Long term health outcomes in people with diabetes 12 months after hospitalisation with COVID-19 in the UK: a prospective cohort study.

Background: People with diabetes are at increased risk of hospitalisation, morbidity, and mortality following SARS-CoV-2 infection. Long-term outcomes for people with diabetes previously hospitalised with COVID-19 are, however, unknown. This study aimed to determine the longer-term physical and mental health effects of COVID-19 in people with and without diabetes.

The current clinical practice and experiences in buccal midazolam prescribing in community for status epilepticus termination in the United Kingdom: The Rescue Epilepsy Medication and Training (REMIT) study.

Background: Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals' clinical practice and experience in community-based rescue therapy prescribing.

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.

Treatment of Seizures in People with Intellectual Disability.

There is a synergistic relationship between epilepsy and intellectual disability (ID), and the approach to managing people with these conditions needs to be holistic. Epilepsy is the main co-morbidity associated with ID, and clinical presentation tends to be complex, associated with higher rates of treatment resistance, multi-morbidity and premature mortality. Despite this relationship, there is limited level 1 evidence to inform treatment choice for this vulnerable population.

Determinants and progression of stigma in amyotrophic lateral sclerosis/motor neuron disease.

: Stigma in amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) may be felt or enacted; felt stigma covers feeling devalued by the illness, whereas enacted stigma refers to being treated differently because of it. Stigma in ALS/MND has been shown to increase social withdrawal, worsen quality of life, and reduce use of assistive devices, so we explored prevalence and factors influencing stigma. : Participants in the Trajectories of Outcome in Neurological Conditions-ALS study completed scales measuring stigma, fatigue, spasticity, functioning, mood, worry, self-esteem, and perceived health, as well as demographic information and symptoms like head drop or emotional lability.

IPEM topical report: guidance on 3D printing in radiotherapy.

There has been an increase in the availability and utilization of commercially available 3D printers in radiotherapy, with applications in phantoms, brachytherapy applicators, bolus, compensators, and immobilization devices. Additive manufacturing in the form of 3D printing has the advantage of rapid production of personalized patient specific prints or customized phantoms within a short timeframe. One of the barriers to uptake has been the lack of guidance.

A Systematic Review of the Prevalence of Overactive Bladder in Women with Non-Urinary Tract Endometriosis and the Effect of Endometriosis Surgery on Symptoms of Overactive Bladder.

Introduction And Hypothesis: Overactive bladder (OAB) is characterised by urinary urgency, with or without incontinence, often accompanied by daytime frequency and nocturia, in the absence of urinary tract infection or other identifiable causes. Population studies estimate the prevalence of OAB at 12.8% (EPIC study), increasing with age, reaching up to 43% after age 40.

Earlier diagnosis of small intestine neuroendocrine tumours (SI-NETs) through transformation of the South Wales NET service.

Small intestine neuroendocrine tumours (SI-NETs) are often diagnosed late with a UK median of 3 years and high misdiagnosis rates. Previous studies, largely based on patient surveys, offer little data on improving diagnosis. In 2017, the South Wales NET service underwent a nationally commissioned, systematic transformation, aiming to improve diagnosis through the development of a gastroenterology and surgical referral network, and education of these specialities.

The role of combined problem-based learning (PBL) and case-based learning (CBL) teaching methodologies in dental education.

Background: Innovative methods of teaching such as problem-based learning (PBL) and case-based learning (CBL) have shown promising results in academic understanding and application and enable one to manage their patients in a better manner. The study aimed to analyze the role of a combination of PBL and CBL teaching methodologies in a dental teaching institute in India.

Materials And Methods: This prospective, cross-sectional randomized study comprised 500 students divided into two study groups, each consisting of 250 participants.

Removing barriers to management of adults with type 2 diabetes on insulin using continuous glucose monitoring in UK primary care practice: An expert consensus.

Aims: This expert consensus reviews the reality of primary care clinical management of people with type 2 diabetes (T2D) on non-intensive insulin therapy, with an emphasis on the use of continuous glucose monitoring (CGM) technology for effective care in this participant group. Here, we identify key unmet needs for skills and systems development within this frontline healthcare setting, along with major challenges and opportunities associated with managing these changes effectively.

Methods: The authors participated in two primary care consensus panels held on 28 November 2023 and on 21 May 2024.

Aspirin modulates generation of procoagulant phospholipids in cardiovascular disease, by regulating LPCAT3.

Enzymatically oxygenated phospholipids (eoxPL) from lipoxygenases (LOX) or cyclooxygenase (COX) are prothrombotic. Their generation in arterial disease, and their modulation by cardiovascular therapies is unknown. Furthermore, the Lands cycle acyl-transferases that catalyze their formation are unidentified.

Acute management of adults following chest wall injury: An assessment of institutional clinical practice guidelines across the UK and synthesis of care recommendations.

Objective: Chest wall injury causes significant morbidity and mortality. There is uncertainty regarding many aspects of clinical care for these patients, including optimal analgesia, acuity of monitoring and surgical fixation. Our aim in this work is to [1] objectively appraise the quality and extent of heterogeneity in UK major trauma centre (MTC) clinical practice guidelines regarding the management of chest wall injury; and [2] narratively summarise clinical and care process recommendations from these guidelines to provide a comparative description of recommendations between institutions.

Reconsidering the Role of Radiotherapy for Inoperable Gastric Cancer: A Systematic Review of Gastric Radiotherapy Given With Definitive and Palliative Intent.

Aims: The role of radiotherapy (RT) for inoperable gastric cancer (IGC) is commonly low-dose, given reactively for symptoms (e.g. bleeding), in contrast to the oesophagus, where high quality evidence exists for higher doses of RT.

Machine learning in predicting cauda equina imaging outcomes- a solution to the problem.

Purpose: Cauda Equina Syndrome (CES) is a rare surgical emergency. The implications for loss of quality of life through delayed management are high, though no clinical symptom is pathognomonic in its diagnosis. We describe how machine learning based algorithms can be used in triaging patients with suspected CES (CES-S).

Meta-analysis of routine abdominal drainage versus no drainage following distal pancreatectomy: Does the best available evidence overcome "HPB surgeon's paranoia"?

Aims: To evaluate comparative outcomes of routine abdominal drainage versus no drainage after distal pancreatectomy (DP).

Methods: A systematic search of MEDLINE, CENTRAL and Web of Science and bibliographic reference lists were conducted (last search: 20th April 2024). All comparative studies reporting outcomes of DP with routine abdominal drainage and no drainage were included and their risk of bias were assessed.

Long-Term Survival of Implants Supporting Oral and Maxillofacial Rehabilitation Prosthesis.

Osseointegrated implants, either in native bone or in reconstructed bone, have allowed clinicians to provide greater function and esthetics, following treatment of head and neck pathology. The survival of these implants may be in variance with the success and survival we see with osseointegrated implants in conventional, nonablative rehabilitation. This article looks at the survival and complications with using osseointegrated implants in rehabilitation of the maxillofacial region.

Rotator Cuff Repair by All-Arthroscopic Versus Mini-Open Technique: A Comparison of Clinical and Functional Outcome.

Background: Rotator cuff tears can lead to debilitating shoulder function and impairment. Rotator cuff repair aims to eliminate pain and improve function with increased shoulder strength and range of motion. This study evaluated the differences between all-arthroscopic (AA) and mini-open (MO) repair procedures for rotator cuff tendon tears regarding clinical and functional outcomes.

Metformin Use and Vitamin B12 Deficiency in People with Type 2 Diabetes. What Are the Risk Factors? A Mini-systematic Review.

Metformin is recommended as the first-line agent for the management of type 2 diabetes following lifestyle and dietary changes. The long-term use of metformin has been associated with vitamin B12 deficiency. The aim of this review is to investigate the effect of metformin on vitamin B12 levels and identify any risk factors.

Success and Survival of Composite Resin Restorations for the Management of Localized Anterior Tooth Wear: A Systematic Review and Meta-Analysis.

Purpose: To systematically review the literature and assess the success and survival rates of anterior composite restorations used in the management of anterior tooth surface loss, and to estimate complete posterior occlusion re-establishment when a Dahl approach is utilized.

Materials And Methods: An electronic search was performed in the following databases: MEDLINE via Ovid and Scopus, for articles published from 1970 to November 2020. The systematic review was performed according to the PRISMA and Meta-analyses guidelines.

Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales.

Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges.

Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between National Health Service (NHS) Wales, industry and academia was developed.

Exploring the experiences of healthcare professionals when breaking bad news in major trauma care.

Breaking bad news is a challenging yet essential part of the role of healthcare professionals who care for major trauma patients and their families. This service evaluation investigated healthcare professionals' attitudes and experiences regarding breaking bad news in the context of major trauma. Healthcare professionals were recruited from the South Wales Trauma Network and their views collected via an online survey based on the Breaking Bad News Attitudes Scale.