An Integrated Pathophysiological and Clinical Perspective of the Synergistic Effects of Obesity, Hypertension, and Hyperlipidemia on Cardiovascular Health: A Systematic Review.

This review paper explores the synergistic effects of obesity, hypertension (HTN), and hyperlipidemia on cardiovascular health by integrating pathophysiological and clinical perspectives. Obesity, characterized by excessive body fat, HTN, defined by elevated blood pressure, and hyperlipidemia, indicated by high blood lipid levels, are globally prevalent conditions that significantly increase the risk of cardiovascular diseases (CVDs). The interplay between these conditions exacerbates cardiovascular risk through mechanisms such as chronic inflammation, insulin resistance, endothelial dysfunction, arterial stiffness, and atherogenesis.

Understanding the Impact COVID-19 Has Had on Traumatic Ankle Fractures in a UK Orthopaedic Department: Should Current Guidelines Be Revised?

Introduction Ankle fractures are common yet debilitating injuries. Surgery is the mainstay treatment for ankle fractures displaying a high suspicion of instability. During the coronavirus disease 2019 (COVID-19) pandemic, conservative management became prominent in patients with ankle fractures.

Streamlining the Non-operative Management of Adhesive Small Bowel Obstruction: A Closed-Loop Audit Evaluating the Introduction of a Standardised Gastrografin Protocol in a District General Hospital.

Introduction Adhesive small bowel obstruction (ASBO) is a common cause of admissions to general surgery services. Water-soluble contrast (WSC), such as Gastrografin® (GGF), can be utilised in the conservative management of patients with ASBO, with predictive and possible therapeutic value. We audited the non-operative management of ASBO in the general surgery department of East and North Hertfordshire NHS Trust, a district general hospital.

Communicating health risk in chronic kidney disease: a scoping review.

Background: Communicating risk is a key component of shared decision-making and is vital for the management of advanced chronic kidney disease (CKD). Despite this, there is little evidence to suggest how best to communicate health risk information to people living with CKD. The aim of this review was to identify and understand the nature of evidence-based risk communication strategies for people living with CKD.

A systematic review of virtual elective programmes for medical students.

Background: Clinical electives are a compulsory part of many medical courses, enabling students to gain exposure to foreign health systems. The COVID-19 pandemic led to a surge in the development in virtual elective programmes, for which there had been a sparse evidence base. This is the first systematic review assessing the implementation, advantages and disadvantages of virtual elective programmes for medical students.

The Impact of a Modular Robotic Total Mesorectal Excision Training Program on Perioperative and Oncological Outcomes in Robotic Rectal Cancer Surgery.

Background: Structured training programs for robotic colorectal surgery are limited, and there are concerns about surgical outcomes and operating times.

Objective: To compare perioperative and oncological outcomes of robotic total mesorectal excision for rectal cancer performed by expert consultants and surgical trainees in a modular surgical training program.

Design: Retrospective cohort study.

Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis.

Backgrounds And Aims: This study explores the impact of allograft selection in revision ACL reconstruction (RACLR). Allografts reduce donor-site morbidity and surgery duration but are costly and may prolong graft integration times. We aimed to assess various allograft subtypes for their efficacy and failure rates in RACLR.

Silent severe aortic regurgitation due to blunt chest trauma: ignore it at your peril-a case report.

Background: Blunt chest trauma (BCT) presenting to the emergency department is common and may cause life-threatening cardiac complications. Whilst complications causing haemodynamic instability are generally detected promptly, others may present late with long-term consequences. We describe a rare, serious complication of BCT presenting five years after a road traffic accident (RTA).

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.

"To BAL or not to BAL, that is the question": Variations in smoke inhalation injury guidelines from burn units and centres in England, Scotland and Wales.

Aim: To evaluate variations in diagnostic criteria and management recommendations for smoke inhalation injury (SII) amongst the burn networks of England, Scotland, and Wales.

Methods: A descriptive cross-sectional study examining SII guidelines provided by adult burn units and centres in England, Scotland and Wales.

Results: All 16 adult burn units and centres responded.

The prevalence of coronary artery disease in patients presenting with 'non-anginal chest pain'.

The National Institute for Health and Care Excellence (NICE) advise against routine testing for coronary artery disease (CAD) in patients with non-anginal chest pain (NACP). This clinical audit sought to establish the prevalence of significant CAD in this cohort using computed tomography angiography (CTCA) and evaluate differences in the prevalence of cardiovascular risk factors between those with and without obstructive coronary disease. Over 23 months, 866 patients with NACP underwent CTCA.

Standardized assessment of evidence supporting the adoption of mobile health solutions: A Clinical Consensus Statement of the ESC Regulatory Affairs Committee: Developed in collaboration with the European Heart Rhythm Association (EHRA), the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC, the Heart Failure Association (HFA) of the ESC, the ESC Young Community, the ESC Working Group on e-Cardiology, the ESC Council for Cardiology Practice, the ESC Council of Cardio-Oncology, the ESC Council on Hypertension, the ESC Patient Forum, the ESC Digital Health Committee, and the European Association of Preventive Cardiology (EAPC).

Mobile health (mHealth) solutions have the potential to improve self-management and clinical care. For successful integration into routine clinical practice, healthcare professionals (HCPs) need accepted criteria helping the mHealth solutions' selection, while patients require transparency to trust their use. Information about their evidence, safety and security may be hard to obtain and consensus is lacking on the level of required evidence.

Optimising prostate biopsies and imaging for the future-a review.

Conventionally, transrectal ultrasound guided prostate biopsy (TRUS-Bx) was the main technique used for the diagnosis of prostate cancer since it was first described in 1989 [1]. However, the PROMIS trial showed that this random, nontargeted approach could miss up to 18% of clinically significant cancer (csPCa) [2]. Furthermore, risk of sepsis post TRUS-Bx can be as high as 2.

Association of mammographic and sonographic findings with prognostic molecular factors and hormone receptor expression in malignant breast lesions.

Background: The aim of this study was to determine whether mammographic and sonographic features of malignant breast lesions are correlated with tumor histologic grade, hormonal receptor, human epidermal growth factor receptor 2 (HER2), and Ki-67 status.

Materials And Methods: In this retrospective study, imaging and histopathological findings of 187 biopsy-proven breast cancer cases from November 2019 to February 2021 were reviewed. The Chi-square test was used to examine the potential correlation between mammographic and sonographic characteristics with histopathological features such as hormonal receptor, HER2 status, Ki-67 labeling index, and histological grade.

The journey to LDL-C goal in the era of combination lipid lowering therapy and why it matters for ASCVD patients: a UK perspective.

Objective: We aim to explore the concept of distance and journey to goal, and consideration of these 2 elements a priori when choosing LLT.

Methods: Modelling of expected % LDL-C reductions was carried out on a range of hypothetical patients' baseline LDL-C values prior to any LLT being commenced. Therapies were then added in a stepwise manner based on the pathway demonstrated in current national guidance and compared with goal achievement on a novel LLT optimization pathway implemented in Morecambe Bay NHS Trust.

The Role of Patient-Reported Experience and Outcome Measures in Kidney Health Equity-Oriented Quality Improvement.

Risk, prevalence, management, and outcomes in chronic kidney disease (CKD) are influenced by social and broader determinants of health. Consequently, there are wide-ranging kidney health inequities. As patients are key stakeholders, their perspectives on the care they receive and on health status are central in guiding health system improvement, particularly to reduce the impact of disadvantage.

Minimally invasive vs. conventional mitral valve surgery: a meta-analysis of randomised controlled trials.

Objective: The evidence underlying the efficacy and safety of minimally invasive mitral valve surgery (MIMVS) is inconclusive. We conducted a meta-analysis to evaluate whether MIMVS improves clinical outcomes compared with conventional sternotomy.

Methods: We searched MEDLINE (via PubMed), Embase, the Cochrane Library, and ClinicalTrials.