Prehospital video triage of suspected stroke patients in Greater Manchester: pilot project report.

Introduction: Stroke is a leading cause of mortality and morbidity, demanding prompt and accurate identification. However, prehospital diagnosis is challenging, with up to 50% of suspected strokes having other diagnoses. A prehospital video triage (PHVT) system was piloted in Greater Manchester to improve prehospital diagnostic accuracy and appropriate conveyance decisions.

Determinants and progression of stigma in amyotrophic lateral sclerosis/motor neuron disease.

: Stigma in amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) may be felt or enacted; felt stigma covers feeling devalued by the illness, whereas enacted stigma refers to being treated differently because of it. Stigma in ALS/MND has been shown to increase social withdrawal, worsen quality of life, and reduce use of assistive devices, so we explored prevalence and factors influencing stigma. : Participants in the Trajectories of Outcome in Neurological Conditions-ALS study completed scales measuring stigma, fatigue, spasticity, functioning, mood, worry, self-esteem, and perceived health, as well as demographic information and symptoms like head drop or emotional lability.

Risk Factors and Outcomes of Acute Pulmonary Embolism in African Patients: A Systematic Review.

Pulmonary embolism is a common cause of morbidity and mortality. Numerous risk factors have been identified that predispose patients to this disease. This study aims to identify these risk factors and the possible outcomes (recovery or mortality) after receiving treatment from any hospital.

Prediction of chronic severe intestinal failure-associated liver disease by current criteria in adults: A descriptive cohort study.

Introduction: Intestinal failure-associated liver disease covers a spectrum of conditions from mild to end-stage disease. Currently, there are 9 diagnostic criteria divided to four categories: cholestasis, steatosis, fibrosis, and unclassified. Our aim was to evaluate the application of these criteria to patients with chronic severe liver disease in patients with intestinal failure.

Metabolite Biomarkers for Early Detection of Pancreatic Ductal Adenocarcinoma: A Systematic Review.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with a poor prognosis. This poor prognosis is largely attributed to a late-stage diagnosis. Recent advancements in metabolomics have emerged as a promising avenue for biomarker discovery in PDAC.

Bilateral femoral neck fractures and fixation failure due to stiff-person syndrome.

We describe a woman with stiff-person syndrome (SPS), whose muscle spasms resulted in sequential bilateral femoral neck fractures. Orthopaedic fixation of the first fracture was complicated by increased muscle spasm, fracture nonunion and ultimately metalwork fracture. SPS was diagnosed following the fracture of the contralateral femoral neck, neurology assessment and detection of high-titre antibodies to glutamic acid decarboxylase.

Association of Polypharmacy and Burden of Comorbidities on COVID-19 Adverse Outcomes in People with Type 1 or Type 2 Diabetes.

Introduction: It is widely accepted that the higher the number of medications prescribed and taken by an individual, the higher the risk of poor health outcomes. We have investigated whether polypharmacy and comorbidities conveyed more risk of adverse health outcomes following COVID-19 infection (as a paradigm of serious viral infections in general) in people with type 1 diabetes (T1DM) or type 2 diabetes (T2DM).

Methods: The Greater Manchester Care Record (GMCR) is an integrated database of electronic health records containing data collected from 433 general practices in Greater Manchester.

The Impact of Age and Sex on Fasting Plasma Glucose and Glycated Haemoglobin (HbA1c) in the Non-diabetes Population.

Introduction: We previously reported sex differences in the distribution of glycated haemoglobin (HbA1c) for men/women aged < 50 years vs older individuals, with implications for delayed diabetes diagnosis. Here, we explored whether this pattern was also seen in matched fasting plasma glucose (FPG) levels.

Methods: We extracted data on same-day, paired HbA1c and FPG levels from clinical biochemistry laboratory databases from Mersey and West Lancashire Teaching Hospitals NHS Trust (n = 10,153) and Cambridge University Hospitals NHS Foundation Trust (n = 10,022) between Jan 2019 and Dec 2023.

Baseline Anal Sphincter Elastance May Predict Long-Term Outcomes of Sacral Neuromodulation for Fecal Incontinence.

Introduction: Anal acoustic reflectometry (AAR), a novel test of anal sphincter function, was shown to predict a successful trial phase of sacral neuromodulation (SNM) for fecal incontinence. This follow-up study aims to explore if AAR can also predict short- and long-term SNM outcomes at less than and more than 5 y, respectively.

Methods: Outcome data were reviewed from a prospectively managed database.

Frontal Fibrosing Alopecia: An Update.

In this review, we discuss recent developments in our understanding of frontal fibrosing alopecia, a disease that has become increasingly common and widespread since its first description in 1994. An inherited predisposition to frontal fibrosing alopecia, previously suspected from the occurrence of familial cases, has been confirmed through genetic studies. Nevertheless, the epidemiology continues to implicate environmental factors in the aetiology.

Exploring How the Kidney BEAM Physical Activity Digital Health Intervention Improved Mental Health-Related Quality of Life for People Living With Kidney Disease.

Introduction: The Kidney BEAM randomized controlled trial reported clinically meaningful and statistically significant improvements in mental health-related quality of life (HRQoL), physical function (sit-to-stand-60, but not the physical component of HRQoL) and patient activation after a 12-week physical activity digital health intervention (DHI). This study explores factors that contributed to the effectiveness of Kidney BEAM through mixed methods analyses.

Methods: Quantitative data analysis was obtained from the recently published primary manuscript.

The association between TNF-receptors (TNFR1 and TNFR2) and mortality as well as kidney function decline in patients with chronic kidney disease.

Background: Higher circulating levels of tumor necrosis factor (TNF) alpha receptors 1 (TNFR1) and 2 (TNFR2) are associated with increased long-term mortality and impaired kidney function.

Aim: To study associations between levels of TNFR1 and TNFR2 and all-cause mortality as well as estimated glomerular filtration rate (eGFR) decline.

Population And Methods: Patients with chronic kidney disease (CKD) stages 3-5 in the Salford Kidney Study were included.

Systemic sclerosis-related fecal incontinence: a scoping review focusing on a neglected manifestation.

Objectives: This scoping-review sought to summarize the current knowledge on the epidemiology, pathogenesis, clinical presentation, and the investigations that may help characterize faecal incontinence (FI) in patients with systemic sclerosis (SSc).

Methods: The planned scoping review was based on the methodological framework proposed by Arksey & O'Malley.Two databases were screened: PubMed (Medline), (webofSciences), data extraction was performed using a predefined template.

Evaluating the SAFE Tool's Impact on Documentation and Patient Safety During Structured Ward Rounds in General Surgery: A Retrospective Study.

Aim  Effective documentation of critical clinical information is vital for patient safety and timely discharges. Ward rounds (WRs) are crucial for multidisciplinary assessments and care planning. Current emergency surgical WR documentation is inconsistent; therefore, this study will implement a structured WR template adapted from the Royal College of Surgeons of Edinburgh's "Surgical Assessment for Emergencies Ward Round Tool" (SAFE) to address these shortcomings.

Meta-analyses uncover the genetic architecture of Idiopathic Inflammatory Myopathies.

Objective: Idiopathic inflammatory myopathies (myositis, IIMs) are rare, systemic autoimmune disorders that lead to muscle inflammation, weakness, and extra-muscular manifestations, with a strong genetic component influencing disease development and progression. Previous genome-wide association studies identified loci associated with IIMs. In this study, we imputed data from two prior genome-wide myositis studies and analyzed the largest myositis dataset to date to identify novel risk loci and susceptibility genes associated with IIMs and its clinical subtypes.

Exploring urinary incontinence in hospitalised older women: A mixed methods investigation of prevalence and nurse perspectives.

Background: Approximately 40% of older women in the community report experiencing urinary incontinence (UI); prevalence within secondary care is unknown. Illness, comorbidities, and hospital environments are likely to lead to higher prevalence.

Objectives: This study aimed to establish UI prevalence in older women admitted to hospitals and understand the views and knowledge of ward nurses in relation to older women's UI.

EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial).

Introduction: The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care.

Methods: A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week.

Infective Endocarditis in Patients Receiving Hemodialysis: A Current Review.

Background: Cardiovascular and infective complications are commonly observed in patients receiving hemodialysis (HD) with cardiovascular events and infection-related complications being the first and second leading causes of death. Infective endocarditis (IE) is characterized by inflammation of the endocardium caused by infection, typically affecting the cardiac valves and can be in acute, subacute, or chronic forms. It is a serious complication within the HD population due to their predisposition for both infection and valvular damage.

Autoantibodies in sarcoidosis: Innocent bystander or promising biomarker for organ involvement?

Background And Aim: Sarcoidosis is a rare inflammatory disease that can affect any organ in the body, but most commonly involves lungs and lymph nodes. Sarcoidosis is often considered an autoimmune disease, attributed to many factors, including autoantigen-specific T cells, antibodies producing B lymphocytes, autoimmune inflammation, although its exact cause and classification are still under debate.The aim of our study was to evaluate the possible role of autoantibodies, such as anti-nuclear (ANA), extractable nuclear antigen (ENA) and antiphospholipids, in sarcoidosis patients.

Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial.

Importance: For hospitalized critically ill adults with suspected sepsis, procalcitonin (PCT) and C-reactive protein (CRP) monitoring protocols can guide the duration of antibiotic therapy, but the evidence of the effect and safety of these protocols remains uncertain.

Objective: To determine whether decisions based on assessment of CRP or PCT safely results in a reduction in the duration of antibiotic therapy.

Design, Setting, And Participants: A multicenter, intervention-concealed randomized clinical trial, involving 2760 adults (≥18 years), in 41 UK National Health Service (NHS) intensive care units, requiring critical care within 24 hours of initiating intravenous antibiotics for suspected sepsis and likely to continue antibiotics for at least 72 hours.

Cognition and wellbeing in middle-aged early treated people with phenylketonuria: Preliminary results and methodological lessons.

The first cohort of early-treated adults with phenylketonuria (PKU) is reaching middle-age and moving towards old age. We do not know if and how the effects of an aging brain may interact with the effect of PKU. This study compared wellbeing and cognition in 19 middle-aged adults with PKU (age 40+ mean = 45.