A pilot and feasibility study investigating the abundance and activity of nitrate-reducing bacteria in women with pre-eclampsia.

Background: Oral health may influence blood pressure control by modulating the abundance and activity of nitrate-reducing bacteria, which are essential for enhancing nitrite and nitric oxide (NO) bioavailability. This study aimed to investigate the oral health and microbiome composition of women with pre-eclampsia (PET) compared to healthy controls (CN).

Methods: Ten PET and eleven CN women participated in this study, respectively.

Buried or exposed kirschner wires in paediatric upper extremity fracture fixation: A systematic review and meta-analysis of infection rates and complications.

Background: Paediatric upper limb fractures are commonly treated with Kirschner (K) wire fixation, which can be buried or left exposed. Although both techniques are widely used, controversy remains regarding infection risk, complications, and other clinical outcomes between buried and exposed K-wires. This systematic review and meta-analysis aimed to compare infection rates and secondary outcomes between buried and exposed K-wires in paediatric upper limb fractures located distal to and including the elbow, and proximal to the carpus.

Randomized Comparison of Magnetic Resonance Imaging Versus Transurethral Resection for Staging New Bladder Cancers: Results From the Prospective BladderPath Trial.

Purpose: Transurethral resection of bladder tumor (TURBT) is the initial staging procedure for new bladder cancers (BCs). For muscle-invasive bladder cancers (MIBCs), TURBT may delay definitive treatment. We investigated whether definitive treatment can be expedited for MIBC using flexible cystoscopic biopsy and multiparametric magnetic resonance imaging (mpMRI) for initial staging.

What strategies are used to select patients for direct admission under acute medicine services? A protocol paper for a systematic review of the literature.

Introduction: Despite unprecedented pressures on urgent and emergency care services, there is no clear consensus on how to provide acute medical care delivery in the UK. These pressures can lead to significant delays in care for patients presenting with emergencies when admitted via traditional routes through the emergency department. Historically, a separate pathway has existed where patients are directly admitted to acute medicine services without attending the emergency department.

Emergency and postoperative access to critical and enhanced care: a multicentre prospective observational study.

Introduction: The ability to admit patients to enhanced or critical care may be limited by bed availability. In a network with low provision of critical and enhanced care beds, we aimed to assess the proportion of patients having surgery with moderate (1%-< 5%) or high (≥ 5%) predicted risk of 30-day postoperative mortality and their postoperative care location. We also aimed to study referral and admission outcomes to critical care.

SPEED (SPlEnic Embolisation Decisions) study-Decision to treat acute traumatic splenic artery injury in the context of trauma protocol.

Background: The spleen is commonly injured in trauma and this may be managed with a conservative approach, embolisation or splenectomy. There is uncertainty how splenic embolisation fits into the treatment paradigm and the delivery of IR services remains variable.

Aims And Objectives: The primary objectives are to determine if service design significantly affects splenic embolisation (SE) rates in AAST grade 2-5 acute traumatic splenic injuries (ATSI) across the Major Trauma Centres (MTCs) in England and to determine if variation in treatment affects SE outcomes in ATSI.

Extrication following a motor vehicle collision: a consensus statement on behalf of The Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh.

Background: Road traffic injury is the leading cause of death among young people globally, with motor vehicle collisions often resulting in severe injuries and entrapment. Traditional extrication techniques focus on limiting movement to prevent spinal cord injuries, but recent findings from the EXIT project challenge this approach. This paper presents updated recommendations from the Faculty of Pre-Hospital Care (FPHC) that reflect the latest evidence on extrication practices.

A multi-centre UK-based survey on angioedema secondary to acquired C1 inhibitor deficiency.

Background: Acquired angioedema due to C1-inhibitor deficiency (AAE-C1-INH) is very rare compared to its prototype, hereditary angioedema. An updated characterisation of the AAE-C1-INH cohort in UK is required to inform management.

Objectives: To describe the disease burden of AAE-C1-INH, long-term prophylaxis (LTP) and the clinical, immunochemical and treatment profiles of AAE-associated diseases in UK.

A Rare Case of Small Bowel Intussusception Secondary to Angiomyxoma With Concurrent Ovarian Cystadenofibroma.

Adult intussusception is an uncommon condition that constitutes a small percentage of cases of bowel obstruction in adults. Unlike its paediatric counterpart, it is often linked to an underlying pathology, necessitating surgical interventions for diagnosis and treatment. This report discusses a case involving a 54-year-old woman who presented with symptoms of small bowel obstruction, including abdominal pain, nausea, and constipation, along with a one-month history of weight loss.

Maternal and neonatal outcomes following resuscitative hysterotomy for out of hospital cardiac arrest: A systematic review.

Objective: To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery.

Methods: The review was registered with PROSPERO (CRD42023445064). Studies included pregnant women with out of hospital cardiac arrest and resuscitative hysterotomy performed (in any setting) during cardiac arrest.

Navigating the challenges in radiology training expansion: costs and benefits.

Clinical and interventional radiology services play a vital role in the provision of modern healthcare, but there is a widening gap between the capacity of the imaging workforce and increasing demand. In recent years there has been a programme of training expansion in England supported by tariff level funding from NHS England (Workforce Training and Education Directorate), enhancing long-term radiology workforce sustainability and bringing quality benefits for patients, departments, and trusts. Expansion is a multifaceted and challenging process in the current NHS climate, involving coordination of funding, capacity, and sustained educational quality.

Can We Improve Geriatrics Recruitment? An Analysis of U.S. Geriatrics Fellowship Programs on X.

Introduction: The COVID-19 pandemic accelerated the shift from in-person to virtual recruitment, prompting residency and fellowship programs to adopt innovative strategies, such as leveraging social media platforms to attract applicants and enhance visibility. Our aim was to identify and describe the presence of U.S.

Derivation and validation of the simplified BleedingAudit Triage Trauma (sBATT) score: a simplified trauma score for major trauma patients injured in motor vehicle collisions.

Objectives: To develop and validate a simplified Bleeding Audit Triage Trauma (sBATT) score for use by lay persons, or in areas and environments where physiological monitoring equipment may be unavailable or inappropriate.

Design: The sBATT was derived from the original BATT, which included prehospital systolic blood pressure (SBP), heart rate, respiratory rate, Glasgow Coma Scale (GCS), age and trauma mechanism. Variables suitable for lay interpretation without monitoring equipment were included (age, level of consciousness, absence of radial pulse, tachycardia and trapped status).

Evaluating the Impact of Artificial Intelligence (AI) on Clinical Documentation Efficiency and Accuracy Across Clinical Settings: A Scoping Review.

Artificial intelligence (AI) technologies (natural language processing (NLP), speech recognition (SR), and machine learning (ML)) can transform clinical documentation in healthcare. This scoping review evaluates the impact of AI on the accuracy and efficiency of clinical documentation across various clinical settings (hospital wards, emergency departments, and outpatient clinics). We found 176 articles by applying a specific search string on Ovid.

Can a Surgical Vulnerability Score Predict Outcomes of Hip Reconstruction in Children with Severe Neuromuscular Disability?

Background: Hip surgery is often necessary for children with severe neuromuscular disabilities to avoid chronic pain resulting from hip migration. This study correlated the Surgical Vulnerability Score (SVS), a novel measure of physiological reserve, with reconstructive hip surgery outcomes to improve shared surgical decision-making.

Materials And Methods: Sixty-eight cases performed by a single surgeon were retrospectively evaluated.

The added value of narrow band imaging in Sinonasal tumour resection and surveillance: Our experience.

Background & Purpose: Narrow Band Imaging (NBI), developed by Olympus Medical Systems, has played a role in diagnosing digestive tract lesions and cancers, diagnosing and characterizing bladder cancers during cystoscopy and in the diagnosis and management of Head and Neck cancers. We aim to explore the potential use of NBI in the diagnosis, management, and follow-up of sinonasal tumours.

Methods: We present a series of cases treated at our institution, where NBI played a crucial role in the diagnosis, surgical management, intraoperative decision-making, and follow-up.

Animal-assisted intervention services across UK intensive care units: A national service evaluation.

Background: Animal-assisted interventions (AAI) can provide psychological support to critical care patients during their intensive care unit (ICU) admission. However, there are currently no data on AAI services across UK ICUs. The current study therefore aims to (i) determine how many ICUs in the UK offer services, (ii) characterise available services and (iii) explore and review local documentation for service oversight.

Current Practices and Perceptions of Indocyanine Green Fluorescence Guided Liver Surgery: Insights from a Survey of Hepato-Pancreato-Biliary Surgeons in the United Kingdom.

Indocyanine Green (ICG) fluorescence-guided surgery (I-FIGS) is increasingly being used in hepato-pancreatico-biliary (HPB) surgery. However, the true benefit of I-FIGS, the optimum dosing, and the timing of ICG administration still need to be determined. To conduct future research studies in the above areas, it is essential to understand the current I-FIGS practices among surgeons.

Recurrent Gastrointestinal Symptoms and Diagnosis of Superior Mesenteric Artery Syndrome.

This is a case of a young lady who was admitted multiple times with complaints of inability to digest food and abdominal pain. She had nausea and vomiting for long periods and was unable to tolerate orally. As she was unable to tolerate oral feeding and losing weight, she was started on nasogastric feed (NG feed) and later percutaneous endoscopic gastrostomy (PEG) tube feeding because NG feed was uncomfortable for the patient and did not alleviate the problem.

Comparative Effectiveness of Different Cystic Duct Ligation Techniques in Laparoscopic Cholecystectomy: A Systematic Review and Network Meta-Analysis.

Laparoscopic cholecystectomy is one of the most common surgical procedures. Several techniques of ligating the cystic duct have been compared in randomized trials, but data on comparative effectiveness are missing. Our aim was to systematically review the literature and, if appropriate, synthesize the available evidence.

Sensitivity of diagnosis of spontaneous bacterial peritonitis is higher with the automated cell count method.

Background: Spontaneous bacterial peritonitis (SBP) is one of the most important complications of patients with liver cirrhosis entailing high morbidity and mortality. Making an accurate early diagnosis of this infection is key in the outcome of these patients. The current definition of SBP is based on studies performed more than 40 years ago using a manual technique to count the number of polymorphs in ascitic fluid (AF).

An Atypical Presentation of Posterior Reversible Encephalopathy Syndrome (PRES): Sticking to the Basics.

Posterior reversible encephalopathy syndrome (PRES) is a reversible clinico-radiological condition primarily affecting the occipito-parietal regions. Thalami, brainstem, and cerebellar involvement with posterior fossa oedema are rare manifestations of this condition. We present the case of a 66-year-old male with a travel history to Thailand who was found collapsed on the floor two weeks after his return.