Outcome Measures in intellectual disability: A Review and narrative synthesis of validated instruments.

Background: Outcome measurement is essential to determine the effectiveness of health interventions and improve the quality of services. The interplay of social, individual, and biological factors makes this a complex process in the psychiatry of people with intellectual disability (PwID).

Aim: Review of outcome measures which are validated in PwID.

Metastatic Adenocarcinoma of the Prostate Masquerading as a Splenic Flexure Colonic Polyp: A Diagnostic Conundrum.

Metastasis of prostate cancer to the gastrointestinal tract is infrequently described in the literature, with only a limited number of cases reporting metastasis to the rectum. We present a rare case of a 74-year-old man initially presenting with symptomatic anemia and weight loss. A colonoscopy revealed a sessile polyp in the splenic flexure.

Preventive Antibiotic Use and Complications After Endoscopic Retrograde Cholangiopancreatography in Patients Hospitalized for Primary Sclerosing Cholangitis.

Background: The American Society for Gastrointestinal Endoscopy recommends prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) in primary sclerosing cholangitis (PSC). We assessed the impact of this approach on the incidence of post-ERCP outcomes using nationwide data.

Methods: Using 2015-2021 Nationwide Inpatient Sample data and relevant ICD-10 codes, we analyzed adult hospitalizations for PSC who underwent ERCP, with and without antibiotic prophylaxis.

Thirty-Day Readmissions After Hospitalization for Psoriatic Arthritis.

Background Psoriatic arthritis (PsA) is correlated with higher rates of major adverse cardiovascular events and autoimmune disorders than the general population, leading to more frequent hospitalizations. This study assessed the rates and characteristics of index and 30-day readmissions among adults hospitalized for PsA and evaluated the indications and predictors of 30-day readmissions across the United States. Methodology We analyzed the 2020 Nationwide Readmissions Database for adult PsA hospitalizations using the International Classification of Diseases, Tenth Revision, Clinical Modification codes.

Systematic Review and Meta-Analysis of Prehospital Machine Learning Scores as Screening Tools for Early Detection of Large Vessel Occlusion in Patients With Suspected Stroke.

Background: Enhanced detection of large vessel occlusion (LVO) through machine learning (ML) for acute ischemic stroke appears promising. This systematic review explored the capabilities of ML models compared with prehospital stroke scales for LVO prediction.

Methods And Results: Six bibliographic databases were searched from inception until October 10, 2023.

Intra-articular steroids for the treatment of coxarthrosis; a retrospective cohort study comparing three contrast techniques.

Introduction: Intra-articular steroid injections (IAS) are a treatment for coxarthrosis. This study examines the efficacy of three fluoroscopy-guided IAS contrast techniques for coxarthrosis: contrast-assisted (Iohexol), air arthrogram-assisted and blind (contrast/air free) and stratifies efficacy based on multiple patient variables.

Materials And Methods: A cohort of 307 hip IAS was retrospectively analysed over a four-year period.

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered.

Background: Breast pathology reporting, especially for breast cancer, has evolved through the years, from terse succinct diagnostic conclusions with scant histological details to the current comprehensive reporting guidelines issued by major pathology colleges and bodies, including the International Collaboration on Cancer Reporting. Pathology elements included in reporting guidelines are evidence based and contribute significantly to individualised and personalised patient management.

Summary: This article is based on the lively interactive question and answer session that followed the breast pathology segment in the symposium jointly organised by the British Association of Urological Pathology, British Association of Gynaecological Pathologists, British Society of Gastroenterology and the Association of Breast Pathology, in November 2022, titled "Personalised histopathology reporting for personalised medicine.

Albumin Levels and Risk of Early Cardiovascular Complications After Ischemic Stroke: A Propensity-Matched Analysis of a Global Federated Health Network.

Background: No studies have investigated the association between albumin levels and the risk of early cardiovascular complications in patients with ischemic stroke.

Methods: Retrospective analysis with a federated research network (TriNetX) based on electronic medical records ( and logical observation identifiers names and codes) mainly reported between 2000 and 2023, from 80 health care organizations in the United States. Based on albumin levels measured at admission to the hospital, patients with ischemic stroke were categorized into 2 groups: (1) reduced (≤3.

Nutrition counselling and clinical outcomes in HIV: A systematic review and meta-analysis.

Background: People living with the HIV (PLHIV) are at an increased risk of various diseases due to a weakened immune system, particularly if they are naïve or poorly adherent to antiretroviral therapy (ART). Nutrients play a critical role in improving immune health, especially among this population. We systematically reviewed the evidence concerning the impact of nutritional counselling on the occurrence of important clinical outcomes among PLHIV.

Creating evidence-based engaging online learning resources in neuroanatomy.

Online anatomical resources are rising in popularity since the COVID-19 pandemic, but the pedagogical principles and effectiveness of their use remain unclear. This article aims to demonstrate evidence-informed ways in which fellow educators can create engaging online learning resources in clinical neuroanatomy and compare the effectiveness of text-based and online learning resources. Data were analyzed from the Soton Brain Hub (SBH) YouTube page.

Social determinants of health and clinical outcomes among patients with atrial fibrillation: evidence from a global federated health research network.

Background: Few studies have investigated the role of social determinants of health (SDoH) in patients with atrial fibrillation (AF).

Aim: To investigate the relationship between SDoH and adverse events in a large multinational AF cohort.

Design: Retrospective study utilizing a global federated health research network (TriNetX).

'Experience days': promoting interprofessional collaboration and understanding for postgraduate doctors in training.

An 'experience day' is a novel concept in medical education, targeted at postgraduate doctors in training. In this article, the term postgraduate doctors in training includes all junior doctors, ranging from foundation year level to junior specialist doctors to higher specialist registrars. Experience days offer postgraduate doctors in training the opportunity to shadow other healthcare professionals in their working environment, to enhance their perspective of their role as a clinician and their understanding of the complex interplay of services.

Adverse health outcomes among people who inject drugs who engaged in recent sex work: findings from a national survey.

Objectives: This study explores trends in sex work among people who inject drugs (PWID) by gender and the relationship between sex work and adverse health outcomes including overdose, injection-site, and blood-borne virus (BBV) infections.

Study Design: The Unlinked Anonymous Monitoring Survey of PWID is an annual cross-sectional survey that monitors BBV prevalence and behaviours, including transactional sex, among PWID recruited through specialist services in England, Wales, and Northern Ireland.

Methods: Trends in sex work among PWID (2011-2021) were described.

Factors leading to the late diagnosis and poor outcomes of breast cancer in Matabeleland South and the Bulawayo Metropolitan Provinces in Zimbabwe.

Introduction: Breast cancer (BC) is the leading cause of female cancer deaths in Africa, and in Zimbabwe, >80% present with advanced disease. A Needs Project (NP) was carried out to determine the key factors responsible for delayed diagnosis and poor BC outcomes and to investigate possible solutions in 6 rural and urban districts of Matabeleland South and Bulawayo Metropolitan Provinces.

Methods: A mixed method approach was used to collect data in 2 phases.

Tips from the shop floor: postgraduate doctors working in trauma and orthopaedics.

Trauma and orthopaedics is a useful rotation for junior doctors to undertake. Experience in the specialty allows doctors to feel more confident in the diagnosis and treatment of conditions affecting the entire musculoskeletal system. Many junior doctors cover on-calls in trauma and orthopaedics departments, often with no prior specialist experience.

Haemorrhagic cholecystitis in a young patient, complicated by gallbladder perforation and choledocholithiasis.

Haemorrhagic cholecystitis is a rare condition associated with a high risk of morbidity and mortality. Its pathophysiology is thought to be due to gallbladder wall erosion and infarction secondary to inflammation, which subsequently leads to haemorrhage into the gallbladder lumen or the peritoneal cavity. There is no current official guidance on optimal management of this condition.

Clinical emergencies in inpatient hospice: simulation-based training to improve nursing confidence.

Objectives: This study aims to assess whether a simulation-based training programme focusing on palliative care emergencies conducted in a hospice setting could improve the self-reported confidence and competence of nursing staff.

Methods: A training programme was developed to enable nursing professionals to practice clinical skills necessary for recognising and managing palliative care emergencies including opioid induced respiratory depression, catastrophic haemorrhage, anaphylaxis, seizure and acute airway obstruction. Eight sessions were conducted.

Opioid use and associated factors in 1676 patients with inflammatory bowel disease: a multicentre quality improvement project.

Objective: Despite its association with poorer outcomes, opioid use in inflammatory bowel disease (IBD) is not well characterised in the UK. We aimed to examine the extent of opioid use, the associated factors and the use of mitigation techniques such as pain-service review and opioid weaning plans among individuals with IBD.

Methods: Data were collected from consecutive patients attending IBD outpatient appointments at 12 UK hospitals.

Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit.

Aim: To describe a UK-wide re-audit of the 2019 Royal College of Radiologists (RCR) audit evaluating patient-related data and organisational infrastructure in the radiological reporting of vertebral fragility fractures (VFFs) on computed tomography (CT) studies and to assess the impact of a series of RCR interventions, initiated to raise VFF awareness, on reporting practice and outcomes.

Materials And Methods: Patient specific and organisational questionnaires largely replicated those utilised in 2019. The patient questionnaire involved retrospective analysis of between 50 and 100 consecutive, non-traumatic CT studies which included the thoracolumbar spine.

Small bowel obstruction secondary to phytobezoar in a patient with myotonic dystrophy.

A male patient in his 30s, with myotonic dystrophy (DM), presented to the emergency department with abdominal pain and vomiting. CT imaging revealed a soft tissue lesion in the terminal ileum causing small bowel obstruction (SBO). The patient underwent diagnostic laparoscopy which allowed identification and removal of the obstructing lesion.

A Longitudinal Clinical Trajectory Analysis Examining the Accumulation of Co-morbidity in People with Type 2 Diabetes (T2D) Compared with Non-T2D Individuals.

Background: Type 2 diabetes mellitus (T2D) is commonly associated with an increasing complexity of multimorbidity. While some progress has been made in identifying genetic and non-genetic risk factors for T2D, understanding the longitudinal clinical history of individuals before/after T2D diagnosis may provide additional insights.

Methods: In this study, we utilised longitudinal data from the DARE (Diabetes Alliance for Research in England) study to examine the trajectory of clinical conditions in individuals with and without T2D.

Association Between Depression and Anxiety Status With Uptake of Colorectal Cancer Screening Among US Adults: A Population-Level Study.

Background: Individuals with different mental disorders tend to experience higher rates of colorectal cancer (CRC)-related mortality compared to the general population. Discrepancies in CRC screening behaviors have been suggested as a potential contributing factor to this difference in mortality. However, existing evidence on this topic has been inconclusive and conflicting.