Stent diameter and stent-related symptoms, does size matter? A systematic review and meta-analysis.

The ureteral insertion of a silicone tube was first performed in 1967. A validated ureteral stent symptom questionnaire (USSQ) is used for an objective assessment of patient-reported stent-related symptoms. As the impact of stent diameter on the incidence of stent-related symptoms is unclear, we aimed to perform a systematic review and meta-analysis comparing USSQ reported outcomes when using a 6 Fr diameter ureteric stent, versus smaller diameter stents (4.

45 years' experience with early childhood anatomical technique of feminising genitoplasty for 46 XX Congenital Adrenal Hyperplasia -observations of vaginal introital anatomy and its relationship to the perineal body.

In Manchester, feminising genitoplasty is offered to children with 46XX Congenital Adrenal Hyperplasia (CAH) when there is a single perineal opening and/or enlarged clitoris. Our aims are to describe the anatomical reconstructive technique and present long-term outcomes. Our hypothesis is that 'the common channel (CC) length and distance to the vagina from perineal skin is mostly due to virilisation and hypertrophy of perineal tissue over the almost normally positioned vaginal introitus (V-I) in relation to the perineal body (PB)'.

Anatomical variations of the thyroid gland: An experimental cadaveric study.

Introduction: The thyroid gland displays numerous variations in its anatomy. Understanding the variations that occur can benefit diagnosis of thyroid disorders and improve management. The aim of this study was to investigate how factors such as age and sex may influence variations in the thyroid.

Failure to rescue patients after emergency laparotomy for large bowel perforation: analysis of the National Emergency Laparotomy Audit (NELA).

Background: Past studies have highlighted variation in in-hospital mortality rates among hospitals performing emergency laparotomy for large bowel perforation. The aim of this study was to investigate whether failure to rescue (FTR) contributes to this variability.

Methods: Patients aged 18 years or over requiring surgery for large bowel perforation between 2013 and 2016 were extracted from the National Emergency Laparotomy Audit (NELA) database.

Subclinical cardiovascular disease in patients with chronic obstructive pulmonary disease: a systematic review.

Background: Cardiovascular disease (CVD) accounts for a significant portion of deaths in patients with COPD; however, evidence for early detection strategies for CVD in this population remain limited. Our paper aims to summarize existing data regarding subclinical CVD in patients with COPD with a view to identifying screening strategies in these patients.

Methods: A systematic review of published literature was conducted for studies examining the relationship of COPD and markers of subclinical disease such as coronary artery calcification (CAC), carotid intima media thickness (cIMT), endothelial dysfunction, arterial stiffness as measured by pulse wave velocity (PWV) and augmentation indices (AIx).

Rationale and design of the Baptist Employee Healthy Heart Study: a randomized trial assessing the efficacy of the addition of an interactive, personalized, web-based, lifestyle intervention tool to an existing health information web platform in a high-risk employee population.

Background: Metabolic syndrome (MetS) and diabetes confer a high risk for developing subsequent cardiovascular disease (CVD). Persons with MetS constitute 24-34 % of the employee population at Baptist Health South Florida (BHSF), a self-insured healthcare organization. The Baptist Employee Healthy Heart Study (BEHHS) aims to assess the addition of a personalized, interactive, web-based, nutrition-management and lifestyle-management program to the existing health-expertise web platform available to BHSF employees in reducing and/or stabilizing CVD and lifestyle risk factors and markers of subclinical CVD.

Elevated gamma-glutamyl transferase is associated with subclinical inflammation independent of cardiometabolic risk factors in an asymptomatic population: a cross-sectional study.

Background: Serum Gamma-Glutamyl Transferase (GGT), a marker of oxidative stress, has been suggested to be independently associated with cardiovascular disease (CVD) events. We examined the association of serum GGT levels with the burden of subclinical inflammation across a spectrum of metabolic conditions.

Methods: We evaluated 5,446 asymptomatic subjects (43 ± 10 years, 78 % males) who had an employer-sponsored physical between 2008 and 2010.

Suggested spontaneous resolution of possible paediatric hydrosalpinx: a case report with discussion.

Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can resent mimicking an acute abdomen or can be asymptomatic.

Best practice in management of paediatric and adolescent hydrosalpinges: a systematic review.

Background: Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can present mimicking an acute abdomen or can be asymptomatic.

Elevated serum uric acid is associated with vascular inflammation but not coronary artery calcification in the healthy octogenarians: the Brazilian study on healthy aging.

Background: There is a limited data on the association between serum uric acid (SUA) and cardiovascular disease (CVD) among the very elderly population.

Aims: We evaluated the association of SUA, highly sensitive C-reactive protein (hs-CRP, a marker of vascular and systemic inflammation), and coronary artery calcification (CAC, a marker of subclinical CVD) in a cohort of Brazilian octogenarians (≥80 years) free from known clinical CVD.

Methods: 208 individuals were included and evaluated for an association between increasing tertiles of SUA, elevated hs-CRP (>3 mg/dL), the presence and burden of CAC (CAC > 0 and CAC > 400).

Five years' real-life experience with raltegravir in a large HIV centre.

Raltegravir was the first licensed integrase inhibitor. Real-life experience is informative and complements trial data. We therefore evaluated raltegravir use in adults in a large HIV treatment centre.

Paediatric post-burn scar management in the UK: a national survey.

Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems.

Measuring coronary artery calcification: is serum vitamin D relevant?

Objectives: To synthesize evidence of the association between low vitamin D levels and subclinical coronary atherosclerosis measured by coronary artery calcium (CAC).

Methods: A systematic MEDLINE search was conducted for relevant published literature. Ten studies (7 cross-sectional, 3 longitudinal) met the inclusion criteria.

Classification of thymic epithelial neoplasms is still a challenge to thoracic pathologists: a reproducibility study using digital microscopy.

Context: Thymic epithelial tumors are rare, constituting interpretive challenges for pathologists. Digital imaging can be useful as an educational tool for these rare tumors.

Objectives: To evaluate the diagnostic reproducibility of thymic tumors among thoracic pathologists.

Systematic review on noninvasive assessment of subclinical cardiovascular disease in obstructive sleep apnea: new kid on the block!

Patients with obstructive sleep apnea (OSA) have a high burden of cardiovascular disease (CVD) but a causal relationship between OSA and atherosclerotic CVD remains unclear. We systematically reviewed the literature analyzing the relationship. A review of the Medline database for studies noninvasively evaluating subclinical CVD in OSA was conducted.

Risk factors in child sexual abuse.

Objectives: To quantify the incidence of child sexual abuse allegations referred to a forensic examination centre; to identify possible risk factors predisposing children to sexual abuse by measuring their prevalence among the complainant population.

Methodology: The records of children involved in sexual abuse allegations presenting over a 12 month period were reviewed retrospectively. Demographic data such as nature of case, sex, ethnicity, number of previous allegations, assailant relationship, month of presentation, and age were compiled.

Mechanisms of traumatic shoulder injury in elite rugby players.

Background: Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce.

Materials And Methods: Twenty-four elite rugby players, referred to the senior author for diagnosis and management of shoulder injuries, were selected.

Short bowel syndrome: a practical pathway leading to successful enteral autonomy.

Background: Short bowel syndrome is a multisystemic disorder that results from the loss of a significant amount of small bowel. The goal of treatment in these patients is to achieve complete enteral autonomy while minimizing complications. Our unit has 30 years of experience in the management of short gut patients.

Provision of undergraduate otorhinolaryngology teaching within General Medical Council approved UK medical schools: what is current practice?

Objectives: Despite longstanding concern, provision of undergraduate ENT teaching has not improved in response to the aims of the UK General Medical Council's initiative Tomorrow's Doctors. Previous studies have demonstrated poor representation of ENT within the undergraduate curriculum. We aimed to identify current practice in order to establish undergraduate ENT experience across UK medical schools, a timely endeavour in light of the General Medical Council's new 2011-2013 education strategy.

Application of a novel decontamination process using gaseous ozone.

Environmental disinfection in a health care setting is an important aspect of infection control. Recently, there has been interest in the use of vapor- and gas-based treatments for decontamination of surfaces and rooms. We describe preliminary results for an ozone-based decontamination of surfaces seeded with a range of vegetative cells and spores of bacteria of clinical relevance.

Low concentrations of vancomycin stimulate biofilm formation in some clinical isolates of Staphylococcus epidermidis.

Aims: To examine the response of Staphylococcus epidermidis isolates from prosthetic orthopaedic infections to vancomycin concentrations below the minimum inhibitory concentration.

Methods: Staphylococcal biofilms were grown in 96-well flat-bottomed cell culture plates under a variety of culture conditions and stained using an ammonium crystal violet solution. Optical density (450 nm wavelength) was recorded to estimate the biofilm density for each strain.

Identification of best evidence in medical education. Case study.

Aim: Compare how different researchers performed in screening for informative evidence about medical education.

Method: Six researchers with three different levels of involvement in a systematic literature review screened articles by title and (where available) abstract, and then by reading articles they had selected in full text. The reference standard was a consensus decision to include or exclude the article in the final analysis, whose results are published elsewhere.