Why the UK is vaccinating its older adult population against RSV-what geriatricians should know.

The UK is launching a new free vaccination programme against respiratory syncytial virus (RSV) in adults aged 75 or over. This follows the development of safe and effective vaccines against RSV and the growing realisation of the burden of RSV-related disease in older adults-estimated at circa 8000 deaths and 175 000 GP episodes every year in the UK. It is likely that the full burden of RSV-related illness is under-appreciated and under-reported due to a lack of testing and awareness of its dangers in older adults.

Awareness of radiation risks by medical students & referrers requesting radiological examinations in the North of Scotland: an audit.

Introduction: Radiological imaging has played an important role in diagnostic medicine for over a century, though it is known to contribute to dermatological conditions, cataracts, and cancer. The associated risk of harm has led to the introduction of protective regulations around the world. Present-day NHS clinicians are increasingly requesting and relying on diagnostic imaging.

The need for creation of new learning outcomes in core curricula publications on differences in sex development and transgender anatomy.

Despite recognition that sex is a spectrum there are no learning outcomes in the Anatomical Society's Core Curricula that effectively deal with the anatomy of differences in sex development or the anatomy of transgender individuals who have undergone gender affirming surgery. We believe this is a gap that needs to be plugged urgently. Particularly in relation to healthcare students the consequence of perpetuating the stereotype of sexual dimorphism as a norm could marginalise these communities of patients even further.

Challenges of acute pain management in older patients.

Adequate management of acute pain in the older population is crucial. However, it is inherently complex because of multiple physiological changes that significantly impact both the pharmacokinetics and pharmacodynamics of medications. Current guidelines promote paracetamol as the first-line analgesic for acute pain in older adults, whereas opioids are advised cautiously for moderate to severe acute pain.

Outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus: Systematic review and meta-analysis.

Purpose: To evaluate the outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus.

Methods: We searched PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials databases for articles published from 2000 to May 2023 (last search date May 6, 2023). Keywords searched included "endoscopic third ventriculostomy", "ventriculoperitoneal shunting", "paediatric population", and "outcomes".

Understanding and reporting odds ratios as rate-ratio estimates in case-control studies.

Background: We noted that there remains some confusion in the health-science literature on reporting sample odds ratios as estimated rate ratios in case-control studies.

Methods: We recap historical literature that definitively answered the question of when sample odds ratios (ORs) from a case-control study are consistent estimators for population rate ratios. We use numerical examples to illustrate the magnitude of the disparity between sample ORs in a case-control study and population rate ratios when sufficient conditions for them to be equal are not satisfied.

Opioid prescribing for acute postoperative pain: an overview of systematic reviews related to two consensus statements relevant at patient, prescriber, system and public health levels.

Background: National guidelines for rational opioid prescribing for acute postoperative pain are needed to optimise postoperative pain control and function whilst minimising opioid-related harm.

Objectives: This overview of systematic reviews aims to summarise and critically assess the quality of systematic reviews related to the 20 recommendations from two previously published consensus guideline papers (ten relevant at patient and prescriber levels and ten at a system / Public Health level). It also aims to identify gaps in research that require further efforts to fill these in order to augment the evidence behind creating national guidelines for rational opioid prescribing for acute postoperative pain.

Coronary Artery Bypass Surgery in a Preoperative Total Laryngectomy Patient.

For patients awaiting urgent total laryngectomy who require coronary artery bypass grafting (CABG), the conventional median sternotomy should be avoided. We present a 69-year-old male who had urgent CABG as a prelude to an urgent laryngectomy for recurring laryngeal carcinoma. We recommend a manubrium-sparing T-shaped ministernotomy to preserve tissues and to avoid the disruption of the anatomy of the lower neck and superior mediastinum.

h-Index, Journal Citation Indicator, and Other Impact Factors in Neurosurgical Publications: Is There a Cost Factor That Determines the Quality?

Objective: There has been an increase in number of Neurosurgical publications, including open access (OA), in recent years. We aimed to compare journals' performance and the relationship to submission fees incurred in publication.

Methods: We identified 53 journals issuing neurosurgery-related work.

Dietary and/or physical activity interventions in women with overweight or obesity prior to fertility treatment: protocol for a systematic review and individual participant data meta-analysis.

Introduction: Dietary and/or physical activity interventions are often recommended for women with overweight or obesity as the first step prior to fertility treatment. However, randomised controlled trials (RCTs) so far have shown inconsistent results. Therefore, we propose this individual participant data meta-analysis (IPDMA) to evaluate the effectiveness and safety of dietary and/or physical activity interventions in women with infertility and overweight or obesity on reproductive, maternal and perinatal outcomes and to explore if there are subgroup(s) of women who benefit from each specific intervention or their combination (treatment-covariate interactions).

Quantitative Assessment of Secondary Healthcare Utilisation by Patients With Functional Abdominal Pain.

There is increasing awareness of the impact functional conditions have on the National Health Service (NHS). Less is known about the resources used to manage these conditions. This retrospective quantitative audit aims to determine the demographic and healthcare utilisation of functional abdominal pain patients presenting to the hospital.

Impact on emergency and elective hospital-based care in Scotland over the first 12 months of the pandemic: interrupted time-series analysis of national lockdowns.

Objectives: COVID-19 has resulted in the greatest disruption to National Health Service (NHS) care in its over 70-year history. Building on our previous work, we assessed the ongoing impact of pandemic-related disruption on provision of emergency and elective hospital-based care across Scotland over the first year of the pandemic.

Design: We undertook interrupted time-series analyses to evaluate the impact of ongoing pandemic-related disruption on hospital NHS care provision at national level and across demographics and clinical specialties spanning the period 29 March 2020-28 March 2021.

First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations and cerebral venous sinus thrombosis: A pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales.

Background: Several countries restricted the administration of ChAdOx1 to older age groups in 2021 over safety concerns following case reports and observed versus expected analyses suggesting a possible association with cerebral venous sinus thrombosis (CVST). Large datasets are required to precisely estimate the association between Coronavirus Disease 2019 (COVID-19) vaccination and CVST due to the extreme rarity of this event. We aimed to accomplish this by combining national data from England, Scotland, and Wales.

Uptake, effectiveness and safety of COVID-19 vaccines in children and young people in Scotland: Protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II).

Background: The dynamics of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and severity of disease among children and young people (CYP) across different settings are of considerable clinical, public health and societal interest. Severe COVID-19 cases, requiring hospitalisations, and deaths have been reported in some CYP suggesting a need to extend vaccinations to these age groups. As part of the ongoing Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) study, we aim to investigate the uptake, effectiveness and safety of COVID-19 vaccines in children and young people (CYP) aged 0 to 17 years in Scotland.

The unspoken benefit of participation in a clinical trial.

Background: Publicly funded trials do not usually offer financial incentives to volunteers. An intensive level of medical care could act as an additional motivator for participation. Our aim was to establish whether patients may draw any clinical benefit from volunteering in a clinical trial.

Regulatory T Cells in Pregnancy Adverse Outcomes: A Systematic Review and Meta-Analysis.

Background: Several studies report the role of Regulatory T-cells (Tregs) in the pathophysiology of pregnancy adverse outcomes.

Objective: The aim of this systematic review and meta-analysis was to determine whether there is an association between regulatory T cell levels and pregnancy adverse outcomes (PAOs), including pre-eclampsia and preterm birth (PTB).

Method: Literature searches were conducted in PubMed/MEDLINE, Embase, and Cochrane CENTRAL databases.

Teaching Benign Paroxysmal Positional Vertigo to Emergency Medicine Residents by Using Gagne's Nine Steps of Instructional Design.

Introduction: Patients commonly seek medical advice with dizziness symptoms. One of the common subtypes of dizziness is benign paroxysmal positional vertigo (BPPV). The American Academy of Neurology recommends that physicians should be trained in the physical maneuvers for the treatment of BPPV.

COVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2·57 million people in Scotland (EAVE II): a prospective cohort study.

Background: The UK COVID-19 vaccination programme has prioritised vaccination of those at the highest risk of COVID-19 mortality and hospitalisation. The programme was rolled out in Scotland during winter 2020-21, when SARS-CoV-2 infection rates were at their highest since the pandemic started, despite social distancing measures being in place. We aimed to estimate the frequency of COVID-19 hospitalisation or death in people who received at least one vaccine dose and characterise these individuals.

Factors predicting complications following cranioplasty.

This study aimed to identify factors that predict complications following cranioplasty, by conducting a retrospective cohort study at a large tertiary care center. Electronic databases were searched to identify all patients who underwent cranioplasty at our institution. Baseline demographics, perioperative variables, and outcomes were extracted.