Impact of Silymarin Supplementation on Liver Function and Enzyme Profiles in Diverse Chronic Liver Disease Etiologies.

Aim And Background: This study aimed to evaluate the efficacy of silymarin in improving liver function and reducing liver stiffness in chronic liver disease (CLD) patients. Silymarin, a hepatoprotective agent, has shown potential benefits in non-alcoholic fatty liver disease (NAFLD) and liver fibrosis, but evidence in CLD with varied etiologies remains limited. This study addresses the gap by assessing its impact across diverse etiological subgroups.

YouTube Videos of Pacemaker Implantation: An Assessment of Information Content and Quality.

Background: Permanent pacemaker (PPM) implantation is a commonly performed procedure. Patients increasingly use the Internet for information on medical interventions. We aimed to assess the quality of videos discussing PPM implantation on YouTube for patient consumption.

Patient and public involvement in the design and protocol development for a platform randomised trial to evaluate diagnostic tests to optimise antimicrobial therapy (PROTECT).

Background: Our patient and public involvement activities were part of a project aiming to develop a master protocol and National Institute for Health and Care research application for the PROTECT trial aiming to assess the effectiveness, implementation, and efficiency of antimicrobial stewardship interventions, to safely reduce unnecessary antibiotic usage by excluding severe bacterial infection in acutely unwell patients.

Methods: Three public involvement sessions were held with representation from young people and parents, people from diverse backgrounds and people with experience of presenting to the emergency department with undifferentiated illness. The teleconference meetings lasted between 60-90 minutes, were recorded, notes were subsequently taken, and findings summarised.

Elective Aortic Surgery for Prevention of Aortic Dissection in Turner Syndrome: The Potential Impact of Updated European Society of Cardiology and International Turner Syndrome Consensus Group Guidelines on Referrals to the Heart Team.

Objective: The risk of aortic dissection is increased in Turner Syndrome (TS). Aortic dilation is thought to contribute to this risk and may be managed with elective aortic surgery. New TS guidance has lowered the aortic size thresholds for consideration of aortic surgery.

Artificial intelligence can help individualize Wilms tumor treatment by predicting tumor response to preoperative chemotherapy.

Purpose: To create a computer-aided prediction (CAP) system to predict Wilms tumor (WT) responsiveness to preoperative chemotherapy (PC) using pre-therapy contrast-enhanced computed tomography (CECT).

Materials And Methods: A single-center database was reviewed for children <18 years diagnosed with WT and received PC between 2001 and 2021. Patients were excluded if pre- and post-PC CECT were not retrievable.

Relationships between hearing, auditory processing, and communication in children diagnosed with auditory neuropathy spectrum disorder.

Objectives: The objectives of this study were to evaluate the relationships between auditory processing, speech discrimination, and listening and communication abilities in children diagnosed with auditory neuropathy spectrum disorder (ANSD) compared to those with normal hearing.

Methods: This was a case-control study involving seventeen participants with a diagnosis of ANSD who used spoken language as their primary mode of communication and wore hearing aids or were unaided and 21 normally hearing controls. All underwent a battery of behavioural measures of hearing, speech perception and auditory processing skills.

Activating waitlists: Identifying barriers and facilitators to pain self-management while waiting.

Objectives: Waitlists for pain management services are often extensive, risking psychological and physical decline and patient non-engagement in treatment once accessed. Currently, for outpatient pain management, no standardised waiting list interventions exist, resulting in passive waiting. To arrest prospective wait-related decline(s), this study aimed to identify the barriers and facilitators to pain self-management while waiting, forming the foundation for a waitlist intervention development.

A Systematic Review and Meta-Analysis of Medial Meniscus Root Tears: Is Surgery the Key to Better Outcomes?

Medial meniscus root tears (MMRTs) are serious injuries that disrupt knee biomechanics, often accelerating cartilage degeneration and osteoarthritis when left untreated. These injuries are increasingly recognized as a major cause of knee pain and functional limitations, particularly among middle-aged and older adults. This systematic review and meta-analysis aimed to evaluate the outcomes of conservative management compared to surgical intervention for MMRT, focusing on pain relief, functional recovery, and the progression of osteoarthritis.

Comprehensive Analysis of Minimally Invasive Management for Persistent Anterolateral Ankle Pain: A Systematic Review.

Persistent anterolateral ankle pain is a debilitating condition often associated with soft tissue impingement following inversion injuries. It can lead to significant limitations in daily activities and overall quality of life, particularly in individuals with chronic ankle instability. This systematic review examines the efficacy and safety of minimally invasive arthroscopic decompression techniques in managing anterolateral ankle impingement syndrome.

Outcomes of Fasciotomy Versus Conservative Management for Chronic Exertional Compartment Syndrome: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to evaluate and compare the effectiveness of surgical fasciotomy and conservative management for chronic exertional compartment syndrome (CECS) concerning symptom relief, functional recovery, and patient satisfaction. A comprehensive search of PubMed, Scopus, Google Scholar, and Cochrane Library identified studies comparing surgical fasciotomy with conservative management for CECS. Four studies met the inclusion criteria, comprising both retrospective and prospective cohort designs.

Platelet-Rich Plasma Versus Corticosteroid Injections for Chronic Tendinopathies: A Systematic Review and Meta-Analysis.

Chronic tendinopathy is a degenerative condition characterized by persistent pain, functional limitations, and tendon thickening, often resulting from repetitive overuse or failed tendon healing. Left untreated, it can progress to tendon rupture, prolonged disability, and impaired quality of life. Management typically includes conservative therapies, such as physical therapy, corticosteroid (CS) injections for short-term relief, and platelet-rich plasma (PRP) as a regenerative therapy with potential long-term benefits.

Comprehension of acoustically degraded emotional prosody in Alzheimer's disease and primary progressive aphasia.

Previous research suggests that emotional prosody perception is impaired in neurodegenerative diseases like Alzheimer's disease (AD) and primary progressive aphasia (PPA). However, no previous research has investigated emotional prosody perception in these diseases under non-ideal listening conditions. We recruited 18 patients with AD, and 31 with PPA (nine logopenic (lvPPA); 11 nonfluent/agrammatic (nfvPPA) and 11 semantic (svPPA)), together with 24 healthy age-matched individuals.

Approach to investigation and management of proteinuria in pregnancy.

Pregnancy leads to significant changes in renal physiology, which result in increases in glomerular filtration rate (GFR) and enhanced protein excretion. These changes may continue in the postnatal period and might be observed for 5-6 months after birth. Once confirmed, proteinuria warrants investigation and close surveillance.

Neurovascular Complications Associated With Clavicle Fractures: A Report of Three Cases and Recommendations.

Neurovascular complications associated with clavicular shaft fractures can manifest at presentation, develop gradually over time, or potentially be iatrogenically induced. Conducting a thorough neurovascular examination and, when warranted, pursuing further investigation through modalities such as CT angiogram, MRI, and nerve conduction studies (NCS) are crucial for early diagnosis and pre-operative planning. This comprehensive approach enhances patient outcomes by facilitating timely intervention and addressing any underlying neurovascular issues associated with the fracture.

Efficacy of Arthroscopic Meniscal Surgery Versus Conservative Management on Knee Pain and Functional Outcomes: A Meta-Analysis of Randomized Controlled Trials.

Knee pain is a prevalent issue among older adults, often resulting from degenerative joint changes, and significantly impacts functionality and quality of life. While arthroscopic meniscal surgery is a common intervention for managing knee pain, its effectiveness compared to conservative treatments remains debated. This meta-analysis aims to compare the efficacy of arthroscopic meniscal surgery versus conservative management in alleviating knee pain and enhancing functional outcomes in patients with degenerative meniscal tears.

2-year results from an observational study of proactive treatment regimens with intravitreal aflibercept 2 mg in patients with nAMD in clinical practice: XTEND study UK cohort.

Objectives: The 36-month XTEND (NCT03939767) multicentre, observational, prospective study examined the effectiveness of proactive treatment regimens of intravitreal aflibercept (IVT-AFL) 2 mg in treatment-naïve patients with neovascular age-related macular degeneration (nAMD) in routine clinical practice. The 12- and 24-month outcomes from the XTEND UK cohort are reported.

Methods: Patients aged ≥50 years with nAMD planned to receive IVT-AFL 2 mg were eligible.

A bipartite medial cuneiform bone: a rare variant with symptomatic presentation and the classic "E-sign".

Background: Bipartite medial cuneiform bone (BMC) is located at the Lisfranc joint of the midfoot, and it represents a rare variant involving two separate ossification centers in the medial cuneiform bone. Although BMC is typically asymptomatic, it can become clinically relevant under conditions of trauma or chronic stress, affecting foot stability.

Case Report: The current imaging report describes a 48-year-old female presenting with chronic dorsal midfoot pain, worsened by extended standing and ambulation.

Operative Repair of Medial Patellofemoral Ligament Injury Versus Knee Bracing in Acute First-Time Traumatic Patellar Dislocation: A Systematic Review and Meta-Analysis.

Acute first-time traumatic patellar dislocation is a prevalent knee injury, particularly in adolescents, often managed conservatively with knee bracing. Recently, medial patellofemoral ligament (MPFL) reconstruction has gained popularity for its potential benefits in reducing redislocation rates and enhancing functional outcomes. This systematic review and meta-analysis compared the outcomes of MPFL reconstruction versus knee bracing for managing acute first-time traumatic patellar dislocation.

The role of healthcare professionals' communication in trial participation decisions: a qualitative investigation of recruitment consultations and patient interviews across three RCTs.

Background: Although the challenges of recruiting to randomised controlled trials (RCTs) are well documented, few studies have focused on the impact that the communication between recruiters and patients has on patients' participation decisions. Recruiters are thought to influence patient decision-making, but the mechanisms by which this occurs are unclear. The aim of this research was to investigate how patients interpret and use the information conveyed to them by healthcare professionals (HCPs) in trial participation decisions.

Faecal immunochemical tests for patients with symptoms suggestive of colorectal cancer: An updated systematic review and multiple-threshold meta-analysis of diagnostic test accuracy studies.

Aim: Extending faecal immunochemical tests for haemoglobin (FIT) to all primary care patients with symptoms suggestive of colorectal cancer (CRC) could identify people who are likely to benefit from colonoscopy and facilitate earlier treatment. The aim of this work was to investigate the diagnostic accuracy of FIT across different analysers at different thresholds, as a single test or in duplicate (dual FIT).

Method: This systematic review and meta-analysis searched 10 sources (December 2022).

Biomechanical Evaluation and Comparative Analysis of Functional Scores in Suture Anchor Versus Transosseous Tunnel Patellar Tendon Repair Techniques in Adult Patients: A Systematic Review and Meta-Analysis.

Patellar tendon injuries, although less frequent than other knee injuries, can have a profound impact on knee function, often leading to significant disability. Among the various surgical techniques employed to repair these injuries, the suture anchor and transosseous tunnel methods are the most commonly used. This systematic review and meta-analysis compares the biomechanical properties and functional outcomes of these two repair techniques.

The genomic and clinical consequences of replacing procarbazine with dacarbazine in escalated BEACOPP for Hodgkin lymphoma: a retrospective, observational study.

Background: Procarbazine-containing chemotherapy regimens are associated with cytopenias and infertility, suggesting stem-cell toxicity. When treating Hodgkin lymphoma, procarbazine in escalated-dose bleomycin-etoposide-doxorubicin-cyclophosphamide-vincristine-procarbazine-prednisolone (eBEACOPP) is increasingly replaced with dacarbazine (eBEACOPDac) to reduce toxicity. We aimed to investigate the impact of this drug substitution on the mutation burden in stem cells, patient survival, and toxicity.

Feasibility of embedding orthopaedic clinical trials into national registries: a pilot quality improvement study for the UK Non-Arthroplasty Hip Registry (UK-NAHR).

The integration of 'Registry-based Randomised Control Trials' (RRCT) into national registries has the potential to catalyse prospective research, enhancing the evidence base for practice. The aim of this study was to assess the feasibility of embedding a trial within the UK Non-Arthroplasty Hip Registry. This was a national observational, multi-centre study.