The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

Patients' views on stroke prevention for atrial fibrillation after an intracerebral haemorrhage: a qualitative study.

Aim: (i) To explore the attitudes of patients with atrial fibrillation (AF) towards oral anti-coagulation (OAC) for stroke prevention post-intracerebral haemorrhage (ICH) and (ii) to explore factors that influence patients' decision-making process for stroke prevention.

Methods And Results: Patients with documented diagnosis of AF and history of a non-traumatic ICH, who were eligible for long-term OAC were recruited from eight hospitals in England, using purposive sampling. Data were collected using semi-structured interviews and analysed using Framework analysis.

Long-Term Improvements in Glycemia and User-Reported Outcomes Associated with Open-Source Automated Insulin Delivery Systems in Adults with Type 1 Diabetes in the United Kingdom: A Real-World Observational Study.

To evaluate real-world outcomes in adults with type 1 diabetes initiating open-source automated insulin delivery systems (OS-AID). Adults with type 1 diabetes who commenced OS-AID, between May 2016 and April 2021, across 12 centers in the United Kingdom were included. Anonymized clinical data, collected during routine clinical care between December 2019 and November 2023, were submitted to a secure web-based tool within the National Health Service network.

Understanding how and why users might use NHS repositories: A mixed methods study.

Background: There is little evidence on the use or potential use of NHS repositories within the UK.

Methods: A mixed methods (quantitative/qualitative) study of two repositories: amber-the home of ambulance service research, and East Midlands Evidence Repository (EMER). A structured online questionnaire was distributed via the repository home page, and promoted via social media, email networks, and lists.

Prevalence of synchronous bilateral/contralateral tonsil carcinoma: A systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis was to identify the prevalence of synchronous contralateral tonsil carcinoma (SCTC) amongst patients with tonsil carcinoma or head and neck squamous cell carcinoma of unknown primary (HNSCCUP). Thirteen retrospective studies, comprising 2623 patients, were analysed, revealing an overall pooled SCTC prevalence of 4%, rising to 10% in HNSCCUP cases. HPV/p16 positivity was associated with SCTC prevalence of 3%, while HPV/p16 negativity was greater at 8%.

Guideline on managing thumb base osteoarthritis: The British Society for Surgery of the Hand Evidence for Surgical Treatment (BEST) findings and recommendations.

This review paper provides a summary of the evidence for non-surgical and surgical management of thumb base osteoarthritis and suggests guidelines through including and a . The guidelines were developed through systematic reviews in accordance with the British Society for Surgery of the Hand Evidence for Surgical Treatment (BEST) Process Manual, which has been accredited by the National Institute for Health and Care Excellence. A stepwise approach is recommended with initial non-invasive treatment consisting of a comprehensive and multimodal package of supported self-management.

Reproducibility and diagnostic performance of superb microvascular Imaging's vascular index in solid breast lesions.

Aim: Superb microvascular imaging (SMI) is a new ultrasound tool that can detect small blood vessels while cancelling out artefacts. It may be useful in detecting the vascularity associated with malignant breast lesions. This study evaluated the reproducibility and diagnostic performance of SMI's Vascular Index (VI) in differentiating benign from malignant solid breast lesions.

Value of endometrial biopsy in patients with hysteroscopically atrophic endometrium in patients with postmenopausal bleeding.

Purpose: To determine the rate of precancer and cancer in women presenting with PMB who have a visually atrophic endometrium at hysteroscopy and assess the value of endometrial biopsy in this situation and the adequacy of the samples obtained.

Methods: Retrospective reviews of all patients with a visually atrophic endometrium at hysteroscopy who had presented with PMB and had an ET > / = 4 mm or ET < 4 mm with focal changes or irregular features between 2013 and 2024 at University Hospitals of Derby and Burton were included (n = 1096). Patients who had previously had cancer or precancer or had unclear hysteroscopy findings were excluded.

Specialist pharmacist prescribing in dermatology.

Across the country, pharmacists are developing their professional competencies to move outside the dispensary and directly integrate with specialist teams. Within dermatology, the widespread use of high-cost and high-risk pharmacological interventions presents a range of opportunities for a pharmacist to contribute to safer, more cost-effective use of medicines. As well as using prescribing qualifications to take on clinical workloads, pharmacists can enact cost-saving changes to routine prescribing; improve clinical governance and use their expertise in medicines to effectively advocate for access to new or alternative treatment options, as well as demystify complex funding pathways.

Quantification of heavy metal exposure in a British population cohort links total mercury levels in plasma with skin tissue-specific changes in mitochondrial-related gene expression.

Heavy metals in our direct environment have profound effects on human health and while some are essential for life, others can be toxic. In vivo studies often focus on clinical features caused by overexposure to, or by deprivation of a heavy metal. However, to understand the cellular impact of heavy metals on health, studies in healthy volunteers before symptom onset are needed.

Neuroendocrine tumour of the urinary bladder.

We report a rare case of urinary bladder neuroendocrine tumour (NET) in a young, non-smoking man. He had no known risk factors and no comorbidities. After being diagnosed with a bladder tumour while being investigated for flank pain and poor renal function, he was treated with transurethral resection of the bladder tumour and deroofing of ureters bilaterally.

A Rare Case of Isolated Diverticular Disease of the Appendix Combined With Uncomplicated Appendicitis.

The differential diagnoses for patients presenting with right iliac fossa pain are broad, with appendicitis almost always on the top of the list. Although rare, diverticulosis of the appendix, complicated by inflammation, should be considered in these patients. We report a case of a middle-aged female with right iliac fossa pain with a high inflammatory marker.

Efficacy and Safety of Ileal Bile Acid Transport Inhibitors in Inherited Cholestatic Liver Disorders: A Meta-analysis of Randomized Controlled Trials.

Background: Inherited cholestatic liver disorders such as progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome result in significant pruritus and increased serum bile acids, necessitating liver transplantation. This study aims to evaluate the efficacy and safety of Ileal bile acid transport inhibitors (IBATIs) in children with PFIC and Alagille syndrome.

Methods: We conducted a comprehensive search across the databases to identify relevant randomized controlled trials (RCTs), and Covidence was used to screen eligible articles.

β-alanine supplementation in adults with overweight and obesity: a randomized controlled feasibility trial.

Objective: Overweight and obesity are characterized by excess adiposity and systemic, chronic, low-grade inflammation, which is associated with several metabolic disorders. The aim of this study was to assess the feasibility and tolerability of β-alanine supplementation and to explore the effects on cardiometabolic health and cardiovascular, hepatic, and renal function in adults with overweight and obesity.

Methods: A total of 27 adults (44% female; mean [SD], age: 58 [10] years, BMI: 31.

Challenging the Binary Classification of Endometrioid Endometrial Adenocarcinoma: The Evaluation of Grade 2 as an Independent Entity Based on Prognostic Characteristics and Recurrence Patterns.

Although grade is a well-recognised prognostic factor for endometrioid endometrial cancer (EEC), in more studies grade 1 (G1) and grade 2 (G2) EEC are combined and compared together with grade 3 (G3) tumours. The aim of our study is to separately investigate the outcomes, prognostic factors and recurrence patterns of G2 EEC and whether the differentiation between G1 and G2 EEC is clinically useful. we retrospectively reviewed 523 patients with EEC treated with primary surgery over a decade (March 2010-January 2020) at Oxford University Hospitals NHS Trust, focusing on those with G2 disease.

Diabetic foot ulcer photography study: a study within a trial to assess the reliability of two-dimensional (2D) photography for the assessment of ulcer healing in patients with diabetes-related foot ulcers-protocol paper.

Background: The primary endpoint in diabetes-related foot ulcer (DFU) trials is often time to healing, defined as complete re-epithelialisation with absence of drainage, requiring clinical expert assessment as the gold standard. Central blinded photograph review for confirmation of healing is increasingly being undertaken for internal validity. The Diabetic Foot Ulcer Photography study aims to determine the agreement between blinded independent review panel members for assessing ulcer healing status in patients with DFUs.

Palliative care management of head and neck cancer patients amongst oral and maxillofacial surgeons: A novel national survey assessing knowledge, decision making, perceived confidence, and training in the UK.

Palliative care strives to improve the quality of life of patients experiencing life-limiting conditions by providing personalised holistic care. Head and neck cancer patients may require palliation at different stages of their disease, thus timely recognition and management is vital when considering supportive care. This study assesses the awareness, perceived confidence, and knowledge of palliative care management of UK-based oral and maxillofacial surgery (OMFS) head and neck surgeons.

Time Below Range and Its Influence on Hypoglycemia Awareness and Severe Hypoglycemia: Insights From the Association of British Clinical Diabetologists Study.

Objective: This study aimed to explore the relationship between time below range (TBR), impaired awareness of hypoglycemia (IAH), and severe hypoglycemia (SH).

Research Design And Methods: This cross-sectional study analyzed data from individuals with diabetes using continuous glucose monitors (CGMs) in the Association of British Clinical Diabetologists audit. Hypoglycemia awareness was assessed via the Gold score (≥4 denoting IAH), and SH was defined as hypoglycemia requiring third-party assistance.

Do patients with minimally displaced distal radial fractures need a plaster cast?

Traditionally, patients with a fracture of the distal radius are treated in a cast if they do not require surgery. If the fracture requires manipulation, the cast is moulded to hold the reduction and maintain normal anatomical alignment during healing. However, is a cast necessary for patients whose fracture does not require manipulation? Removable splints are an alternative treatment option.

Transthoracic Repair of Giant Paraesophageal and Hiatal Hernias: A Systematic Review and Meta-Analysis.

The utilization of transthoracic approaches for the repair of large hiatus hernias remains a topic of clinical debate. This study aims to evaluate the efficacy, safety, and recovery metrics for transthoracic hiatal hernia repair. A literature search was conducted using the key terms "hiatus hernia," "thoracotomy," "thoracic approach," and "Belsey Mark IV.

Living with pain and Parkinson's developing an understanding of the impact, trajectory and pain management needs: a qualitative interview study protocol.

Introduction: Pain is reported as one of the most troubling symptoms for people with Parkinson's (PwP); however, the literature exploring their lived experience of pain and how to manage it is limited. Pain affects PwP at all stages of their condition and can fluctuate and change over time. Therefore, it is pertinent to speak to PwP to understand their experiences of pain to inform the development of tailored behavioural interventions to manage pain.