A standardised model for stool banking for faecal microbiota transplantation: a consensus report from a multidisciplinary UEG working group.

Background: Faecal microbiota transplantation is an emerging therapeutic option, particularly for the treatment of recurrent Clostridioides difficile infection. Stool banks that organise recruitment and screening of faeces donors are being embedded within the regulatory frameworks described in the European Union Tissue and Cells Directive and the technical guide to the quality and safety of tissue and cells for human application, published by the European Council.

Objective: Several European and international consensus statements concerning faecal microbiota transplantation have been issued.

Maternal chronic stress correlates with serum levels of cortisol, glucose and C-peptide in the fetus, and maternal non chronic stress with fetal growth.

Introduction: During pregnancy, maternal stressors cause changes in both maternal and fetal HPA axes. We therefore investigated the impact of maternal non chronic and chronic stress on fetal glucose metabolism and growth, and serum levels of cortisol in the fetus.

Materials And Methods: Normal weight pregnant women (n = 192; mean ± SD 27.

A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom.

Aims: High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics.

Methods: A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery.

Neonatal birth waist is positively predicted by second trimester maternal active ghrelin, a pro-appetite hormone, and negatively associated with third trimester maternal leptin, a pro-satiety hormone.

Introduction: In pregnancy physiological mechanisms activated by maternal appetite contribute to adequate energy intake for the mother and for the fetus. The role of maternal appetite-related peptides and their possible association with neonatal energy stores and glucose metabolism have not been investigated as yet. The aim was to investigate, during pregnancy, the association of fasting maternal appetite-related hormones levels [ghrelin (active), GLP1 (active), total PYY and leptin] with neonatal waist, percent total body fat and insulin levels at birth.

First trimester maternal BMI is a positive predictor of cord blood c-peptide levels while maternal visfatin levels is a negative predictor of birth weight.

Objective: The role of first trimester maternal body mass index (BMI) and adipocytokines in cord blood c-peptide and birth weight in pregnancy was investigated.

Design: Seventy non-diabetic pregnant Caucasian women were recruited. Anthropometry and measurements of fasting adipocytokines (visfatin, leptin, adiponectin), insulin and glucose were performed in each of the three trimesters.

Surgical management of chronic ruptures of the Achilles tendon remains unclear: a systematic review of the management options.

Background: Chronic ruptures of the Achilles tendon cause marked functional impairment. Given the different repair techniques used, there is a need for a systematic review of the literature to investigate whether these procedure are comparable with one another when performed by experienced surgeons.

Sources Of Data: A systematic literature search using the Medline (Pubmed), EMBASE and CINHAL databases.

Treatment of acute tibial shaft fractures with an expandable nailing system: a systematic review of the literature.

Locked Intramedullary Nailing is an established method of treatment for tibial shaft fractures. Locking of tibial nails is however not without its drawbacks. Locking is time consuming, and is associated with a noteworthy complication rate.

Glaucoma medication ignored in general medical and surgical patients.

Objectives: To quantify the risk glaucoma patients are at, having their eye treatment omitted on admission to non-ophthalmic wards at a tertiary referral centre.

Design: A criterion audit surveying all adult inpatients on 13 wards at a tertiary referral centre on two separate dates to reduce convenient sample bias.

Setting: A tertiary referral centre in the West Midlands of England.

The impact of insulin resistance on woman's health and potential treatment options.

Insulin resistance (IR) is causatively related to metabolic syndrome and type 2 diabetes, both of which increase the risk of adverse cardiovascular events; in women in particular, severe IR affects the reproductive system causing subfertility and health problems to the mother and the fetus. To date lifestyle modification is the mainstay of treatment, whereas antiobesity drugs and bariatric surgery have been shown to improve insulin sensitivity and many surrogate metabolic defects, real reduction in cardiovascular endpoints has yet to be proved. Increasing attention is being directed to the role of the central nervous system in the modulation of IR, as well as to the use of recombinant adipocytokines for IR management.

Comparing the performance of graduate-entry and school-leaver medical students.

Objectives: Between 2000 and 2006 Leicester-Warwick Medical Schools (LWMS) provided parallel courses for graduate and school-leaver entrants into medicine. The parallel courses were based upon a single curriculum with ;identical teaching programmes and assessment methods over the two sites (Warwick and Leicester). Warwick runs the curriculum over an accelerated 4-year period for its graduate-entry students.

The influence of computer navigation on trainee learning in hip resurfacing arthroplasty.

Computer navigation in arthroplasty surgery is a form of concurrent augmented feedback. Motor learning theory suggests such feedback may be detrimental to learning as a result of the learner either developing a dependence on the additional feedback or being distracted from using intrinsic feedback. To determine whether computer navigation influences the learning curve of novices performing hip resurfacing arthroplasty, a systematic review and critical appraisal of the current English-language literature on the topic was conducted.

A study of medical intervention in routine breast cancer follow-up.

Aims: The incidence and prevalence of breast cancer is increasing, and survival rates continue to climb, placing increasing demands on clinic time. In the modern health service, the value of routine follow-up has been questioned, as there is a very low rate of detection of asymptomatic recurrences in such clinics. The National Institute for Health and Clinical Excellence has recommended potential discharge after the completion of adjuvant treatment.

Schistosomiasis: a rare cause of acute appendicitis.

Schistosomiasis is a parasitic infection in humans, which is prevalent in developing countries. The infection manifests itself as a variety of different pathologies, depending on the location of the parasite and its eggs. A rare manifestation is that of a common surgical presentation, acute appendicitis.

A validity study of the national UK colposcopy objective structured clinical examination--is it a test fit for purpose?

This study examines the validity and reliability of the British Society for Colposcopy and Cytopathology (BSCCP) objective structured clinical examination (OSCE). The BSCCP OSCE results obtained over eight OSCE circuits were analysed using SPSS 15. Face validity and content validity were established from expert opinion and blueprinting.

Can experienced paramedics perform tracheal intubation at cardiac arrests? Five years experience of a regional air ambulance service in the UK.

Aims: Paramedic tracheal intubation has been reported to carry a high failure rate and morbidity. A comparison between doctor and paramedic-led intubation at out-of-hospital cardiac arrests (OHCA) was conducted to assess whether this finding was observed in our clinical practice.

Methods: Retrospective review of all medical OHCA attended by the Warwickshire and Northamptonshire Air Ambulance (WNAA) over a 64-month period.

Colonic fermentation--more than meets the nose.

Fermentation of undigested foods in the colon by its resident bacteria affects not only colonic health (protection against inflammation and tumour formation) but also influences metabolic health. Studying fermentation directly is difficult for lack of access. We hypothesise that the anatomical structure of the colon is suited to act as a fermenting chamber with the gaseous molecules (VOCs) emitted having direct effects on the colonocytes as well as gut neural and metabolic effects.

Idiopathic intracranial hypertension in otolaryngology.

Idiopathic intracranial hypertension (IIH) is defined as increased intracranial pressure in the absence of intracranial mass or obstructive hydrocephalus. Over 80% of patients are overweight women. IIH is usually encountered in the neurology and ophthalmology practise as headaches, visual disturbance and papilloedema are the characteristic features of this syndrome.

A review of 1241 trauma cases: a study of efficiency in trauma theatres.

Background: Our trauma department has recently moved to a newly built University hospital. Its geographic situation and the fact that all surgical sub-specialties are represented make it a very busy level 1 trauma centre. Our aim was to assess our activity and efficiency in trauma looking at 1241 consecutive trauma operations over a period of 6 months.

Just another sebaceous cyst?

Two cases are presented where an incorrect diagnosis of a sebaceous cyst delayed the treatment of a more serious underlying problem. The history and examination findings pointed to the diagnosis in both cases. Although not rare entities in themselves, these cases illustrate the importance of formulating a differential diagnosis even when confronted with an apparently straightforward condition.

Strong diabetes.

The case of a 36-year-old male professional bodybuilder is reported. He presented to the accident and emergency department with right upper quadrant pain. This was on the background of a 15-year history of anabolic steroid and growth hormone misuse.

The mitochondrial intermembrane loop region of rat carnitine palmitoyltransferase 1A is a major determinant of its malonyl-CoA sensitivity.

Carnitine palmitoyltransferase (CPT) 1A adopts a polytopic conformation within the mitochondrial outer membrane, having both the N- and C-terminal segments on the cytosolic aspect of the membrane and a loop region connecting the two transmembrane (TM) segments protruding into the inter membrane space. In this study we demonstrate that the loop exerts major effects on the sensitivity of the enzyme to its inhibitor, malonyl-CoA. Insertion of a 16-residue spacer between the C-terminal part of the loop sequence (i.