Risk factors and evolution of calcium and parathyroid hormone levels in hungry bone syndrome after parthyroidectomy for primary hyperparathyroidism.

Introduction: Hungry bone syndrome (HBS) is a complication occurring after parathyroid surgery that can cause severe and prolonged hypocalcemia. The study objective was to know the risk factors for HBS after surgery for primary hyperparathyroidism and its relationship with serum calcium and parathyroid hormone levels.

Material And Methods: A case-control, observational, analytical study was conducted in patients who had undergone surgery for primary hyperparathyroidism in the past 10 years (2007-2016).

Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies.

Background: Despite advances in healthcare, stillbirth rates remain relatively unchanged. We conducted a systematic review to quantify the risks of stillbirth and neonatal death at term (from 37 weeks gestation) according to gestational age.

Methods And Findings: We searched the major electronic databases Medline, Embase, and Google Scholar (January 1990-October 2018) without language restrictions.

Gastric perforation through a hiatus hernia into the left lung in an 84-year-old woman.

An 84-year-old woman presented to the emergency department with a sudden onset of chest pain, shortness of breath and vomiting. She had a medical history of hiatus hernia, gastro-oesophgeal reflux disease and asthma only, but had several recent courses of oral steroids to treat her asthma. Initially she was hypoxic, tachycardic and normotensive.

The use of mobile computing devices in microsurgery.

Mobile computing devices (MCDs), such as smartphones and tablets, are revolutionizing medical practice. These devices are almost universally available and offer a multitude of capabilities, including online features, streaming capabilities, high-quality cameras, and numerous applications. Within the surgical field, MCDs are increasingly being used for simulations.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

Management of laryngeal papillomatosis using coblation: another option of surgical intervention.

Purpose: Recurrent respiratory papillomatosis is a disease caused by the human papilloma virus (HPV). HPV is frequently localised in the larynx. The disease tends to recur and frequent intervention is usually required.

High-sensitivity troponin T in marathon runners, marathon runners with heart disease and collapsed marathon runners.

Endurance exercise is an established cause of cardiac troponin (cTn) elevation, of further interest is whether this rise represents clinical significance. This study compared cTnT rise in three cohorts of marathon runners using a high-sensitivity assay; control runners, those with known heart disease and runners who collapsed at the finish line. Control runners (n = 126) and runners with heart disease (n = 12) were prospectively recruited with cTnT levels measured pre-race and at race completion.

From Voice Clinic to Operating Room: Are We Out of Tune?

Introduction: To determine the consistency and accuracy of preoperative diagnosis in the voice clinic with intraoperative diagnosis and to suggest a standardized laryngeal examination protocol in the UK that is supported by evidence-based findings.

Method: From January 2011-September 2014, 164 patients were referred to the Multidisciplinary Team voice clinic and diagnosed with laryngeal pathology that required phonosurgery. The visualization (videostrobolaryngoscopy) in clinic was performed using either rigid laryngoscope or a video-naso-laryngoscope.

An unusual cause of intestinal failure.

Unlabelled: A 62-year-old man presented to the emergency department with 5 weeks of worsening lower abdominal pain associated with watery diarrhoea, vomiting and 10% loss of body weight. He had recently experienced night blindness. There was no history of foreign travel.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study.

Background: Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

Methods: This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014.

Impact of an auditory hallucinations simulation on trainee and newly qualified clinical psychologists: A mixed-methods cross-sectional study.

Simulation training is an effective teaching tool enabling learners to gain a subjective understanding of a range of skills. Our aim in this study was to pilot and evaluate a newly designed simulation of auditory hallucinations as a future training tool for clinicians. This was a mixed-methods study in two parts.

Competence in thoracic ultrasound.

Ultrasound examination is traditionally considered a safe and repeatable exam, but its use is highly operator-dependent. Because of this, lack of sufficient operator skills could lead to diagnostic errors and damage to patient safety related to unnecessary tests or interventional procedures. The indications for lung ultrasound include: diagnosis, quantification, and follow-up of different conditions for which acute respiratory failure or chest pain are the main clinical presentation.

Bombay phenotype (O ) and high-titer anti-H in pregnancy: two case reports and a review of the literature.

Background: Antenatal cases of Bombay-phenotype (O ) individuals and hemolytic disease of the fetus and newborn (HDFN) are not well described in the literature. We present two case reports of high-titer anti-H in pregnant O individuals and their serologic investigation, clinical management, and subsequent outcomes. We describe current published cases detailing pregnancy in O individuals, to add to the evidence base for clinical decision making and management of pregnancy.

A Qualitative Study Exploring the Role of Pharmacists in Medical Student Training for the Prescribing Safety Assessment.

Five years after the introduction of the Prescribing Safety Assessment (PSA) in the UK, the role pharmacists play to help prepare medical students for this challenge is uncertain. Our study explored pharmacists' perceptions about their role in undergraduate medical training for the Prescribing Safety Assessment (PSA). One hundred and seventy-nine prospective participants from UK hospitals and education and training boards were emailed an interview schedule aimed at ascertaining their current involvement in undergraduate medical education, particularly the preparation for PSA.

Does the Technique of Skin Closure Affect the Cosmesis of Cervical Thyroidectomy and Parathyroidectomy Scars? A Review of Literature.

The cosmetic outcomes following thyroid and parathyroid surgery is a priority for patients as the surgical scar is in a visible area of the body. Although some have advocated the use of minimally invasive and robotic surgery, these are not without risks and it has been suggested that the scars are not necessarily more favorable. The three most common means of skin closure include the use of subcuticular sutures, clips, and tissue adhesive (with or without deeper subcutaneous sutures) and there are no previous reviews of the published evidence.

Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation.

Objective: To examine the performance of screening for early, preterm and term pre-eclampsia (PE) at 11-13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A).

Methods: The data for this study were derived from three previously reported prospective non-intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE.

Identification of new risk factors for rolandic epilepsy: CNV at Xp22.31 and alterations at cholinergic synapses.

Background: Rolandic epilepsy (RE) is the most common genetic childhood epilepsy, consisting of focal, nocturnal seizures and frequent neurodevelopmental impairments in speech, language, literacy and attention. A complex genetic aetiology is presumed in most, with monogenic mutations in accounting for >5% of cases.

Objective: To identify rare, causal CNV in patients with RE.

Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis.

Background: Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is associated with acute neurological disease in children. This study aimed to estimate the burden of long-term sequelae and death following severe HFMD.

Methods: This systematic review and meta-analysis pooled all reports from English and Chinese databases including MEDLINE and Wangfang on outbreaks of clinically diagnosed HFMD and/or laboratory-confirmed EV-A71 with at least 7 days' follow-up published between 1st January 1966 and 19th October 2015.