1,548 results match your criteria: "Royal Centre for Defence Medicine Research & Academia[Affiliation]"

The incidence of admission ionised hypocalcaemia in paediatric major trauma-A systematic review and meta-analysis.

PLoS One

May 2024

Emergency and Urgent Care Research in Cambridge (EURECA), PACE Section, Department of Medicine, Cambridge University, Cambridge, United Kingdom.

Objectives: In adult major trauma patients admission hypocalcaemia occurs in approximately half of cases and is associated with increased mortality. However, data amongst paediatric patients are limited. The objectives of this review were to determine the incidence of admission ionised hypocalcaemia in paediatric major trauma patients and to explore whether hypocalcaemia is associated with adverse outcomes.

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Introduction: Musculoskeletal injuries (MSKIs) are a significant problem in the Royal Navy, contributing to 48% of all medical discharges from service between 2019 and 2020. The objective of the study was to assess efficacy of implementing a neuromuscular training intervention to improve movement quality and reduce MSKIs in Royal Navy recruits undertaking initial military training.

Methods: Neuromuscular training (pre-activation exercises, focusing on hip control) was integrated into the warm-up exercise regimen preceding physical training during the 10-week initial naval training (recruits) programme (January-March 2020) at HMS Raleigh (intervention group; n=162).

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The function and phenotype of γδ T cells in the context of common variable immunodeficiency (CVID) has not been explored. CVID is a primary immunodeficiency disorder characterized by impaired antibody responses resulting in increased susceptibility to infections. γδ T cells are a subset of unconventional T cells that play crucial roles in host defence against infections.

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Article Synopsis
  • The GBD 2021 study aims to quantify the health impacts of 88 risk factors across 204 countries from 1990 to 2021, helping to inform public health policies.
  • The analysis utilized over 54,000 data sources to assess 631 risk-outcome pairs, determining how specific risk factors contribute to various health issues.
  • By calculating relative risks and population attributable fractions, the study provides insights into the disease burden tied to each risk factor, measured in disability-adjusted life-years (DALYs).
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Maternal mortality rates are at an all-time high across the world and are set to increase in subsequent years. Cardiovascular disease is the leading cause of death during pregnancy and postpartum, especially in the United States. Therefore, understanding the physiological changes in the cardiovascular system during normal pregnancy is necessary to understand disease-related pathology.

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Background And Importance: Following the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA), a low body temperature on arrival at the hospital and on admission to the ICU is reportedly associated with increased mortality. Whether this association exists in the prehospital setting, however, is unknown.

Objective: The objective of this study was to investigate whether the initial, prehospital core temperature measured post-ROSC is independently associated with survival to hospital discharge in adult patients following OHCA.

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Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication: Practice Guideline From the AAN, AES, and SMFM.

Neurology

June 2024

From the Department of Neurology (A.M.P.), Columbia University, New York City; Departments of Pediatrics and Neurology & Neurosurgery (M.O.), McGill University, Montreal, Quebec, Canada; Departments of Neurology (S.W.R.), Biomedical Engineering (S.W.R.), and Obstetrics and Gynecology (S.S.O.), Vanderbilt University Medical Center, Nashville, TN; Northern Michigan Neurology and Munson Medical Center (D.K.D.), Traverse City, MI; Department of Neurology (J.F.), NYU Grossman School of Medicine, New York City; Feinberg School of Medicine (E.E.G.), Northwestern University, Chicago, IL; The NeuroMedical Center (D.G.), Baton Rouge, LA; Epilepsy Foundation (W.R.M.), Bowie, MD; Department of Neurology (H.M.M.C.), Wake Forest University School of Medicine, Winston-Salem, NC; My Epilepsy Story (B.M.), Nashville, TN; Institute of Clinical Neurosciences (K.P.), Royal Prince Alfred Hospital, Sydney, Australia; Department of Neurology (P.B.P.), University of Pittsburgh School of Medicine, PA; Department of Ob-Gyn (G.S.), Eastern Virginia Medical School, Norfolk; Department of Neurology (D.B.S.), University of Colorado School of Medicine, Aurora; Department of Biostatistics, Epidemiology, and Environmental Health Sciences (K.S.), Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro; Department of Neurology (S.V.T.), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India; Department of Clinical Neuroscience (T.T.), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; American Academy of Neurology (M.D.O.B., K.B.-D., H.M.S.), Minneapolis, MN; and Centre Hospitalier de l'Université de Montréal Research Centre (CRCHUM) (M.R.K.), Quebec, Canada.

This practice guideline provides updated evidence-based conclusions and recommendations regarding the effects of antiseizure medications (ASMs) and folic acid supplementation on the prevalence of major congenital malformations (MCMs), adverse perinatal outcomes, and neurodevelopmental outcomes in children born to people with epilepsy of childbearing potential (PWECP). A multidisciplinary panel conducted a systematic review and developed practice recommendations following the process outlined in the 2017 edition of the American Academy of Neurology Clinical Practice Guideline Process Manual. The systematic review includes studies through August 2022.

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One-carbon (1-C) metabolic deficiency impairs homeostasis, driving disease development, including infertility. It is of importance to summarize the current evidence regarding the clinical utility of 1-C metabolism-related biomolecules and methyl donors, namely, folate, betaine, choline, vitamin B12, homocysteine (Hcy), and zinc, as potential biomarkers, dietary supplements, and culture media supplements in the context of medically assisted reproduction (MAR). A narrative review of the literature was conducted in the PubMed/Medline database.

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Methods for pragmatic randomized clinical trials of pain therapies: IMMPACT statement.

Pain

October 2024

Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom.

Pragmatic, randomized, controlled trials hold the potential to directly inform clinical decision making and health policy regarding the treatment of people experiencing pain. Pragmatic trials are designed to replicate or are embedded within routine clinical care and are increasingly valued to bridge the gap between trial research and clinical practice, especially in multidimensional conditions, such as pain and in nonpharmacological intervention research. To maximize the potential of pragmatic trials in pain research, the careful consideration of each methodological decision is required.

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Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) last published clinical guidelines for the management of major depressive disorder (MDD) in 2016. Owing to advances in the field, an update was needed to incorporate new evidence and provide new and revised recommendations for the assessment and management of MDD in adults.

Methods: CANMAT convened a guidelines editorial group comprised of academic clinicians and patient partners.

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Background: Staffing and resource shortages, especially during the COVID-19 pandemic, have increased stress levels among health care workers. Many health care workers have reported feeling unable to maintain the quality of care expected within their profession, which, at times, may lead to moral distress and moral injury. Currently, interventions for moral distress and moral injury are limited.

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Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs.

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Introduction: ECG changes are associated with regular long-term intensive exercise due to electrical manifestations of increased vagal tone, increased ventricular wall thickness and enlarged chamber size. The aim of this study was to further understand the relationship of athletic ECG changes and athletic performance in an athletic population.

Methods: A retrospective cohort study was performed in 195 Nepali civilian males undergoing selection to the Gurkhas.

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Background And Aims: HBV and HIV coinfection is a common occurrence globally, with significant morbidity and mortality. Both viruses lead to immune dysregulation including changes in natural killer (NK) cells, a key component of antiviral defense and a promising target for HBV cure strategies. Here we used high-throughput single-cell analysis to explore the immune cell landscape in people with HBV mono-infection and HIV/HBV coinfection, on antiviral therapy, with emphasis on identifying the distinctive characteristics of NK cell subsets that can be therapeutically harnessed.

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Article Synopsis
  • The study looks at why some people have died from injuries that could have been prevented in Northern Malawi.
  • They found that many of these deaths had delays in getting help, with different reasons for each delay.
  • A large number of potentially avoidable deaths were linked to issues like not knowing how to get care, problems in communication, and lack of resources in hospitals.
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Background: Urothelial carcinoma, a prevalent and aggressive urological malignancy, necessitates early detection for improved prognosis. Urine cytology serves as a cost-effective screening tool, but inconsistencies in reporting due to the lack of standardized criteria limit its efficacy. The Paris System for reporting urinary cytology (TPS) was introduced to address this issue, aiming to improve diagnostic accuracy.

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Optical coherence tomography angiography (OCTA) is widely used for non-invasive retinal vascular imaging, but the OCTA methods used to assess retinal perfusion vary. We evaluated the different methods used to assess retinal perfusion between OCTA studies. MEDLINE and Embase were searched from 2014 to August 2021.

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Botulinum toxin type A (BONT-A) has shown promise in improving the mood-related symptoms of psychiatric disorders by targeting muscles linked to the expression of negative emotions. We conducted a systematic review of past and ongoing efficacy trials of BONT-A therapy for psychiatric disorders to identify relevant trends in the field and discuss the refinement of therapeutic techniques. A comprehensive search for published clinical trials using BONT-A injections for psychiatric disorders was performed on 4 May 2023 through OVID databases (MEDLINE, Embase, APA PsycINFO).

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Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals.

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The effect of pressure injury prevention care bundles on pressure injuries in hospital patients: A complex intervention systematic review and meta-analysis.

Int J Nurs Stud

July 2024

NHMRC Centre of Research Excellence in Wiser Wound Care, Griffith University, Gold Coast Campus, Queensland 4222, Australia; School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Queensland 4222, Australia; Gold Coast University Hospital and Health Service, Gold Coast, QLD, Australia. Electronic address: https://twitter.com/bgillespie6.

Background: Numerous interventions for pressure injury prevention have been developed, including care bundles.

Objective: To systematically review the effectiveness of pressure injury prevention care bundles on pressure injury prevalence, incidence, and hospital-acquired pressure injury rate in hospitalised patients.

Data Sources: The Medical Literature Analysis and Retrieval System Online (via PubMed), the Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus, the Cochrane Library and two registries were searched (from 2009 to September 2023).

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Despite guideline-based recommendation of the interchangeable use of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) to guide revascularization decision-making, iFR/FFR could demonstrate different physiological or clinical outcomes in some specific patient or lesion subsets. Therefore, we sought to investigate the impact of difference between iFR and FFR-guided revascularization decision-making on clinical outcomes in patients with left main disease (LMD). In this international multicenter registry of LMD with physiological interrogation, we identified 275 patients in whom physiological assessment was performed with both iFR/FFR.

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A roadmap for therapeutic discovery in pulmonary hypertension associated with left heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Pulmonary Circulation & Right Ventricular Function.

Eur J Heart Fail

April 2024

Department of Translational Medical Sciences, Interdepartmental Center for Clinical and Translational Research (CIRCET), and Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy.

Article Synopsis
  • Pulmonary hypertension (PH) linked to left heart failure (PH-LHF) is a common condition that worsens symptoms, reduces physical ability, and harms right heart function, leading to a poor outlook for patients.
  • Despite various drugs being tested, there are currently no specific treatments for PH-LHF, highlighting significant gaps in understanding its pathophysiology and clinical management.
  • The document calls for improved research on pulmonary venous changes, patient categorization for tailored therapies, and rigorous pre-clinical studies to enhance clinical trials and expand treatment options beyond current methods used for pulmonary arterial hypertension.
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Chest computed tomography (CT) scans are essential to diagnose and monitor bronchiectasis (BE). To date, few quantitative data are available about the nature and extent of structural lung abnormalities (SLAs) on CT scans of patients with BE. To investigate SLAs on CT scans of patients with BE and the relationship of SLAs to clinical features using the EMBARC (European Multicenter Bronchiectasis Audit and Research Collaboration) registry.

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