Patient and caregiver return to work after a primary brain tumor.

Background: Studies focusing on the return to work (RTW) experiences of patients with a brain tumor (BT) are scarce. We aimed to explore, in-depth, the occupational expectations, experiences, and satisfaction of patients who RTW after a BT diagnosis and treatment, those not able to, and their family caregivers.

Methods: This multicenter, cross-sectional study utilized semi-structured interviews and reflexive thematic analysis.

Does comorbidity index predict OPAT readmission?

Objectives: To determine if the Charlson comorbidity index (CCI) is an accurate predictor of unplanned readmissions for patients using outpatient parenteral antimicrobial therapy (OPAT) services.

Methods: Retrospective analysis of patients >16 years of age who had received OPAT at Lancashire Teaching Hospitals between 2019 and 2021. The number of unplanned hospitalizations was measured and categorized as OPAT related or non-OPAT related.

Advancing pressure ulcer prevention: evaluating the impact of patient and lay carer education.

Decubitus ulcers, also known as bed ulcers or pressure ulcers, result from prolonged pressure on the skin, with contributing factors such as shear forces, friction and excessive moisture. Pressure ulcers have significant physical, social and psychological consequences for patients and impose a substantial financial burden on healthcare providers. Patient and caregiver education has been suggested as a potential approach for preventing pressure ulcers.

Time Dependent Correlation Between Sac Behaviour and Re-intervention after Endovascular Aneurysm Repair.

Objective: This study aimed to investigate the correlation between aneurysm sac behaviour and time to re-intervention after endovascular aneurysm repair (EVAR).

Methods: A retrospective observational cohort study of patients who underwent EVAR at a single centre between January 2008 and November 2011 and who were followed up for a mean of 6.6 ± 2.

Evaluating the effect of a digital health intervention to enhance physical activity in people with chronic kidney disease (Kidney BEAM): a multicentre, randomised controlled trial in the UK.

Background: Remote digital health interventions to enhance physical activity provide a potential solution to improve the sedentary behaviour, physical inactivity, and poor health-related quality of life that are typical of chronic conditions, particularly for people with chronic kidney disease. However, there is a need for high-quality evidence to support implementation in clinical practice. The Kidney BEAM trial evaluated the clinical effect of a 12-week physical activity digital health intervention on health-related quality of life.

Could you give me a leg up …? Models, frameworks and support structures to help aspiring clinical academic speech and language therapists.

Background: Increasing research capacity and capability for the speech and language therapy (SLT) profession is a key national strategic driver, with many speech and language therapists (SLTs) aspiring to a clinical academic (CA) career. There are known benefits but also acknowledged challenges with this career path, including limited funding opportunities and a poorly established career trajectory.

Aims: To present models, frameworks and support structures that can be used by aspiring SLT CAs to chart research knowledge and skills, and plan career development.

Posterior cervical foraminotomy versus anterior cervical discectomy for Cervical Brachialgia: the FORVAD RCT.

Background: Posterior cervical foraminotomy and anterior cervical discectomy are routinely used operations to treat cervical brachialgia, although definitive evidence supporting superiority of either is lacking.

Objective: The primary objective was to investigate whether or not posterior cervical foraminotomy is superior to anterior cervical discectomy in improving clinical outcome.

Design: This was a Phase III, unblinded, prospective, United Kingdom multicentre, parallel-group, individually randomised controlled superiority trial comparing posterior cervical foraminotomy with anterior cervical discectomy.

Discovering patterns in outpatient neurology appointments using state sequence analysis.

Background: Outpatient services in the UK, and in particular outpatient neurology services, are under considerable pressure with an ever-increasing gap between capacity and demand. To improve services, we first need to understand the current situation. This study aims to explore the patterns of appointment type seen in outpatient neurology, in order to identify potential opportunities for change.

Surgical Techniques and Related Perioperative Outcomes After Robot-assisted Minimally Invasive Gastrectomy (RAMIG): Results From the Prospective Multicenter International Ugira Gastric Registry.

Objective: To gain insight into the global practice of robot-assisted minimally invasive gastrectomy (RAMIG) and evaluate perioperative outcomes using an international registry.

Background: The techniques and perioperative outcomes of RAMIG for gastric cancer vary substantially in the literature.

Methods: Prospectively registered RAMIG cases for gastric cancer (≥10 per center) were extracted from 25 centers in Europe, Asia, and South-America.

The post-operative tonsillectomy (POPT) study: A multi-centre prospective paediatric cohort study.

Objectives: Tonsillectomy is the most common operation performed by otolaryngologists in the UK, despite this we have a poor understanding of the post-operative recovery. We aimed to investigate post-operative bleeding and pain following paediatric tonsillectomy using a patient diary.

Design: Prospective observational cohort study.

Conservative Treatment of Ruptured Abdominal Aortic Aneurysm.

Although nonsurgical management of ruptured abdominal aortic aneurysm (rAAA) is still used among a significant number of patients, survival after conservative treatment is extremely rare. We report a case of an 86-year-old female who presented with an rAAA that was confirmed clinically and radiologically via computed tomography angiography. Although the patient was not deemed a candidate for surgery owing to significant comorbidities and poor baseline function, she survived the episode with no surgical intervention.

Hydration and nutrition care practices in stroke: findings from the UK and Australia.

Background: Dehydration and malnutrition are common in hospitalised patients following stroke leading to poor outcomes including increased mortality. Little is known about hydration and nutrition care practices in hospital to avoid dehydration or malnutrition, and how these practices vary in different countries. This study sought to capture how the hydration and nutrition needs of patients' post-stroke are assessed and managed in the United Kingdom (UK) and Australia (AUS).

Patient satisfaction of specialist nurse-led renal cancer follow-up.

Background: For many patients with locally advanced renal cancer, management is surgery followed by surveillance imaging for several years. There is no concrete data regarding specialist nurse follow-up for patients after they have had surgery.

Aims: The authors' aim was to assess patient satisfaction with specialist nurse follow-up for patients with renal cancer who have undergone surgery.

Idiopathic intracranial hypertension: expanding our understanding.

Purpose Of Review: Idiopathic intracranial hypertension (IIH) affects predominantly overweight women of childbearing age, causing chronically-disabling headaches and visual loss. Weight loss remains the most effective management strategy, but innovative treatments and randomized control trials (RCTs) remain few. This paper will review recent IIH research.

Artificial intelligence for automated detection of diabetic foot ulcers: A real-world proof-of-concept clinical evaluation.

Objective: Conduct a multicenter proof-of-concept clinical evaluation to assess the accuracy of an artificial intelligence system on a smartphone for automated detection of diabetic foot ulcers.

Methods: The evaluation was undertaken with patients with diabetes (n = 81) from September 2020 to January 2021. A total of 203 foot photographs were collected using a smartphone, analysed using the artificial intelligence system, and compared against expert clinician judgement, with 162 images showing at least one ulcer, and 41 showing no ulcer.

biomArker-guided Duration of Antibiotic treatment in hospitalised Patients with suspecTed Sepsis (ADAPT-Sepsis): A protocol for a multicentre randomised controlled trial.

Aim: To describe the protocol for a multi-centre randomised controlled trial to determine whether treatment protocols monitoring daily CRP (C-reactive protein) or PCT (procalcitonin) safely allow a reduction in duration of antibiotic therapy in hospitalised adult patients with sepsis.

Design: Multicentre three-arm randomised controlled trial.

Setting: UK NHS hospitals.

Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists.

A significant problem facing routine medicolegal coroner-referred autopsies is a shortfall of pathologists prepared to perform them. This was particularly acute in Lancashire, where the coroner decided to initiate a service that relied on post-mortem computed tomography (PMCT). This involved training anatomical pathology technologists (APTs) to perform external examinations, radiographers to perform scans, and radiologists to interpret them.

Peripheral Arteriovenous Malformation Embolization Using Squid.

Materials And Methods: Between January 2018 and December 2020, twenty patients (7 men and 13 women) with peripheral high-flow arteriovenous malformations who were treated primarily with arterial embolization using squid were retrospectively included. Anatomical sites being treated included the head and neck (16), extremities (2), uterus (1), and pelvis (1). Squid was used as the sole embolic agent in 15 patients, and transarterial embolization was employed in all cases except one where direct puncture embolization was used.

Comparison of three-weekly and six-weekly pembrolizumab United Kingdom prescribing practice for advanced and resected melanoma.

Background: Pembrolizumab is approved for the treatment of advanced and resected melanoma and was originally licensed as a three-weekly infusion (Q3W). In April 2019, a six-weekly infusion schedule (Q6W) was also approved. We retrospectively reviewed pembrolizumab prescribing for patients with melanoma across multiple United Kingdom (UK) centres to compare the safety and efficacy of Q6W with Q3W in real-world clinical practice.

Predictors of recurrence following local excision for early-stage anal squamous cell carcinoma.

Introduction: There is increasing use of local excision (LE) for definitive treatment of early-stage anal squamous cell carcinoma (ASCC) to avoid the morbidity associated with chemoradiotherapy (CRT). However, the importance of different histological variables on risk of recurrence is poorly understood.

Methods: A detailed analysis of patient characteristics, histology results, recurrence patterns and salvage treatment was conducted in consecutive T1/T2N0 ASCC patients treated by LE 2010-2021 across a UK regional cancer network multi-disciplinary team (MDT).

Toxic leukoencephalopathy versus delayed post-hypoxic leukoencephalopathy after oral morphine sulphate overdose.

Toxic leukoencephalopathy (TLE) is a rare pathology caused by various substances including opioids (notably heroin), immunosuppressants, chemotherapy agents, cocaine, alcohol and carbon monoxide. However, although heroin is metabolised by the body into morphine, there is a striking paucity in cases of primary oral morphine-induced TLE, especially in the adult population. We present the case of a man in his 40s admitted to hospital in respiratory depression with a Glasgow Coma Scale (GCS) score of 6 after taking an overdose of oral morphine sulphate.

Unilateral retinal neovascularization associated with recurrent vitreous hemorrhage in a patient with gyrate atrophy.

Background/purpose: To describe the first case of unilateral peripheral retinal neovasularization associated with recurrent vitreous hemorrhage and localised tractional retinal detachment in a patient with gyrate atrophy (GA).

Methods: Interventional case report.

Results: A 23-year-old man with confirmed diagnosis of gyrate atrophy presented with vitreous hemorrhage and history of stable peripheral inferior tractional retinal detachment in the left eye.