A review of Kilovoltage (kV) Radiotherapy Treatment in the UK: Quality Control, Radiation Dosimetry, Treatment Equipment and Workload.

Objectives: To survey kilovoltage (kV) radiotherapy in the UK, updating a 2016 study, focussing on radiotherapy physics, including equipment quality control (QC) and radiation dosimetry, with information on installed equipment and clinical activity.

Methods: All UK radiotherapy physics departments (n = 68) were invited to complete a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical activity, QC testing and radiation dosimetry processes were undertaken.

Comparing the Efficacy and Safety of the Transperineal Versus Transrectal Prostate Biopsy Approach in the Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis.

Prostate cancer (PCa) has high prevalence rates in men and is a leading cause of cancer-related death. Transrectal (TR) biopsy has traditionally been the gold standard for diagnosis, but transperineal (TP) biopsy is increasingly favoured due to its lower infection risk. However, debate remains regarding which method has superior cancer detection rates.

Lymphatic leaks - success of intranodal lymphangiogram first strategy.

Background: Lymphatic leaks are associated with significant mortality and morbidity. Intranodal lymphangiography (ILAG) involves the direct injection of ethiodised lipid into the hilum of lymph nodes. It is diagnostic procedure that can have therapeutic effects secondary to a local sclerosant effect.

Cost effectiveness of different treatment strategies with natalizumab for pregnant women with multiple sclerosis.

Background: The management of multiple sclerosis (MS) during pregnancy poses significant challenges. This study aimed to evaluate the cost-effectiveness of three natalizumab treatment strategies during pregnancy from the UK healthcare system's perspective.

Methods: A Markov model was developed to assess the health outcomes and costs associated with three treatment strategies: continuous natalizumab treatment throughout pregnancy, treatment until the first trimester followed by discontinuation, and discontinuation at conception with resumption post-pregnancy.

Maximum Tumor Diameter is Associated with Relapse Risk in Limited-Stage Hodgkin Lymphoma: An International Study.

Tumour bulk is an established prognostic factor in Hodgkin lymphoma (HL) but most patients with limited-stage (LS) HL do not have 'bulk' by standard binary definitions. In the RAPID trial, maximum tumor diameter (MTD) was associated with risk of relapse for LS-HL patients achieving PET-negativity after ABVD chemotherapy. We aimed to externally validate these findings in the H10 trial.

Therapeutic Monitoring of Vancomycin Implemented by Eremomycin ELISA.

Background/objectives: Due to a narrow therapeutic window, side-effects, toxicities, and individual pharmacokinetics (PK) variability, WHO classifies vancomycin (VCM) as a "watch antibiotic" whose use should be monitored to improve clinical effectiveness. Availability and ease of use have made the immunoassay technique the basic tool for the therapeutic drug monitoring (TDM) of VCM concentrations.

Methods: The present study describes the development of a TDM tool for VCM based on anti-eremomycin (ERM) antibody enzyme-linked immunosorbent assay (ELISA).

Optimising recovery after caesarean delivery.

Caesarean delivery is the most performed inpatient surgery worldwide, with rates expected to rise. Optimising maternal recovery benefits not only the mother, but also the newborn and society. Enhanced Recovery After Caesarean delivery (ERAC) protocols standardize the approach to perioperative management of patients in order to accelerate early postoperative maternal rehabilitation.

Review of Outcomes of Intramedullary Fibular Nails in the Management of Ankle Fractures in Adults.

Distal fibula fractures involving the ankle are one of the most common fractures, often requiring open reduction and internal fixation with plates and screws. The increased incidence of potential wound complications arising from open reduction methods led to a rejuvenated interest in the application of minimally invasive methods like intramedullary nailing of the fibula in the management of ankle fractures and isolated distal fibular fractures. A literature search was performed using Medline, Cochrane, and Embase from 1993 to 2023.

Implant waste and associated costs in trauma and orthopaedic surgery: a systematic review.

Purpose: Trauma and orthopaedic (T&O) surgery relies on medical implants and materials, often resulting in metalwork wastage (prosthesis, screws, nails, and plates). This places an economic strain on healthcare services and the environment. Our primary outcome is to quantify the implant wastage across the literature, and secondarily investigate the associated costs in this specialty.

Impact of number of passes and futile reperfusion in basilar artery occlusion acute ischaemic stroke.

Introduction: Mechanical thrombectomy (MT) is the standard of care in anterior circulation large vessel occlusion. A vital modifiable factor is successful reperfusion. While multiple passes improve the rates of successful reperfusion, previous studies have reported progressively diminishing returns.

Respiratory support strategies in neonatal transport in the UK and Ireland.

Unlabelled: Infants requiring interhospital transfer for a higher level of care in the neonatal period are at increased risk of adverse outcomes. Optimising respiratory management is an important priority. The aim of this survey was to investigate current respiratory support strategies in neonatal transport and identify opportunities for the optimisation of clinical care and future research.

Update on B-cell maturation antigen-directed therapies in AL amyloidosis.

Systemic light chain (AL) amyloidosis is a rare clonal plasma cell disorder characterized by the production of amyloidogenic immunoglobulin light chains, which causes the formation and deposition of amyloid fibrils, leading to multi-organ dysfunction. Current treatment is directed at the underlying plasma cell clone to achieve a profound reduction in the monoclonal free light chain production. The standard-of-care first-line therapy is a combination of daratumumab, cyclophosphamide, bortezomib and dexamethasone (D-VCd regimen), resulting in high rates of haematological and organ responses.

Transplant and Nontransplant Salvage Therapy in Pediatric Relapsed or Refractory Hodgkin Lymphoma: The EuroNet-PHL-R1 Phase 3 Nonrandomized Clinical Trial.

Importance: The current standard-of-care salvage therapy in relapsed/refractory classic Hodgkin lymphoma (cHL) includes consolidation high-dose chemotherapy (HDCT)/autologous stem cell transplant (aSCT).

Objective: To investigate whether presalvage risk factors and fludeoxyglucose-18 (FDG) positron emission tomography (PET) response to reinduction chemotherapy can guide escalation or de-escalation between HDCT/aSCT or transplant-free consolidation with radiotherapy to minimize toxic effects while maintaining high cure rates.

Design, Setting, And Participants: EuroNet-PHL-R1 was a nonrandomized clinical trial that enrolled patients younger than 18 years with first relapsed/refractory cHL across 68 sites in 13 countries in Europe between January 2007 and January 2013.

The Role of Different Modalities of Regenerative Therapies in the Treatment of Erectile Dysfunction: A Global Survey and Global Andrology Forum Expert Recommendations.

Purpose: There is increased interest in regenerative therapies (RTs) to treat erectile dysfunction (ED). However, the need for society's guidelines has led to varied practices. This study aims to investigate current global practices, address the heterogeneity in treatment protocols and evaluations, and establish expert recommendations in clinical practice.

Haemodynamic measurements during hip hemiarthroplasty surgery for hip fracture.

Aims: There is compelling evidence for the use of cemented hip hemiarthroplasty for displaced intracapsular hip fractures; however, the risks of cement are well reported and in rare cases may be associated with haemodynamic collapse. It is therefore important to improve our understanding of haemodynamic instability, intraoperative monitoring, and strategies to reduce the risk to patients.

Methods: We measured arterial blood pressure using the LiDCO Continuous Non-invasive Arterial Pressure (CNAP) finger cuff during surgery in patients enrolled in the WHiTE 5 trial randomized to cemented or modern uncemented hip hemiarthroplasty at a single recruiting site.

Long-Term Outcomes From a Randomized Controlled Trial of Acceptance and Commitment Therapy (ACT) Compared to Standard Medical Care for Improving Quality of Life in Muscle Disorders.

Introduction/aims: A previous randomized controlled trial showed that guided self-help acceptance and commitment therapy plus standard medical care (ACT+SMC) was superior to standard medical care alone (SMC) for improving quality of life (QoL) and mood at 9-weeks post randomization in a sample of people with muscle disorders (MD). This follow-up study evaluated whether these effects were maintained in the longer term alongside individual patterns of response.

Methods: The original study was a two-arm parallel group randomized controlled trial, which compared ACT+SMC to SMC.

A new diagnosis of primary biliary cholangitis in pregnancy treated with a combination of ursodeoxycholic acid and bezafibrate.

This primigravid pregnant woman had a new diagnosis of primary biliary cholangitis (PBC) that was treated with a combination of ursodeoxycholic acid (UDCA) and bezafibrate. Pregnancy may unmask underlying chronic hepatic disorders in susceptible women and, in some cases, the associated abnormalities of liver function or increased serum bile acids (hypercholanaemia) can result in significant fetal and maternal risk. Maternal pruritus, with associated sleep deprivation, may cause considerable distress.

Hyponatremia incidence after subarachnoid hemorrhage and association with outcomes: systematic review and meta-analysis.

Objective: Hyponatremia after aneurysmal subarachnoid hemorrhage (aSAH) is common, however the incidence, and association with vasospasm, morbidity, and mortality, has yet to be defined. We aimed to identify incidence of hyponatremia after aSAH, and quantify its association with measurable outcomes.

Methods: A PRISMA-compliant systematic review and meta-analysis was conducted (PROSPERO ID CRD42022363472).

Impact of Race on the Outcomes of Retinoblastoma Treated With Primary Enucleation: A Global Study of 1426 Patients.

Background: To evaluate the clinical presentation, pathological features and outcomes of retinoblastoma based on the race of origin in a global cohort of patients.

Methods: Retrospective collaborative study of 1426 patients who underwent primary enucleation for retinoblastoma.

Results: Patients were grouped into Caucasians (n = 231, 16%), Asians (n = 841, 59%), Hispanics (n = 226, 16%), Arabs (n = 96, 7%) and Others (Africans, African Americans, Indigenous Australians; n = 32, 2%) cohorts.

The Burden of Recurrent Head and Neck Squamous Cell Carcinoma Across the United Kingdom: Results From a National Snapshot Study.

Background: To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes.

Methods: Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included.