High-dose intravenous iron reduces myocardial infarction in patients on haemodialysis.

Aims: To investigate the effect of high-dose iron vs. low-dose intravenous (IV) iron on myocardial infarction (MI) in patients on maintenance haemodialysis.

Methods And Results: This was a pre-specified analysis of secondary endpoints of the Proactive IV Iron Therapy in Hemodialysis Patients trial (PIVOTAL) randomized, controlled clinical trial.

A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom.

Objective: Unruptured intracranial aneurysms (UIA) are common. For many the treatment risks outweigh their risk of subarachnoid haemorrhage and patients undergo surveillance imaging. There is little data to inform if and how to monitor UIAs resulting in widely varying practices.

The effect of digoxin on renal function in patients with heart failure.

Introduction: Digoxin is used in patients with chronic heart failure (CHF) who remain symptomatic despite optimal medical treatment. Impaired renal function is commonly associated with CHF. We investigated the relation between digoxin use and change in renal function over time in patients with CHF.

Modern cemented Furlong hemiarthroplasty: Are dislocations rates better?

Background: Dislocation following hip hemiarthroplasty is a major complication with increased mortality and morbidity. Data looking at dislocation following contemporary bipolar stems are lacking in literature.

Methods: Retrospective review of our prospective national hip fracture database over a two-year period.

A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease.

Introduction: Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are common causes of anaemia with similar clinical and laboratory features. IDA is caused by low iron stores while ACD is due to iron-restricted erythropoiesis occurring in inflammatory states. Differential diagnosis requires analysis of multiple biochemical and haematological parameters.

Heart Failure Hospitalization in Adults Receiving Hemodialysis and the Effect of Intravenous Iron Therapy.

Objectives: This study sought to examine the effect of intravenous iron on heart failure events in hemodialysis patients.

Background: Heart failure is a common and deadly complication in patients receiving hemodialysis and is difficult to diagnose and treat.

Methods: The study analyzed heart failure events in the PIVOTAL (Proactive IV Iron Therapy in Hemodialysis Patients) trial, which compared intravenous iron administered proactively in a high-dose regimen with a low-dose regimen administered reactively.

Characterisation of baseline microbiological and host factors in an inception cohort of people with surgical wounds healing by secondary intention reveals circulating IL-6 levels as a potential predictive biomarker of healing.

More than 2 million people per year are treated for surgical wounds in the UK.  Over a quarter of these wounds are estimated to heal by secondary intention (from the "bottom up") resulting in further complications and requiring increased healthcare resources. Identification of microbiological or host biomarkers that can predict healing outcomes may help to optimize the management of surgical wounds healing by secondary intention.

Ga-Prostate-Specific Membrane Antigen Uptake as a Surrogate Biomarker of Neovascularity in Hepatocellular Carcinoma.

Ga-prostate-specific membrane antigen (Ga-PSMA) is expressed in the endothelium of tumor-associated neovasculature of various solid malignancies possibly due to tumor-associated angiogenic factors and endothelial cell sprouting. We report a case of a 45-year-old man with known colorectal cancer, cirrhosis, and hepatitis C. Contrast-enhanced computed tomography (CT) showed a hypervascular lesion in the liver, and F- positron emission tomography (PET) did not show any suspicious hepatic uptake.

Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study.

Objective: To assess medium-term organ impairment in symptomatic individuals following recovery from acute SARS-CoV-2 infection.

Design: Baseline findings from a prospective, observational cohort study.

Setting: Community-based individuals from two UK centres between 1 April and 14 September 2020.

Improving practice in radiology: a quality-improvement project examining CT colonography patient dose and scanning technique.

Aim: To audit scanning technique and patient doses for computed tomography (CT) colonography (CTC) examinations in a large UK region and to identify opportunities for quality improvement.

Materials And Methods: Scanning technique and patient dose data were gathered for both contrast-enhanced and unenhanced CTC examinations from 33 imaging protocols across 27 scanners. Measurements of patient weight and effective diameter were also obtained.

X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

Background & Aims: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease.

Methods: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals).

Palliative medicine in the intensive care unit: needs, delivery, quality.

Background: 15%-20% of critical care patients die during their hospital admission. This service evaluation assesses quality of palliative care in intensive care units (ICUs) compared with national standards.

Methods: Retrospective review of records for all patients who died in four ICUs (irrespective of treatment limitation) between 1 June and 31 July 2019.

The PINS Trial: a prospective randomized clinical trial comparing a traditional versus an emollient skincare regimen for the care of pin-sites in patients with circular frames.

Aims: Pin-site infection remains a significant problem for patients treated by external fixation. A randomized trial was undertaken to compare the weekly use of alcoholic chlorhexidine (CHX) for pin-site care with an emollient skin preparation in patients with a tibial fracture treated with a circular frame.

Methods: Patients were randomized to use either 0.

Increased development of radiographic hip osteoarthritis in individuals with high bone mass: a prospective cohort study.

Background: Individuals with high bone mass (HBM) have a greater odds of prevalent radiographic hip osteoarthritis (OA), reflecting an association with bone-forming OA sub-phenotypes (e.g. osteophytosis, subchondral sclerosis).

Endoscopic versus conventional parotid gland excision: a systematic review and meta-analysis.

The objective of this review was to conduct a systematic review and meta-analysis to compare endoscopic with conventional parotid tumour excision. Online databases including MEDLINE, EMBASE, EMCare, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), the World Health Organization International Clinical Trials Registry (ICTRP), and the ISRCTN registry were all searched. All randomised controlled trials and observational studies comparing endoscopic with conventional parotid tumour excision were included.

Comparing scoring systems for prediction of mortality in patients with bloodstream infection.

Background: Blood stream infections (BSIs) are associated with significant short-term mortality. There are many different scoring systems for assessing the severity of BSI.

Aim: We studied confusion, urea, respiratory rate, blood pressure, age 65(CURB65), Confusion Respiratory Rate, Blood pressure, age 65(CRB65), quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS) and National Early Warning Score (NEWS) and assessed how effective they were at predicting 30-day mortality across three separate BSI cohorts.

Ventilation and outcomes following robotic-assisted abdominal surgery: an international, multicentre observational study.

Background: International data on the epidemiology, ventilation practice, and outcomes in patients undergoing abdominal robotic-assisted surgery (RAS) are lacking. The aim of the study was to assess the incidence of postoperative pulmonary complications (PPCs), and to describe ventilator management after abdominal RAS.

Methods: This was an international, multicentre, prospective study in 34 centres in nine countries.

Impact of repeated simulation on learning curve characteristics of residents exposed to rare life threatening situations.

Background: Little is known about the learning curve characteristics of residents undertaking simulation-based education. It is important to understand the time for acquisition and decay of knowledge and skills needed to manage rare and difficult clinical situations.

Method: Ten anaesthesiology residents underwent simulation-based education to manage a cannot intubate cannot ventilate scenario during general anaesthesia for caesarean section.

A Very Unusual Pattern of Intraperitoneal and Extraperitoneal Heterotropic Splenic Tissue-Mimicking Metastases Identified on Ga-DOTA-NOC Positron Emission Tomography/Computed Tomography and 99mTc Heat-denatured Erythrocyte Study.

The dissemination and autotransplantation of viable splenic tissue in different anatomic compartments of the body can present a diagnostic dilemma, especially when metastatic disease is suspected. We report a case of a 30-year-old male with well-differentiated gastric neuroendocrine tumor (Grade II) treated with surgery. Follow-up Ga-DOTA-NOC demonstrated a suspicious peritoneal soft-tissue nodule in the right paracolic gutter with increased tracer uptake.

Integrin-associated ILK and PINCH1 protein content are reduced in skeletal muscle of maintenance haemodialysis patients.

Key Points: Patients with renal failure undergoing maintenance haemodialysis are associated with insulin resistance and protein metabolism dysfunction. Novel research suggests that disruption to the transmembrane protein linkage between the cytoskeleton and the extracellular matrix in skeletal muscle may contribute to reduced amino acid metabolism and insulin resistance in haemodialysis. ILK, PINCH1 and pFAK were significantly decreased in haemodialysis compared to controls, whereas Rac1 and Akt2 showed no different between groups.