British medical bulletin
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British medical bulletin · Dec 2021
Membrane scaffolds for matrix-induced autologous chondrocyte implantation in the knee: a systematic review.
Chondral defects of the knee are common and their management is challenging. ⋯ Hyaluronic acid membrane yields a lower rate of failures and revision surgeries for mACI in the management of focal articular cartilage defects of the knee compared with collagenic scaffolds at midterm follow-up. No difference was found in patient reported outcome measures (PROMs). Further comparative studies are required to validate these results in a clinical setting.
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Despite advances in technology including the development of more sophisticated methods of monitoring blood glucose and delivering insulin, many individuals with type 1 diabetes continue to experience significant challenges in optimizing glycaemic control. Alternative treatment approaches to insulin are required. Increasing efforts have focused on developing treatments aimed at targeting the underlying disease process to modulate the immune system, maximize beta cell function and enhance endogenous insulin production and action. ⋯ The development of optimal strategies for preventing and delaying progression of type 1 diabetes, and monitoring the response to immunointervention.
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British medical bulletin · Dec 2021
Healthy, happy places-a more integrated approach to creating health and well-being through the built environment?
This paper explores how the built environment impacts upon health and well-being and suggests that there are opportunities for more integrated working between professionals and citizens to create healthier, happier places. ⋯ Health and public health professionals can contribute to the evidence base using objective measures to assess the impact of the built environment on mental health and well-being.
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British medical bulletin · Sep 2021
ReviewWhy exercise has a crucial role in cancer prevention, risk reduction and improved outcomes.
Exercise is one of several factors known to lower the risk of developing cancer, as well as improve outcomes in patients already diagnosed. People who exercise after cancer have lower rates of cancer complications, treatment toxicities, relapse and improved survival. This review highlights the supportive data and biochemical processes, which explain these potential benefits. ⋯ More robust clinical trial data are needed to substantiate a causal effect of exercise on overall and cancer-specific survival. These studies are ongoing. Research evaluating the most cost-efficient ways of incorporating prehabilitation, adjunct and rehabilitation programmes into routine practice would be helpful to funding bodies and health care strategists.
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British medical bulletin · Sep 2021
Subacromial spacer implantation: an alternative to arthroscopic superior capsular reconstruction. A systematic review.
This systematic review evaluated and compared the use of a subacromial spacer implantation (SSI) with arthroscopic superior capsular repair (ASCR) in the management of massive irreparable rotator cuff tears (MIRCTs) with an assessment of clinical and imaging outcomes. ⋯ The subacromial spacer is a biodegradable implant easily implanted at arthroscopy. It can lead good clinical and imaging outcomes in MIRCTs. Similarly, ASCR can be performed with either an autograft or synthetic allograft transplantation, with satisfactory results. Long-term prospective studies are needed to compare SSI and ASCR to verify their effectiveness.