Predictive Performance of NELA Versus P-POSSUM Mortality Scores: Are We Underestimating the Risk of Mortality Following Emergency Laparotomy?

Background In this study, we aimed to compare the performance of the National Emergency Laparotomy Audit (NELA) and Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) mortality risk scores in predicting 30-day and 90-day mortality in patients undergoing emergency laparotomy. Methodology A retrospective cohort study was conducted to compare the predictive performance of preoperative NELA, postoperative NELA, and P-POSSUM predicted mortality scores in patients undergoing emergency laparotomy between 2014 and 2021. The outcomes of interest included the observed 30-day and 90-day mortality.

A Randomized Trial of Autologous Chondrocyte Implantation Versus Alternative Forms of Surgical Cartilage Management in Patients With a Failed Primary Treatment for Chondral or Osteochondral Defects in the Knee.

Background: There are limited randomized controlled trials with long-term outcomes comparing autologous chondrocyte implantation (ACI) versus alternative forms of surgical cartilage management within the knee.

Purpose: To determine at 5 years after surgery whether ACI was superior to alternative forms of cartilage management in patients after a failed previous treatment for chondral or osteochondral defects in the knee.

Study Design: Randomized controlled trial; Level of evidence, 1.

Becoming an inner ally: the compassionate minds approach to self-compassion - an online programme.

A rapidly growing body of evidence indicates the enormous psychological burden of working in health care on nurses and other health professionals that is resulting in high levels of psychological problems. These will have profound effects on individuals and long-term ramifications for healthcare systems. Effective interventions that can counter the adverse psychological effects of caring during the COVID-19 pandemic and beyond are urgently required.

A Specific Criteria-Based Guideline Improves Compliance With General Surgery Ambulatory Care Standards and Reduces Overcrowding in "Hot Clinic": A Quality Improvement Study.

Background A general surgery hot clinic is designed for the assessment and management of acute general surgical patients in ambulatory settings to avoid unnecessary hospital admissions. Overcrowding in the hot clinic is a major issue in many general surgical settings, and it is thought to be due to a lack of specific criteria-based guideline for identifying eligible patients for ambulatory care. We aimed to perform a prospective audit to assess what proportion of hot clinic patients meets the criteria for ambulatory care.

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial.

Background: The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population.

Methods: PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial.

Neoadjuvant chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: Meta-analysis and trial sequential analysis of randomized controlled trials.

We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data.

The Need for Children's Advocacy Centres: Hearing the Voices of Children.

Children and young people (CYP) can be empowered to take on roles as agents of change in their own communities. CYP want to be heard and should be actively involved in the co-production, design and development of services aimed at them to ensure that the resulting services are acceptable and accessible. Little analysis of the framing and discourse of co-production in different contexts has been undertaken.

Sudden Unexpected Death in Childhood in Greater Manchester (United Kingdom): A Five-Year Review (2015-2020).

The sudden, unexpected death of a child (SUDC) is a devastating experience. It is vital that supportive and investigative services are effective and promote the best outcomes for families. Analysis of 5 years of data from 309 SUDC cases in Greater Manchester, United Kingdom (UK) shows how a number of key service outcomes can be measured and achieved through a raft of actions which are commensurate with and exceed the service level recommended by the UK Government.

Visual and Auditory Hallucinations: An Uncommon Side Effect of Levetiracetam in an Elderly Patient.

This report focuses on a 77-year-old female who was admitted to an acute geriatrics unit at a tertiary care hospital with a history of recurrent falls and right leg weakness. Computed tomography of the head demonstrated acute left subdural hemorrhage with a possible extradural component at the vertex. This was causing mass effect with effacement of the left superior, frontal, and parietal lobes with no hydrocephalus or fracture.

Rates and Predictors of Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections According to Different Management Strategies: A Multinational Cohort Study-The ARTHR-IS Study Group.

Introduction: Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome.

Methods: A retrospective cohort study of SA-PJI was performed in 19 European hospitals between 2014 and 2016.

Tixagevimab/cilgavimab for prevention and treatment of COVID-19: a review.

Introduction: There is a need to protect vulnerable individuals who do not respond to vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), particularly following the emergence of new variants. Tixagevimab/cilgavimab, the only monoclonal antibody combination authorized for pre-exposure prophylaxis of coronavirus disease 2019 (COVID-19), demonstrated efficacy in unvaccinated individuals in the PROVENT study.

Areas Covered: This review focuses predominantly on real-world evidence examining the effectiveness and safety of tixagevimab/cilgavimab in populations who are immunocompromised and otherwise vulnerable.

Development of the remote 100 ml water swallow test versus clinical assessment in patients with head and neck cancer: Do they agree?

Background: The 100 ml water swallow test (WST) is a validated swallow assessment used in head and neck cancer (HNC). We aimed to determine the level of agreement when completing the 100 ml WST via clinician-graded video-testing or patient self-testing compared to standard face-to-face assessment (FTF).

Methods: Convenience sampling from four UK centers.

Manifestation of glucose-6-phosphate dehydrogenase deficiency in the wake of new-onset type 1 diabetes mellitus: a case report.

Background: Diabetes mellitus is the most common metabolic disease globally, while glucose-6-phosphate dehydrogenase deficiency, an X-linked inherited disorder, is the most common erythrocyte enzyme defect. The association between the two in children has been infrequently reported.

Case Presentation: We report the case of a 10-year-old boy of Iraqi descent who presented to our emergency department with new-onset type 1 diabetes mellitus without Diabetic Keto Acidosis.

Predictive Significance of Tumour Size in Patients Undergoing Curative Surgery for Colorectal Cancer: A Retrospective Cohort Study.

Objectives To evaluate the predictive significance of tumour size in patients undergoing curative surgery for colorectal cancer (CRC). Methods All patients undergoing curative surgery for colon or rectum cancer performed by a single colorectal surgeon between January 2013 and January 2020 were considered eligible for inclusion. Linear and binary logistic regression analyses were modelled to assess whether colonic or rectal tumour size could predict R0 resection, specimen length, number of harvested and positive lymph nodes, lymphocytic infiltration, venous invasion, and overall survival.

Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study.

Objective: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection.

Methods: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant.

Evaluation of the ® Prep&Amp UM RT-PCR for detection of SARS-CoV-2 from nasopharyngeal swabs without prior nucleic acid eluate extraction.

Here we describe a retrospective clinical evaluation of the QIAGEN SARS-CoV-2 Prep&Amp UM RT-PCR assay that detects SARS-CoV-2 RNA without the need for a nucleic acid eluate extraction procedure. Using Roche SARS-CoV-2 RT-PCR on the cobas® 8800 platform as a reference standard, a total of 225 confirmed SARS-CoV-2 positive and 320 negative nasopharyngeal swabs in viral transport media, were used to evaluate the assay. Using the RT-PCR cycle threshold as a semi-quantitative marker of viral load, an assessment of over 370,000 SARS-CoV-2 RT-PCR positive results was used in the design of the reference positive specimen cohort.

Spindle Cell Carcinoma in the Breast: A Case Report.

We aim to report on a patient presenting with a rare breast tumor. The tumor was recurrent with the patient having undergone wide local excision twice previously and the diagnosis was inconclusive both times. Under our care, the patient underwent a modified radical mastectomy with a level III dissection and a transverse rectus abdominis myocutaneous (TRAM) flap for reconstruction.

Risk factors associated with short-term complications in mandibular fractures: the MANTRA study-a Maxillofacial Trainee Research Collaborative (MTReC).

Introduction: Complications following mandibular fractures occur in 9-23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders.

Air guns and their wider relevance to the dental profession.

Crimes involving air guns have declined over the last 16 years in England and Wales; however, still represent a significant occurrence, with 3,028 crimes involving air guns reported in 2019 (just under one-third of all firearm crime). We aim to present points regarding air gun injuries and their wider relevance to the dental profession which have not been covered in previous publications.This article covers air gun licensing in the UK and the relevant safeguarding issues, as well as optimal imaging of suspected retained pellets in the head and neck.

The association between temperature, heart rate, and respiratory rate in children aged under 16 years attending urgent and emergency care settings.

Background And Importance: Body temperature is considered an independent determinant of respiratory rate and heart rate; however, there is limited scientific evidence regarding the association. This study aimed to assess the association between temperature, and heart rate and respiratory rate in children.

Objective: The objective of this study was to validate earlier findings that body temperature causes an increase of approximately 10 bpm rise in heart rate per 1 °C rise in temperature, in children aged under 16 years old.

HIV at 40: reflections on and development of interdisciplinary working in HIV care.

This article reflects on 40 years of HIV and the growing need to work collaboratively to improve outcomes for people living with HIV. It reflects on the history of interdisciplinary working in HIV care in the UK and discusses the development of links between the professions of nursing and clinical psychology. Both professions had contributed to the development of the .

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis.

Background: Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.

Methods: We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions.