Late complication of cosmetic injectable treatments presenting to oral and maxillofacial surgeons: soft tissue filler granulomas.

Hospital-based clinicians have seen a progressive increase in complications following cosmetic treatments. A challenging late complication of soft tissue filler treatments is granuloma formation. Oral and maxillofacial surgeons have a key role in the discussion around this delayed-onset complication.

Prostate MR image segmentation using a multi-stage network approach.

Prostate cancer (PCa) remains one of the most prevalent cancers among men, with over 1.4 million new cases and 375,304 deaths reported globally in 2020. Current diagnostic approaches, such as prostate-specific antigen (PSA) testing and trans-rectal ultrasound (TRUS)-guided biopsies, are often Limited by low specificity and accuracy.

Enhancing severe asthma care: real-world outcomes of a digital adherence and self-management platform.

https://bit.ly/41FuddG.

Narrative review on immune-related adverse events (irAEs) of immune checkpoint inhibitors in the adjuvant therapy of urological cancers.

Background And Objective: Immune checkpoint inhibitors (ICIs) have transformed the treatment of advanced urothelial carcinoma (UC) and renal cell carcinoma (RCC). Their expanding use in the adjuvant setting, aimed at eliminating micrometastatic disease post-surgery, holds significant promise. However, balancing potential survival benefits with the risk of immune-related adverse events (irAEs) in patients who are otherwise disease-free requires careful consideration.

New hormonal agents and integrated strategies for non-metastatic, hormone-sensitive prostate carcinoma: the orphan setting?-a narrative review.

Background And Objective: Most of newly diagnosed prostate carcinomas (PCas) present as non-metastatic disease, with approximately 15% of them presenting with characteristics predicting for a high-risk of relapse. Hence, specific focus has to be placed on patients affected by localised or locally advanced disease, whose chances of cure are notably higher than those of patients in advanced settings. With androgen receptor pathway inhibitors (ARPIs) and docetaxel chemotherapy improving treatment efficacy outcomes when compared to traditional androgen deprivation therapy (ADT) in the metastatic disease, clinical trials are currently investigating the activity of ARPI for clinical management of localised or locally advanced prostate patients, with the aim of preventing the cancer from spreading systemically.

A Comparison of the Molecular Pharmacological Properties of Current Short, Long, and Ultra-Long-Acting β-Agonists Used for Asthma and COPD.

β-agonists have been used in asthma for 120 years. There are two recent changes: ultra-long-acting agonists for COPD and new asthma guidelines recommending formoterol/ICS inhalers phasing out short-acting salbutamol inhalers. Few studies directly compare the molecular pharmacological properties of short (salbutamol, terbutaline, fenoterol), long (formoterol, salmeterol), and ultra-long-acting (indacaterol, olodaterol, vilanterol) β-agonists.

Suspected capecitabine-induced fatal toxicity in the context of a new DPYD variant.

We present the case of a male in his early 70s who died after receiving adjuvant chemotherapy, probably due to an undiagnosed dihydropyrimidine dehydrogenase (DPYD) deficiency. Despite normal results from standard DPYD genotyping prior to treatment, he developed severe gastrointestinal toxicity that progressed to bowel ischaemia and ultimately death. This case underscores the potential limitations of current genotyping approaches, which may not detect rare or functionally significant DPYD variants.

Guidance for Prenatal, Postnatal and Neonatal Immunohaematology Testing in Canada: Consensus Recommendations from a Modified Delphi Process.

Objective: Blood Group, antibody screen, fetal-maternal hemorrhage (FMH) tests and Rh(D) immunoglobulin (RhIG) administration are interventions during pregnancy that aid in the prevention of haemolytic disease of the fetus and newborn (HDFN). The timing, frequency, and nature of testing varies across centres due to limited data to inform standards development. Using Delphi methodology, this study aimed to establish guidance for Canadian practice related to prenatal, postnatal and neonatal immunohaematologic testing, and RhIG administration, to reduce risk and improve diagnosis of HDFN.

Using Wearable Sensors to Identify Home and Community-Based Movement Using Continuous and Straight Line Stepping Time.

Objective measurement of community participation is essential for evaluating functional recovery and intervention outcomes in clinical populations, yet current methods rely heavily on subjective self-report measures. This study developed and validated a classification model to distinguish between home- and community-based activities using stepping and lying data from activPAL devices. Twenty-four healthy participants wore activPAL 4+ monitors continuously while completing activity diaries over 7 days.

The landscape of conventional and artificial intelligence-based clinical prediction models in non-small-cell lung cancer: from development to real-world validation.

Globally, lung cancer remains the most common cause of cancer mortality, with non-small-cell lung cancer (NSCLC) being the most common subtype of lung cancer diagnosed. This review paper provides a comprehensive landscape of clinical prediction models (CPMs) in NSCLC, including in early-stage and metastatic disease, and the recent acceleration of artificial intelligence integration. Prediction models are developed using multimodal patient data to allow oncologists to make evidence-based decisions regarding patient treatment options.

Cataract Surgery in Cognitive Impairment: Navigating the Accessibility Challenge in European Healthcare.

This narrative review examines the challenges of providing cataract surgery to people living with cognitive impairment within European healthcare systems. It highlights the significant unmet need for improved ophthalmological management of this vulnerable population, given the established link between visual impairment, cognitive decline, and quality of life. While the benefits of cataract surgery in improving vision and cognition are well-documented, significant inconsistencies exist across European healthcare systems regarding protocols and access.

STAndardization of Reports (the STAR project) Upper gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative.

Upper gastrointestinal (UGI) endoscopy is the mainstay for the diagnosis and staging of precancerous and cancerous conditions of the esophagus, stomach, and duodenum. Despite development of several validated classifications for UGI diseases, endoscopy reports differ between endoscopists and endoscopy departments. This document proposes a standardized high quality UGI endoscopy report, including preprocedural, periprocedural, endoscopic findings, and postprocedural information.

The use of drone-delivered Automated External Defibrillators in the emergency response for out-of-hospital cardiac arrest. A simulation study.

Background: Drones are now being used to deliver Automated External Defibrillators (AEDs) for out-of-hospital cardiac arrest. Delays occur before (between emergency call and drone take-off) and after drone flight itself (related to bystander interaction with drone/AED). The emergency call-handler may have an important role in helping bystanders retrieve and use an AED.

Using individualised bowel care plans to improve clinical outcomes in specialist intellectual disability mental health units in England and Wales: quality improvement project.

Background: Constipation is a significant problem for people with intellectual disabilities, with a prevalence of 33-50%, causing at least five deaths annually in England. Individualised bowel care plans (IBCP) are recommended in England and Wales.

Aims: We evaluated the feasibility and impact of IBCPs for people with intellectual disabilities who are in in-patient psychiatric units, and the effect on clinical outcomes.

Utility and outcomes of routine jejunostomy placement following oesophagectomy.

Introduction: Feeding jejunostomy (FJ) is used widely as a nutritional adjunct in oesophagectomy. However, FJ placement is also associated with additional morbidity. While FJ may be invaluable in some patients, particularly in those who suffer postoperative complications, it may be an avoidable source of distress and morbidity in others.

Implementation of a care bundle improves PBC management.

Background & Aims: In 2021, we conducted a UK-wide audit of the management of primary biliary cholangitis (PBC) in the National Health Service (NHS) of the UK, which identified widespread deficiencies in PBC-related healthcare. In the current study, recognising the need to address these deficiencies, we aimed to (1) develop a PBC care bundle to support clinicians in the provision of high-quality, standardised care; (2) pilot the bundle in selected centres across the UK; and (3) re-evaluate adherence to quality standards.

Methods: We designed a PBC care bundle that incorporated a checklist of quality standards and a summary of guidelines from the British Society of Gastroenterology.

Effectiveness of nivolumab-based immunotherapy and prognostic stratification by the Meet-URO score in real-world older patients with metastatic renal cell carcinoma.

Introduction: The incidence of renal cell carcinoma (RCC) increases with age, yet older patients (≥70 years) are underrepresented in clinical trials. Evidence on the efficacy of immune checkpoint inhibitors (ICIs) and on reliable prognostic tools for this population remains limited. We aimed to evaluate the effectiveness of nivolumab-based immunotherapy in older patients with metastatic RCC (mRCC) and assess the prognostic accuracy of the International Metastatic RCC Database Consortium (IMDC) and Meet-URO scores.

The impact of psychosocial interventions on women with gynaecological cancers: a systematic review and meta-analysis.

Women affected by gynaecological cancers are at an increased risk of psychological distress, diminished psychological wellbeing and quality of life (QoL). This systematic review and meta-analysis synthesised the impact of psychosocial interventions on these three outcomes. A total of 23 studies ( = 3345 participants), including 19 randomised controlled trials (RCTs) and 4 non-randomised studies of interventions (NRSIs) were assessed using Cochrane RoB2 and ROBINS-I tools.

Heterologous COVID-19 vaccine schedule with protein-based prime (NVX-CoV2373) and mRNA boost (BNT162b2) induces strong humoral responses: Results from COV-BOOST trial.

Background: Heterologous schedules of booster vaccines for COVID-19 following initial doses of mRNA or adenoviral vector vaccines have been shown to be safe and immunogenic. There are few data on booster doses following initial doses of protein nanoparticle vaccines.

Methods: Participants of the phase 3 clinical trial of the COVID-19 vaccine NVX-CoV2373 (EudraCT 2020-004123-16) enroled between September 28 and November 28, 2020, who received 2 doses of NVX-CoV2373 administered 21 days apart were invited to receive a third dose booster vaccine of BNT162b2 (wild type mRNA vaccine) as a sub-study of the COV-BOOST clinical trial, and were followed up for assessment of safety, reactogenicity and immunogenicity to day 242 post-booster.

Risk factors and risk prediction modelling for pelvic sepsis and anastomotic leak following robotic total mesorectal excision with primary anastomosis for rectal cancer.

Background: Reporting of pelvic sepsis rates following robotic total mesorectal excision (R-TME) for rectal cancer is inconsistent. This IDEAL stage 2b international multicentre study analysed the prevalence of pelvic sepsis rates and associated risk factors following R-TME and generated a risk prediction model for anastomotic leak (AL).

Methods: Patients were identified through the EUREKA (Expert DUtch, FREnch and UK robotic rectal cAncer centres) collaborative.

Farber's Lipogranulomatosis: Multimodal Therapy With Tocilizumab and Consolidative HSCT Improves Assessment, and Long-Term Outcome.

Farber's lipogranulomatosis (FL) is an autosomal recessive lipid storage disorder, arising as a consequence of genetic acid ceramidase deficiency. Clinically, it presents as severe arthritis, voice hoarseness, and widespread, painful subcutaneous nodules (SCN). For those without CNS involvement, haematopoietic stem cell transplant provides a viable option for the improvement of both respiratory and musculoskeletal morbidity.

Competency-based European training requirements for the specialty of ophthalmology. Recommendations from the UEMS section of ophthalmology and the European Board of Ophthalmology.

Purpose: Ophthalmology encompasses comprehensive medical and surgical care for patients with diverse visual system disorders, significantly impacting eye health, vision, and quality of life. European ophthalmologists undergo specialized residency training to acquire necessary competencies, emphasizing theoretical knowledge, clinical and surgical skills, and professional behaviour. The European Union of Medical Specialists (UEMS) and the European Board of Ophthalmology (EBO) advocate for competency-based medical education (CBME), standardized training frameworks, and harmonized assessments across Europe.

Perioperative management of renin-angiotensin system inhibitors in patients undergoing elective major noncardiac surgery: a mixed model investigation using systematic review, meta-analysis, multicentre service evaluation, and national survey.

Background: The risks and benefits of stopping or continuing renin-angiotensin system (RAS) inhibitors for major noncardiac surgery remain uncertain. We conducted an updated systematic review, national service evaluation, and clinician survey to inform the design of a large clinical trial of perioperative RAS inhibitor use.

Methods: We searched MEDLINE, CINAHL, ProQuest, Cochrane database, Scopus, and Web of Science from January 2000 to October 2024 for randomised controlled trials (RCT) of perioperative RAS inhibitor use.

Topical hemostatic agents in endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review.

Gastrointestinal (GI) endoscopy has evolved from a diagnostic tool into a therapeutic modality, leading to a higher incidence of bleeding complications during and after procedures. To address this issue, various hemostatic agents have been developed, including injectable, mechanical, thermal, and topical products. Topical hemostatic agents, available in powder or gel forms, can be used as standalone treatments or as adjuncts to traditional hemostatic therapies to control or prevent bleeding.