaesthesia for total knee arthroplasty: a narrative and systematic literature review.

Total knee arthroplasty is a life-changing surgical procedure that is associated with a high incidence of severe postoperative pain. Key to enhancing recovery after surgery is effective analgesia and early mobilisation. Innovations in motor-sparing regional anaesthesia techniques that have improved recovery include targeted surgical local infiltration analgesia, adductor canal blockade, genicular nerve blocks, and the infiltration between the popliteal artery and posterior capsule of the knee (iPACK) block.

Hyperactive delta isoform of PI3Kinase enables long distance regeneration of adult rat corticospinal tract.

Neurons in the central nervous system (CNS) lose regenerative potential with maturity, leading to minimal corticospinal tract (CST) axon regrowth after spinal cord injury (SCI). In young rodents, knockdown of PTEN, which antagonises PI3K signalling by hydrolysing PIP3, promotes axon regeneration following SCI. However, this effect diminishes in adults, potentially due to lower PI3K activation leading to reduced PIP3.

The global impact of the COVID-19 pandemic on delays and disruptions in cancer care services: a systematic review and meta-analysis.

The coronavirus disease 2019 pandemic substantially impacted the delivery of cancer services and programs. Here we reviewed and synthesized the global scale and impact of pandemic-related delays and disruptions on cancer services, including diagnosis, diagnostic procedures, screening, treatment and supportive and palliative care. Based on data from 245 articles in 46 countries, we observed declines in the number of cancer screening participation (39.

Reporting of nutritional screening, status and intake in trials of nutritional and physical rehabilitation following critical illness: a systematic review.

Background: Surviving critical illness leads to prolonged physical and functional recovery with both nutritional and physical rehabilitation interventions for prevention and treatment being investigated. Nutritional status and adequacy may influence outcome, but no consensus on which nutritional-related variables should be measured and reported in clinical trials exists.

Objective: To undertake a systematic review investigating the reporting of nutritional screening, nutritional status and nutritional intake/delivery in randomised controlled trials (RCTs) evaluating nutritional and/or physical rehabilitation on physical and functional recovery during and following critical illness.

Parathyroid carcinoma: New insights.

Parathyroid carcinoma (PC) is a rare malignancy, comprising 1 % of all cases of primary hyperparathyroidism (PHPT). This narrative review explores recent advances in PC management, with a focus on molecular insights, diagnostic advancements, surgical innovations, and emerging targeted therapies. Manuscripts published between 2023 and 2024 were obtained from PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL).

Transcoronary cooling and dilution for cardioprotection during revascularisation for ST-segment elevation myocardial infarction: Design and rationale of the STEMI-Cool study.

Background: ST-segment elevation myocardial infarction (STEMI) is treated with immediate primary percutaneous coronary intervention (pPCI) to restore coronary blood flow in the acutely ischaemic territory, but is associated with reperfusion injury limiting the benefit of the therapy. No treatment has proven effective in reducing reperfusion injury. Transcoronary hypothermia has been tested in clinical studies and is well tolerated, but is generally established after crossing the occlusion with a guidewire therefore after initial reperfusion, which might have contributed to the neutral outcomes.

Quantification of atrial cardiomyopathy disease severity by electroanatomic voltage mapping and cardiac magnetic resonance imaging.

Introduction: Atrial late gadolinium enhancement (Atrial-LGE) and electroanatomic voltage mapping (Atrial-EAVM) quantify the anatomical and functional extent of atrial cardiomyopathy. We aimed to explore the relationships between, and outcomes from, these modalities in patients with atrial fibrillation undergoing ablation.

Methods: Patients undergoing first-time ablation had disease severities quantified using both Atrial-LGE and Atrial-EAVM.

Myocardial ischaemia following COVID-19: a cardiovascular magnetic resonance study.

The pathophysiology of myocardial injury following COVID-19 remains uncertain. COVID-HEART was a prospective, multicentre study utilising cardiovascular magnetic resonance (CMR) to characterise COVID-related myocardial injury. In this pre-specified analysis, the objectives were to examine (1) the frequency of myocardial ischaemia following COVID-19, and (2) the association between ischaemia and myocardial injury.

Antibodies to the RBD of SARS-CoV-2 spike mediate productive infection of primary human macrophages.

The role of myeloid cells in the pathogenesis of SARS-CoV-2 is well established, in particular as drivers of cytokine production and systemic inflammation characteristic of severe COVID-19. However, the potential for myeloid cells to act as bona fide targets of productive SARS-CoV-2 infection, and the specifics of entry, remain unclear. Using a panel of anti-SARS-CoV-2 monoclonal antibodies (mAbs) we performed a detailed assessment of antibody-mediated infection of monocytes/macrophages.

T* relaxometry of fetal brain structures using low-field (0.55T) MRI.

Purpose: Human brain development during gestation is complex, as both structure and function are rapidly forming. Structural imaging methods using MRI are well developed to explore these changes, but functional imaging tools are lacking. Low-field MRI is a promising modality to bridge this gap.

Fatigue, pain and faecal incontinence in adult inflammatory bowel disease patients and the unmet need: a national cross-sectional survey.

Background And Aims: The co-existence of fatigue, pain and faecal incontinence in people with Inflammatory Bowel Disease (IBD) is unknown. We aimed to determine the presence of and relationship between these symptoms and patients' desire for intervention.

Methods: Adults with IBD in the UK, recruited from clinics, the national IBD-BioResource, a patient charity and social media sources, completed PROMIS validated patient-reported questionnaires to identify fatigue, pain and faecal incontinence, in addition to symptom severity and impact, disease activity, anxiety and depression questionnaires and questions about their desire for help with these symptoms.

In silico pace mapping identifies pacing sites more accurately than inverse body surface potential mapping.

Background: Electrocardiographic imaging (ECGi) is a noninvasive technique for ventricular tachycardia ablation planning. However, it is limited to reconstructing epicardial surface activation. In silico pace mapping combines a personalized computational model with clinical electrocardiograms (ECGs) to generate a virtual 3-dimensional pace map.

The Effectiveness of Platelet Rich Fibrin in Alveolar Ridge Reconstructive or Guided Bone Regenerative Procedures: A Systematic Review and Meta-Analysis.

Introduction And Objectives: Clinical studies have shown favorable outcomes following use of platelet rich fibrin (PRF), either alone or in conjunction with biomaterials for alveolar ridge reconstruction (ARR) or guided bone regeneration (GBR) . While PRF application accelerates wound healing and reduces postoperative discomfort, its effects on the alveolar bone gain, as part of ARR or GBR is less clear. Therefore, this study aims to investigate the clinical effectiveness of PRF when used in ARR or GBR, as well as postoperative discomfort following these procedures.

PGE and HCN2 ion channels are critical mediators of pain initiated by angiotensin II.

Angiotensin II is well known to have an important influence on blood pressure, mediated via the angiotensin II type 1 receptor (AT1R), and more recent studies have shown that angiotensin II may play an important additional role in eliciting pain via a distinct action at the angiotensin II type 2 receptor (AT2R). Signalling pathways that link activation of AT2R to a sensation of pain are, however, incompletely understood. Here we use rodent inflammatory pain models to confirm that selective activation of AT2R triggers aversive responses, and that these are abolished by either antagonism or genetic deletion of AT2R.

Weight discrimination partially mediates the longitudinal relationship between Body Mass Index and pain.

Pain is common among individuals with high Body Mass Index (BMI). This study investigated weight discrimination as a mediator of the longitudinal relationship between BMI and the presence of moderate/severe pain among adults from the English Longitudinal Study of Ageing (ELSA) cohort. ELSA is a longitudinal study of middle-aged and older adults living in England.

Polygenic score distribution differences across European ancestry populations: implications for breast cancer risk prediction.

Background: The 313-variant polygenic risk score (PRS) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS across different European populations which could influence risk estimation has not been performed.

Methods: We explored the distribution of PRS across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank.

The management of severe eczema in pregnancy.

Atopic eczema (eczema; also known as atopic dermatitis) is a chronic inflammatory skin condition. The burden of eczema can be very substantial with significant itch, skin pain, secondary infection, sleep disturbance and psychological distress. Eczema is common in pregnancy.

Regulatory T cell therapy is associated with distinct immune regulatory lymphocytic infiltrates in kidney transplants.

Background: Adoptive transfer of autologous regulatory T cells (Tregs) is a promising therapeutic strategy aimed at enabling immunosuppression minimization following kidney transplantation. In our phase 1 clinical trial of Treg therapy in living donor renal transplantation, the ONE Study (ClinicalTrials.gov: NCT02129881), we observed focal lymphocytic infiltrates in protocol kidney transplant biopsies that are not regularly seen in biopsies of patients receiving standard immunosuppression.

Industry updates from the field of stem cell research and regenerative medicine in October 2024.

Latest developments in the field of stem cell research and regenerative medicine compiled from publicly available information and press releases from non-academic institutions in October 2024.

The role of virtual wards in maternity in the United Kingdom.

Virtual wards are an initiative which aims to provide hospital care from the comfort of the patient's own home. Monitoring and additional services, such as intravenous drugs and fluids and blood tests can be undertaken through this system. Although virtual wards have been used in the UK since 2005 in specialties such as General Medicine, General Surgery and Paediatrics, their use in maternity has been more limited.

Conduction System Pacing Following a Double Switch Operation for Congenitally Corrected Transposition of the Great Arteries.

The use of conduction system pacing (CSP) in adults with congenital heart disease (CHD) is growing, however data remain limited. In patients with congenitally corrected transposition of the great arteries following the double switch operation, existing CSP tools and techniques require modification to allow for the anterior displacement of the atrioventricular node and proximal conduction system in addition to navigating the tortuous route of the atrial redirection. We report the successful use of CSP focusing on the technique of delivery tool modification to allow stability on the basal septum for deployment to the area of the distal His bundle and proximal left bundle branch.