Assessing Lung Ventilation and Bronchodilator Response in Asthma and Chronic Obstructive Pulmonary Disease with F MRI.

Background Pulmonary function tests are central to diagnosis and monitoring of respiratory diseases but do not provide information on regional lung function heterogeneity. Fluorine 19 (F) MRI of inhaled perfluoropropane permits quantitative and spatially localized assessment of pulmonary ventilation properties without tracer gas hyperpolarization. Purpose To assess regional lung ventilation properties using F MRI of inhaled perfluoropropane in participants with asthma, participants with chronic obstructive pulmonary disease (COPD), and healthy participants, including quantitative evaluation of bronchodilator response in participants with respiratory disease.

Ensuring the Future Pool of Gastroenterologists in the United Kingdom Is Imperative.

This perspective article explores the importance of fostering interest in gastroenterology among medical students and addressing the barriers that deter them from pursuing careers in this specialty. The paper highlights the critical role of early exposure to research, specialized electives, and mentorship in encouraging students to consider gastroenterology as a career choice. Current challenges include limited access to specialized electives and research opportunities within UK medical schools, inadequate hands-on experience, and a perceived lack of stability and control over future training pathways.

The Efficacy of Biodegradable Temporising Matrix for Upper Limb Reconstruction: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis is to assess the efficacy of the biodegradable temporising matrix (BTM) (NovoSorb; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) in the reconstruction of complex upper extremity wounds. The authors conducted a systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines assessing the efficacy of BTM in complex upper extremity wound reconstruction. The primary outcome measures were successful BTM integration and the proportion of wounds healed.

Increasing Life Expectancy in Patients with Genitourinary Malignancies: Impact of Treatment Burden on Disease Management and Quality of Life.

Background And Objective: Treatment burden refers to the overall impact of medical treatments on a patient's well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient care.

Methods: We conducted a narrative review of clinical trials focused on GU malignancy (prostate, bladder, and kidney) between January 2000 and June 2024, analyzing related PROs and findings regarding treatment burden.

An international and multidisciplinary EORTC survey on resectability of stage III non-small cell lung cancer.

Introduction: The EORTC-Lung Cancer Group initiated a Delphi consensus process to establish a consensual definition of resectable stage III non-small cell lung cancer (NSCLC) for the use in clinical trials, including a systematic review, survey, and review of clinical cases. Here, the survey results are presented, aimed to identify areas of controversy.

Methods: A survey was distributed among the members of six international organizations related to lung cancer.

Remote ischaemic conditioning for neurological disorders-a systematic review and narrative synthesis.

Introduction: Remote ischaemic conditioning (RIC) refers to the use of controlled transient ischemic and reperfusion cycles, commonly of the upper or lower limb, to mitigate cellular damage from ischaemic injury. Preclinical studies demonstrate that RIC may have a neuroprotective effect and therefore could represent a novel therapeutic option in the management of neurological disorders. The aim of this review is to comprehensively describe the current clinical evidence of RIC in neurological disorders.

Clinical Utility of Bone Turnover Markers in Chronic Kidney Disease.

Chronic kidney disease (CKD) often leads to mineral and bone disorders (CKD-MBDs), which are nearly universal in patients undergoing dialysis. CKD-MBD includes abnormal calcium-phosphate metabolism, vascular and soft tissue calcification, and bone abnormalities (renal osteodystrophy [ROD]). Bone fragility in CKD occurs due to low bone mass and poor bone quality, and patients with CKD have higher fracture and mortality rates.

Immediate improvement in patient care: Auditing adherence to the British Society for Haematology guidelines on screening and management of the long-term consequences of multiple myeloma and treatment.

Advances in myeloma have resulted in improved prognosis for patients. However complications of the disease and treatment, pose a risk of specific long-term consequences. An audit tool was adapted to assess adherence to the British Society for Haematology guidelines for screening and management of long-term myeloma consequences.

Faecal immunochemical tests for patients with symptoms suggestive of colorectal cancer: An updated systematic review and multiple-threshold meta-analysis of diagnostic test accuracy studies.

Aim: Extending faecal immunochemical tests for haemoglobin (FIT) to all primary care patients with symptoms suggestive of colorectal cancer (CRC) could identify people who are likely to benefit from colonoscopy and facilitate earlier treatment. The aim of this work was to investigate the diagnostic accuracy of FIT across different analysers at different thresholds, as a single test or in duplicate (dual FIT).

Method: This systematic review and meta-analysis searched 10 sources (December 2022).

A pictorial review of osseous and cartilaginous soft tissue tumours.

Osseous and cartilaginous soft tissue tumours are a heterogenous group of neoplasms characterised by the presence of an osseous or cartilaginous component. Mineralisation of the osseous or cartilaginous component is a common finding amongst these lesions, presenting as calcification/ossification on radiological imaging. This pictorial review examines the key imaging findings and characteristics of osseous and cartilaginous soft tissue tumours with a focus on the distinguishing features which can help the radiologist to differentiate benign and malignant lesions.

Integration of a surgical bipolar ablation device within an electroanatomical mapping system during epicardial ventricular tachycardia ablation via video-assisted thoracoscopic surgery: a case report.

Background: Epicardial ventricular tachycardia (VT) ablation is an established approach in patients with epicardial arrhythmogenic foci and is most commonly performed via percutaneous access. An alternative approach is via video-assisted thoracoscopic surgery (VATS), although reports of this technique are limited to the use of catheter-based technologies for radiofrequency ablation delivery.

Case Summary: A 55-year-old man with non-ischaemic cardiomyopathy presented with recurrent VT despite medical therapy.

Systematic Evaluation of Lower Urinary Tract Sensations to Improve Management of LUTS: ICI-RS 2024.

Aims: Lower urinary tract (LUT) sensations form an essential part of diagnostic criteria for many LUT symptoms, additionally LUT sensations are used to evaluate the effectivity of therapeutic interventions. The accurate measurement of LUT sensations, however, is severely hampered by the subjective nature of these sensations.

Methods: This paper summarizes the discussions from the 2024 meeting of the International Consultation for Incontinence-Research Society (ICI-RS 2024) regarding systematic evaluations of LUT sensations and the design of more objective tools to measure these.

Functional assessment of coronary artery disease in patients with severe aortic stenosis: a review.

A significant proportion of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) have concomitant coronary artery disease (CAD). The best way to treat these patients is contentious. Conventional assessments of ischaemia such as fractional flow reserve (FFR) and instantaneous wave-free ratio are not validated in the context of severe AS despite having a Class I European Society of Cardiology indication in patients with isolated coronary disease.

The diagnostic journey of patients being investigated for myopathy in a tertiary centre in England.

Myopathies are heterogenous and can provide a diagnostic puzzle. Many patients investigated for myopathy will go on to other diagnoses. An overall understanding of how patients are investigated for suspected myopathy is lacking.

'How Long Do I Have?' - Examining survival outcomes in laryngeal cancer patients managed with non-curative intent in Northern UK: Insights from the Northern Head & Neck Cancer Alliance Retrospective Study.

Introduction: Historically, 15% of laryngeal cancer patients undergo non-curative management, but pragmatic data on this group are limited. This information is crucial to help patients make informed decisions about their care. Supported by the Northern Head & Neck Alliance, this retrospective study is the first to present survival outcomes for non-curative laryngeal cancer patients in Northern UK.

Mean pulmonary artery pressure prediction with explainable multi-view cardiac MR cine series deep learning model.

Background: Pulmonary hypertension (PH) is a heterogeneous condition and regardless of aetiology impacts negatively on survival. Diagnosis of PH is based on hemodynamic parameters measured invasively at right heart catheterization (RHC), however, a non-invasive alternative would be clinically valuable. Our aim was to estimate RHC parameters non-invasively from cardiac MR data using deep learning models and to identify key contributing imaging features.

SENP3-FIS1 axis promotes mitophagy and cell survival under hypoxia.

SUMOylation, the covalent attachment of the small ubiquitin-like modifier (SUMO) to target proteins, and its reversal, deSUMOylation by SUMO proteases like Sentrin-specific proteases (SENPs), are crucial for initiating cellular responses to hypoxia. However, their roles in subsequent adaptation processes to hypoxia such as mitochondrial autophagy (mitophagy) remain unexplored. Here, we show that general SUMOylation, particularly SUMO2/3 modification, suppresses mitophagy under both normoxia and hypoxia.

The impact of patient ethnicity on haematopoietic cell transplantation outcome: a retrospective cohort study on the UK experience.

Background: Patient ethnicity has been correlated with different outcomes after haematopoietic cell transplantation (HCT), with patients from minority ethnic backgrounds reported to have worse outcomes compared with White patients. To date, studies have been predominantly done in the USA, where health-care models are different to many European countries, including the UK. We aimed to evaluate the impact of patient-reported ethnicity on autologous and allogeneic HCT outcomes in the UK.

Vaginal metastasis in gestational trophoblastic neoplasia: Experience from Sheffield trophoblastic disease Centre and recommendations for management.

Introduction: Gestational trophoblastic neoplasia (GTN) is rare in the UK, with an estimated incidence of one in 50,000 live births. Cases of vaginal metastasis are even rarer, with only eight case series reporting 187 cases over the past 40 years. Management recommendations in the literature are scarce despite the potential risk of massive, potentially life-threatening vaginal haemorrhage.

Real-Time In Vivo Human Skin Testing Using a Handheld Fourier Transform Infrared Spectrometer with a Three-Bounce Two-Pass Attenuated Total Reflection Interface.

Attenuated total reflection (ATR) Fourier transform infrared spectroscopy (FT-IR) is used to characterize a vast array of materials at the molecular level in various industry types. Here we compare the performance of a portable spectrometer with a novel three-bounce-two-pass (3B2P) ATR scanning interface to the same device with a standard one-bounce (1B) ATR, and to a benchtop spectrometer with a 10-bounce (10B) ATR, in ideal sample-interface conditions and an applied dermatological study setting. In both application settings, the benchtop 10B ATR interface showed the highest signal-to-noise ratio (SNR), however, the novel 3B2P produced a six-fold increase in the sensitivity of the portable spectrometer when analyzing isopropanol and showed the greatest consistency of SNR of all devices when analyzing isopropanol and in vivo skin samples.

Exploring the current provision of pancreatic transplantations in low- and middle-income countries: Current landscape, challenges, future prospects.

This comprehensive review addresses the global health challenge of disparities in pancreas transplant access, particularly in low- and middle-income countries (LMICs) compared to high-income countries. Despite advancements in surgical techniques and immunosuppression for procedures like simultaneous pancreas-kidney, pancreas-after-kidney, and pancreas-transplant alone, LMICs face significant challenges, including limited infrastructure, financial constraints, and a shortage of skilled medical professionals. Donation after brain death remains constrained by sociocultural barriers.