Neurodevelopmental Outcomes after Multiple General Anesthetic Exposures before 5 Years of Age: A Cohort Study.

Background: The general anaesthesia or awake-regional anaesthesia in infancy (GAS) trial demonstrated evidence that most neurodevelopmental outcomes at 2 and 5 yr of age in infants who received a single general anesthetic for elective inguinal herniorrhaphy were clinically equivalent when compared to infants who did not receive general anesthesia. More than 20% of the children in the trial had at least one subsequent anesthetic exposure after their initial surgery. Using the GAS database, this study aimed to address whether multiple (two or more) general anesthetic exposures compared to one or no general anesthetic exposure in early childhood were associated with worse neurodevelopmental outcomes at 5 yr.

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.

Comparing achievability and reproducibility of pulsed wave doppler and tissue doppler myocardial performance index and spatiotemporal image correlation annular plane systolic excursion in the cardiac function assessment of normal pregnancies.

Objectives: Multiple techniques have been proposed for functional fetal cardiology, including pulsed-wave (PW) and tissue Doppler imaging (TDI), Myocardial Performance Index (MPI), annular plane systolic excursion (TAPSE/MAPSE) and spatiotemporal image correlation (STIC). We aimed to compare these techniques' achievability and reproducibility to determine their clinical utility for each cardiac side.

Methods: Uncomplicated pregnancies from 22 to 39 weeks were recruited and images and volumes stored for offline analysis.

Procalcitonin-guided duration of antibiotic treatment in children hospitalised with confirmed or suspected bacterial infection in the UK (BATCH): a pragmatic, multicentre, open-label, two-arm, individually randomised, controlled trial.

Background: Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods: The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales.

Incidence of childhood and youth epilepsy: A population-based prospective cohort study utilizing current International League Against Epilepsy classifications for seizures, syndromes, and etiologies.

Objective: This study was undertaken to describe incidence and distribution of seizures, etiologies, and epilepsy syndromes in the general child and youth population, using the current International League Against Epilepsy (ILAE) classifications.

Methods: The study platform is the Norwegian Mother, Father, and Child Cohort Study (MoBa). Epilepsy cases were identified through registry linkages facilitated by Norway's universal health care system and mandatory reporting to the Norwegian Patient Registry.

Retrospective observational cohort study of premature neonates screened for ROP with 7 years of follow-up assessing the visual outcomes and adequacy of preschool visual screening.

Background: Very premature infants screened for retinopathy of prematurity (ROP) that do not develop ROP still experience serious visual developmental challenges, and while it is recommended that all children in the UK are offered preschool visual screening, we aimed to explore whether this vulnerable group requires dedicated follow-up.

Methods: We performed a real-world retrospective observational cohort study of children previously screened for ROP in NHS Greater Glasgow and Clyde (Scotland) between 2013 and 2015. We excluded those with any severity of ROP identified during screening.

The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis.

Background And Objectives: Nutrient supplements are commonly used to improve fertility outcomes by women with infertility trying to conceive spontaneously or utilising medically assisted reproduction (MAR). However, despite their widespread use and perceived safety, there is a lack of clear guidance on the efficacy and safety of these supplements for female infertility. The aim of this umbrella review was to identify the best available and most recent evidence on the efficacy and safety of nutrient supplements for female infertility to provide evidence-based guidance for clinicians and reproductive couples.

Barriers to Yearly Diabetic Retinopathy Screening Attendance: A Retrospective Clinical Audit.

Diabetic retinopathy is the most common sight-threatening complication of diabetes, necessitating regular monitoring of progression via diabetic eye screening (DES). The National Institute for Health and Care Excellence (NICE) recommends DES annually for diabetic patients aged 12 years and older. This retrospective clinical audit assessed the reasons behind non-attendance and evaluated the adherence to guidelines set by NICE in a general practice with approximately 9000 patients.

Capacity and Capability for Nursing, Midwifery and Allied Health Professional Principal Investigator Roles in Healthcare Research: A National Survey.

Aims: To understand the current capacity and capability for nursing, midwifery and allied health professional (NMAHP) principal investigator roles in England.

Design: Quantitative online survey.

Methods: Online national quantitative survey across England analysed using descriptive statistics.

Maintenance treatment with vedolizumab in paediatric inflammatory bowel disease (VEDOKIDS): 54-week outcomes of a multicentre, prospective, cohort study.

Background: Infliximab and adalimumab are the only biologics thus far approved for paediatric patients with inflammatory bowel disease (IBD), so other biologics, such as vedolizumab, are prescribed off-label. Despite its frequent use, prospective data for vedolizumab treatment in children are available only for short-term induction outcomes. We aimed to evaluate the long-term efficacy and safety of maintenance therapy with vedolizumab in paediatric patients with IBD.

Frozen Section Doughnuts Obtained with a 5 mm Stapling Device Improve Outcomes in Laparoscopic Endorectal Pull-Throughs for Hirschsprung's Disease.

A primary pull-through for Hirschsprung's disease (HD) requires confirmation of normal ganglionic bowel by intraoperative biopsies to determine the level of resection. Despite this, aganglionic bowel that is not fully resected (so-called "transition zone pull-throughs") is reported in 15%-19% of patients. We hypothesize that this may result from insufficient biopsies sent for intraoperative diagnosis.

Gonadal function and pathology in 17beta-HSD 3 and 5alpha-reductase deficiency.

Objective: 17β-Hydroxysteroid dehydrogenase 3 deficiency (17β-HSDD) and 5α-reductase type 2 deficiency (5α-RD) are rare 46,XY differences of sex development (DSD). This study aims to enlarge the limited knowledge on long-term gonadal function and gonadal pathology in these conditions.

Design: Retrospective multicentre cohort study.

Lisfranc Injury: a Comprehensive Analysis of LongTerm Outcomes - the Oswestry Experience.

Purpose Of The Study: Lisfranc is a challenging injury both diagnostically and surgically, with sparse long-term literature evidence of surgical practice. We aim to review our long-term specialist orthopaedic institutional experience of Lisfranc injuries and the surgical management of this complex injury, specifically considering surgical outcomes as per radiological and clinical assessment.

Material And Methods: We present data from a prospectively maintained institutional database, reviewing patients who underwent operative fixation for Lisfranc injury between April 2014 and August 2020.

Intrasellar Tuberculosis Presenting as Pituitary Apoplexy: A Case Report.

Patients presenting with acute onset of headache and ophthalmoplegia are clinically diagnosed as having a pituitary adenoma with apoplexy. Rarely, other diseases can mimic this condition clinically and radiologically, requiring a high index of suspicion to reach the correct diagnosis. We present a case of a 37-year-old male of Indian origin, who had intra- and supra-sellar tuberculosis (TB), presenting with classical clinical features of pituitary apoplexy and constitutional symptoms.

The Hyperdense Right Hemidiaphragm Sign: A Novel Radiological Indicator of Diffuse Fatty Liver Infiltration on Non-Enhanced CT.

Objectives The primary objective of this study is to describe and evaluate the diagnostic performance of the hyperdense right hemidiaphragm sign (HRHS) as a novel radiological indicator for diffuse fatty infiltration of the liver on non-enhanced CT (NECT) scans. This includes assessing its sensitivity, specificity, positive predictive value, and negative predictive value, and comparing these metrics with other established NECT signs. Methods This cross-sectional multicenter retrospective study included all patients over 12 years of age who underwent both abdominal MRI and NECT scans of the abdomen within a period not exceeding six months at two tertiary hospitals (The Royal Hospital and Armed Forces Hospital, Muscat, Sultanate of Oman) between January 2010 and December 2022.

Investigations for Suspected Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP): A National Cohort Study.

Objectives: Head and neck squamous cell carcinoma from unknown primary (HNSCCUP) is a rare and challenging condition. This study aimed to investigate the diagnostic pathways of suspected HNSCCUP patients in the United Kingdom.

Methods: A retrospective observational cohort study was conducted, over 5 years from January 2015, in UK Head and Neck centres of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT (PET-CT) within 3 months of diagnosis with metastatic cervical squamous cell carcinoma.

Insights from a publicly funded homebirth program.

Background: There are high levels of consumer demand for homebirth in Australia, however access is limited due to a wide range of factors, including associated costs of a private midwife and the limited number of publicly funded homebirth models. Homebirth with a qualified midwife, networked into a health system, is a safe option for women with a low-risk pregnancy. This paper has two aims.

Extension-block pinning versus custom-made plate fixation technique: A comparison of two methods in the treatment of osseous mallet finger injuries.

Background: Mallet finger injuries, characterized by a flexion deformity caused by trauma to the extensor mechanism at the base of the distal phalanx, can lead to significant functional impairment if not treated appropriately. Surgical interventions for osseous mallet finger injuries often include techniques such as extension-block pinning and perioperative modifying plate fixation. When comparing these two methods, it is critical to assess factors such as technical ease, perioperative considerations, and postoperative outcomes.

Developing an adaptive paediatric intensive care unit platform trial with key stakeholders: a qualitative study.

Objectives: Platform trials were used successfully in adult populations during the COVID-19 pandemic. By testing multiple treatments within a single trial, platform trials can help identify the most effective treatments (and any interactions between treatments) for patients more quickly and with less burden for patients and their families. The aim of this qualitative research was to inform the design of the first adaptive platform trial for paediatric intensive care in the UK with young people, parents/carers and paediatric intensive care unit (PICU) staff.

A Rare Case of a Primary Non-parasitic Splenic Cyst Removed via Laparoscopic Intervention.

Splenic cysts are differentiated into primary and secondary cysts based on epithelial lining. Primary non-parasitic epithelial splenic cysts are extremely rare. We report a case of a 24-year-old male with left hypochondrial swelling with no history of abdominal trauma.

The incidence, technical management and outcomes of impacted stones encountered during 1447 laparoscopic bile duct explorations.

Background: Stone impaction is an obstacle to successful laparoscopic common bile duct exploration (LCBDE). This study aims to identify the incidence, operative difficulties and techniques used to disimpact and remove impacted stones during LCBDE.

Methods: Prospectively collected data from a large series of LCBDE.

Birth weight and head circumference for 22-29 weeks gestation neonates from an international cohort.

Objective: Size at birth is a key indicator of in utero growth. Our objective was to generate sex-specific percentiles for birth weight and head circumference in neonates born between 22 and 29 weeks gestation from pregnancies without hypertension or diabetes and assess differences between vaginal and caesarean births and between singletons and twins.

Methods: We used data from 12 countries participating in the International Network for Evaluating Outcomes in Neonates database from 2007 to 2021.