Evaluating the Efficacy of Common Femoral Endarterectomy With Profundoplasty: A Three-Year Single-Center Perspective.

Background: This study aims to synthesise recent findings on the outcomes of common femoral endarterectomy (CFE) with profundoplasty, evaluating the efficacy, complications, and predictors of long-term success in patients undergoing this procedure.

Patients And Methods: This is a descriptive retrospective study assessing the outcomes of CFE with profundoplasty. All patients with chronic limb-threatening ischaemia (CLTI) who attended and underwent CFE with profundoplasty with or without iliac intervention at Glan Clwyd Hospital (Wales, United Kingdom) were studied.

Benign multinodular goitre presenting as acute decompensated type two respiratory failure.

Acute airway obstruction is a life-threatening complication of benign goitre mostly occurring in cases of known progressing goitres. The index presentation of goitre with decompensated type two respiratory failure is an exceedingly rare and a diagnostically challenging presentation. We discuss the case of a woman in her 50 s, who had been diagnosed with asthma by her general practitioner, but during admission was found to have a large goitre with retrosternal extension causing critical tracheal compression.

What impact do self-referral and direct access pathways for patients have on health inequalities?

Background: There is increasing interest in self-referral and direct access as alternatives pathways to care to improve patient access to specialist services. The impact of these pathways on health inequalities is unknown.

Objectives: The purpose of this systematic review is to explore the impact of self-referral and direct access pathways on inequalities in health care use.

Optic Neuritis following Second Administration of COVID-19 Vaccine: A Case Report.

A 28-year-old woman presented to eye casualty with signs and symptoms suggestive of optic neuritis following a recent COVID-19 vaccination (the Moderna mRNA-1273 vaccine). The best corrected visual acuity was 6/15 in the right eye and 6/6 in the left eye with a relative afferent pupillary defect in the right eye. Following examination and investigation, she was found to fit the McDonald criteria for multiple sclerosis and was commenced on disease-modifying therapy.

Teaching medical students about nutrition: from basic principles to practical strategies.

Poor nutrition is widely recognised as one of the key modifiable risks to health and life, with doctors in an ideal position to recognise when suboptimal nutrition is impacting on their patients' health and provide them with advice and support to create sustainable and achievable diet and lifestyle modifications. However, it has been acknowledged that nutrition training within medical schools is extremely varied, and in many cases inadequate. The Association for Nutrition UK Undergraduate Curriculum in Nutrition for Medical Doctors provides medical schools with guidance on what should be included in the training of all medical students.

Safety and efficacy of Sinopharm vaccine (BBIBP-CorV) in elderly population of Faisalabad district of Pakistan.

Introduction: The first case of novel SARS-COV-2 (COVID-19) in Pakistan was detected on 26 February 2020. Pharmacological and non-pharmacological strategies have been tried to lessen the mortality and morbidity burden. Various vaccines have been approved.

Transition to adult services: the current and potential role of the UK hospital pharmacist.

Purpose: To explore the current and potential role for UK pharmacists in the transition to adult services for young people with chronic health problems.

Methods: UK hospital pharmacists were surveyed using an online questionnaire with closed and open questions covering their involvement in a transition programme, demography and scope of work, experiences of transition, and the barriers encountered in providing an effective transition service.

Results: Overall, 74 pharmacists completed the questionnaire.

The British Orthopaedic Surgery Surveillance study: slipped capital femoral epiphysis: the epidemiology and two-year outcomes from a prospective cohort in Great Britain.

Aims: The aim of this study was to inform the epidemiology and treatment of slipped capital femoral epiphysis (SCFE).

Methods: This was an anonymized comprehensive cohort study, with a nested consented cohort, following the the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) framework. A total of 143 of 144 hospitals treating SCFE in Great Britain participated over an 18-month period.

The British Orthopaedic Surgery Surveillance study: Perthes' disease: the epidemiology and two-year outcomes from a prospective cohort in Great Britain.

Aims: The aim of this study was to evaluate the epidemiology and treatment of Perthes' disease of the hip.

Methods: This was an anonymized comprehensive cohort study of Perthes' disease, with a nested consented cohort. A total of 143 of 144 hospitals treating children's hip disease in the UK participated over an 18-month period.

Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review.

Vitamin A deficiency is a major health risk for infants and children in low- and middle-income countries. This scoping review identified, quantified, and mapped research for use in updating nutrient requirements and upper limits for vitamin A in children aged 0 to 48 months, using health-based or modelling-based approaches. Structured searches were run on Medline, EMBASE, and Cochrane Central, from inception to 19 March 2021.

Case of positional dyspnoea and hypoxia secondary to intracardiac shunting.

Platypnea-orthodexia syndrome (POS) is a rare but well-characterised condition where hypoxaemia and breathlessness occur while upright but resolve once recumbent. Early recognition can result in excellent outcomes for patients and can prevent unnecessary investigations for patients, especially if they present repeatedly to hospital after missed diagnosis. We present a case of a 75-year-old woman with a chronic history of breathlessness who was picked up after observations at a routine outpatient clinic.

Fifteen-minute consultation: How to approach the withdrawal of neonatal intensive care.

Withdrawal of life-sustaining support on the neonatal unit presents a set of unique challenges specific in this age group of patients. This article aims to provide an overview of the key factors that should be considered during this process. It explores the practicalities of care delivery that reflects the psychological impact of undergoing end-of-life care on parents and team members.

Management of an acute cerebral embolic infarct with thrombolysis and mechanical thrombectomy in the presence of an aortic arch floating thrombus.

An aortic arch floating thrombus is a rare cause of embolic ischaemic cerebral infarction. Previously, thrombolysis or mechanical thrombectomy has been used to treat acute cerebral infarction in this context; however, combination therapy using both modalities is yet to be published. The optimal management of aortic arch floating thrombi is debated.

Safe surgical tracheostomy in patients with COVID-19: key clinical considerations.

Surgical tracheostomy is a high aerosol-generating procedure that is an essential aid to the recovery of patients who are critically ill with COVID-19 pneumonia. We present a single-centre case series of 16 patients with COVID-19 pneumonia who underwent tracheostomy. We recommend that the patient selection criteria for achieving a favourable outcome should be based on fraction of inspired oxygen together with prone-position ventilation.

Improving the care of term babies at risk of hypoglycaemia: A microsystem approach.

Aim: Neonatal hypoglycaemia is a common problem, often requiring admission to the neonatal intensive care unit (NICU). Our aim was to reduce term admissions to NICU for hypoglycaemia by 50% over 4 years.

Methods: Inborn term babies from 1 January 2015 to 31 December 2018 were included.

Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts.

Objective: We aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.

Design: The study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites.

Ten tips for organising a Bleep Roulette for final year medical students and new foundation trainees.

The initial period adjusting to the roles and responsibilities of a new foundation doctor can be a challenging and anxious time for graduating medical students and new trainees. Over recent years, many educational initiatives such as shadowing placements, assistantships and compulsory induction programmes have been implemented to improve medical student preparedness for clinical practice. Despite this, many graduates still report a lack of confidence and preparedness when starting their clinical placements, specifically within the context of on-call shifts.

Training in endotherapy for acute upper gastrointestinal bleeding: a UK-wide gastroenterology trainee survey.

Introduction: Competence in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB) is typically expected upon completion of gastroenterology training. However, training in haemostasis is currently variable without a structured training pathway. We conducted a national gastroenterology trainee survey on haemostasis exposure and on attitudes and barriers to training.

Reduced circulating BMP10 and BMP9 and elevated endoglin are associated with disease severity, decompensation and pulmonary vascular syndromes in patients with cirrhosis.

Background: BMP9, originating from the liver, and BMP10 are circulating BMPs that preserve vascular endothelial integrity. We assessed BMP9, BMP10 and soluble endoglin (sEng) levels and their relationships to liver disease severity and associated pulmonary vascular syndromes in a cohort of well-characterised liver disease patients.

Methods: Plasma samples from patients with liver disease (n = 83) and non-disease controls (n = 21) were assayed for BMP9, BMP10 and sEng.

Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort.

Background: Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours.

Methods: We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery.

Results of the British Association of Urological Surgeons female stress urinary incontinence procedures outcomes audit 2014-2017.

Objectives: To analyse the results of the stress urinary incontinence (SUI) audit conducted by the British Association of Urological Surgeons (BAUS), and to present UK urologists' contemporary management of SUI.

Patients And Methods: The BAUS audit tool is an online resource, to which all UK urologists performing procedures for SUI are invited to submit data. The data entries for procedures performed during 2014-2016 were collated and analysed.