British medical bulletin
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British medical bulletin · Sep 2024
New developments in the diagnosis and management of motor neuron disease.
Motor neuron disease (MND) is a devastating neurodegenerative disease characterized by progressive muscle weakness. ⋯ Further work should focus on the elucidation of environmental causes of MND, gene-environment interactions, and advanced cellular models of disease.
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British medical bulletin · Sep 2024
ReviewPharmacological management of secondary chronic spinal cord injury: a systematic review.
Spinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system. ⋯ Different approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date.
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British medical bulletin · Sep 2024
ReviewLong COVID among healthcare workers: a narrative review of definitions, prevalence, symptoms, risk factors and impacts.
Long COVID (LC) occurs when people experience symptoms for weeks, months or even years after a COVID-19 infection. This review looks at research exploring the LC definitions, prevalence, symptoms, risk factors, and associated impacts in research on healthcare workers (HCWs). ⋯ Future research should move towards a standard definition for LC. Greater attention should be paid to longitudinal and qualitative studies, which could give insights into prognosis, lived experience and work participation. Finally, studies evaluating treatments suitable for people with LC are timely.
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British medical bulletin · Sep 2024
ReviewManagement of acute severe ulcerative colitis-an update for generalist and specialist clinicians.
Acute severe ulcerative colitis (ASUC) is a potentially life-threatening medical emergency that occurs in up to 25% of patients with ulcerative colitis. Although intravenous corticosteroids remain the cornerstone of therapy, 30-40% of patients will not respond and need timely consideration of rescue therapy with (currently) either infliximab or ciclosporin or indeed colectomy, underscoring the importance of multidisciplinary care to ensure favourable outcomes for patients. We discuss the current evidence and present an approach to the management of ASUC for general and specialist clinicians caring for patients with ASUC. ⋯ Developing predictive biomarkers and clinical risk scores for personalized rescue therapy selection is an evolving area of research.
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British medical bulletin · Sep 2024
Bone-patellar tendon-bone, hamstring, and quadriceps tendon autografts for anterior cruciate ligament reconstruction in skeletally immature patients: a systematic review.
Historically, anterior cruciate ligament (ACL) ruptures in the paediatric age group were managed conservatively with bracing, casting, activity modification, and physical therapy. However, most of these patients had to reduce their sports activities, and secondary damages to the affected knee were prevalent. ⋯ In skeletally immature patients, HT, BPTB, and QT autografts for ACL reconstruction yielded good outcomes. Comparative studies are strongly required to establish the most suitable autograft.