Progressive hemispheric atrophy in HIV: A Rasmussen's-like variant of CD8 encephalitis?

We report two cases of progressive lateralising encephalopathy in adult patients with treated HIV in the absence of opportunistic infection or vasculitis. One case was characterised by CD8 cortical infiltrates and was steroid responsive and may represent a variant of CD8 encephalitis. The other case presented with focal seizures and episodes of status epilepticus and pathology showed severe cortical atrophy with features reminiscent of the chronic phase of Rasmussen's encephalitis.

Disparities of SARS-CoV-2 Nucleoprotein-Specific IgG in Healthcare Workers in East London, UK.

SARS-CoV-2 antibody detection serves as an important diagnostic marker for past SARS-CoV-2 infection and is essential to determine the spread of COVID-19, monitor potential COVID-19 long-term effects, and to evaluate possible protection from reinfection. A study was conducted across three hospital sites in a large central London NHS Trust in the UK, to evaluate the prevalence and duration of SARS-CoV-2 IgG antibody positivity in healthcare workers. A matrix equivalence study consisting of 228 participants was undertaken to evaluate the Abbott Panbio™ COVID-19 IgG/IgM rapid test device.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

Splinting and mechanical disruption of the mitral valve apparatus by an endocardial left ventricular lead while delivering cardiac resynchronization therapy.

Splinting and mechanical disruption of the mitral valve apparatus is an important limitation of an endocardial left ventricular (LV) pacing lead. Further, long-term data are required before this approach is more widely adopted.

UK O&G trainees' attitudes to caesarean delivery for maternal request.

We assessed the attitudes of UK Obstetrics and Gynaecology (O&G) trainees towards a caesarean delivery for maternal request (CDMR); and identified differences in attitude towards patients requesting CDMR and preferences for their own mode of delivery. An internet survey was constructed with questions covering trainees' personal preferences towards and experience of CDMR; attitudes to CDMR; and how they might treat patients making this request. From 02/2013 to 06/2013, the survey was sent electronically via email to all UK Deaneries to be forwarded to O&G trainees.

Prenatal reflex DNA screening for trisomies 21, 18, and 13.

Purpose: The purpose of the study was to determine the screening performance of prenatal reflex DNA screening for trisomies 21 (T21), 18 (T18), and 13 (T13) as part of a routine service at five hospitals.

Methods: Women who accepted screening had a first-trimester combined test (pregnancy-associated plasma protein A, free β-human chorionic gonadotropin, nuchal translucency interpreted with maternal age). Those with a risk of having an affected pregnancy ≥1 in 800 were reflexed to a DNA sequencing test using stored plasma from the original blood sample, thereby avoiding the need to recall them.

Recreational drug use and chemsex among HIV-infected in-patients: a unique screening opportunity.

Objectives: While a high rate of recreational drug use (RDU) has been documented among HIV-infected out-patients, particularly in men who have sex with men (MSM), there is a distinct lack of data for HIV-infected in-patients. Hospital admission offers a unique opportunity to engage drug users. We aimed to establish and characterize RDU among new admissions to a large dedicated London HIV in-patient unit and compare it to RDU among general medical admissions to inform clinical pathways.

The art of performing a safe forceps delivery: a skill to revitalise.

The number of forceps deliveries is globally falling possibly due to Obstetricians gaining more experience and competence in the use of Ventouse deliveries. The declining use of traction forceps can increase the rate of second stage caesarean sections, which may have a long-term impact on the overall rate of vaginal births, despite the efforts of improving uptake of vaginal births after caesarean sections. The failures in forceps deliveries are commonly related to inaccurate assessment of the foetal position and station, which can be addressed by gaining sound clinical experience and applying intra-partum scanning to determine the fetal head position in the second stage, and should be part of the core curriculum in obstetric training.

Chemotherapy for Hodgkin's lymphoma in a patient receiving clozapine for treatment-resistant schizophrenia: use of the Mental Capacity Act 2005.

Treatment resistance occurs in approximately 30% of individuals with schizophrenia and is commonly treated with clozapine. Nodular sclerosing Hodgkin's lymphoma is a subtype of Hodgkin's lymphoma predominantly affecting those under 50 years of age. In this case report, an individual with treatment-resistant schizophrenia developed nodular sclerosing Hodgkin's lymphoma and is treated with concurrent clozapine and systemic chemotherapy.

A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals.

Background: Most people are not meeting the minimal requirements for physical activity participation, particularly people who are overweight or obese. Numerous initiatives have been developed which aim to increase levels of physical activity in this group, yet little is known about their feelings towards different types of exercise. In particular, resistance exercise may offer unique benefits to people seeking to lose weight, yet no study to date has examined views of resistance exercise amongst the overweight and obese.

Managing patients without their consent: a guide to recent legislation.

Patients who do not consent to treatment are frequently encountered in the general hospital setting. Issues of personal autonomy, best interests, mental health and capacity need to be carefully considered in these cases. This article summarizes recent changes in the law governing the management of patients who do not, or cannot, consent.

The utility of screening for parasitic infections in HIV-1-infected Africans with eosinophilia in London.

The presence of asymptomatic eosinophilia in HIV patients has been demonstrated to have a wide variety of causes. Untreated parasitic infections in immunocompromised individuals can have potentially serious consequences. The utility of screening for parasitic infections in immigrant HIV-positive Africans with eosinophilia was investigated in a UK-based HIV clinic.

Urachal fistula presenting as umbilical sepsis: a rare case in an adult male.

Background: Urachal anomalies are rare normally presenting during childhood. They are difficult to diagnose and surgical treatment is always needed to prevent recurrence.

Case Report: A 28 year old male presented with a red tender umbilical swelling that was confused with an umbilical hernia.

Changes in laboratory features of 192 children with imported falciparum malaria treated with quinine.

Little is known about changes in laboratory values of children with imported falciparum malaria. Of 192 children, 69% had parasitemia of 2% or less and 64% had platelets <150 x 10/L. In 20%, parasite counts rose within 12-24 hours of starting treatment before falling, whereas the platelet counts dropped in 45% but returned to normal levels within 5 days.

Staphylococcal skin infections in children: rational drug therapy recommendations.

Staphylococcus aureus remains one of the most common and troublesome of bacteria causing disease in humans, despite the development of effective antibacterials and improvement in hygiene. The organism is responsible for over 70% of all skin and soft tissue infections in children and accounts for up to one-fifth of all visits to pediatric clinics. Skin and soft tissue infections that are predominantly caused by S.

A case report of polysplenia syndrome associated with genital tract duplication anomaly.

Polysplenia syndrome is a condition that persists as a defect of lateralisation, the embryonic process by which the site of body organs is determined. The most frequent manifestations of this syndrome, in addition to polysplenia are complex cardiac malformations, situs inversus, and bilobed lungs. Laterality defects have been known to be due to autosomal recessive inheritance.

The risk of accidental transmission of transmissible spongiform encephalopathy: identification of emerging issues.

The transmissible spongiform encephalopathies (TSEs), thought to be caused by prions, are fatal neurodegenerative disorders of humans and animals. Despite their rarity, human prion diseases have received prominence because the consumption of prion-contaminated meat from cattle with bovine spongiform encephalopathy (BSE) is thought to be responsible for the emergence of variant Creutzfeldt-Jakob disease (vCJD) in humans. Clinical criteria for the diagnosis of vCJD is now available.

Presentation of vitamin D deficiency.

Aims: To describe the various ways in which vitamin D deficiency presents in children in selected districts of London and to identify which factors, if any, determine the mode of presentation.

Methods: Retrospective review of patients presenting to Newham General, Royal London, Great Ormond Street, and King's College Hospitals between 1996 and 2001 with either hypocalcaemia or rickets caused by vitamin D deficiency. Children with plasma 25-hydroxyvitamin D levels <25 nmol/l (10 ng/ml) were considered to have vitamin D deficiency.