Exploring knowledge of first aid in epistaxis-25 years on.

Background: Epistaxis is the most common acute disorder managed by ENT services. A 1998 survey (Strachan and England) demonstrated widespread ignorance of correct first aid amongst the public with only 11% of respondents applying correct first aid techniques. Here we repeated and expanded the 1998 study to investigate whether understanding of correct first aid in epistaxis amongst the public and emergency department staff has improved in the last 25 years.

Randomized Comparison of Magnetic Resonance Imaging Versus Transurethral Resection for Staging New Bladder Cancers: Results From the Prospective BladderPath Trial.

Purpose: Transurethral resection of bladder tumor (TURBT) is the initial staging procedure for new bladder cancers (BCs). For muscle-invasive bladder cancers (MIBCs), TURBT may delay definitive treatment. We investigated whether definitive treatment can be expedited for MIBC using flexible cystoscopic biopsy and multiparametric magnetic resonance imaging (mpMRI) for initial staging.

Development and evaluation of a high-fidelity, multi-disciplinary simulation training course for high-consequence infectious diseases using fluorescence visualization.

Background: High-consequence infectious diseases (HCIDs) include contact-transmissible viral haemorrhagic fevers and airborne-transmissible infections such as Middle Eastern Respiratory Syndrome. Assessing suspected HCID cases requires specialized infection control measures including patient isolation, personal protective equipment (PPE), and decontamination. There is need for an accessible course for NHS staff to improve confidence and competence in using HCID PPE outside specialist HCID centres.

The collaborative working group method for pre-trial knowledge mobilisation: a qualitative evaluation of a structured process for iteratively refining a complex intervention (DAFNEplus).

Background: There is a lack of practical guidance about how to effectively mobilise knowledge at the pre-trial stage. Despite increased guidance on developing complex interventions in recent years, much of this focuses on the theory and principles behind high-quality intervention development, rather than the practical aspects of how this should be achieved. This paper shares the findings from an embedded, qualitative evaluation of the Collaborative Working Group (CWG) process, a structured approach we developed to iteratively refine a complex intervention prior to a randomised controlled trial.

A Survey of the Current UK Physician Associate Educator Workforce and Recommendations for Courses and Provider Organizations.

Introduction: In the United Kingdom there are 37 physician associate (PA) training programs with limited knowledge of the educators involved, their training, and specific needs.

Method: An online questionnaire was sent to PA educators in all UK training programs requesting information on academic title and responsibilities, clinical and nonclinical background, education and qualifications before becoming a PA educator, formal and informal training received in the role, and insights into career progression.

Discussion: The questionnaire highlighted 5 specific areas that should be specific recommendations for UK training programs to support PA educators, alongside existing guidance.

Therapeutic drug monitoring of tenofovir disoproxil and emtricitabine in oral HIV pre-exposure prophylaxis (PrEP) users who have undergone gastrointestinal surgery.

Objectives: Oral HIV pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV, but its efficacy depends on adequate absorption of drug, which may decrease following gastrointestinal surgery.

Methods: Clinicians across eight Genito-urinary Medicine clinics in the United Kingdom submitted data on PrEP users with history of gastrointestinal surgery who were referred to a national complex PrEP multi-disciplinary team between June 2021 and April 2023. Anonymised data were submitted on demographics, surgical history, PrEP regimen, and results of therapeutic drug monitoring (TDM) and HIV screening tests.

Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE): an international, multicentre, randomised phase 3 trial.

Background: Locally advanced cervical cancer is treated with chemoradiotherapy (standard of care), but many patients still relapse and die from metastatic disease. We investigated chemoradiotherapy with or without induction chemotherapy to determine whether induction chemotherapy improves both progression-free survival and overall survival.

Methods: The INTERLACE trial was a multicentre, randomised phase 3 trial done at 32 medical centres in Brazil, India, Italy, Mexico, and the UK.

Regional differences in neo/adjuvant chemotherapy timing in patients with early-stage triple-negative breast cancer in England.

Purpose: Triple-negative breast cancer (TNBC) is an aggressive breast cancer histological type that is predictive of poor outcomes, shorter remission periods and reduced survival. TNBC is treated with surgery and neo/adjuvant chemotherapy, with evidence of association between longer periods from surgery to adjuvant chemotherapy (time to chemotherapy, TTC) and poorer survival outcomes. This study investigated regional differences in TTC period between regions and ethnic groups to evaluate equity of care in the English TNBC population.

Outcomes with single-agent gilteritinib for relapsed or refractory FLT3-mutant AML after contemporary induction therapy.

Gilteritinib is the current standard of care for relapsed or refractory fms related receptor tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia in many countries, however outcomes for patients relapsing after contemporary first-line therapies (intensive chemotherapy with midostaurin, or nonintensive chemotherapy with venetoclax) are uncertain. Moreover, reported data on toxicity and health care resource use is limited. Here, we describe a large real-world cohort of 152 patients receiving single-agent gilteritinib in 38 UK hospitals.

Unenhanced computed tomography as a diagnostic tool in suspected pulmonary hypertension: a retrospective cross-sectional pilot study.

Background: Computed tomography pulmonary angiography (CTPA) has been proposed to be diagnostic for pulmonary hypertension (PH) in multiple studies. However, the utility of the unenhanced CT measurements diagnosing PH has not been fully assessed. This study aimed to assess the diagnostic utility and reproducibility of cardiac and great vessel parameters on unenhanced computed tomography (CT) in suspected pulmonary hypertension (PH).

Comparative study between endovenous laser ablation (EVLA) with 1940 nm versus EVLA with 1470 nm for treatment of incompetent great saphenous vein and short saphenous vein: A randomized controlled trial.

Background: To date, the most commonly used endothermal ablation method is endovenous laser ablation (EVLA). The objective of this work is to assess the initial and short-term outcomes of a 1940 nm diode laser compared with 1470 nm diode laser utilization for the treatment of lower limb varicose veins.

Methods: This is a randomized controlled prospective study that included patients with varicose veins.

Calcitriol in Sepsis-A Single-Centre Randomised Control Trial.

: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis is a significant cause of hospital admission and the leading reason for admission to the ICU and is associated with high mortality. Vitamin D has shown promising immunomodulatory effects by upregulating the antimicrobial peptide, cathelicidin.

Patient and staff perspectives on the concept of frailty and its role in assessment and decision making in treatment for older people with lung cancer.

Purpose: Frailty influences outcomes in patients with cancer and should be considered when making decisions about treatment but concerns have been raised about possible negative consequences of doing this. Many patients with lung cancer have attributes of frailty and this study explores patient and staff perspectives on its role in decision making in older people with lung cancer.

Methods: The study adopted a two-phase qualitative approach using semi-structured telephone interviews and an in-person focus group.

Sensory Symptoms without Structural Pathology in Patients with Gluten Sensitivity.

Unlabelled: We report on a group of patients with gluten sensitivity with and without coeliac disease presenting with unexplained sensory symptoms in the absence of structural pathology.

Methods: The patients were selected from the gluten neurology clinic based at the Royal Hallamshire Hospital, Sheffield, UK, on the basis of sensory symptoms but normal neuroaxis imaging and peripheral nerve evaluation.

Results: A total of 30 patients were identified with a mean age at presentation of 47 years.

AI-assisted capsule endoscopy reading in suspected small bowel bleeding: a multicentre prospective study.

Background: Capsule endoscopy reading is time consuming, and readers are required to maintain attention so as not to miss significant findings. Deep convolutional neural networks can recognise relevant findings, possibly exceeding human performances and reducing the reading time of capsule endoscopy. Our primary aim was to assess the non-inferiority of artificial intelligence (AI)-assisted reading versus standard reading for potentially small bowel bleeding lesions (high P2, moderate P1; Saurin classification) at per-patient analysis.

Essential data variables for a minimum dataset for head and neck cancer trials and clinical research: HNCIG consensus recommendations and database.

The Head and Neck Cancer International Group (HNCIG) has undertaken an international modified Delphi process to reach consensus on the essential data variables to be included in a minimum database for HNC research. Endorsed by 19 research organisations representing 34 countries, these recommendations provide the framework to facilitate and harmonise data collection and sharing for HNC research. These variables have also been incorporated into a ready to use downloadable HNCIG minimum database, available from the HNCIG website.