Pyrexia of Foreign Origin: Exploring the Impact of Travel History.

Malaria remains a significant global health challenge, particularly in endemic regions of Africa, with being the most virulent species. This case report details the presentation of a 24-year-old Caucasian woman who collapsed at a train station in the United Kingdom after experiencing a week of fever, malaise, abdominal pain, and gastrointestinal symptoms. At emergency care, she was initially resuscitated with intravenous fluids and antipyretics.

Evaluating the Role of Maximal Expiratory Flow at 25% (MEF-25) in Detecting and Managing Patients With Small Airway Disease in the United Arab Emirates.

Middle Eastern countries, such as the United Arab Emirates and Oman, are affected by frequent dust storms and extreme hot climatic conditions, which can exacerbate respiratory conditions. These environmental factors are particularly injurious to asthmatic patients, as they can aggravate small airway disease (SAD), leading to increased morbidity and healthcare challenges. The evaluation of maximal mid-expiratory flow (MEF-25) as a diagnostic and therapeutic tool for early-stage small airway dysfunction is of significant clinical importance, particularly in hot and arid metropolitan environments where dusty conditions exacerbate pulmonary issues.

The use of peripheral blood biomarkers for predicting the risk of immune related adverse events in immune checkpoint inhibitor therapy.

Background: Immune checkpoint inhibitors (ICIs) have revolutionised oncology care, by enhancing the body's T cell lymphocyte response against tumour cells. ICIs block the inhibitory signalling between tumour cells and the immune system, but consequently reduce immunological tolerance. Subsequently for some, this leads to immune-related adverse events (irAE), a spectrum term for autoimmune-like toxicities induced by ICIs that affects various tissues and organs.

Outcomes of Concomitant Mitral Intervention in Hypertrophic Obstructive Cardiomyopathy Surgery?: A Systematic Review and Meta-Analysis of Contemporary Evidence.

The 2020 American Heart Association Guidelines advise not to perform mitral valve replacement (MVR) during septal myectomy (SM) to alleviate outflow obstruction. This study aims to review outcomes after concomitant mitral valve (MV) intervention versus SM alone. We conducted a comprehensive literature search across Embase, PubMed, and Scopus.

Surgical techniques to treat thumb spasticity in children and adults: A systematic review.

Upper limb spasticity surgery is an area of increasing interest and advances have been made in assessment and management, however treatment of the thumb remains a challenge. This systematic review evaluated current techniques to treat thumb spasticity. A search of three databases identified 14 articles between 2005 and 2023.

Non-contrast ultrasound assessment of blood flow in clinical practice.

Since the first clinical use of ultrasound in the 1940s, significant advancements have been made in its applications. Color Doppler imaging and power Doppler imaging are considered the first and second generations of flow ultrasound assessment tools, respectively. Subsequently, the introduction of contrastenhanced ultrasound has significantly improved the assessment of arterial and venous vascular patterns in lesions and vessels.

Histopathological outcomes of transanal, robotic, open, and laparoscopic surgery for rectal cancer resection. A Bayesian network meta-analysis of randomized controlled trials.

Background: While total mesorectal excision is the gold standard for rectal cancer, the optimal surgical approach to achieve adequate oncological outcomes remains controversial. This network meta-analysis aims to compare the histopathological outcomes of robotic (R-RR), transanal (Ta-RR), laparoscopic (L-RR), and open (O-RR) resections for rectal cancer.

Materials And Methods: MEDLINE, Embase, and the Cochrane Library were screened from inception to June 2024.

MR dacryocystography - Optimising a dynamic imaging protocol for patients with epiphora.

Introduction: Radiological investigations for epiphora often use techniques involving ionising radiation and may require invasive canalicular cannulation. Magnetic resonance dacryocystography (MRDCG) has been explored but is currently not widely utilised in clinical imaging departments. The aim of this technical report is to describe the optimisation of a non-invasive MRDCG technique using a continuous gadolinium drip to assess the anatomy and real-time functionality of the nasolacrimal drainage system (NLDS).

Local excision of early rectal cancer: A multi-centre experience of transanal endoscopic microsurgery from the United Kingdom.

Background: Total mesorectal excision remains the gold standard for the management of rectal cancer however local excision of early rectal cancer is gaining popularity due to lower morbidity and higher acceptance by the elderly and frail patients.

Aim: To investigate the results of local excision of rectal cancer by transanal endoscopic microsurgery (TEMS) approach carried out at three large cancer centers in the United Kingdom.

Methods: TEMS database was retrospectively reviewed to assess demographics, operative findings and post operative clinical and oncological outcomes.

A national survey of the provision of prehabilitation for oesophagogastric cancer patients in the UK.

Introduction: Studies have demonstrated that prehabilitation in oesophagogastric cancer (OGC) improves body composition, physical fitness and quality of life, and can reduce surgical complications. However, it is not offered in all OGC centres. Furthermore, definitions, funding and access to services vary.

Frailty and body composition predict adverse outcomes after emergency general surgery admission: a multicentre observational cohort study.

Introduction: Emergency surgical admissions represent the most unwell patients admitted to any hospital. Frailty and body composition independently identify risk of adverse outcomes but are seldom combined to predict outcomes in emergency patients. We aim to determine the relationships between frailty, body composition analyses (BCA) and mortality in an undifferentiated emergency general surgical patient population.

The 2023 ESC heart failure guideline update and its implications for clinical practice.

In this article we focus on areas of the European Society for Cardiology (ESC) heart failure guideline 2023 update that will be most relevant in the day-to-day management of patients with heart failure. These include an expanded indication for sodiumglucose cotransporter 2 (SGLT2) inhibitors and intravenous iron, together with rapid optimisation of foundation therapies. With important outcomes for patients, there will undoubtedly need to be modifications to service delivery to ensure that they are widely available for patient benefit.

Prognostic factors and treatment choice for stage IV, low-volume metastasis hormone-sensitive prostate cancer: cross-sectional study of real-world data.

Background: Many metastatic prostate cancer prognostics have been suggested, but few are validated. Nodal metastasis burden and baseline biochemical characteristics are overlooked in the currently accepted stratifications for metastatic hormone-sensitive prostate cancer (mHSPC). Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) is likely to increase the incidence of pelvic nodal and mHSPC undetected by conventional scans.

Robotic colorectal surgery in Latin America: a systematic review on surgical outcomes.

Background And Objectives: Robotic approach in colorectal surgery is rapidly gaining interest, particularly in the context of rectal cancer resection. Despite economic barriers, substantial proliferation of robotic colorectal procedures has been observed throughout Latin America. However, there is a lack of data regarding intraoperative and early postoperative outcomes, as well as oncological and long-term results.

Digital Versus Paper-Based Consent from the UK NHS Perspective: A Micro-costing Analysis.

Background: The paper-based consent pathway can be associated with missing information, error, and inadequate patient comprehension. Digital consent addresses some of these limitations. However, limited research has been conducted to understand relative costs and consequences associated with adopting digital consent pathways.

Evaluating the Risk of Traumatic Brain Injury in Adults Following a Fall With Concomitant Use of Anti-Coagulation: A Retrospective Cohort Study.

Introduction Falls and fractures are major health challenges for older adults in England. Despite the advantages of anticoagulants, their use in the elderly is often restricted due to concerns about fall-related injuries. However, there is a lack of clear data on the risk of discontinuing anticoagulation therapy solely due to fall risk.