Knights in shining armour and (M)others in life jackets: Women's experiences of advocating for care alone when suffering recurrent early pregnancy loss during the SARS-CoV-2 pandemic.

Background: Recurrent early pregnancy loss [rEPL] is a traumatic experience, marked by feelings such as grief and depression, and often anxiety. Despite this, the psychological consequences of rEPL are often overlooked, particularly when considering future reproductive health or approaching subsequent pregnancies. The SARS-CoV-2 pandemic led to significant reconfiguration of maternity care and a negative impact on the perinatal experience, but the specific impact on women's experience of rEPL has yet to be explored.

Outcomes of functional tics in adolescents: a single-centre tertiary study.

Objective: To investigate the prognosis and co-occurring disorders, including functional neurological symptoms, in adolescents diagnosed with functional tic-like behaviour (FTLB).

Design: This was a single-centre tertiary study in the UK. A structured clinical interview was administered to 43 parents or carers of adolescents assessed with FTLB at their previous outpatient clinic appointment.

Risk stratification and exercise recommendations in cardiomyopathies and channelopathies: a practical guide for the multidisciplinary team.

Exercise offers a plethora of health benefits. However, certain genetic and acquired diseases such as cardiomyopathies and channelopathies are associated with sudden cardiac death during exercise. Several factors complicate exercise prescription in individuals living with these conditions.

Multicentre adaptive randomised trial of GvHD prophylaxis following unrelated donor stem cell transplantation comparing Thymoglobulin versus calcineurin inhibitor-based or sirolimus-based post-transplant cyclophosphamide (Methods of T cell Depletion, MoTD trial).

Introduction: Graft-versus-host disease (GvHD) remains a major complication of allogeneic stem cell transplantation (allo-SCT), affecting 30-70% of patients (representing 800 new patients per year in the UK). The risk is higher in patients undergoing unrelated allo-SCT. About 1 in 10 patients die as a result of GvHD or through complications of its treatment.

Latest clinical frontiers related to autism diagnostic strategies.

The diagnosis of autism is currently based on the developmental history, direct observation of behavior, and reported symptoms, supplemented by rating scales/interviews/structured observational evaluations-which is influenced by the clinician's knowledge and experience-with no established diagnostic biomarkers. A growing body of research has been conducted over the past decades to improve diagnostic accuracy. Here, we provide an overview of the current diagnostic assessment process as well as of recent and ongoing developments to support diagnosis in terms of genetic evaluation, telemedicine, digital technologies, use of machine learning/artificial intelligence, and research on candidate diagnostic biomarkers.

Respiratory physiological changes post initiation of neurally adjusted ventilatory assist in preterm infants with evolving or established bronchopulmonary dysplasia.

To assess respiratory changes after neurally adjusted ventilatory assist (NAVA) initiation in preterm infants with evolving or established bronchopulmonary dysplasia (BPD). Premature infants born less than 32 weeks gestation with evolving or established BPD initiated on invasive or non-invasive (NIV) NAVA were included. Respiratory data: PCO and SpO₂/FiO₂ (S/F) ratio before and at 4, 24, 48 h post-NAVA initiation were collected.

Prehabilitation of Patients With Oesophageal Malignancy Undergoing Peri-Operative Treatment (Pre-EMPT): Outcomes From a Prospective Controlled Trial.

Background: The Pre-EMPT study aimed to determine if structured exercise could reduce length of stay, post-operative complications and improve fitness and health-related quality of life (HQRL) in patients undergoing neoadjuvant chemotherapy (NAC) and oesophagectomy.

Methods: A prospective non-randomised trial compared a standard care pathway (control) to a structured prehabilitation exercise programme (intervention) commenced before NAC and surgery for oesophageal adenocarcinoma. Length of hospital stay and post-operative complications were recorded.

Raynaud Syndrome Associated with Medication for Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Background: Raynaud syndrome (RS) is a peripheral vasculopathy characterised be impaired acral perfusion typically manifesting as skin discolouration with pallor, cyanosis and/or erythema, and increased sensitivity to cold. RS may be primary or secondary to systemic disease, lifestyle and environmental factors or medication. RS has been reported with medication to treat ADHD, but we found no recent comprehensive overview of the literature.

The role of nutritional vitamin D in CKD-MBD in children and adults with CKD, on dialysis and after kidney transplantation - a European consensus statement.

Vitamin D deficiency is common in patients with chronic kidney disease (CKD) and associates with poor outcomes. Current clinical practice guidelines recommend supplementation with nutritional vitamin D as for the general population. However, recent large-scale, clinical trials in the general population failed to demonstrate a benefit of vitamin D supplementation on skeletal or non-skeletal outcomes, fueling a debate on the rationale for screening for and correcting vitamin D deficiency, both in non-CKD and CKD populations.

Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance.

Objectives: To examine the provision of cardiovascular magnetic resonance (CMR) using gadolinium-based contrast agents (GBCA) in patients with chronic kidney disease (CKD).

Methods: An electronic survey was sent to the service leads of all CMR units in the UK in October 2022 requesting information on current departmental protocols and practice.

Results: A response rate of 55% was achieved from the 82 UK CMR units surveyed.

Clinico-pathological characterisation of human papillomavirus-associated oral epithelial dysplasia.

Background: Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) has been recently recognised by the World Health Organisation (WHO) as a distinct type of oral epithelial dysplasia. The rarity of HPV-OED, together with gaps in the current understanding of risk factors and clinical behaviour raise the risk of under-recognition and misdiagnosis. To address this, we describe the clinico-pathological features of a consecutive series of HPV-OED from a single institution to provide additional insight into the presentation and behaviour of this disease.

The international trial of nasal oxygen therapy after cardiac surgery (NOTACS) in patients at high risk of postoperative pulmonary complications: Economic evaluation protocol and analysis plan.

Introduction: High-Flow Nasal Therapy (HFNT) is an innovative non-invasive form of respiratory support. Compared to standard oxygen therapy (SOT), there is an equipoise regarding the effect of HFNT on patient-centred outcomes among those at high risk of developing postoperative pulmonary complications after undergoing cardiac surgery. The NOTACS trial aims to determine the clinical and cost-effectiveness of HFNT compared to SOT within 90 days of surgery in the United Kingdom, Australia, and New Zealand.

Translation and cultural adaption of MacLeod Clark professional identity scale among Chinese therapy students.

Background: Fostering a strong professional identity (PI) enhances career fulfillment. In China, therapy education is undergoing development, integrating both Western and traditional health concepts, causing inconsistent PI among therapy students. To date, no validated tools exist to measure and monitor PI of Chinese therapy students.

Milestone events in recessive dystrophic epidermolysis bullosa (RDEB): findings of the PEBLES Study.

Background: In recessive dystrophic epidermolysis bullosa (RDEB), complications like oesophageal strictures, hand contractures, cardiomyopathy and cutaneous squamous cell carcinoma (SCC) may develop, necessitating procedures such as oesophageal dilatation (OD), gastrostomy tube placement and hand surgery.

Objectives: To determine prevalence and age of onset of milestone events by RDEB subtype, specifically dysphagia, first OD, first gastrostomy tube, first hand surgery, cardiomyopathy, first SCC and death.

Methods: The Prospective Epidermolysis Bullosa Longitudinal Evaluation Study (PEBLES) is a register study of individuals with RDEB which records comprehensive EB- and non-EB-related health information.

Antiretroviral therapy in people with HIV and end-stage kidney disease.

Objective: To summarize antiretroviral therapy (ART) use in the setting of end-stage kidney disease (ESKD).

Design: Cross-sectional analysis.

Methods: Descriptive analysis of ART regimens and dose of nucleoside/nucleotide reverse-transcriptase inhibitors (NRTI) in people with HIV and ESKD (dialysis, kidney transplantation, or estimated glomerular filtration rate (eGFR) <15 mL/min/1.

Exploring variation in the six-month review for stroke survivors: a national survey of current practice in England.

Background: The Six-Month Review (6MR) was introduced in the United Kingdom to provide a holistic, systematic review of the ongoing needs faced by stroke survivors. However, a theoretical underpinning regarding how it should work is lacking, potentially leading to wide variation in service provision. This study aimed to understand the current degree of variation in 6MR delivery across England and explore the potential driving factors.

The evolving landscape of COVID-19: factors associated with in-hospital COVID-19 related mortality during the 2023-2024 phase of JN.1 subvariant dominance.

Background: COVID-19 remains a complex health challenge. We analysed the characteristics and outcomes of COVID-19-related hospitalisations during JN.1 variant dominance.

Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS-A multicentre case-control study.

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case-control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases).

Patterns, timing and predictors of recurrence following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: an international multicentre retrospective cohort study.

Background: Most patients undergoing pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) develop recurrence. No previous studies have investigated predictors of local-only recurrence following PD for PDAC. Our study aimed to determine timing, pattern and predictors of any-site and local-only recurrence following PD for PDAC.

Salivary cortisol measures across the clinical stages of psychosis: An individual participant data (IPD) meta-analysis.

Background: Studies of salivary cortisol levels in psychosis have yielded inconsistent findings, which may be attributable to heterogeneity in cortisol measurement, illness stage, and approaches to dealing with sampling factors and potential confounders. To address these issues, we performed an individual participant data (IPD) meta-analysis comparing individuals at different stages of psychosis to controls using five different salivary cortisol measures and explored potential effect modifiers.

Methods: Salivary cortisol data from five London-based cohorts were used to derive the cortisol awakening response, total daytime cortisol output, basal cortisol, and diurnal slope measures (wake-to-evening and peak-to-evening).

Anti-tumor Necrosis Factor Drug Concentration Is Not Associated with Disease Outcomes in Pouchitis: A Retrospective, International Study.

Background: Therapeutic drug monitoring is important for optimizing anti-tumor necrosis factor-α (TNF-α) therapy in inflammatory bowel disease. However, the exposure-response relationship has never been assessed in pouchitis.

Aims: To explore associations between anti-TNF-α drug concentration and pouchitis disease activity in patients with a background of ulcerative colitis.

Preoperative and intraoperative neuromonitoring and mapping techniques impact oncological and functional outcomes in supratentorial function-eloquent brain tumours: a systematic review and meta-analysis.

Background: Supratentorial function-eloquent brain tumour surgeries challenge the balance between maximal tumour resection and preservation of neurological function. This study aims to evaluate the efficacy of preoperative and intraoperative mapping techniques on resection outcomes and post-operative deficits.

Methods: This systematic review and meta-analysis examined literature up to March 2023, sourced from PubMed, Embase, and Medline.