Aortitis Increases the Risk of Surgical Complications and Re-Operations After Major Aortic Surgery.

Aortitis, defined as inflammation of the aorta, can lead to aneurysms and dissections. Intra-operative sampling is essential for diagnosis, with many cases presenting asymptomatically as clinically isolated aortitis. Previous studies investigating aortitis in major aortic surgery have been limited by low intra-operative sampling.

A Qualitative Study of Barriers and Facilitators to the Uptake of Cardiac Rehabilitation in Octogenarians.

Despite an established evidence-base for cardiac rehabilitation (CR) improving functional outcomes and quality of life and reducing re-hospitalisation, there is limited research on CR for older cardiac patients, who require rehabilitation the most, as they are often very deconditioned due to aortic stenosis (AS). CR uptake in the UK is limited to 52% with national variability of provision and accessibility, and it is a national priority to increase uptake to 85%. Frequently, research has excluded older populations as they are deemed to be too frail or generally not suitable for inclusion.

Enhancing mental health literacy and care through community-driven solutions in rural Bangladesh.

Women in rural Bangladesh encounter significant barriers to seeking mental healthcare, primarily due to stigmatization rooted in a lack of knowledge about mental health. To address this issue, community-based participatory research (CBPR) has been identified as a promising approach. CBPR involves the active collaboration of community members and stakeholders in the research process to tackle pressing community issues.

The education café: A novel model to provide specialist perioperative continuing professional development during theatre downtime.

Recent healthcare staff industrial action disrupted operating theatres activity, delaying procedures, and increasing waiting lists due to cancellations. Strike days have also led to inadvertent idling of theatre practitioners during decreased activity. To maximise paid staff working time during down-times, the Theatres Education Team devised the Education Café for self-directed online specialist continuing professional development activities compiled into menus of QR codes.

Access to specialist plastic surgery in rural vs. Urban areas of Africa.

Introduction: Plastic surgery is an essential yet underdeveloped field in many African nations, especially in rural areas. The demand for plastic surgery is increasing, but differences in access to respective services between rural and urban domiciles remain ever existent, despite the exponentiation of trauma, burns, and congenital disorders. According to this review, urban areas have access to better facilities and specialized surgeons, while rural areas frequently lack infrastructure, educated healthcare personnel, and medical resources.

Olympic distance duathlon and cardiac performance in highly-trained triathletes.

The effects of triathlon exercise on cardiac function are well documented. While Olympic triathlon (swim-bike-run) remains the standard format, increasing concerns about water quality in natural waterways present ongoing challenges for open-water swimming events, highlighting the potential need to consider alternative formats such as duathlon (run-bike-run) in some circumstances. An additional run may increase the overall metabolic and cardiovascular demand compared with the swim in triathlon, leading to reduced future performance.

Empowering professionals: a multidisciplinary approach to supporting people seeking asylum and refugees.

People seeking asylum and refugees living in initial accommodation in the UK can experience significant barriers to accessing care. They often have complex health and social needs and may experience fragmentation in the delivery of services. The Respond Integrated Refugee Health Service, hosted by University College London Hospital and operating across North Central London, has been created to address some of these challenges.

Living with pain and Parkinson's developing an understanding of the impact, trajectory and pain management needs: a qualitative interview study protocol.

Introduction: Pain is reported as one of the most troubling symptoms for people with Parkinson's (PwP); however, the literature exploring their lived experience of pain and how to manage it is limited. Pain affects PwP at all stages of their condition and can fluctuate and change over time. Therefore, it is pertinent to speak to PwP to understand their experiences of pain to inform the development of tailored behavioural interventions to manage pain.

Implementation and impact of NHS-funded tobacco dependence services in England: a mixed-method evaluation protocol.

Introduction: Tobacco smoking remains a leading cause of ill-health, premature mortality and a driver of health inequalities. To support smokers in England, a comprehensive approach to treating tobacco dependence is being implemented. This includes offering support to all people admitted to hospitals, as well as women and pregnant people within NHS settings.

TOURISM study (Treatment Outcomes in UteRIne SarcoMa): a 10-year retrospective evaluation of practice in the UK.

Background: Although rare, uterine sarcomas account for a high proportion of uterine cancer mortality. Treatment options and robust trial data are limited.

Objectives: The TOURISM study (Treatment Outcomes in UteRIne SarcoMa) is a UK-wide study by the National Oncology Trainees Collaborative for Healthcare Research which aimed to characterise this patient cohort.

Pelvis Or Involved Node Treatment: Eradicating Recurrence in Prostate Cancer (POINTER-PC) - study protocol paper for a phase III multicentre, open-label randomised controlled trial.

Introduction: Prostate cancer (PCa) is the most common cancer in men. Recurrence may occur in up to half of patients initially treated with curative intent for high-risk localised/locally advanced PCa. Pelvic nodal recurrence is common in this setting, but no clear standard of care exists for these patients, with potential therapeutic approaches including stereotactic body radiotherapy (SBRT) to the involved node(s) alone, extended nodal irradiation (ENI) to treat sites of potential micrometastatic spread in addition to involved node(s) and androgen deprivation therapy with or without additional systemic anticancer therapies.

Delays to Revascularisation and Outcomes of Non-elective Admissions for Chronic Limb Threatening Ischaemia: a UK Population Based Cohort Study.

Objective: Major amputation and death are significant outcomes after lower limb revascularisation for chronic limb threatening ischaemia (CLTI), but there is limited evidence on their association with the timing of revascularisation. The aim of this study was to examine the relationship between time from non-elective admission to revascularisation and one year outcomes for patients with CLTI.

Methods: This was an observational, population based cohort study of patients aged ≥ 50 years with CLTI admitted non-electively for infra-inguinal revascularisation procedures in English NHS hospitals from January 2017 to December 2019 recorded in the Hospital Episode Statistics database.

Navigating UK internal medicine training applications: 10 essential tips.

Internal medicine training applications in the UK have become increasingly competitive. This article provides ten tips for optimizing internal medicine training applications covering portfolio development, teaching experience, project selection, and interview preparation. We outline strategies for maximizing application scores through efficient resource allocation, effective project selection, and structured interview preparation.

Kinomic profiling to predict sunitinib response of patients with metastasized clear cell Renal Cell Carcinoma.

Introduction: Treatment with Sunitinib, a potent multitargeted receptor tyrosine kinase inhibitor (TKI) has increased the progression-free survival (PFS) and overall-survival (OS) of patients with metastasized renal cell carcinoma (mRCC). With modest OS improvement and variable response and toxicity predictive and/or prognostic biomarkers are needed to personalize patient management: Prediction of individual TKI therapy response and resistance will increase successful treatment outcome while reducing unnecessary drug use and expense. The aim of this study was to investigate whether kinase activity analysis can predict sunitinib response and/or toxicity using tissue samples obtained from primary clear cell RCC (ccRCC) from a cohort of clinically annotated patients with mRCC receiving sunitinib as first-line treatment.

Experience of conductive hearing loss and impacts of hearing aid use throughout life.

Introduction: Hearing loss and Deafness/deafness affects as much as 5% of the world's population and has a considerable health and economic burden. We explored the relationship with hearing and hearing aids as well as other assistive technology for health in general with a cohort of UK adults who have conductive hearing loss. We anticipated that insights could lead to greater understanding for the delivery of assistive technology (AT) for conductive hearing loss and the participant's lived experience related to technology and society.

The impact of traumatic brain injury on visual processing: a neuro-ophthalmological perspective.

Introduction: Traumatic brain injury (TBI) is a critical global health issue characterized by perturbance in cerebral function attributed to mechanical force. TBI often precipitates significant visual impairment that negatively impacts the patients' quality of life. This review examines the effects of TBI on visual function from a neuro-ophthalmological perspective, focusing on the assessment, diagnostics, and management of associated sequelae.

Bilateral femoral neck fractures and fixation failure due to stiff-person syndrome.

We describe a woman with stiff-person syndrome (SPS), whose muscle spasms resulted in sequential bilateral femoral neck fractures. Orthopaedic fixation of the first fracture was complicated by increased muscle spasm, fracture nonunion and ultimately metalwork fracture. SPS was diagnosed following the fracture of the contralateral femoral neck, neurology assessment and detection of high-titre antibodies to glutamic acid decarboxylase.

Testing a signal-processing image analysis technology in hospital on suspicious pigmented naevi referred for biopsy.

Four versions of the novel Moletest on-device signal-processing analysis software, delivered on a single-application iPadPro11, were evaluated in pigmented skin lesions of patients sent for biopsy comparing its results with the lesion histology. The primary objective was to demonstrate that the nomela test provided at least 95 ± 2% sensitivity for not-melanoma. Proprietary software recognised the lesion perimeter, rejecting images with uncertain border, and performed analysis using non-scalar metrics of the image within the perimeter.

Case report: Primary infection of conjunctival histoplasmosis mimicking a large conjunctival neoplasm in an immunosuppressed patient.

We report a rare case of a rapidly growing and large conjunctival histoplasmosis lesion in an immunosuppressed West African woman in her 80s, affecting her only eye. The patient had undergone a renal transplant and was on immunosuppressive medications. Additionally, she had previously been treated for presumed systemic histoplasmosis with itraconazole more than 5 years ago.

Femoral tunnel enlargement after medial patellofemoral ligament reconstruction is common and can be monitored using plain radiographs.

Introduction: medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively.