Evaluating the Diagnostic Accuracy and Challenges of the Two-Week Wait Referral Pathway for Skin Cancers in Primary Care.

Skin cancers are among the most common cancers in the Western world, with incidence rates increasing significantly over time. Skin cancer survival rates are highly dependent upon early identification. In the United Kingdom (UK), initial assessment of skin lesions is carried out via general practitioners (GPs) who identify and refer suspected cases under the two-week pathway in compliance with the National Institute for Health and Care Excellence (NICE) guidelines.

Inequalities in colorectal cancer diagnosis by ethnic group: a population-level study in the English National Health Service.

Objective: Studies in the USA examining the relationship between ethnicity and colorectal cancer (CRC) identified significant variation. This study sought to examine the relationship between ethnic group, route to diagnosis, early-onset CRC and stage at diagnosis in the English National Health Service.

Methods: Data from COloRECTal cancer data Repository for all individuals diagnosed with CRC (International Classification of Diseases version 10, C18-C20) between 2012 and 2017.

Sulcal Hyperintensity as an Early Imaging Finding in Cerebral Amyloid Angiopathy-Related Inflammation.

Background And Objectives: Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a subtype of CAA with distinct clinical and radiologic features. Existing diagnostic criteria require the presence of characteristic asymmetrical white matter hyperintensity (WMH), together with classical hemorrhagic neuroimaging markers of CAA. There are limited data for other diagnostic neuroimaging markers of CAA-ri.

Single-Dose Versus Extended Antibiotic Prophylaxis in Primary Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis.

The optimal duration of antibiotic prophylaxis for patients undergoing primary hip or knee arthroplasty remains debated. We conducted a systematic review and meta-analysis to compare the outcomes of single-dose versus extended antibiotic prophylaxis. Studies assessing these strategies for periprosthetic joint infection (PJI), revision surgery, and superficial surgical site infections were selected from systematic searches in PubMed, Embase, and the Cochrane Library.

Disproportionately Increased Incidence of Anaplastic Thyroid Cancer in the North Yorkshire Region: A UK Tertiary Centre Study.

Globally, the incidence of anaplastic thyroid cancer (ATC) has followed a stable trend. However, over the past decade, we have observed a marked rise in the number of cases in the North Yorkshire region of the United Kingdom. Our study aimed to explore the incidence, demographics, and geographical distribution of ATC in this region over a 12-year period.

A systematic review and meta-analysis of operative versus non-operative management for first time traumatic anterior shoulder dislocation in young adults.

Background: The most appropriate management following primary traumatic anterior shoulder dislocation in young adults is unclear. This systematic review and meta-analysis evaluated operative versus non-operative management. The primary outcome measure was re-dislocation rate, in contrast to the often reported 'recurrent instability', which includes subjective instability.

Integration of lung function data: turning snapshots into stories.

Missing or inaccessible lung function measurements, gathered over time, have the potential to stagnate or impair clinical care decisions being made. This jeopardises patient safety and often contributes to excessive resource utilisation. Data integration is fundamental to clinical decision-making and entails amalgamating lung function data from multiple sources in a user-friendly format.

Expert Panel Consensus for Optimizing Outcomes in Neovascular Age-Related Macular Degeneration in the Context of Suboptimal Response to a Biosimilar: The Role of Aflibercept.

Purpose: The inclusion of ranibizumab biosimilars into National Health Service England commissioning recommendations published in 2022 created a need for expert guidance to optimize treatment outcomes in patients with neovascular age-related macular degeneration (nAMD) who otherwise may not have received first-line ranibizumab. This article provides a consensus treatment pathway supporting timely identification and management of a suboptimal response to these therapies, thereby aiming to facilitate clinically meaningful outcomes and efficient management of service capacity under specific circumstances where ranibizumab biosimilars may be initiated as a first-line treatment.

Methods: Two structured round-table meetings of UK medical retina specialists were held in person and virtually on September 22 and November 3, 2022, respectively.

The role of pericoronary fat thickness in prediction of long-term outcomes after percutaneous coronary intervention for chronic total occlusions.

Introduction: Pericoronary fat thickness (PFT) is a well-established marker crucial for evaluating the extent and severity of coronary artery disease (CAD). While its role in CAD is widely acknowledged, a considerable gap exists in understanding the prognostic implications of PFT after percutaneous coronary intervention (PCI), specifically for coronary chronic total occlusions (CTO).

Aim: This study investigated the relationship between PFT and prognostic outcomes in patients undergoing PCI for CTO.

Socioeconomic inequalities in waiting times for breast cancer surgery.

Prompt access to cancer care is a policy priority in several OECD countries, because delayed access can exacerbate deleterious health outcomes. Access to care based on need remains a key pillar of publicly-funded health systems. This study tests for the presence of inequalities in waiting times by socioeconomic status for patients receiving breast cancer surgery (mastectomy or breast conserving surgery) in England using the Hospital Episode Statistics.

Comparative effectiveness of standard vs. AI-assisted PET/CT reading workflow for pre-treatment lymphoma staging: a multi-institutional reader study evaluation.

Background: Fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) is widely used for staging high-grade lymphoma, with the time to evaluate such studies varying depending on the complexity of the case. Integrating artificial intelligence (AI) within the reporting workflow has the potential to improve quality and efficiency. The aims of the present study were to evaluate the influence of an integrated research prototype segmentation tool implemented within diagnostic PET/CT reading software on the speed and quality of reporting with variable levels of experience, and to assess the effect of the AI-assisted workflow on reader confidence and whether this tool influenced reporting behaviour.

Acute Metabolic Decompensation of Isovaleric Acidemia Presenting as Persistent Metabolic Acidosis in a Middle-Aged Man: A Case Report.

Isovaleric acidemia is a rare autosomal recessive inborn error of metabolism that affects the breakdown of the essential amino acid leucine. Acute metabolic decompensation is often triggered by stressors such as surgery, concurrent illness, excessive protein intake, or dehydration. This can lead to a catabolic state with increased endogenous protein turnover, posing a risk of potentially life-threatening crises due to the accumulation of toxic metabolites from incomplete leucine breakdown.

Effectiveness and cost-effectiveness of offering a chair-based yoga programme in addition to usual care in older adults with multiple long-term conditions: a pragmatic, parallel group, open label, randomised controlled trial.

Background: People with multiple long-term conditions are more likely to have poorer health-related quality of life (HRQOL). Yoga has the potential to improve HRQOL. Gentle Years Yoga© (GYY) is a chair-based yoga programme for older adults.

Evaluating the impact of a new clean intermittent self-catheterisation device: experiences of male patients.

Urinary incontinence is common and has many causes. A main one is urinary retention, and clean intermittent self-catheterisation is the gold standard for managing it. There are, however, complications associated with performing this, which affect patient experience, quality of life and compliance with the procedure.

Investigating the effectiveness of commercially available mouthwash on SARS-CoV-2 in vivo using viable virus titre as the primary outcome. A randomised controlled trial.

This multi-arm, parallel group, single-blinded randomised controlled trial aimed to assess three commercially available mouthwashes effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This manuscript has been written in accordance with the CONSORT statement. Eligible participants were SARS-CoV-2 positive with a positive test in the last 72 h.

Safety and reactogenicity of a controlled human infection model of sand fly-transmitted cutaneous leishmaniasis.

The leishmaniases are globally important parasitic diseases for which no human vaccines are currently available. To facilitate vaccine development, we conducted an open-label observational study to establish a controlled human infection model (CHIM) of sand fly-transmitted cutaneous leishmaniasis (CL) caused by Leishmania major. Between 24 January and 12 August 2022, we exposed 14 participants to L.

Exploring the psychosocial burden of foot complications in diabetes: A cross-sectional survey and qualitative interview study in a United Kingdom coastal community.

Background: Foot complications in diabetes are common and destructive, resulting in substantial healthcare costs and high rates of morbidity. Coastal areas have a significantly higher burden of disease. People with diabetes experience disproportionately high rates of psychological health issues, including anxiety, depression and diabetes distress.