Prolonged weaning from mechanical ventilation: who, what, when and how?

Weaning from invasive mechanical ventilation is an important part of the management of respiratory failure patients. Patients can be classified into those who wean on the first attempt (simple weaning), those who require up to three attempts (difficult weaning) and those who require more than three attempts (prolonged weaning). The process of weaning includes adequately treating the underlying cause of respiratory failure, assessing the readiness to wean, evaluating the response to a reduction in ventilatory support, and eventually liberation from mechanical ventilation and extubation or decannulation.

Impact of CT-angiography derived plaque characteristics on cardiac events in patients with a negative invasive fractional flow reserve.

Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque.

Treatments for RYR1-related disorders.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To analyse the benefits and harms of pharmacological or other interventions (e.g.

The effects of blood cell salvage on transfusion requirements after decannulation from veno-venous extracorporeal membrane oxygenation: an emulated trial analysis.

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a supportive therapy for acute respiratory failure with increased risk of packed red blood cells (PRBC) transfusion. Blood cell salvage (BCS) aims to reduce blood transfusion, but its efficacy is unclear. This study aimed to estimate the effect of BCS at the time of removal of the ECMO circuit (ECMO decannulation) on PRBC transfused.

Childhood interstitial lung disease survivors in adulthood: a European collaborative study.

Background: Interstitial lung disease (ILD) is rarer in children (chILD) than adults, but with increasing diagnostic awareness, more cases are being discovered. chILD prognosis is often poor, but increasing numbers are now surviving into adulthood.

Aim: To characterize chILD-survivors and identify their impact on adult-ILD centers.

Left-right difference in acetabular articular cartilage surface area and the quantification of acetabular fractures.

X-ray computer tomography scans were carried out on 11 female and 9 male dry bony pelvises. A 512 x 512 image matrix was used with a slice thickness and separation of 2 mm. Images were transferred onto a computer and the articular cartilage marked on each relevant image.

Bifocal retinal degeneration observed on ultra-widefield autofluorescence in some cases of CRX-associated retinopathy.

Background: Variants in CRX are associated with dominantly inherited retinopathy with considerable phenotypic variability. Many patients have central retinal degeneration; in some patients, we have observed an additional focus of degeneration in the nasal retina. This study explores this phenotypic association amongst patients with CRX-associated disease.

The impact of age and number of oocytes retrieved on the cumulative live birth rate in women with poor ovarian response: A 15-year study.

Background: Approximately 15 % of women undergoing assisted reproductive treatment (ART) fall in the category of poor ovarian reserve defined as the retrieval of three or fewer oocytes following conventional ovarian stimulation with a daily gonadotrophin dose of 150-450 international units, according to the Bologna criteria. Low number of oocytes collected is, therefore, likely to translate to low chance of successful ART treatment.

Objectives: The objective of the study was to assess if age and number of oocytes retrieved influence the cumulative live birth rate (LBR) in women with poor ovarian response (POR) to controlled ovarian hyperstimulation.

The impact of 3D real-IR delayed post gadolinium MRI parameterisation on the diagnostic performance and optimal descriptor selection in Ménière's disease.

Objectives: To compare the performance and optimal combination of MRI descriptors used for the diagnosis of Ménière's disease (MD) between a real-IR sequence with "zero-point" endolymph (ZPE), and an optimised real-IR sequence with negative signal endolymph (NSE).

Materials And Methods: This retrospective single-centre cross-sectional study evaluated delayed post-gadolinium ZPE and NSE real-IR MRI in consecutive patients with Ménièriform symptoms (8/2020-10/2023). Two observers assessed 14 MRI descriptors.

Histopathologic and Molecular Insights Following the Management of Ameloblastomas via Targeted Therapies - Pathological and Clinical Perspectives.

Purpose: Current standard of care for ameloblastoma (conventional/unicystic - mural type) usually mandates extensive bone resection that frequently necessitates immediate reconstruction with serious sequelae, especially among young patients. BRAF-mutated ameloblastomas can be targeted by BRAF inhibitors to markedly reduce their size, enabling conservative removal of residual tumor. We aimed to characterize the effect of post-treatment histomorphologic changes.

The efficacy of arterial only microsurgical nasal replantation: a systematic review.

Background: Microsurgical nasal replantation is a rare yet important procedure in order to regain the respiratory, olfactory, and aesthetic features of the nose. However, due to the traumatic nature of most nasal amputations, appropriate veins for anastomosis are difficult to find- complicating replantation. This is the first systematic review that compares peri operative and post-operative outcomes in arterial only versus arterial and venous anastomosis for nasal replantation.

Surgical Simulation of Kirschner Wiring-Discussion and Review of the Newcastle Surgical Training Centre K-Wiring Course May 2024.

Simulation training has been growing in popularity, as a means to help supplement the training of surgical residents. The Newcastle Surgical Training Centre K-wiring course, a 1-day course designed for early-years surgical trainees, aims to teach essential skills in K-wire fixation for hand fractures. The course integrates lectures and hands-on practice with both simulated and cadaveric specimens, supported by a high faculty-to-delegate ratio.

INSIGHT-2: mechanistic studies into pregnancy complications and their impact on maternal and child health-study protocol.

Background: Pregnancy and early childhood cohorts provide a framework for investigating the complex interplay between early-life exposures and health outcomes, thereby informing prevention strategies and interventions to improve maternal and child health. In this paper, we outline the objectives, methodologies and expected contributions of INSIGHT-2, a comprehensive cohort study dedicated to advancing our understanding of pregnancy and pregnancy complications towards improving the health and well-being of mothers and their offspring.

Methods: Over the course of 5 years, the study aims to establish a diverse cohort of 1700 pregnant women and to follow up their children up to 2 years of age.