Isthmocele: A Case Report and Review of an Increasingly Common Gynecological Hurdle.

Isthmocele is emerging as an increasingly common yet troublesome diagnosis. The spectrum of potential symptoms is large, with subsequent management strategies continuing to evolve. For clinicians, having first recognized the inconsistencies in presentation, familiarity with the differing treatment options is important.

Ethanol for the management of alcohol withdrawal syndrome: a systematic review.

Introduction: Alcohol withdrawal is typically managed using benzodiazepines. However, modulation of both γ-aminobutyric acid-A and N-methyl-d-aspartate-receptors through ethanol provision may provide an alternative management strategy. This systematic review critically analyses the evidence surrounding the use of oral or intravenous ethanol for the management of alcohol withdrawal syndrome.

Ambulatory management of acute uncomplicated diverticulitis (AmbUDiv study): a multicentre, propensity score matching study.

Introduction: Recent studies have suggested that ambulatory management is feasible for acute uncomplicated diverticulitis (AUD); however, there is still no consensus regarding the most appropriate management settings. This study presents a multi-centre experience of managing patients presenting with AUD, specifically focusing on clinical outcomes and comparing ambulatory treatment with in-patient management.

Methods: A retrospective multi-centre study was conducted across four hospitals in the UK and included all adult patients with computed tomography (CT) confirmed (Hinchey grade 1a) acute diverticulitis over a 12-month period (January - December 2022).

Physical harms associated with suprascapular nerve block interventions in the non-surgical management of acute and chronic shoulder pain: A systematic review.

Background: The utility of the suprascapular nerve block (SSNB) in the non-surgical management of shoulder pain continues to be explored, whilst its associated physical harms have not. This systematic review aims to report the physical harms associated with the SSNB in the non-surgical management of shoulder pain.

Methods: A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline, Pubmed, and Scopus databases.

The Risk of Venous Thromboembolism in Children With Inflammatory Bowel Disease.

Background: Recent studies of children with inflammatory bowel disease (IBD) demonstrate an increased venous thromboembolism (VTE) risk. However, estimates of risk are variable and case numbers are limited. The aim of this study was to provide national estimates of the risk of VTE in children with IBD.

An Unusual Case of Haemophilus influenzae Associated Polyarthritis: Diagnostic and Therapeutic Challenges in Concurrent Septic and Reactive Arthritis.

Septic arthritis and reactive arthritis are both recognized as distinct causes of swollen joints; however, they can, at times, overlap as causes of acute polyarthritis. Septic arthritis is an orthopedic emergency, typically caused by bacterial infection, and requires urgent antibiotic treatment and joint drainage to prevent irreversible joint damage. In contrast, reactive arthritis is a sterile, immune-mediated arthritis that occurs following infections and is managed with anti-inflammatory treatments such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs).

Promising strategies for the prevention of alcohol-related brain damage through optimised management of acute alcohol withdrawal: A focussed literature review.

There is an increasing awareness of the link between chronic alcohol consumption and the development of cognitive, behavioural and functional deficits. Currently, preventative strategies are limited and require engagement in dedicated long-term rehabilitation and sobriety services, the availability of which is low. The acute alcohol withdrawal syndrome is an episode of neurochemical imbalance leading to autonomic dysregulation, increased seizure risk and cognitive disorientation.

Automated decision making in Barrett's oesophagus: development and deployment of a natural language processing tool.

Manual decisions regarding the timing of surveillance endoscopy for premalignant Barrett's oesophagus (BO) is error-prone. This leads to inefficient resource usage and safety risks. To automate decision-making, we fine-tuned Bidirectional Encoder Representations from Transformers (BERT) models to categorize BO length (EndoBERT) and worst histopathological grade (PathBERT) on 4,831 endoscopy and 4,581 pathology reports from Guy's and St Thomas' Hospital (GSTT).

Phenotyping patients with chronic obstructive pulmonary disease and heart failure.

Aims: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are prevalent comorbidities associated with significant morbidity/mortality. We assessed prevalence of, patient profiles and outcomes associated with COPD across the ejection fraction (EF) spectrum.

Methods: HF patients enrolled in the Swedish HF registry between 2005 and 2021 were considered.

Rehabilitation of stage-one scapholunate instability (ReSOS): An online survey of UK practice.

Introduction: Scapholunate instability is one of the most frequent types of wrist instability, but optimal management is not established. This research aims to identify current conservative management strategies for stage-one scapholunate instability and how these interventions are evaluated in the UK.

Methods: A cross-sectional online survey of UK physiotherapists and occupational therapists with self-reported experience in the rehabilitation of stage-one scapholunate instability (ReSOS), was developed using the CROSS guideline and a clinical vignette.

Hand Osteomyelitis: A Systematic Review of the Literature and Recommendations for Diagnosis and Management.

Hand osteomyelitis is a complex condition to diagnose and treat, with an opportunity to improve care through organization of existing evidence. The literature was systematically searched for series of hand osteomyelitis between 1990 and 2022 for evidence regarding diagnosis and treatment, to formulate recommendations. Twenty-one series reported at least 5 cases of hand osteomyelitis in adults, with a total of 666 cases.

A mixed-methods evaluation of a longitudinal primary-secondary school transitions support intervention.

Introduction: Primary-secondary school transitions are critical transitions for children that can be emotionally demanding longitudinal experiences, which can positively and negatively impact future emotional wellbeing and mental health. However, interventions that have been developed to reduce the negative outcomes children commonly experience are limited in number, sustainability, and reach and rely on a cross-sectional approach, as opposed to longitudinal evaluations. The current study evaluates , a universal, class-based 9-week intervention to develop children's awareness and ability to cope with the multiple changes experienced over primary-secondary school transitions.

Infliximab versus interferon-alpha in the treatment of Behçet's Syndrome: Clinical data from the BIO-BEHÇET'S randomised controlled trial.

Objectives: Whilst biologic therapy is used for Behçet's Syndrome of all subtypes refractory to first-line immunomodulation, there has been an absence of high-quality evidence-and no predictive biomarkers to optimally inform choice. BIO-BEHÇET'S was a randomised, controlled, head-to-head clinical trial comparing the two most frequently used biologics in active refractory Behçet's.

Methods: Bayesian-designed, pragmatic, standard of care, two-arm, parallel head-to-head trial at four UK centres.

Single Best Answer Questions as a Teaching Tool in Medical Education: An International Mixed-Method Comparative Evaluation.

Introduction Single Best Answer questions are an established assessment format in medical education, however, their use as a teaching tool is underexplored in the literature. We aimed to assess the effectiveness and impact of implementing Single Best Answer (SBA) questions into lecture teaching, compared to standard lectures. Methods This evaluation utilised a mixed-method retrospective approach, combining quantitative and qualitative analysis of routine teaching feedback.

Duty of Candour legislation in post-colonoscopy colorectal cancer: a prospective cohort study.

Background: This study investigated the application of Duty of Candour (DoC) legislation in the context of post-colonoscopy colorectal cancers (PCCRCs). DoC mandates transparent disclosure of notifiable safety incidents to patients in the English National Health Service, including incidences leading to severe or moderate harm. This study aimed to analyze the application of DoC in PCCRCs, improve understanding of the legislation, and identify challenges in DoC implementation.

Corpus Spongiosum Abscess in a Patient Undergoing Intermittent Self-Dilatation: A Rare Case Report.

Penile abscesses of the corpus spongiosum are rare in urology, with few documented cases. These abscesses may occur spontaneously or due to risk factors such as diabetes mellitus, intracavernosal injection therapy, tuberculosis, trauma, and perianal or intra-abdominal abscesses. This report discusses a 76-year-old man who developed a penile abscess involving the corpus spongiosum following intermittent self-dilatation.