A multimodal approach to reduce the incidence of peripheral venous cannula bacteraemias and improve patient safety.

Background: Incidence of peripheral venous cannula (PVC) bacteraemia have been rising in a trust in the south-west of England, with a 267% increase noted over the 2022/23 financial year compared with the previous year.

Aim: To use a multimodal approach to reduce the incidence of PVC bacteraemia and improve patient safety.

Methods: The initiative consisted of an educational poster highlighting the severity of infection associated with PVCs alongside key prevention messages rooted in Trust policy.

The Ocular Surface and the Anterior Segment of the Eye in the Pseudoexfoliation Syndrome: A Comprehensive Review.

Pseudoexfoliation syndrome (PXS) is an age-related fibrillopathy where fibrillar exfoliation material accumulates and deposits in ocular and extra-ocular tissue. Within the eye, this substance accumulates on the ocular surface and in the anterior segment of the eye, impacting ocular structures such as the conjunctiva, Tenon's capsule, sclera, cornea, iris, ciliary body, trabecular meshwork, and lens. This review aims to collate the current literature on how each anatomical part of the eye is affected by PXS, with a strong focus on molecular changes.

A novel, dominant disease mechanism of distal renal tubular acidosis with specific variants in ATP6V1B1.

Background And Hypothesis: ATP6V1B1 encodes a subunit of the vacuolar H+-ATPase and pathogenic variants are associated with autosomal recessive distal renal tubular acidosis (dRTA) with deafness. Heterozygous variants predicted to affect a specific amino acid, Arg394, have been recurrently reported in dRTA but their significance has been unclear. We hypothesised that these variants are associated with a dominant disease mechanism.

Discovery of a DNA methylation profile in individuals with Sifrim-Hitz-Weiss syndrome.

Pathogenic heterozygous variants in CHD4 cause Sifrim-Hitz-Weiss syndrome, a neurodevelopmental disorder associated with brain anomalies, heart defects, macrocephaly, hypogonadism, and additional features with variable expressivity. Most individuals have non-recurrent missense variants, complicating variant interpretation. A few were reported with truncating variants, and their role in disease is unclear.

Large-scale evaluation of outcomes after a genetic diagnosis in children with severe developmental disorders.

Purpose: We sought to evaluate outcomes for clinical management after a genetic diagnosis from the Deciphering Developmental Disorders study.

Methods: Individuals in the Deciphering Developmental Disorders study who had a pathogenic/likely pathogenic genotype in the DECIPHER database were selected for inclusion ( = 5010). Clinical notes from regional clinical genetics services notes were reviewed to assess predefined clinical outcomes relating to interventions, prenatal choices, and information provision.

Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.

Purpose: Revision knee replacement (RevKR) for infection is rare but increasing. It is hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit volume with outcomes following first, single-stage RevKR for infection.

Characteristics of older patients undergoing surgery in the UK: SNAP-3, a snapshot observational study.

Background: Frailty and multimorbidity are common in older adults, but the prevalence and interaction of these conditions in surgical patients remain unclear. This study describes the clinical characteristics of a heterogeneous cohort of older UK surgical patients.

Methods: We conducted a prospective observational cohort study during 5 days in March 2022, aiming to recruit all UK patients aged 60 yr and older undergoing surgery, excluding minor procedures (e.

High patient acceptance of immediately sequential bilateral cataract surgery (ISBCS) as part of a one-stop see-and-treat pathway within an innovative NHS cataract unit.

Background: Constituting ~0.5% of all NHS cataract operations, national provision of immediately sequential bilateral cataract surgery (ISBCS) is limited. Combining offering ISBCS within a novel one-stop see-and-treat (S&T) cataract pathway would offer patients the opportunity for two cataract operations in a single hospital visit.

Time Below Range and Its Influence on Hypoglycemia Awareness and Severe Hypoglycemia: Insights From the Association of British Clinical Diabetologists Study.

Objective: This study aimed to explore the relationship between time below range (TBR), impaired awareness of hypoglycemia (IAH), and severe hypoglycemia (SH).

Research Design And Methods: This cross-sectional study analyzed data from individuals with diabetes using continuous glucose monitors (CGMs) in the Association of British Clinical Diabetologists audit. Hypoglycemia awareness was assessed via the Gold score (≥4 denoting IAH), and SH was defined as hypoglycemia requiring third-party assistance.

Congenital hyperinsulinism in the Ukraine: a 10-year national study.

Introduction: Congenital Hyperinsulinism (CHI) has not been previously studied in Ukraine. We therefore aimed to elucidate the genetics, clinical phenotype, histological subtype, treatment and long-term outcomes of Ukrainian patients with CHI.

Methods: Forty-one patients with CHI were recruited to the Ukrainian national registry between the years 2014-2023.

A systematic review of short- compared with standard-length Exeter stems in primary total hip arthroplasty.

Aims: The Exeter femoral stem has a cemented, polished taper-slip design, and an excellent track record. The current range includes short-length options for various offsets, but less is known about the performance of these stems. The aim of this study was to compare the survival of short-length stems with standard-length Exeter stems.

Reducing Time Taken to Gather Equipment for Venepuncture and Cannulation: A Quality Improvement Project.

Timely gathering of equipment for venepuncture or cannulation on hospital wards is important, particularly in emergency situations. Anecdotally several doctors working at a hospital in England expressed frustration at low equipment stock, layout, and discrepancies between wards leading to significant delays in this process. This quality improvement project therefore aimed to reduce the time taken to gather equipment for venepuncture or cannulation to 20 seconds by June 2023.

Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres.

Introduction: Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.

Methods: Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.

Nationwide Cross-Sectional Analysis of Mortality Trends in Patients with Sarcoidosis and Non-Ischemic Cardiovascular Disease-The Impact of Gender, Ethnicity, Geographical Location, and COVID-19 Pandemic.

The epidemiological data regarding mortality rates of adults with sarcoidosis and non-ischemic cardiovascular disease (CVD) are limited. A retrospective observational analysis was conducted to identify trends and disparities related to sarcoidosis and non-ischemic cardiovascular disease mortality among the adult US population from 1999 to 2022. We used the Centers for Disease Control and Prevention (CDC) WONDER database to extract death certificate data for the adult US population (≥25 years).

Lifting limitations following elbow arthroplasty: A survey of British Elbow and Shoulder Society members.

The primary aim of this survey was to capture current practice with regard to lifting limitations following elbow arthroplasty. An online survey was emailed to all members of the British Elbow and Shoulder Society. All consultant respondents who reported performing elbow arthroplasty were asked about their advice for post-operative lifting limitations.

Measuring the impact of digitisation on NHS nurses' time and morale: A time and motion study.

Objective: Despite the benefits of digital transformation, many healthcare organisations still rely on manual, traditional processes to transfer clinical images and videos to electronic patient records (EPRs), consuming valuable nurse-patient-facing time. Our study aimed to outline tasks performed by nurses to traditionally transfer clinical images and videos to EPRs, assess the impact on nurses' time and efficiency cost, and report on nurse experiences when transitioning to a digitised process.

Methods: Observations spanned two one-week periods in the ENT outpatient department of Royal Devon University Healthcare NHS Foundation Trust, using direct observational time and predetermined motion time system analysis to map nurses' tasks pre-and post-implementation of a Medical Video Recorder and Centralised Medical Content Management.

Propionic Acidemia diagnosed in Amish adults and pregnancy outcomes: A case series.

Background: Propionic acidemia (PA) is an inborn error of metabolism (IEM) that typically presents in the newborn. The Amish of North America have an increased prevalence of PA due to a founder variant in the gene. The Amish PA phenotype is variable, and some individuals remain asymptomatic and undiagnosed until adulthood.

Management of individuals with heterozygous germline pathogenic variants in ATM: A clinical practice resource of the American College of Medical Genetics and Genomics (ACMG).

Purpose: ATM germline pathogenic variants (GPVs) are associated with a moderately increased risk of female breast cancer, pancreatic cancer, and prostate cancer. Resources for managing ATM heterozygotes in clinical practice are limited.

Methods: An international workgroup developed a clinical practice resource to guide management of ATM heterozygotes using peer-reviewed publications and expert opinion.