Diagnostic interobserver variability of atypia assessment in columnar cell lesions among a group of expert breast pathologists in the United Kingdom and the Republic of Ireland, on behalf of the UK national coordinating committee for breast pathology.

Aims: Atypical ductal hyperplasia and flat epithelial atypia (FEA) have defined diagnostic criteria, yet there is variation in the interpretation of these criteria, particularly when the atypia is present in a background of columnar cell lesions (CCLs). This study focuses upon cases which are especially challenging or difficult to classify reproducibly according to existing criteria.

Methods And Results: Thirteen breast pathology experts were asked to classify 10 challenging cases with CLLs as atypical or non-atypical.

Baseline Anal Sphincter Elastance May Predict Long-Term Outcomes of Sacral Neuromodulation for Fecal Incontinence.

Introduction: Anal acoustic reflectometry (AAR), a novel test of anal sphincter function, was shown to predict a successful trial phase of sacral neuromodulation (SNM) for fecal incontinence. This follow-up study aims to explore if AAR can also predict short- and long-term SNM outcomes at less than and more than 5 y, respectively.

Methods: Outcome data were reviewed from a prospectively managed database.

Long term follow-up of women treated for screen detected atypical ductal hyperplasia or lobular neoplasia in a large UK screening centre.

Background: Atypical ductal hyperplasia (ADH) and lobular neoplasia (LN) increase subsequent breast cancer (BC) risk. However, optimal surveillance and risk reduction regimes remain uncertain. We report management and outcomes of women with ADH and LN to provide data on potential screening/prevention strategies.

Adjuvant local antibiotic therapy in the management of diabetic foot osteomyelitis.

Background: The management of diabetic foot osteomyelitis (DFO) is complex. The targeted use of adjuvant local antibiotics, in the form of biocomposite bone void filler, in DFO, can enhance patient outcomes while minimising the adverse effects associated with systemic antibiotic therapy and its shortcomings.

Methods: We reviewed a series of 105 consecutive patients who underwent surgical management for diabetic foot osteomyelitis.

Primary Oesophageal Lymphoma: A Diagnostic Dilemma.

Primary oesophageal lymphoma is an exceptionally rare cancer originating in the esophagus, distinct from more common oesophageal malignancies. Dawson's criteria has been the mainstay for diagnosis for such entities. However, recognizing primary oesophageal lymphoma is particularly challenging due to its rarity, diverse clinical presentations, and non-specific radiological and endoscopic features.

Population-based germline testing of , and in breast cancer patients in the United Kingdom: Evidence to support extended testing, and definition of groups who may not require testing.

Purpose: To assess the contribution of germline pathogenic variants (PVs) in population-based series of breast cancers and the best strategy to improve detection rates.

Methods: Three cohort studies were utilized, including a hospital-based series identified from new UK mainstream testing criteria (group-1), offering testing to all women (group-2-BReast CAncer [BRCA]-DIRECT), and a Greater Manchester cohort study recruited from the mammography screening population (group-3-Predicting Risk of Cancer at Screening). DNA samples from women with breast cancer were sequenced for PVs in , , and Partner and Localiser of BRCA2 ().

The prevalence and prognostic significance of Sarcopenia and Adipopenia in Pleural Mesothelioma.

Introduction: Altered body composition is associated with adverse survival in multiple cancers. We determined the prevalence, prognostic significance and clinicopathological correlates of sarcopenia and adipopenia in Pleural Mesothelioma (PM) patients receiving chemotherapy.

Methods: We performed a multi-centre retrospective cohort study.

The Effect of Inhaled Beta-2 Agonists on Heart Rate in Patients With Asthma: Sensor-Based Observational Study.

Background: Beta-2 agonists play an important role in the management of asthma. Inhaled long-acting beta-2 agonists (LABAs) and short-acting beta-2 agonists (SABAs) cause bronchodilation by stimulating adrenoceptors. These receptors are also present in cardiac cells and, as a side effect, could also be stimulated by inhaled beta-2 agonists.

A Case of Kanamycin Self-Injection for Penile Augmentation and a Literature Review of Penile Foreign Body Injections.

Injection of various substances into the penis for augmentation is an uncommon and concerning practice that can have serious consequences, such as skin necrosis, ulcers, suboptimal cosmetic results, and persistent edema, often requiring extensive surgical repair. In this article, we present a rare case of penile self-injection with Kanamycin ointment. We describe the clinical course of the disease and the management framework that was followed.

The prevalence and impact of microaggressions within orthopaedics in the United States of America: A systematic review.

Background: Microaggressions are being increasingly documented within the medical community. With their rising prevalence, there is concern that microaggressions can lead to suboptimal working environments, victim burnout, and compromised patient safety. Orthopaedics, known for macroaggressions like bullying and sexual discrimination, remains the least diverse specialty, potentially predisposing its staff to microaggressions.

Peri-Operative Hypothermia in Trauma Patients: A Retrospective Cohort Analysis at a Busy District General Hospital Within the National Health Service (NHS).

Introduction:  Perioperative hypothermia is defined as a patient's core body temperature of less than 36°C, which can lead to several complications. Even mild hypothermia increases the incidence of post-operative wound infection, post-operative ischaemic cardiac events and intra-operative blood loss and prolongs post-operative recovery. It is, hence, essential to maintain and provide normothermia during the perioperative phases for optimal surgical results and patient satisfaction.

The relationship between composite lipid indices and baveno classification in patients with obstructive sleep apnoea.

Obstructive Sleep Apnoea (OSA) is associated with the development of cardiovascular disease (CVD); however, the risk is only weekly related to OSA severity traditionally determined by the apnoea-hypopnoea index. The Baveno classification was developed to improve patient selection who would benefit from OSA treatment in terms of symptoms improvement and CVD risk reduction. However, it is unclear how the classification relates to biomarkers of CVD risk.

An Assessment of Functional Outcomes and Prognostic Measures Following the Management of Shoulder Dislocations at a Tertiary Care Hospital in the United Kingdom.

Background and objective Shoulder dislocations account for around half of all major joint dislocations in the UK and pose a significant healthcare burden. Management decisions post-reduction procedures involve a range of options, including conservative measures, surgery, and physiotherapy. Patient-reported outcome measures (PROMs), such as the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test (SST), have emerged as crucial tools for evaluating treatment outcomes, reflecting a shift towards patient-centred care.

Assessing the Value of New Antimicrobials: Evaluations of Cefiderocol and Ceftazidime-Avibactam to Inform Delinked Payments by the NHS in England.

Objectives: The UK has recently established subscription-payment agreements for two antimicrobials: cefiderocol and ceftazidime-avibactam. This article summarises the novel value assessments that informed this process and lessons learned for future pricing and funding decisions.

Methods: The evaluations used decision modelling to predict population incremental net health effects (INHEs), informed by systematic reviews, evidence syntheses, national surveillance data and structured expert elicitation.

Greater Trochanteric Pain Syndrome and the Efficacy of Platelet-Rich Plasma Injections: A Systematic Review.

Greater trochanteric pain syndrome (GTPS) is one of the most prevalent causes of lateral hip pain. The incidence rate is as high as 1.8 patients per 1000 annually, with females predominantly affected.

Post-operative periprosthetic femoral fractures in England: Patient profiles and short-term outcomes.

Background And Objective: Post-operative periprosthetic femoral fractures (POPFF) present a growing challenge for healthcare services, but there are limited national data on patient profiles, short-term outcomes, and post-discharge follow-up. We aimed to fill these gaps.

Methods: Using Hospital Episode Statistics (HES), we identified POPFF discharges from hospitals in England for patients aged 18 and above between April 2016 and December 2022.

Insights into durability against resistance from the antibiotic nitrofurantoin.

Nitrofurantoin has shown exceptional durability against resistance over 70 years of use. This longevity stems from factors such as rapid achievement of therapeutic concentrations, multiple physiological targets against bacteria, low risk of horizontal gene transfer, and the need to acquire multiple mutations to achieve resistance. These combined features limit resistance emergence and spread of nitrofurantoin resistance.