Feasibility of embedding orthopaedic clinical trials into national registries: a pilot quality improvement study for the UK Non-Arthroplasty Hip Registry (UK-NAHR).

The integration of 'Registry-based Randomised Control Trials' (RRCT) into national registries has the potential to catalyse prospective research, enhancing the evidence base for practice. The aim of this study was to assess the feasibility of embedding a trial within the UK Non-Arthroplasty Hip Registry. This was a national observational, multi-centre study.

The anatomical basis for surgical intervention in myositis ossificans-A systematic review.

Myositis ossificans (MO) is a benign condition characterized by heterotrophic bone formation, most commonly within muscle tissue. Multiple types have been described, the most predominant being myositis ossificans circumscripta, which occurs in response to trauma. Myositis ossificans cases reported in the literature were reviewed systematically.

Quality of life, pain and use of analgesic, anxiolytic and antidepressant medication, in people living in care homes.

Background: People living in care homes often have problems with pain, anxiety and depression. Whether being on analgesia, anxiolytics or antidepressants has any bearing on pain severity and quality of life (QoL) in this population, requires further investigation.

Objectives: (i) to examine the relationship between pain, anxiety and depression and medication use in care home residents and (ii) to compare those on medications to treat pain, anxiety and depression, and those who were not, and associations with pain severity and overall QoL.

Charcot Neuroarthropathy of the Shoulder Caused by Cervical Spondylotic Myelopathy: A Case Report and Literature Review.

Charcot neuroarthropathy (CN) is a chronic degenerative disorder of bones and joints, mostly associated with diabetes mellitus and human immunodeficiency virus. CN of the upper limb is rare, with only 58 case reports identified on PubMed with the majority of cases being closely associated with syringomyelia. Very rarely, cervical spondylotic myelopathy (CSM) is associated with CN of the upper limb; with very few literature reporting this association.

Metabolic effects of very-low calorie diet, Semaglutide, or combination of the two, in individuals with type 2 diabetes mellitus.

Background & Aims: Very-low calorie diets (VLCD) and the glucagon-like peptide-1 receptor agonist (GLP1RA) Semaglutide induce significant weight loss and improve glycaemic control in individuals with type 2 diabetes (T2D). This pilot study was conducted to explore the comparative short-term effects of these interventions individually, and in combination, on weight, body composition and metabolic outcomes.

Methods: Thirty individuals with T2D (age 18-75 years, BMI 27-50  kg m) were randomly assigned to receive Semaglutide (SEM), 800 kilocalorie/day VLCD (VLCD), or both in combination (COMB) for 12 weeks.

Consensus study on UK weight management services' response to COVID-19: best practices in outpatient management, governance and digital solutions.

Background: The COVID-19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID-19 pandemic.

Glenoid Fracture Fixation Using an Acu-Loc Distal Radius Plate.

Displaced fractures of the glenoid require surgical fixation. This poses multiple problems, including a difficult approach and achieving adequate reduction with current implants. We provide a surgical technical tip for fixing scapula neck and glenoid rim fractures with an Acu-Loc distal radius plate (Acumed, Weyhill, UK), illustrated with two recent case reports.

How to successfully secure a higher speciality training post in the United Kingdom: dermatology focus.

Navigating the labyrinthine process of securing higher speciality training poses formidable challenges for doctors in training. Achieving success in this endeavour demands more than a mere grasp of the prerequisites; it necessitates meticulous preparation and foresight. Dermatology, as a medical speciality, stands out on account of its appeal, encompassing a diverse patient population, expansive scope of work, work-life balance, a plethora of procedural variety, intellectual stimulation, and abundant research opportunities.

Extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (MARS 2): a phase 3 randomised controlled trial.

Background: Extended pleurectomy decortication for complete macroscopic resection for pleural mesothelioma has never been evaluated in a randomised trial. The aim of this study was to compare outcomes after extended pleurectomy decortication plus chemotherapy versus chemotherapy alone.

Methods: MARS 2 was a phase 3, national, multicentre, open-label, parallel two-group, pragmatic, superiority randomised controlled trial conducted in the UK.

Sodium-glucose cotransporter-2 inhibitors (SGLT2) in frail or older people with type 2 diabetes and heart failure: a systematic review and meta-analysis.

Objective: Sodium-glucose cotransporter-2 inhibitors (SGLT2Is) reduce cardio-metabolic and renal outcomes in patients with type 2 diabetes (T2D) but their efficacy and safety in older or frail individuals remains unclear.

Methods: We searched PubMed, Scopus, Web of Science, Cochrane CENTRA and Google Scholar and selected randomised controlled trials and observational studies comparing SGLT2Is versus placebo/other glucose-lowering agent for people with frailty or older individuals (>65 years) with T2D and heart failure (HF). Extracted data on the change in HbA1c % and safety outcomes were pooled in a random-effects meta-analysis model.

Teaching Professionalism during and Posta Pandemic to Surgical Trainees: A Survey of the Impact of a Workshop on Trainers and Trainees.

Introduction: Focussed professionalism training improves surgical trainees' communication, information gathering, and counselling skills. This study reviews the impact of a professionalism workshop for surgical trainees within a large trust in the United Kingdom developed during the pandemic to support the trainees and help them develop resilience and appropriate behaviours during the time of increased pressure.

Methods: A workshop involving case-based discussions and reflections on professionalism was developed from the themes and methods of training noted to be effective on a literature search of Medline, EMBASE, and PsycINFO databases carried out in May 2020.

Plus Sutures for preventing surgical site infection: a systematic review of clinical outcomes with economic and environmental models.

Background: Surgical site infections (SSIs) represent ~ 20% of all hospital-acquired infections in surgical patients and are associated with prolonged hospital stay, admission to intensive care, and mortality. We conducted a systematic review with economic and environmental models to assess whether triclosan-coated sutures (Plus Sutures) provide benefits over non-coated sutures in the reduction of SSI risk.

Methods: Searches were conducted in fifteen databases.

Fall Prevalence and Associated Risk Factors in the Hospitalised Adult Population: A Crucial Step Towards Improved Hospital Care.

Background Falls among the adult population are a major global health concern with severe repercussions for individuals and healthcare systems. The purpose of this study was to investigate the prevalence and associated risk factors of falls in hospitalized patients in order to improve hospital care for elderly adults. Materials and methods The research was conducted at two institutions of tertiary care in Abbottabad, Pakistan.

Efficacy and safety of intensive versus conventional glucose targets in people with type 2 diabetes: a systematic review and meta-analysis.

Objective: The aim of study is to re-evaluate the risk-benefits of intensive glycemic control in the context of multi-factorial intervention in adults with T2D.

Methods: We searched Ovid MEDLINE, Embase, Cochrane, and CINHAL for randomized control trials comparing standard glucose targets to intensive glucose targets with pre-specified HbAlevels. Subgroup analysis was also performed to account for the inclusion of glucose only versus multi-factorial intervention trials.

Baerveldt Aqueous Shunt with or without Mitomycin C Augmentation: A Retrospective Comparison Study.

Objective: To evaluate if intraoperative mitomycin C (MMC) influences the success of Baerveldt aqueous shunts.

Design: Retrospective comparative case series.

Participants: The study population consisted of 88 patients.

Effects of GLP-1 Infusion Upon Whole-body Glucose Uptake and Skeletal Muscle Perfusion During Fed-state in Older Men.

Introduction: Ageing skeletal muscles become both insulin resistant and atrophic. The hormone glucagon-like peptide 1 (GLP-1) facilitates postprandial glucose uptake as well as augmenting muscle perfusion, independent of insulin action. We thus hypothesized exogenous GLP-1 infusions would enhance muscle perfusion and positively affect glucose metabolism during fed-state clamps in older people.

Time in range following flash glucose monitoring: Relationship with glycaemic control, diabetes-related distress and resource utilisation in the Association of British Clinical Diabetologists national audit.

Aims: The aim of this study was to understand the relationship between time in range (TIR) achieved using the isCGM with changes in glycaemic control, diabetes-related distress (DRD) and resource utilisation in people living with diabetes.

Methods: Clinicians from 106 National Health System (NHS) UK hospitals submitted isCGM user baseline and follow-up data in a web-based tool held within the UK NHS network. Linear regression analysis was used to identify the relationship between follow-up glucose TIR (3.

The Open-Fracture Patient Evaluation Nationwide (OPEN) study: the management of open fracture care in the UK.

Aims: The Open-Fracture Patient Evaluation Nationwide (OPEN) study was performed to provide clarity in open fracture management previously skewed by small, specialist centre studies and large, unfocused registry investigations. We report the current management metrics of open fractures across the UK.

Method: Patients admitted to hospital with an open fracture (excluding phalanges or isolated hand injuries) between 1 June 2021 and 30 September 2021 were included.

Intensive glycemic control and macrovascular, microvascular, hypoglycemia complications and mortality in older (age ≥60years) or frail adults with type 2 diabetes: a systematic review and meta-analysis from randomized controlled trial and observation studies.

Introduction: Guidelines for type 2 diabetes (T2D) recommend individualized HbA1c targets to take into account patient age or frailty. We synthesized evidence from randomized controlled trials and observational studies for intensive glycemic control (HbA1c target ≤58 mmol/mol) versus standard care, in elderly (age ≥60 years) or frail adults with T2D.

Methods: Searches were performed utilizing recognized terms for T2D, frailty, older age, and HbA1c control and outcomes of interest.

Can sodium-glucose co-transporter-2 (SGLT-2) inhibitor reduce the risk of adverse complications due to COVID-19? - Targeting hyperinflammation.

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are antidiabetic drugs with numerous pleiotropic and positive clinical effects, particularly regarding a reno-cardiovascular protective effect. More recent studies, including from our laboratory, have highlighted some novel anti-inflammatory activity of SGLT-2 inhibitors. This may confer a theoretical advantage in mitigating excessive cytokine production and inflammatory response associated with serious COVID-19 infection.

Headless Compression Screw Fixation of Delayed Union Jones Fractures: A Case Series.

Background: Different methods have been adopted to treat delayed union and non-union of fractures of the base of the fifth metatarsal using screws, plates and tension band wires. There has been increasing use of intramedullary screw fixation to treat these fractures with variable rates of success. The optimum screw diameter and properties have been a subject of debate.

Locking Plate Fixation System for Intracapsular Fracture Neck of Femur in Young Patients.

Background: Intra-capsular fractures of the femoral neck in young patients are almost always treated with surgical fixation to preserve the native hip anatomy and biomechanics. Multiple Cannulated hip screws and the sliding hip screw have been the hallmark fixation devices for these injuries. The use of locking cannulated hip screws to a side plate was developed to mitigate the biological and mechanical downfalls of these devices.

Achilles Tendon Rupture: Can the Tendon Gap on Ultrasound Scan Predict the Outcome of Functional Rehabilitation Program?

Background and objectives  There is a growing use of functional rehabilitation programs for the treatment of Achilles tendon rupture. Factors such as patient age and level of activity have been used to guide the decision. One of the debated indications is the gap size between the ruptured ends of the tendon.