Solitary pleural fibroma causing IGF-2-mediated hypoglycaemia in a non-diabetic patient.

A patient without a diagnosis of diabetes mellitus presented to the hospital due to a fall and hypoglycaemia on admission. The patient was found to have recurrent nocturnal fasting hypoglycaemia. CT revealed a large lung mass consistent with a solitary pleural fibroma, a rare tumour associated with insulin-like growth factor 2 (IGF-2) production.

Adapting power calculations to include a superiority margin: what are the implications?

This paper examines the application of super-superiority margins in study power calculations. Unlike traditional power calculations, which primarily aim to reject the null hypothesis by any margin, a super-superiority margin establishes a clinically significant threshold. Despite potential benefits, this approach, akin to a non-inferiority calculation but in an opposing direction, is rarely used.

High-grade prostate cancer demonstrates preferential growth in the cranio-caudal axis and provides discrimination of disease grade in an MRI parametric model.

Objectives: To determine if multiparametric MRI prostate cancer (PC) lesion dimensions in different axes could distinguish between PC, grade group (GG) >2, and GG >3 on targeted transperineal biopsy and create and validate a predictive model on a separate cohort.

Methods: The maximum transverse, anterio-posterior, and cranio-caudal lesion dimensions were assessed against the presence of any cancer, GG >2, and GG >3 on biopsy by binary logistic regression. The optimum multivariate models were evaluated on a separate cohort.

Becoming the medical registrar: a qualitative study of a professional transition as a transformative learning event.

Background: The medical registrar is a daunting role to take on for the first time. While studies have explored how preparedness can be improved through simulation, less has been written about how doctors learn to be registrars through clinical practice.

Method: Doctors working as medical registrars were invited to participate in semi-structured interviews.

Maternal hypertensive traits and adverse outcome in pregnancy: a Mendelian randomization study.

Introduction: Hypertensive disorders of pregnancy are associated with adverse feto-maternal outcomes. Existing evidence is mostly limited to observational studies, which are liable to confounding and bias. This study investigated the causal relevance of component hypertensive indices on multiple adverse pregnancy outcomes using Mendelian randomization.

Prescribing in a pandemic: Electronic prescribing aids to improve non-specialist adherence to COVID-19 guidelines.

Introduction: The evidence around COVID-19 management is continuously evolving. Ensuring awareness of, and adherence to current guidance is challenging. As the second wave of COVID-19 emerged, we recognised the urgent need for better standardisation of patient care in the context of increasing patient load and acuity and the resulting redeployment of staff.

Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study.

Objective: The Quality of Recovery-15 questionnaire is a self-rated questionnaire used to assess the quality of the postoperative recovery and health status of patients in the early period following surgery. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the Quality of Recovery-15.

Methods: After approval by the Maltepe University local ethics committee, this observational study was conducted among patients who received surgical interventions at Mersin University Hospital between July 2019 and January 2020.

CNL and aCML should be considered as a single entity based on molecular profiles and outcomes.

Chronic neutrophilic leukemia (CNL) and atypical chronic myeloid leukemia (aCML) are rare myeloid disorders that are challenging with regard to diagnosis and clinical management. To study the similarities and differences between these disorders, we undertook a multicenter international study of one of the largest case series (CNL, n = 24; aCML, n = 37 cases, respectively), focusing on the clinical and mutational profiles (n = 53 with molecular data) of these diseases. We found no differences in clinical presentations or outcomes of both entities.

Safety of beta-blocker and calcium channel blocker antihypertensive drugs in pregnancy: a Mendelian randomization study.

Background: Beta-blocker (BB) and calcium channel blocker (CCB) antihypertensive drugs are commonly used in pregnancy. However, data on their relative impact on maternal and foetal outcomes are limited. We leveraged genetic variants mimicking BB and CCB antihypertensive drugs to investigate their effects on risk of pre-eclampsia, gestational diabetes and birthweight using the Mendelian randomization paradigm.

The role of scapular morphology in traumatic rotator cuff tears and greater tuberosity fractures: A retrospective study.

Background: Traumatic postero-superior Rotator Cuff Tears (RCT) and isolated Greater Tuberosity fractures (GTF) are equivalent injuries resulting in significant shoulder dysfunction if left retracted or displaced. The difference in morphometric aetiology is unclear. A raised critical shoulder angle (CSA) has been associated with rotator cuff degeneration.

How chronic ear disease affects quality of life: a qualitative research study in Nepal.

Objective: Hearing loss is the third leading cause globally for 'years lived with disability'. The majority of those affected live in low and middle-income countries.

Method: This study used qualitative research methods to explore the impact of chronic ear disease on quality of life in Nepal.

Case series of COVID-19 infection in pregnancy complicated by ketoacidosis and symptomatic breathlessness.

Background: The differential diagnosis of acute shortness of breath in a pregnant woman with COVID-19 is broad. Pregnancy is a ketosis-prone state, which can result in metabolic acidosis and tachypnoea.

Methods: We describe four pregnant women with COVID-19 and breathlessness where ketoacidosis was found to contribute to symptomatic tachypnoea.

Can digital rectal examination be used to detect cauda equina compression in people presenting with acute cauda equina syndrome? A systematic review and meta-analysis of diagnostic test accuracy studies.

Background: Digital rectal examination (DRE) is a commonly used test to help identify people with cauda equina compression (CEC).

Objective: To determine the diagnostic accuracy of DRE in assessment of anal tone, squeeze, sensation and reflexes, as predictors of CEC.

Design: A systematic review to investigate the diagnostic accuracy of DRE to detect CEC compared with lumbar Magnetic Resonance Imaging (MRI).

Medial/central PF arthritis and functionally stable ACL deficiency do not compromise outcomes of fixed-bearing medial UKA.

Background: There is limited published data assessing functional scores and patient satisfaction following unicompartmental knee arthroplasty (UKA) in patients with patellofemoral (PF) arthritis or anterior cruciate ligament (ACL) deficiency. The purpose of this study was to determine whether medial/central PF arthritis or functionally stable ACL deficiency compromise outcomes of fixed-bearing medial UKA at a minimum follow-up of 2 years. The hypothesis was that equivalent outcomes can be achieved in patients with substantial medial/central PF arthritis or with functionally stable ACL deficiency.