An Overview of SARS-CoV-2 Molecular Diagnostics in Europe.

The COVID-19 pandemic has led to the rapid development of a plethora of molecular diagnostic assays with real-time polymerase chain reaction (RT-PCR) at the forefront. In this review, we will discuss the history and utility of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) molecular diagnostics and the associated current and future regulatory process in Europe. We will assess the performance characteristics of a range of the most common SARS-CoV-2 molecular tests currently used in Europe with a focus on as rapid molecular platforms, stand-alone RT-PCR kits, the role of low-throughput and high-throughput end-to-end testing platforms, and the rapidly evolving field of SARS-CoV-2 variant of concern identification.

Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus: a multinational matched case-control study.

Objectives: We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI) and to develop and validate risk-scoring systems, to allow a better identification of high-risk patients for more efficient targeted interventions.

Methods: We performed a multicenter matched case-control study of patients who underwent a primary hip and knee arthroplasty from 2014 to 2016. Two multivariable models by logistic regression were performed, one for the preoperative and one for perioperative variables; predictive scores also were developed and validated in an external cohort.

Functional in-vitro evaluation of the non-specific effects of BCG vaccination in a randomised controlled clinical study.

Bacille Calmette-Guérin (BCG), the only currently licenced tuberculosis vaccine, may exert beneficial non-specific effects (NSE) in reducing infant mortality. We conducted a randomised controlled clinical study in healthy UK adults to evaluate potential NSE using functional in-vitro growth inhibition assays (GIAs) as a surrogate of protection from four bacteria implicated in infant mortality. Volunteers were randomised to receive BCG intradermally (n = 27) or to be unvaccinated (n = 8) and were followed up for 84 days; laboratory staff were blinded until completion of the final visit.

Hajibandeh Index versus NELA score in predicting mortality following emergency laparotomy: A retrospective Cohort Study.

Objectives: To compare performance of the Hajibandeh Index (HI) and National Emergency Laparotomy Audit (NELA) score in predicting postoperative mortality in patients undergoing emergency laparotomy.

Methods: In compliance with STROCSS guidelines for observational studies a cohort study was conducted. All patients aged over 18 who underwent emergency laparotomy between January 2014 and January 2021 in our centre were considered eligible for inclusion.

When can anterior dislocations of the shoulder with an isolated fracture of the greater tuberosity be safely reduced in the emergency department?

Following dislocation of the glenohumeral joint with an isolated greater tuberosity fracture, closed reduction in the emergency department can lead to fracture propagation or iatrogenic fractures. This article assesses the evidence regarding when anterior dislocations of the shoulder with an isolated fracture of the greater tuberosity can be safely reduced in the emergency department, as there is currently no clear guidance on this. A total of eight articles described 172 cases which underwent closed reduction, which resulted in 22 cases of iatrogenic fractures.

Tocilizumab in patients hospitalised with COVID-19 pneumonia: Efficacy, safety, viral clearance, and antibody response from a randomised controlled trial (COVACTA).

Background: In COVACTA, a randomised, placebo-controlled trial in patients hospitalised with coronavirus disease-19 (COVID-19), tocilizumab did not improve 28-day mortality, but shortened hospital and intensive care unit stay. Longer-term effects of tocilizumab in patients with COVID-19 are unknown. Therefore, the efficacy and safety of tocilizumab in COVID-19 beyond day 28 and its impact on Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) clearance and antibody response in COVACTA were investigated.

The dark art of syphilis serology - an analysis of testing algorithms at a UK reference laboratory.

Due to the complex nature of treponemal serology interpretation, testing algorithms vary across the UK. There is currently no gold standard method for interpretation of discordant serology results. To analyse serological response in early infection and to determine the best approach for discordant total antibody EIA and TPPA samples.

Intramuscular AZD7442 (Tixagevimab-Cilgavimab) for Prevention of Covid-19.

Background: The monoclonal-antibody combination AZD7442 is composed of tixagevimab and cilgavimab, two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that have an extended half-life and have been shown to have prophylactic and therapeutic effects in animal models. Pharmacokinetic data in humans indicate that AZD7442 has an extended half-life of approximately 90 days.

Methods: In an ongoing phase 3 trial, we enrolled adults (≥18 years of age) who had an increased risk of an inadequate response to vaccination against coronavirus disease 2019 (Covid-19), an increased risk of exposure to SARS-CoV-2, or both.

A double-blind randomised placebo-controlled trial investigating the effects of lesogaberan on the objective cough frequency and capsaicin-evoked coughs in patients with refractory chronic cough.

Objective: Baclofen is a centrally acting γ-aminobutyric acid type B (GABA) receptor agonist which reduces gastro-oesophageal reflux and suppresses the cough reflex; however, central nervous system side-effects limit its use. Lesogaberan is a novel peripherally acting GABA agonist, but its effects on refractory chronic cough are unknown.

Design: We performed a single-centre, placebo-controlled, double-blind randomised crossover study in patients with chronic cough, refractory to the treatment of underlying conditions.

Guillain-Barre syndrome (GBS) associated with COVID-19 infection that resolved without treatment in a child.

A 9-year-old boy presented with unbalanced gait, back pain and lower limb weakness. His physical examination revealed almost absent lower limbs reflexes and cerebro-spinal fluid (CSF) showed albuminocytologic dissociation. The brain and spine MRI with contrast illustrated abnormal enhancement-suggestive of Guillain-Barré syndrome.

Health Risk Factors among Doctors, Psychologists and Nurses of Pakistan during COVID-19 Pandemic.

The present study aimed to find out differences in health risk factors of COVID-19 among doctors, nurses and psychologists by determining the relationship of cognitive appraisal, coping styles, stress and fear among health professionals. Cross-sectional research design was used. Sample comprised of 3 groups; doctors, nurses and psychologists ( = 145 in each group) working in tertiary care hospitals.

The effect of intraoperative wound protector use on the risk of surgical site infections in patients undergoing pancreatoduodenectomy: a systematic review and meta-analysis.

Aims: To evaluate the effect of intraoperative wound protectors on the risk of surgical site infection (SSI) in patients undergoing pancreatoduodenectomy.

Methods: In compliance with PRISMA statement standards, electronic databases were searched to identify all studies comparing wound protector use with no wound protector use in patients undergoing pancreatoduodenectomy. SSI (superficial or deep) was considered primary outcome measure.

Recognising and managing type 1 disordered eating in children and young people with diabetes.

Type 1 disordered eating (T1DE), also referred to as diabulimia, is a serious eating disorder that can occur in children and young people with type 1 diabetes when they deliberately reduce or restrict their insulin doses to lose weight. It is highly dangerous and can cause serious short-term conditions such as diabetic ketoacidosis, as well as various long-term comorbidities. T1DE is challenging to identify, and diagnosis is based on a range of emotional, behavioural and physical signs and symptoms.

What are the current factors that impact on health-related quality of life for women living with HIV?

Since the start of the HIV epidemic, care has often had a strong focus on quality of life. In the early days, this was in part due to the limited treatment options available for people living with HIV, alongside the strong humanistic desire of those working in the specialty to provide optimum care. Advances in HIV treatments have led to care having more of a medical focus, with national and international targets concentrating on the prevention of new infections.

A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement.

Background: Chest drain displacement is a common clinical problem that occurs in 9-42% of cases and results in treatment failure or additional pleural procedures conferring unnecessary risk. A novel chest drain with an integrated intrapleural balloon may reduce the risk of displacement.

Methods: A prospective randomised controlled trial comparing the balloon drain to standard care (12 F chest drain with no balloon) with the primary outcome of objectively defined unintentional or accidental chest drain displacement.

Are child health information services a viable source of accurate vaccination data for clinicians working in paediatric emergency departments in England?

Unlabelled: Vaccination is a global success story, yet UK coverage remains undertarget for a number of diseases. The paediatric emergency department (PED) offers the potential for opportunistic vaccination interventions.

Objectives: To map the Greater Manchester (GM) Child Health Information System network to see if it was a viable source of vaccination data for clinicians working in the PED as a case study.

Delivery of a multi-focus public health intervention in the paediatric emergency department: a feasibility and acceptability pilot study.

Objective: The objective was to see if it was feasible and acceptable to deliver a brief public health intervention as part of an attendance at the paediatric emergency department (PED).

Design: A feasibility and acceptability pilot design was used as there is no previous work done in this clinical area, population or using this approach in children and young people (CYP). Quantitative and qualitative data were collected.

Antibiotic practices in non-condylar mandibular fractures: a Maxillofacial Trainee Research Collaborative (MTReC) UK-wide survey.

Non-condylar mandibular fractures are consdered 'open' fractures and as such are thought to require prophylactic antibiotics. There is no overall consensus on the optimal regimen or choice of antibiotic in the preoperative and postoperative periods due to a lack of high-quality evidence. We therefore set out to ascertain the current UK-wide practice of antibiotic prescribing for non-condylar mandibular fractures.

Cognitive appraisal, Coping, Stress and Fear Contracting Covid-19 in Working People in Pakistan.

The present study aimed to examine the relationship and prediction of cognitive appraisal and coping with Stress and Fear contracting COVID-19 among the working population of Pakistan. Cross-sectional research design was employed. The data was collected from 980 participants of almost 39 different professions using the purposive sampling technique.

Heartburn as a Marker of the Success of Acid Suppression Therapy in Chronic Cough.

Purpose: Gastro-oesophageal reflux disease (GORD) is commonly thought to play an important role in chronic cough and patients are often empirically treated with acid suppression therapy. We sought to investigate the response rate to acid suppression treatment in patients with and without heartburn attending two specialist cough clinics.

Methods: A retrospective review of 558 consecutive patients referred to two specialist cough clinics was performed (UK and USA).

Follicle-stimulating hormone in postmenopausal women living with HIV: a prevalence study.

Objectives: We examined follicle-stimulating hormone (FSH) levels in women living with HIV aged > 45 reporting ≥ 12 months' amenorrhoea, and investigated correlation with menopausal symptoms.

Methods: A cross-sectional substudy of 85 women from the Positive Transitions through the Menopause (PRIME) Study who reported irregular periods at entry into the PRIME Study and ≥ 12 months' amenorrhoea at recruitment into this substudy. Serum FSH was supplemented with clinical data and menopausal symptom assessment.