Modified Delphi expert elicitation of the clinical and economic burden of obstructive hypertrophic cardiomyopathy in England and Northern Ireland.

Objective: To estimate the resource use of patients with obstructive hypertrophic cardiomyopathy (HCM), stratified by New York Heart Association (NYHA) class, in the English and Northern Irish healthcare systems via expert elicitation.

Design: Modified Delphi framework methodology.

Setting: UK HCM secondary care centres (n=24).

Exploring the feasibility of home-delivered capsule endoscopy with 5G support: innovations and carbon footprint insights.

Introduction: Colorectal cancer (CRC) poses a significant global health threat, necessitating early detection. Traditional diagnostic tools like optical colonoscopy have limitations prompting our '5G-SUCCEEDS' initiative to explore a novel approach involving remote colon capsule endoscopy (CCE).

Methods: This prospective feasibility study was conducted at a single hospital in England.

The Beneficial Role of Endotracheal Lidocaine in Mitigating Hemodynamic Responses During Elective Surgical Tracheostomy in Head and Neck Cancer Patients.

Background: The effectiveness of endotracheal lidocaine administration to reduce sympathetic stimulus after tracheostomy is still uncertain.

Purpose: This study aimed to compare the hemodynamic responses of patients undergoing tracheostomy with and without pre-tracheostomy administration of endotracheal lidocaine.

Study Design, Setting And Sample: A prospective cohort study was conducted at a tertiary care cancer center in the United Kingdom.

Do animal models of brain tumors replicate human peritumoral edema? a systematic literature search.

Introduction: Brain tumors cause morbidity and mortality in part through peritumoral brain edema. The current main treatment for peritumoral brain edema are corticosteroids. Due to the increased recognition of their side-effect profile, there is growing interest in finding alternatives to steroids but there is little formal study of animal models of peritumoral brain edema.

A Hybrid Architecture (CO-CONNECT) to Facilitate Rapid Discovery and Access to Data Across the United Kingdom in Response to the COVID-19 Pandemic: Development Study.

Background: COVID-19 data have been generated across the United Kingdom as a by-product of clinical care and public health provision, as well as numerous bespoke and repurposed research endeavors. Analysis of these data has underpinned the United Kingdom's response to the pandemic, and informed public health policies and clinical guidelines. However, these data are held by different organizations, and this fragmented landscape has presented challenges for public health agencies and researchers as they struggle to find relevant data to access and interrogate the data they need to inform the pandemic response at pace.

Role of Temporal artery biopsy in a sequential Giant Cell Arteritis fast-track pathway: a 5-year prospective study.

Background: Increasing number of centres are establishing sequential fast track pathways (FTP) for management of giant cell arteritis (GCA), with temporal artery ultrasound (US) replacing temporal artery biopsy (TAB) as the first investigational method. Biopsy is performed as second investigation, when US is negative/inconclusive. This study investigates the role of TAB in a sequential GCA-FTP and its utility in those with negative/inconclusive US.

Efficacy and Safety of Maintenance Ustekinumab for Ulcerative Colitis Through 3 Years: UNIFI Long-term Extension.

Background And Aims: The UNIFI long-term extension [LTE] study reports the efficacy and safety of subcutaneous 90 mg ustekinumab through 3 years of maintenance therapy.

Methods: Patients randomised to ustekinumab every 12 weeks [q12w] or every 8 weeks [q8w] at maintenance baseline [N = 348] and randomised ustekinumab-treated patients in the LTE [N = 284] were evaluated. Symptomatic remission [Mayo stool frequency = 0/1, rectal bleeding = 0] was assessed.

Initial experience of temperature-controlled irrigated radiofrequency ablation for ischaemic cardiomyopathy ventricular tachycardia ablation.

Background: The DiamondTemp ablation (DTA) catheter system delivers high power, open-irrigated, temperature-controlled radiofrequency (RF) ablation. This novel ablation system has not been previously used for ventricular tachycardia (VT) ablation.

Objective: Feasibility of using the DTA catheter system for VT ablation in ischaemic cardiomyopathy (ICM) patients.

Qualitative exploration of digital chatbot use in medical education: A pilot study.

Purpose: During the coronavirus disease 2019 pandemic, face-to-face teaching has been severely disrupted and limited for medical students internationally. This study explores the views of medical students and academic medical staff regarding the suitability and limitations, of a bespoke chatbot tool to support medical education.

Methods: Five focus groups, with a total of 16 participants, were recruited using a convenience sample.

The challenge of optimising ablation lesions in catheter ablation of ventricular tachycardia.

Radiofrequency catheter ablation has become an established treatment for ventricular tachycardia. The exponential increase in procedures has provided further insights into mechanisms causing arrhythmias and identification of ablation targets with the development of new mapping strategies. Since the definition of criteria to identify myocardial dense scar, borderzone and normal myocardium, and the description of isolated late potentials, local abnormal ventricular activity and decrementing evoked potential mapping, substrate-guided ablation has progressively become the method of choice to guide procedures.

Aortic valve neocuspidization with autologous pericardium in adult patients: UK experience and meta-analytic comparison with other aortic valve substitutes.

Objectives: We sought to provide further evidence on the safety and efficacy of aortic valve neocuspidization (AVNeo) using autologous pericardium in adult patients with aortic valve disease by reporting clinical and echocardiographic results from the first UK experience and performing a meta-analytic comparison with other biological valve substitutes.

Methods: We reported clinical and echocardiographic outcomes of 55 patients (mean age 58 ± 15 years) undergoing AVNeo with autologous pericardium in 2 UK centres from 2018 to 2020. These results were included in a meta-analytic comparison between series on AVNeo (7 studies, 1205 patients, mean weighted follow-up 3.

Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: A systematic review and meta-analysis of prospective studies.

Background And Aims: Overweight and obesity in children have become a global public health problem. Epidemiological studies suggest that sleep duration may contribute to the incidence of overweight and obesity in all stages of life. China has an increasing prevalence of overweight and obesity, and sleep deprivation is common among Chinese children.

Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation.

Background: Substrate mapping has highlighted the importance of targeting diastolic conduction channels and late potentials during ventricular tachycardia (VT) ablation. State-of-the-art multipolar mapping catheters have enhanced mapping capabilities. The purpose of this study was to investigate whether long-term outcomes were improved with the use of a HD Grid mapping catheter combining complementary mapping strategies in patients with structural heart disease VT.

Head and neck ablative and microvascular reconstructive surgery in the UK: current operating team composition.

We sought to explore the current landscape of team composition in the provision of major head and neck ablative and reconstructive surgery in the UK. We conducted a survey of maxillofacial surgery units and compiled data on the operating model adopted at each institution. Our survey confirmed 54 active maxillofacial units undertaking microvascular free flap reconstructive surgery, with 44 (82%) hospitals adopting a two-team operative approach.

Postoperative hemiparesis following tonsillectomy.

We report a rare complication following a routine elective tonsillectomy. A 32-year-old woman woke up from general anaesthesia with left sided hemiparesis. She underwent extensive investigations, which were normal.

Structure of the C1r-C1s interaction of the C1 complex of complement activation.

The multiprotein complex C1 initiates the classical pathway of complement activation on binding to antibody-antigen complexes, pathogen surfaces, apoptotic cells, and polyanionic structures. It is formed from the recognition subcomponent C1q and a tetramer of proteases C1rC1s as a Ca-dependent complex. Here we have determined the structure of a complex between the CUB1-EGF-CUB2 fragments of C1r and C1s to reveal the C1r-C1s interaction that forms the core of C1.

Surgical mortality in patients more than 80 years of age.

Introduction: Patients aged >80 years account for a considerable proportion of the population admitted to hospital under general surgeons. We aimed to establish the prevalence of mortality in patients aged >80 years who underwent emergency general, vascular and urological surgery within a 13-month period at a large teaching hospital in the UK.

Materials And Methods: A retrospective analysis was carried out of all patients aged ≥80 years admitted on acute on-call emergency under general, vascular or urological surgeons.

Persistent air-leak after transhiatal oesophagectomy: A case report.

Introduction: Transhiatal oesophagectomy is a widely accepted technique for resection of tumours of the lower oesophagus. We present a life-threatening complication associated with the placement of a corrugated neck drain during this procedure.

Presentation Of Case: Our patient underwent a transhiatal oesophagectomy for a lower oesophageal tumour.

Emergency department as a 'place of safety': reviewing the use of Section 136 of the Mental Health Act 1983 in England.

Section 136 provides the lawful authority for the removal, by the police, of the person to whom the provision applies, from a place to which the public have access. There has been a longstanding debate as to the most appropriate place of safety for these patients. The aim of this article is to review the literature and determine the ideal place for the detention and assessment of these patients and clarify the responsibilities of the staff of the agencies involved in the detention.

A pre-clinical assessment of an atlas-based automatic segmentation tool for the head and neck.

Background And Purpose: Accurate conformal radiotherapy treatment requires manual delineation of target volumes and organs at risk (OAR) that is both time-consuming and subject to large inter-user variability. One solution is atlas-based automatic segmentation (ABAS) where a priori information is used to delineate various organs of interest. The aim of the present study is to establish the accuracy of one such tool for the head and neck (H&N) using two different evaluation methods.