The feasibility and effectiveness of telecare consultations in a nurse-led post-acute stroke clinic.

Background: Telecare may provide an alternative to maintaining post-acute stroke care services in making benefit to both the providers and the stroke survivors, although study is needed to investigate its feasibility and effectiveness in integrating this innovative delivery mode into a routine.

Objectives: The objectives of this study are to assess the feasibility and effectiveness of telecare consultations in a nurse-led post-acute stroke clinic.

Methods: A pre- and post-test one group quasi-experimental design was adopted.

Distinct genetic risk loci between biopsy-proven renal and non-renal lupus: a 10-year longitudinal cohort.

Objective: Systemic lupus erythematosus (SLE) is a heterogeneous disease which manifests as different subphenotypes. Distinct subphenotypes, such as lupus nephritis (LN), have been associated with increased genetic risk, but prior studies have been limited by cross-sectional and imprecisely subphenotyped cohorts. This study investigated the genetic basis for LN using a longitudinal cohort of distinctly subphenotyped patients.

Treatment of Cardiogenic Shock: Inotropes, Vasopressors and Machines.

Cardiogenic shock (CS) is associated with significant mortality. Advances in pharmacological therapies and mechanical circulatory support (MCS) devices have markedly improved the therapeutic approach to CS, though treatment efficacy and safety vary. The recent DanGer shock trial showed a significant reduction in 6-month mortality for CS patients due to acute myocardial infarction.

Isolated Medial Malleolar Fractures: Current Concepts in Management.

Isolated medial malleolar fractures (IMMFs) are uncommon and often occur with other ankle injuries, complicating their treatment and management. This review aims to compare the complication rates and functional outcomes of surgical versus conservative treatment for IMMFs in skeletally mature patients. The literature suggests that for IMMFs with less than 2 mm of displacement, conservative treatment provides functional outcomes similar to surgical interventions, with minimal complications.

Transitioning to a virtual post-intensive care rehabilitation service in response to the COVID-19 pandemic: results of multidisciplinary focus-groups.

Background: Telehealth has vastly expanded since the SARS-CoV-2 (COVID-19) pandemic and has been widely implemented as an efficient, cost-effective and accepted means of health care delivery, including rehabilitation. Although telerehabilitation is recommended across national guidelines, there is a lack of practical guidance to support clinicians with virtual adaptations.

Aims: This study aimed to describe the key components of a safe and effective virtual post-intensive-care rehabilitation service, through qualitative exploration.

Basic helix-loop-helix ARNT like 1 regulates the function of immune cells and participates in the development of immune-related diseases.

The circadian clock is an internal timekeeper system that regulates biological processes through a central circadian clock and peripheral clocks controlling various genes. Basic helix-loop-helix ARNT-like 1 (), also known as aryl hydrocarbon receptor nuclear translocator-like protein 1 (), is a key component of the circadian clock. The deletion of alone can abolish the circadian rhythms of the human body.

Disparities in menstrual bleeding management during acute venous thromboembolism treatment: A review of UK practice and a call for clinical studies.

Background: Heavy menstrual bleeding (HMB) is a significant clinical burden for premenopausal individuals treated with anticoagulation for acute venous thromboembolism (VTE). Despite its prevalence, HMB management remains poorly studied, with wide variation in clinical practice.

Objectives: The current study aimed to explore current UK practices in managing HMB in anticoagulated individuals and identify areas requiring clinical research to address disparities.

Immunotherapy-Resistant Neuropathic Pain and Fatigue Predict Quality-of-Life in Contactin-Associated Protein-Like 2 Antibody Disease.

The long-term clinical outcomes and associated prognostic factors in contactin-associated protein-like 2 (CASPR2)-antibody diseases are unknown. A total of 75 participants with CASPR2 antibodies were longitudinally assessed for disability, quality-of-life, and chronic pain. Although most symptoms improved within 6 months of treatment, neuropathic pain and fatigue were the most immunotherapy refractory, and persisted for up to 6 years.

Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

The Canadian Stroke Best Practice Recommendations (CSPR) 7th edition includes this new module on the diagnosis and management of vascular cognitive impairment (VCI) with or without neurodegenerative disease. An expert writing group and people with VCI lived experience (PWLE) reviewed current evidence. Existing recommendations were reviewed and revised, and new recommendations added.

CAR T access and outcomes in large B-cell lymphoma according to ethnicity and socioeconomic deprivation in the UK.

Data on the impact of ethnic and socioeconomic factors on Chimeric antigen receptor (CAR) T-cell therapy (access and outcomes are limited, but key to understand whether results from the registration trials are generalizable to real-world patient populations. Here, we analysed ethnicity, socioeconomic deprivation and referral patterns in a cohort of 314 large B-cell lymphoma patients approved for third-line CD19 CAR-T across three large UK CAR-T centres. Patients from deprived areas had a lower infusion rate compared to low deprivation areas (73% vs.

A macro-transection model of brain trauma for neuromaterial testing with functional electrophysiological readouts.

Functional recovery in penetrating neurological injury is hampered by a lack of clinical regenerative therapies. Biomaterial therapies show promise as medical materials for neural repair through immunomodulation, structural support, and delivery of therapeutic biomolecules. However, a lack of facile and pathology-mimetic models for therapeutic testing is a bottleneck in neural tissue engineering research.

Patient preferences for drug therapy in inflammatory arthritis: protocol for a living systematic review and evidence map to inform clinical practice guidelines.

Introduction: The pharmacological management of inflammatory arthritis often requires choices that involve trade-offs between benefits, risks and other attributes such as administration route, frequency and cost. This living systematic review aims to inform international clinical guidelines on inflammatory arthritis by creating an evidence map of patient preference studies concerning the trade-offs in pharmacological management of inflammatory arthritis.

Methods And Analysis: We will include published and peer-reviewed full-text studies in any language that quantitatively assess preferences of patients for the pharmacological management of inflammatory arthritis (rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis).

Adaptation of clinical bacteriology techniques for remote polar research.

Unlabelled: Remote polar regions offer unique opportunities and significant challenges for antimicrobial resistance research in a near-pristine environment. While core microbiology techniques continue to have an important role in supporting environmental research, the severe cold climate presents considerable challenges to laboratory research. We explore adaptations required for core bacteriology investigations in polar regions on an unsupported remote expedition c.

Digital neural loops - a common anatomical surprise.

In a recent operation, we unexpectedly encountered a digital neural loop in the palm. To our surprise we found out that these have a high prevalence but a survey that we carried out showed that there is a low clinical awareness of them. V.

Meta-Analysis: Exclusive Enteral Nutrition in Adults With Ulcerative Colitis.

Background: Exclusive enteral nutrition (EEN) is an established dietary therapy for Crohn's disease but its role in ulcerative colitis remains unclear.

Aims: To investigate the efficacy of EEN in adults with active ulcerative colitis and compare variations in treatment protocols, safety, tolerability and adherence.

Methods: We conducted a systematic search of MEDLINE, Embase, Cochrane CENTRAL, Emcare, CINAHL, Web of Science and trial registries for articles published from inception until July 21, 2024.

Exploring the use and usefulness of living guidelines for consumers: international online survey of patients' and carers' views.

Background: Living guidelines contain continually updated, and potentially changing, clinical recommendations. The implications of living guidelines for consumers (e.g.

Environmental impact of commonly used anaesthetic agents: systematic literature review with narrative synthesis.

Background: Increasing awareness of the potential environmental impact of volatile anaesthetic agents has stimulated increased use of total i.v. anaesthesia.

Establishing the UHB doctor wellbeing group as a model for sustainable change in improving resident doctor wellbeing.

Significant wellbeing concerns have been reported nationally among resident doctors. A peer-led survey at University Hospitals Birmingham NHS Foundation Trust revealed high burnout risk and dissatisfaction. The Doctor Wellbeing Group (DWG) was established to address these multifaceted concerns by supporting resident doctors to run quality improvement projects to improve working conditions, with consultant supervision and regular reports to stakeholders.

Unresolved Complete Heart Block in a Patient Treated for Euthyroid Graves' Disease: A Diagnostic Dilemma.

The cardiovascular implications of thyroid disease have been recognized as one of the most characteristic signs that result from the effect of thyroid hormone (TH). Both hyperthyroidism and hypothyroidism produce changes in cardiac contractility, myocardial oxygen consumption, cardiac output, blood pressure, and systemic vascular resistance. The bradyarrhythmias, including atrioventricular block and sick sinus syndrome, are exceedingly rare in hyperthyroidism.

Ossifying fibromyxoid tumours: A case series.

Background: Ossifying fibromyxoid tumour is a rare mesenchymal soft tissue sarcoma with uncertain differentiation and variable metastatic potential.

Patients And Methods: This study offers a retrospective analysis of 23 patients diagnosed with OFMT between 1993 and 2024.

Results: The tumours most commonly arose in the extremities and trunk, with all patients undergoing surgical resection of the primary tumour.

Brief report: Impact of consolidation durvalumab on unresectable non-small lung cancer with driver mutations.

Unresectable stage III non-small cell lung cancer (NSCLC) carries a poor prognosis. The PACIFIC trial established consolidation durvalumab after chemoradiation as a standard treatment; however, its efficacy in patients with driver mutations remains uncertain. This retrospective cohort study analyzed data from three oncology centers in Hong Kong, covering the period from January 2019 to December 2022.

Meta-analysis of longitudinal comparison of transcatheter versus surgical aortic valve replacement in patients at low to intermediate surgical risk.

Background: Surgical aortic valve replacement (SAVR) is the commonly used approach for aortic valve replacement (AVR) in patients with aortic stenosis at low or intermediate surgical risk. However, transcatheter aortic valve replacement (TAVR) has emerged as an alternative to SAVR for AVR. This meta-analysis aims to assess the comparative efficacy and safety of TAVR versus SAVR in low-to-intermediate surgical risk patients by analyzing temporal trends in the outcomes of TAVR and SAVR at various follow-up intervals, providing a more detailed understanding.