Persistence of Bactericidal Antibodies After Infant Serogroup B Meningococcal Immunization and Booster Dose Response at 12, 18 or 24 Months of Age.

Background: A serogroup B meningococcal vaccine (4CMenB) is licensed for infant use in countries including Canada, Australia and those of the European Union. Data on serum bactericidal antibody (hSBA) waning and the ideal timing of a "toddler" booster dose are essential to optimize vaccine utilization.

Methods: An open-labeled, multicenter phase-2b follow-on European study conducted from 2009 to 2012.

The prognostic role of desmoplastic stroma in pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an abundant desmoplastic stroma. We examined the prognostic value of stroma density and activity in patients with resectable PDAC treated with surgery and adjuvant gemcitabine-based chemotherapy. FFPE-tissue from the pancreatectomy of 145 patients was immunohistochemically stained for haematoxylin-eosin and Masson's trichrome to assess stroma density, and alpha-smooth muscle actin (αSMA) expression for activated pancreatic stellate cells.

Toscana virus encephalitis following a holiday in Sicily.

We report a case of Toscana virus encephalitis. This emerging pathogen is among the three most common causes of meningoencephalitis in Europe during the warm season, yet remains under-recognised. Doctors should consider Toscana virus infection in patients presenting with neurological symptoms who have a relevant exposure history during the summer months.

Intercostal chest drains: Are you confident going on the pull? If not use the I-T-U approach.

Chest drains are common on intensive care units for a wide variety of clinical conditions. Despite this, there are no published data on their use within the intensive care unit and minimal published literature to guide decision making regarding the timing of their removal. Therefore, we undertook an audit to review our experience over one year, as to the degree of variability in when chest drains were removed.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics.

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview.

Molecular mechanisms of myocardial nitroso-redox imbalance during on-pump cardiac surgery.

Background: The mechanism responsible for left ventricular dysfunction after cardiac surgery is only partly understood. In isolated rat hearts subjected to an ischaemia-reperfusion protocol, left ventricular dysfunction was associated with uncoupling of endothelial nitric oxide synthase (NOS) activity secondary to oxidation of the NOS cofactor, tetrahydrobiopterin (BH4). Here we investigated the effect of cardiopulmonary bypass and reperfusion on myocardial nitroso-redox balance in patients undergoing cardiac surgery.

Characterization of lipid metabolism in a novel immortalized human hepatocyte cell line.

The development of hepatocyte cell models that represent fatty acid partitioning within the human liver would be beneficial for the study of the development and progression of nonalcoholic fatty liver disease (NAFLD). We sought to develop and characterize a novel human liver cell line (LIV0APOLY) to establish a model of lipid accumulation using a physiological mixture of fatty acids under low- and high-glucose conditions. LIV0APOLY cells were compared with a well-established cell line (HepG2) and, where possible, primary human hepatocytes.

Visceral leishmaniasis in an infant following a holiday trip to Spain.

Imported leishmaniasis is rare in non-endemic countries such as the UK. Visceral leishmaniasis (VL) can be life-threatening and its recognition is imperative for successful clinical management. We present a case of VL in an 11-month-old infant several months after returning from a 1-week holiday trip to the South of Spain.

How useful are Primary Trauma Care courses in sub-Saharan Africa?

Introduction: More than five million deaths occur each year from injury with the vast majority occurring in low and middle-income countries (LMICs). Africa bears the highest road traffic related mortality rates in the world. Despite this, formal training in trauma management is not widely adopted in these countries.

Long-term outcomes in primary spinal osteochondroma: a multicenter study of 27 patients.

OBJECT Clinical outcomes in patients with primary spinal osteochondromas are limited to small series and sporadic case reports. The authors present data on the first long-term investigation of spinal osteochondroma cases. METHODS An international, multicenter ambispective study on primary spinal osteochondroma was performed.

Validation of the Pancreas Donor Risk Index for use in a UK population.

Pancreas graft failure rates remain substantial. The PDRI can be used at the time of organ offering, to predict one-year graft survival. This study aimed to validate the PDRI for a UK population.

Treatment of hydrofluoric acid exposure to the eye.

Aim: To review the current evidence of the treatment of hydrofluoric acid (HF) exposure to the human cornea.

Methods: A comprehensive manual search of the literature was conducted through the Ovid interface to assess the mechanism and efficacy of each irrigator through a variety of clinical cases and experimental studies.

Results: Ocular exposure to HF is extremely damaging to the eye and swift recognition and decontamination with an appropriate agent forms the basis of treatment.

Early postoperative continuous glucose monitoring in pancreas transplant recipients.

Continuous glucose monitoring (CGM) is used in people with type 1 diabetes to help with insulin treatment regimens. Its value in whole-organ pancreas transplantation (PT) is largely unknown. This study aimed to use CGM to assess the metabolic profile of pancreas transplant recipients in the early post-transplant period.

Medical handovers across shifts within a five-day-working model: results from an electronic handover system in an acute NHS trust.

Electronic handover tools have been advocated as a potential strategy to improve the quality of handover, especially during on-call periods at night and weekends. We aimed to quantify, categorise and explore the temporal relationship of handover tasks stored on an electronic handover system (eHandover) in an acute UK hospital trust in which the day-time primary team worked only weekdays, with only the day-time and night-time on-call teams being available at weekends. Second, we evaluated whether tasks that remained in the eHandover system throughout several shifts were likely to be completed.

Intentional rounding: a review of the literature.

Intentional rounding is a structured approach whereby nurses conduct checks on patients at set times to assess and manage their fundamental care needs. Concerns about poor standards of basic nursing care have refocused attention on the need to ensure fundamental aspects of care are delivered reliably. A literature review was conducted to inform nurses planning to use this approach in their practice and to direct future research in this area.

A novel scientific model for rare and often neglected neoplastic conditions.

Study Type Retrospective cohort. Introduction The treatment of rare neoplastic conditions is challenging, especially because studies providing high levels of evidence are often lacking. Such is the case with primary tumors of the spine (PTS), which have a low incidence, are pathologically heterogeneous, and have diverse treatment approaches.

Down syndrome masked by Marfan syndrome in a neonate.

A male neonate with maternally inherited Marfan syndrome was also diagnosed with Down syndrome at 3 weeks of age. To our knowledge this is the first described case in the literature of the co-occurrence of Down syndrome and Marfan syndrome in a neonate. The diagnosis of Down syndrome was delayed and we hypothesise that Marfan syndrome had masked the usual phenotypic features of Down syndrome.

Angioleiomyoma of the hard palate: report of a case and review of the literature and magnetic resonance imaging findings of this rare entity.

Angioleiomyomas are benign solitary smooth muscle tumors originating in the tunica media of vessels. They are rarely encountered within the oral cavity, and the number of reported cases specifically involving the hard palate remains small. A 39-year-old man presented with a 2-cm painless swelling on the left anterior hard palate.

Comparison of postdischarge physiotherapy versus usual care following primary total knee arthroplasty for osteoarthritis: an exploratory pilot randomized clinical trial.

Objective: To evaluate a pilot trial of a postdischarge physiotherapy intervention to improve patient function versus usual physiotherapy in patients undergoing total knee arthroplasty aiming to assess: recruitment rate, feasibility and acceptability of the intervention and control, suitability of outcomes, retention and adverse events and to inform sample size calculation for a definitive trial.

Design: Exploratory pilot randomized controlled trial using independent assessment.

Setting: Mixed urban and rural, UK.