Complexities, Benefits, Risks, and Clinical Implications of Sodium Bicarbonate Administration in Critically Ill Patients: A State-of-the-Art Review.

Sodium bicarbonate has been used in the treatment of different pathologies, such as hyperkalemia, cardiac arrest, tricyclic antidepressant toxicity, aspirin toxicity, acute acidosis, lactic acidosis, diabetic ketoacidosis, rhabdomyolysis, and adrenergic receptors' resistance to catecholamine in patients with shock. An ongoing debate about bicarbonate's efficacy and potential harm has been raised for decades because of the lack of evidence supporting its potential efficacy. Despite the guidelines' restrictions, sodium bicarbonate has been overused in clinical practice.

A multi-centre UK-based survey on angioedema secondary to acquired C1 inhibitor deficiency.

Background: Acquired angioedema due to C1-inhibitor deficiency (AAE-C1-INH) is very rare compared to its prototype, hereditary angioedema. An updated characterisation of the AAE-C1-INH cohort in UK is required to inform management.

Objectives: To describe the disease burden of AAE-C1-INH, long-term prophylaxis (LTP) and the clinical, immunochemical and treatment profiles of AAE-associated diseases in UK.

The Efficacy of Biodegradable Temporising Matrix for Upper Limb Reconstruction: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis is to assess the efficacy of the biodegradable temporising matrix (BTM) (NovoSorb; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) in the reconstruction of complex upper extremity wounds. The authors conducted a systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines assessing the efficacy of BTM in complex upper extremity wound reconstruction. The primary outcome measures were successful BTM integration and the proportion of wounds healed.

An international and multidisciplinary EORTC survey on resectability of stage III non-small cell lung cancer.

Introduction: The EORTC-Lung Cancer Group initiated a Delphi consensus process to establish a consensual definition of resectable stage III non-small cell lung cancer (NSCLC) for the use in clinical trials, including a systematic review, survey, and review of clinical cases. Here, the survey results are presented, aimed to identify areas of controversy.

Methods: A survey was distributed among the members of six international organizations related to lung cancer.

Hemodialysis Arteriovenous Graft and The Effect of Obesity on Patency. A Retrospective Study.

Background: Obesity is growing in the hemodialysis (HD) population. Few scholars report variable effects of increased body mass index (BMI) on native fistula. Reports on obesity effects on arteriovenous graft (AVG) patency are lacking.

Integration of a surgical bipolar ablation device within an electroanatomical mapping system during epicardial ventricular tachycardia ablation via video-assisted thoracoscopic surgery: a case report.

Background: Epicardial ventricular tachycardia (VT) ablation is an established approach in patients with epicardial arrhythmogenic foci and is most commonly performed via percutaneous access. An alternative approach is via video-assisted thoracoscopic surgery (VATS), although reports of this technique are limited to the use of catheter-based technologies for radiofrequency ablation delivery.

Case Summary: A 55-year-old man with non-ischaemic cardiomyopathy presented with recurrent VT despite medical therapy.

Evaluation of the MRX PT DOAC assay for detection of clinically relevant factor Xa inhibitor drug levels.

Background: Although routine monitoring is not needed for direct oral anticoagulants (DOACs), knowing if a clinically relevant DOAC level is present can be critical, especially in cases of severe bleeding or urgent surgery. Rapid assays to exclude these levels are necessary but not widely available.

Objectives: To determine the test performance of MRX PT DOAC for excluding clinically relevant DOAC drug levels.

Analysis of the lymph node metastasis distribution in patients with invasive resectable non-small cell lung cancer.

Background: The current standard for the surgical management of lung cancer involves anatomic lung resection combined with systemic lymph node dissection/sampling. The purpose of this study was to investigate the patterns of pathological lymph nodes in invasive non-small cell lung cancer (NSCLC), explore the occurrence in lymph node metastasis (LNM), and provide recommendations for optimal lymph node resection/sampling in lung cancer operation.

Methods: There were 1,678 patients with NSCLC who underwent lobectomy between 2018 and 2021 at the Taizhou Hospital of Zhejiang Province were reviewed retrospectively.

The Effects of Low-Level Laser Therapy on Wound Healing and Pain Management in Skin Wounds: A Systematic Review and Meta-Analysis.

Low-level laser therapy (LLLT) is a non-invasive application of non-thermogenic light that is proven to promote tissue healing and alleviate pain. The authors aim to conduct the first meta-analysis, evaluating the effects of LLLT on wound healing and pain in skin wounds by comparing it to skin wounds not treated with LLLT. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed by searching the electronic databases.

Improving current understanding of cognitive impairment in patients with a spinal cord injury: A UK-based clinician survey.

Context: Emerging data suggests that patients with a spinal cord injury (SCI) have a higher risk of developing cognitive impairment. The true incidence of cognitive impairment in this group is unclear due to the difficulty in administering commonly used assessment tools, which are dependent on functional abilities e.g.

Factor XI and XIa inhibition: a new approach to anticoagulant therapy.

Factor (F) XI or XIa inhibition has Fattracted interest due to the protection from thrombotic events and minimal bleeding tendency observed in FXI-deficient individuals. The prospect of uncoupling the management of thrombosis from the bleeding risk inadvertently associated with current therapy inspired the development of agents directed towards this step in the coagulation process. This review describes the physiological rationale behind FXI/FXIa inhibition and the pharmacological properties of existing FXI/FXIa inhibitors.

Sarcoma or haematoma? If only it was that simple! Part 1.

Introduction: Imaging appearances and clinical presentation of soft tissue sarcoma and soft tissue haematomas are similar. It is imperative that sarcoma is differentiated from benign soft tissue lesions due to the poor outcomes and high morbidity associated with sarcoma.

Topic Description: Part 1 of this pictorial review will summarise the paucity of guidance in management of suspected haematomas, the clinical features and ultrasound techniques used in the assessment of soft tissue masses.

Sarcoma or haematoma? If only it was that simple! Part 2.

Introduction: Imaging appearances and clinical presentation of soft tissue sarcoma and soft tissue haematomas are similar. It is imperative that sarcoma is differentiated from benign soft tissue lesions due to the poor outcomes and high morbidity associated with sarcoma.

Topic Description: Part 2 of this pictorial review summarises the key ultrasound appearances of soft tissue sarcoma and soft tissue haematomas and some differential diagnoses.

Outcomes of press-fit radial head arthroplasty in unconstructable radial head fractures with associated elbow injuries: An average 5-year follow up.

Aims: Unstable and nonreconstructable radial head fractures require radial head arthroplasty (RHA) to restore stability. Multiple implant designs are available with varying survival rates (76 to 97%). There is concern that loosening of the press-fit stems leads to implant failure.

Pro: indwelling pleural catheters cause harm to patients.

Malignant pleural effusions (MPE) tend to recur and require definitive treatment with either chest drain and talc pleurodesis or indwelling pleural catheters (IPCs), which offer similar symptomatic benefits. In recent years, IPCs have become popular due to the presumed convenience of an outpatient procedure followed by home drainage leading to a misconception of IPCs being an ideal treatment for MPE. However, IPCs predispose the patient to multiple complications and have significant physical and psychological implications that are under-recognised.

The role of TandemHeart combined with ProtekDuo as right ventricular support device: A simulation approach.

Background And Objective: Right ventricular failure increases short-term mortality in the setting of acute myocardial infarction, cardiogenic shock, advanced left-sided heart failure and pulmonary arterial hypertension. Percutaneous and surgically implanted right ventricular assist devices (RVAD) have been investigated in different clinical settings. The use of the ProtekDuo™ is currently a promising approach due to its features such as groin-free approach leading to early mobilisation, easy percutaneous deployment, compatibility with different pumps and oxygenators, and adaptability to different configurations.

Hand Osteomyelitis: A Systematic Review of the Literature and Recommendations for Diagnosis and Management.

Hand osteomyelitis is a complex condition to diagnose and treat, with an opportunity to improve care through organization of existing evidence. The literature was systematically searched for series of hand osteomyelitis between 1990 and 2022 for evidence regarding diagnosis and treatment, to formulate recommendations. Twenty-one series reported at least 5 cases of hand osteomyelitis in adults, with a total of 666 cases.

Cost-Effectiveness of an Extended-Role General Practitioner Clinic for Persistent Physical Symptoms: Results From the Multiple Symptoms Study 3 Pragmatic Randomized Controlled Trial.

Objectives: This study aimed to evaluate the cost-effectiveness of an extended-role general practitioner symptoms clinic (SC), added to usual care (UC) for patients with multiple persistent physical symptoms (sometimes known as medically unexplained symptoms).

Methods: This was a 52-week within-trial cost-utility analysis of a pragmatic multicenter randomized controlled trial comparing SC + UC (n = 178) with UC alone (n = 176), conducted from the primary perspective of the UK National Health Service and personal and social services (PSS). Base-case quality-adjusted life-years (QALYs) were measured using EQ-5D-5L.

Effect of pyloroplasty on clinical outcomes following esophagectomy.

Introduction: The role of concurrent pyloroplasty with esophagectomy is unclear. Available literature on the impact of pyloroplasty during esophagectomy on complications and weight loss is varied. Data on the need for further pyloric intervention are scarce.