Iatrogenic Type A Aortic Dissection Following Percutaneous Coronary Intervention.

Iatrogenic type A aortic dissection (IAAD) is a rare but life-threatening complication of percutaneous coronary intervention (PCI), often presenting significant therapeutic challenges. A looped guidewire between the right subclavian artery and brachiocephalic artery during coronary angiography (CAG) via right radial artery access can complicate catheter manipulation. This report discusses the case of a 58-year-old hypertensive female patient who developed aortic dissection during PCI, specifically due to wire manipulation at the brachiocephalic loop.

Enhanced glucose processing in gestational diabetes diagnosis: Effects on health equity and clinical outcomes.

Objectives: Gestational diabetes is diagnosed using an oral glucose tolerance test (OGTT), which has limited accuracy, reproducibility and practicality. We assessed the effect of enhanced pre-analytical glucose processing upon glucose concentrations, gestational diabetes diagnosis, health equity and pregnancy outcomes, and if HbA1c was a suitable alternative.

Methods: We recruited pregnant women with ≥1 risk factor to a prospective observational cohort study of pregnancy hyperglycaemia, endocrine causes, lipids, insulin and autoimmunity (OPHELIA), from nine UK centres.

Cystoid macular oedema: a rare complication following selective laser trabeculoplasty.

A female patient with previous vitrectomy for epiretinal membrane in the left eye underwent bilateral selective laser trabeculoplasty (SLT) for pigmentary glaucoma and subsequently developed cystoid macular oedema (CMO) in the vitrectomised eye. This resolved fully with treatment with topical steroids and non-steroidal anti-inflammatory drug (NSAID) drops. This complication has been very rarely reported in the literature, and a subsequent internal audit found a very low rate of CMO temporally related to SLT of 0.

Digital Replantation In Hours Versus Out of Hours: A Retrospective Review of Outcomes.

Introduction: The British Society for Surgery of the Hand's (BSSH) Getting It Right First Time (GIRFT) guidelines recommend that surgery for traumatic amputations of the digits is ideally performed during normal working hours even if this results in a delay of up to 24 hours.

Objective: To compare current practice against the BSSH GIRFT guideline regarding the timing of digital replantation and to compare the success rate of replantation performed within working hours (same or next day) and outside of working hours.

Materials And Methods: A single-centre retrospective analysis of two years of digital replantation was performed.

Uplift of genetic diagnosis of rare respiratory disease using airway epithelium transcriptome analysis.

Rare genetic respiratory disease has an incidence rate of more than 1:2500 live births in Northern Europe and carries significant disease burden. Early diagnosis improves outcomes, but many individuals remain without a confident genetic diagnosis. Improved and expanded molecular testing methods are required to improve genetic diagnosis rates and thereby improve clinical outcomes.

Treatment strategies with electrochemotherapy for limb in-transit melanoma: Real-world outcomes from a European, retrospective, cohort study.

Background: This study analysed treatment strategies with electrochemotherapy (ECT) in melanoma with limb in-transit metastases (ITM).

Methods: We audited AJCC v.8 stage IIIB-IIID patients treated across 22 centres (2006-2020) within the International Network for Sharing Practices of ECT (InspECT).

The Extended Corset with Bra Strap: Refinements in the Corset Trunkplasty Technique.

The corset trunkplasty was introduced by Moya et al. in 2009 (Moya and Sharma in JPRAS 62:56-64, 2009). It is a modified abdominoplasty technique that combines vertical and high lateral incisions to achieve an hourglass shape in post-massive weight loss patients.

Vascular Pathogenesis in Acute and Long COVID: Current Insights and Therapeutic Outlook.

Long coronavirus disease 2019 (COVID-19)-a postacute consequence of severe acute respiratory syndrome coronavirus 2 infection-manifests with a broad spectrum of relapsing and remitting or persistent symptoms as well as varied levels of organ damage, which may be asymptomatic or present as acute events such as heart attacks or strokes and recurrent infections, hinting at complex underlying pathogenic mechanisms. Central to these symptoms is vascular dysfunction rooted in thrombotic endothelialitis. We review the scientific evidence that widespread endothelial dysfunction (ED) leads to chronic symptomatology.

Fifteen-minute consultation: considering greener asthma treatments for children and young people.

Inhalers are the mainstay of asthma treatment, but are responsible for a disproportionately high level of carbon emissions compared with other aspects of healthcare. There is a growing interest among CYP in discussing the environmental impact of their treatment with healthcare staff. In this article, we outline an individualised approach to modifying asthma treatment to be more sustainable.

A Combined Spindle Cell Melanoma and Sarcomatoid Squamous Cell Carcinoma: A Rather Unique Squamomelanocytic Tumor.

Squamomelanocytic tumor is a poorly defined term that indicates co-occurrence of malignant melanoma and squamous cell carcinoma within the same lesion. We present an unusual case of squamomelanocytic tumor in which both intermingling components showed predominantly spindle cell morphology and were confirmed with double staining for SOX-10 and AE1/AE3.

Demystifying the Suprazygomatic Maxillary Nerve Block in Paediatric Cleft Palate Surgery.

Objective: To consider the clinical anatomy, safety and effectiveness of the suprazygomatic maxillary nerve block in cleft palate surgery.

Design: Observational case series.

Setting: Single cleft centre in the United Kingdom.

Pre-and Post-Prostatectomy Detrusor Wall Thickness and the Symptom Profile in Patients with Benign Prostatic Enlargement: A Prospective Review.

Introduction: The urinary bladder undergoes morphological and functional changes in patients with symptomatic benign prostatic enlargement (BPE). These detrusor changes reflect chronically increased intravesical pressure as a result of outlet obstruction. This study aims to determine the relationship between the Pre- and Post-op detrusor wall thickness (DWT), international prostate symptom score (IPSS), and duration of lower urinary tract symptoms (LUTS) in patients who had open simple prostatectomy (OSP).

RSTN COVID-19 Hand Recovery: Two years on, where are we now?

Hand surgery services were required to rapidly adapt to the coronavirus disease 2019 (COVID-19). Two years following the initial wave, hand surgery units continue to adapt and recover from the pandemic. The aim of the RSTN COVID-19 Hand Recovery survey was to evaluate what adaptions made to hand surgery services during COVID-19 have been maintained in the COVID recovery phase.

Urothelial Malignancy After Normal Hematuria Clinic Investigations: Does Non-visible Hematuria Need Reinvestigation?

Objective:  Hematuria is the most common referral to Urology. Most initial evaluations are normal; however there are few medium- to long-term studies about these patients after they are discharged.

Methods:  This study was a retrospective observational case-control study.

Three and twelve-month analysis of the PROM-Q study: comparison of patient-reported outcome measures using the BREAST-Q questionnaire in pre- vs. sub-pectoral implant-based immediate breast reconstruction.

Purpose: Implant-based breast reconstruction (IBR) is being increasingly performed with implant placed above the pectoral muscle (pre-pectoral), instead of below the pectoral muscle (sub-pectoral). Currently, there is a lack of comparative data on clinical and patient-perceived outcomes between pre- vs. sub-pectoral IBR.

Tissue-Free Liquid Biopsies Combining Genomic and Methylation Signals for Minimal Residual Disease Detection in Patients with Early Colorectal Cancer from the UK TRACC Part B Study.

Purpose: The absence of postoperative circulating tumor DNA (ctDNA) identifies patients with resected colorectal cancer (CRC) with low recurrence risk for adjuvant chemotherapy (ACT) de-escalation. Our study presents the largest resected CRC cohort to date with tissue-free minimal residual disease (MRD) detection.

Experimental Design: TRACC (tracking mutations in cell-free tumor DNA to predict relapse in early colorectal cancer) included patients with stage I to III resectable CRC.

A Qualitative Study of Patients' Lived Experiences of Free Tissue Transfer for Diabetic Foot Disease.

Background: Free tissue transfer (FTT) for reconstruction of diabetic foot disease (DFD) is an emerging field to preserve the lower limb within this patient group. The design of future quantitative research and clinical services in this area must consider the needs, expectations and concerns of patients. This qualitative study explores patient experiences of FTT for reconstruction of DFD.