European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.

The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented.

Diagnostic performance of ultrasound vs. ultrasound-guided FNAc in thyroid nodules: data from the ElaTION trial.

Introduction: ElaTION is a large multi-centre pragmatic randomised controlled trial, performed in 18 secondary/tertiary hospitals across England, comparing elastography ultrasound-guided fine needle aspiration cytology (EUS-FNAC) with ultrasound-guided FNAC (US-FNAC) alone in the diagnostic assessment of thyroid nodules. Secondary trial outcomes, reported here, assessed the accuracy of ultrasound-alone (US) compared with US-guided FNAC to inform and update current practice guidelines.

Methods: Adults with single or multiple thyroid nodules who had not undergone previous FNAC were eligible.

Gene-environmental influence of space and microgravity on red blood cells with sickle cell disease.

A fundamental question in human biology and for hematological disease is how do complex gene-environment interactions lead to individual disease outcome? This is no less the case for sickle cell disease (SCD), a monogenic disorder of Mendelian inheritance, both clinical course, severity, and treatment response, is variable amongst affected individuals. New insight and discovery often lie between the intersection of seemingly disparate disciplines. Recently, opportunities for space medicine have flourished and have offered a new paradigm for study.

Long COVID demographic and secondary care referral characteristics in primary care: analysis of anonymised primary care data from a multiethnic, deprived urban area in the UK.

Once the nature and number of patients with Long COVID was more fully understood, UK secondary care developed services to investigate, treat and support these patients. We aimed to identify evidence for demographic health inequalities based on general practitioner (GP) Long COVID referrals to available secondary care services. Despite Long COVID demographics broadly reflecting the multiethnic and socially disadvantaged profile of the study population, we found that secondary care referral was mainly focussed on older age patients and those born in the UK with co-morbid anxiety; although co-morbid diabetes was associated with reduced referrals.

Beyond the Norm: A Unique Case of Adult-Onset Still's Disease.

Polyserositis, characterized by inflammation of multiple serous membranes, frequently occurs secondary to infection, malignancy, or rheumatological disorders. Adult-onset Still's disease (AOSD) is often diagnosed by exclusion, with the Yamaguchi criteria being essential for diagnosis. Disease severity is likely due to immune system changes, comorbidities, delayed diagnosis, and a higher risk of complications, necessitating more aggressive and carefully monitored treatments.

Adopting prospective antimicrobial stewardship (AMS) practice in high-risk immunosuppressed groups: an urgent call to action in the era of antimicrobial resistance (AMR).

Life-saving immunosuppressive treatments including intensive chemotherapy and bone marrow transplantation expose patients to a considerable risk of death from infection globally. With evolving AMR and transmission, this could spell disaster for patients across the world and society at large. Antimicrobial stewardship (AMS) and prompt appropriate management of potentially fatal, emergent infections are essential.

Radiotracers for in situ infection imaging: Experimental considerations for in vitro microbial uptake of gallium-68-labeled siderophores.

In vitro screening of gallium-68(Ga)-siderophores in pathogens relevant to infections is valuable for determining species specificity, their effect on cell viability, and potential clinical applications. As the recognition and internalization of siderophores relies on the presence of receptor- and/or siderophore-binding proteins, the level of uptake can vary between species. Here, we report in vitro uptake validation in Escherichia coli with its native siderophore, enterobactin (ENT) ([Ga]Ga-ENT), considering different experimental factors.

A qualitative study of preoperative anxiety in orthognathic patients: The patient perspective.

Introduction: Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery.

Methods: A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews.

Racial Differences in Respiratory Morbidity in Late Preterm Infants: A Retrospective Cohort Study.

. The role of race in late preterm respiratory morbidity has not been adequately described. We aimed to determine whether neonatal respiratory morbidity differs between Black and White late preterm infants.

Eight-year efficacy and safety of tenofovir alafenamide for treatment of chronic hepatitis B virus infection: Final results from two randomised phase 3 trials.

Background: In two phase 3 studies, tenofovir alafenamide (TAF) showed non-inferior efficacy versus tenofovir disoproxil fumarate (TDF), with more favourable renal and bone safety in patients with chronic hepatitis B (CHB).

Aims: Here, we report the studies' final 8-year results.

Methods: CHB patients (hepatitis B e antigen [HBeAg]-negative and HBeAg-positive) were randomised (2:1) to double-blind TAF 25 mg/day or TDF 300 mg/day for up to 3 years, followed by open-label (OL) TAF through year 8.

EEG-based sensorimotor neurofeedback for motor neurorehabilitation in children and adults: A scoping review.

Objective: Therapeutic interventions for children and young people with dystonia and dystonic/dyskinetic cerebral palsy are limited. EEG-based neurofeedback is emerging as a neurorehabilitation tool. This scoping review maps research investigating EEG-based sensorimotor neurofeedback in adults and children with neurological motor impairments, including augmentative strategies.

Acute Respiratory Failure Requiring Invasive Ventilation in Adults With Congenital Syringomyelia/Arnold-Chiari Malformations: A Systematic Review.

Arnold-Chiari malformations (ACM) and congenital syringomyelia/syrinx are rare neurological phenomenons that can present as acute respiratory failure and contribute to multiple extubation failures despite surgical intervention. A systematic review was conducted to scrutinize the current literature, screening 65 papers and including 12 papers (13 patients). Sixty-one percent of patients had type 1 ACM and 70% had a congenital syringomyelia.

Comparing nursing medication rounds before and after implementation of automated dispensing cabinets: A time and motion study.

Nursing medication administration is an integral, albeit time consuming component of a nursing shift. Automated dispensing cabinets (ADCs) are a medicines management solution designed to improve both efficiency and patient safety. This study aimed to evaluate the time taken to undertake a medication round including the number of locations visited to retrieve medicines, across four different clinical specialties within one hospital.

Is there a role for [F]-FMISO PET to guide dose adaptive radiotherapy in head and neck cancer? A review of the literature.

Purpose: Hypoxia is a major cause of radioresistance in head and neck cancer (HNC), resulting in treatment failure and disease recurrence. F-fluoromisonidazole [F]FMISO PET has been proposed as a means of localising intratumoural hypoxia in HNC so that radiotherapy can be specifically escalated in hypoxic regions. This concept may not be deliverable in routine clinical practice, however, given that [F]FMISO PET is costly, time consuming and difficult to access.