Outcomes of the management of synchronous rectal and prostate cancer: a systematic review.

Background: The optimal management of synchronous rectal cancer (RC) and prostate cancer (PC) remains unclear. This systematic review evaluates treatment strategies and reports postoperative, oncological, and quality-of-life outcomes in patients treated with curative intent.

Methods: Following PRISMA guidelines, this systematic review was registered in PROSPERO (CRD42024598049).

Association between the English National Health Service Diabetes Prevention Programme and incident multiple long-term conditions.

Existing evaluations of the National Health Service Diabetes Prevention Programme (NHS DPP) in England have demonstrated associated reductions in body weight, hemoglobin A1c and incident type 2 diabetes (T2D). In this study, we examined associations between completion of the NHS DPP and incidence of T2D and 30 other long-term conditions (LTCs), including LTCs considered linked to the program's interventional goals of body weight reduction, increased physical activity and improved diet quality (LTC-L) and LTCs considered to be possibly linked to those goals (LTC-PL). We found that completers of the NHS DPP had lower incidences of T2D, LTC-L and LTC-PL compared to non-attenders.

Older Chinese migrants' experiences of remote primary care in England: interview study.

Background: Over the past decade, remote (non-face-to-face) services are being increasingly used in primary care, including interactions through telephone and online platforms. These services bring potential benefits as well as potential barriers for patients. Older migrants are a population that could face intersectional barriers when accessing healthcare; it is important to understand the impact of remote services on them.

Leg blood flow and cardiac output are cyclically reduced during low-intensity exercise with intermittent KAATSU cuff inflation in young adults.

The present investigation sought to determine the cardiovascular responses to a commercially available KAATSU cuff system with rhythmic cuff inflation-deflation periods during leg exercise. Seventeen participants performed two-legged knee flexion/extension exercise at 25% of peak work rate (WR) with bilateral KAATSU cuffs applied to the proximal thigh (KAATSU) or work-rate matched control exercise (CTL). During KAATSU trials, the cuffs were set to Cycle Mode (repeated 30-s inflation; 5-s deflation) at progressively increasing cuff pressure (150-220 mmHg).

Renal tubular dysgenesis due to variants in the gene encoding ACE in a child surviving the neonatal period.

Autosomal recessive renal tubular dysgenesis (RTD) is a rare genetic disorder caused by defects in the renin-angiotensin system, with the most common outcomes being foetal or neonatal death from renal failure, pulmonary hypoplasia and/or refractory arterial hypotension. A small proportion of patients survive past the neonatal period. We present the case of a toddler with RTD due to compound heterozygous variants in the gene that codes for ACE, who has not required renal replacement therapy to date and in whom fludrocortisone has achieved electrolyte and acid/base balance.

Diabetes and optic atrophy in a young adult: consider Wolfram syndrome.

A 22-year-old woman had an 8-year history of progressive bilateral vision loss and of diabetes mellitus. Her mother had diabetes and two first cousins had severe congenital deafness. On examination, her visual acuities were 6/36 bilaterally, with absent colour vision and gross optic disc pallor.

Safety and Effectiveness of Statins for Primary Prevention in Adults With Type 1 Diabetes: An Emulation.

Background: There is no consensus for using statins for primary prevention of cardiovascular disease (CVD) and all-cause mortality in adults with type 1 diabetes mellitus (T1DM), because no randomized controlled trial has exclusively investigated statins in this population.

Objectives: In this study, the authors sought to evaluate the long-term risks and benefits of statins for primary prevention in adults with T1DM.

Methods: We performed a sequential target trial emulation comparing statin initiation vs noninitiation using UK primary care data from the IQVIA Medical Research Data database.

Prehospital 12-lead ECG and outcomes in acute coronary syndrome.

Importance/background: The 12-lead ECG is recommended in clinical guidelines for prehospital assessment of patients with suspected acute coronary syndrome (ACS) presenting to Emergency Medical Services (EMS).

Objectives: To determine prehospital ECG (PHECG) utilisation since UK national rollout of primary percutaneous coronary intervention, and whether this is associated with clinical outcomes in patients with ACS.

Design: Population-based, linked cohort study using Myocardial Ischaemia National Audit Project data from 1 January 2010 to 31 December 2017, related to patients with ACS conveyed by the EMS to hospital in England and Wales.

Accelerated long-term forgetting as a predictor of clinical onset in presymptomatic autosomal dominant Alzheimer's disease.

Background: In Alzheimer's disease (AD), sensitive measures of cognitive decline prior to overt symptoms are urgently needed. Accelerated long-term forgetting (ALF), where new information is retained normally over conventional testing intervals but is then lost at an accelerated rate over the following days and weeks, has been identified cross-sectionally in presymptomatic autosomal dominant and sporadic AD cohorts. We aimed to assess whether ALF testing is predictive of proximity to future symptom onset.

Limited utility of faecal immunochemical testing in a colorectal cancer screening programme for adults with cystic fibrosis: insights from a prospective UK study.

Objective: People with cystic fibrosis (pwCF) are at significantly increased risk of colorectal cancer (CRC), prompting international recommendations for earlier screening with colonoscopy. The utility of faecal immunochemical testing (FIT) as a screening adjunct in pwCF remains unclear. This study evaluates FIT's diagnostic performance and uptake within a CRC screening programme in a UK CF centre.

Effectiveness of a centrally designed, large-scale, multisite undergraduate medical simulation programme: student-reported confidence across eight London hospitals in a UK medical school setting.

Objectives: Simulation is well established in medical education. However, with rising numbers of medical students globally, provision of high-quality, equitable simulation teaching on a large, multisite scale is increasingly challenging. We sought to explore whether a centrally designed, multisite simulation programme could enhance student confidence equitably across multiple clinical sites with differing resources.

Quantitative retinal morphology and mortality in individuals with proliferative diabetic retinopathy: a retrospective cohort study in a large real-world population.

Objectives: To investigate whether quantitative retinal markers, derived from multimodal retinal imaging, are associated with increased risk of mortality among individuals with proliferative diabetic retinopathy (PDR), the most severe form of diabetic retinopathy.

Design: Longitudinal retrospective cohort analysis.

Setting: This study was nested within the AlzEye cohort, which links longitudinal multimodal retinal imaging data routinely collected from a large tertiary ophthalmic institution in London, UK, with nationally held hospital admissions data across England.

Are we closing the gender gap in academic oncology? An observational study of gender disparities in participant engagement at the ASCO 2024 annual meeting.

Objective: Despite global efforts, gender disparities in oncology may persist. Understanding these disparities within the context of major conferences can inform strategies to promote gender inclusiveness in the field. This study evaluates the participation of women and men at the American Society of Clinical Oncology (ASCO) 2024 congress, focusing on chairs, speakers and audience questioners.

Implementing relational continuity in general practice-understanding who needs it, when, to what extent, how and why: a realist review protocol.

Introduction: Relational continuity of care (RCC) refers to the sustained therapeutic relationship between a patient and a clinician, which fosters trust, enhances communication and facilitates the accumulation of knowledge about the patient. RCC is associated with enhanced patient outcomes, reduced hospital admissions, lower mortality rates, decreased healthcare costs and improved patient experience. Despite these benefits, reorganisations within the NHS and workforce challenges have led to an increased reliance on multidisciplinary and part-time working, resulting in fragmented care and a decline in RCC.

Potentially Inappropriate Medications, Frailty, and Outcomes in Patients With Cancer Managed in a National Health Care System.

Background: Previous studies have operationalized the NCCN list of high-risk medications in older adults into a measurable tool known as the Geriatric Oncology Potentially Inappropriate Medications (GO-PIMs) scale. The current study aims to evaluate the ability of GO-PIMs to identify high-risk medications and their impact on patients with both solid and liquid tumors managed in a large national health care system.

Methods: We performed a retrospective cohort study using data from the national Veterans Affairs (VA) Cancer Registry and electronic health records, including all veterans newly diagnosed with a solid or liquid malignancy from 2000 to 2022.

Cohort profile: Design and methods for Project HERCULES (Healthcare Exemplar for Recovery from COVID 19 Using Linear Examination Systems): Multi-disciplinary implementation and evaluation of an asynchronous review clinic in NHS eye-care services.

Objectives: To describe the research principles and cohort characteristics of the multi-disciplinary Project HERCULES, an innovative model of safe high-volume outpatient eye-care service for patients with stable chronic eye diseases. Results and analyses of the workstreams within Project HERCULES will be reported elsewhere. The rationale was to improve eye-care capacity in the National Health Service (NHS) in England through the creation of technician-delivered monitoring in a large retail-unit in a London shopping-centre, with remote asynchronous review of results by clinicians (named Eye-Testing and Review through Asynchronous Clinic (Eye-TRAC)).

More than scientists: How message and messenger attributes influence viewers' climate change intentions.

Effectively motivating public action on climate change remains a central challenge for science communicators. This study investigated how message and messenger attributes shape viewers' motivation to act on climate change, and whether these effects vary as a function of political orientation. Using a policy-capturing design, 581 U.

Experiences of Social Relationships for Adults Living With Multiple Long-Term Conditions: A Qualitative Interview Study.

Background: Social relationships are important for self-management and outcomes of multiple long-term conditions (MLTC). Previous research indicates MLTC negatively impacts social relationships and people living with MLTC do not feel adequately supported to manage their health. However, there is limited understanding of the processes and contextual factors that influence social relationships in the context of MLTC.

A protocol to develop a Quality Assessment Tool for Realist Synthesis (QUATRES).

A realist synthesis or review is a theory-driven, realist-informed interpretive approach to synthesizing secondary data, informing evidence-based practice, and explaining social phenomena. Realist syntheses use flexible and iterative methods to achieve this goal, including drawing on stakeholders' knowledge. Thus, realist syntheses require robust planning to be conducted and reported.

Investigating the mechanisms of indocyanine green tumour uptake in sarcoma cell lines and ex vivo human tissue.

Indocyanine green (ICG) is a well-established near-infrared dye which has been used clinically for several decades. Recently, it has been utilised for fluorescence-guided surgery in a range of solid cancer types, including sarcoma, with the aim of reducing the positive margin rate. The increased uptake and retention of ICG within tumours, compared with normal tissue, gives surgeons a visual reference to aid resection when viewed through a near-infrared camera.

Player-Level Tackle Training Interventions in Tackle-Collision Sports: A Systematic Scoping Review.

Background: In tackle-collision sports, the tackle has the highest incidence, severity, and burden of injury. Head injuries and concussions during the tackle are a major concern within tackle-collision sports. To reduce concussion and head impact risk, evaluating optimal tackle techniques to inform tackle-related prevention strategies has been recommended.