{"title":"Micro RNA in meniscal ailments: current concepts.","authors":"Filippo Migliorini, Gianluca Vecchio, Riccardo Giorgino, Jörg Eschweiler, Frank Hildebrand, Nicola Maffulli","doi":"10.1093/bmb/ldac039","DOIUrl":"https://doi.org/10.1093/bmb/ldac039","url":null,"abstract":"<p><strong>Introduction: </strong>Micro RNAs (miRNAs) are short non-coding RNAs that act primarily in posttranscriptional gene silencing, and are attracting increasing interest in musculoskeletal conditions.</p><p><strong>Source of data: </strong>Current scientific literature published in PubMed, Google Scholar, Embase and Web of Science databases.</p><p><strong>Areas of agreement: </strong>Recently, the potential of miRNAs as biomarkers for diagnosis and treatment of meniscal injuries has been postulated.</p><p><strong>Areas of controversy: </strong>Evaluation of the role of miRNAs in patients with meniscal tears is still controversial.</p><p><strong>Growing points: </strong>A systematic review was conducted to investigate the potential of miRNA in the diagnosis and management of meniscal damage.</p><p><strong>Areas timely for developing research: </strong>Intra-articular injection of microRNA-210 in vivo may represent a potential innovative methodology for the management of meniscal injuries. Characterization of the miRNAs expression in the synovial fluid could lead to the development of better early diagnosis and management strategies for meniscal tears.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"141-150"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9334414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Monkeypox: a review of the 2022 outbreak.","authors":"Eleanor Y Lim, James Whitehorn, Lucy Rivett","doi":"10.1093/bmb/ldad002","DOIUrl":"10.1093/bmb/ldad002","url":null,"abstract":"<p><strong>Introduction: </strong>In May 2022, the World Health Organisation declared a multi-country monkeypox outbreak in non-endemic countries following cases reported from 12 member states that were not endemic for monkeypox virus.</p><p><strong>Sources of data: </strong>Pubmed search.</p><p><strong>Areas of agreement: </strong>The virology, epidemiology, transmission, incubation and aspects of infection control are described. Clinical features of previous and current outbreaks are described, with growing observations that the current outbreak presents with clinical features distinct from previous outbreaks.</p><p><strong>Areas of controversy: </strong>There are variations in clinical presentations seen in the current outbreak that have not been seen in prior outbreaks. More research is needed to investigate the reasons for these differences.</p><p><strong>Growing points: </strong>The higher numbers of HIV-positive patients in the current outbreak has allowed better description of the disease in patients co-infected with HIV and monkeypox. The absence of more severe symptoms in HIV-positive patients in the current outbreak could possibly be due to the fact that most of these patients had well-controlled HIV, although further characterization of this cohort of patients would be useful.</p><p><strong>Areas for developing research: </strong>Current treatment and vaccination options have been extrapolated from studies of other Orthopox viruses. There remains a need for more data on the safety and efficacy of these options in the context of monkeypox infections.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"17-29"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9704508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Roach, Sophie Cullinan, Roz Shafran, Isobel Heyman, Sophie Bennett
{"title":"Implementing brief and low-intensity psychological interventions for children and young people with internalizing disorders: a rapid realist review.","authors":"Anna Roach, Sophie Cullinan, Roz Shafran, Isobel Heyman, Sophie Bennett","doi":"10.1093/bmb/ldad001","DOIUrl":"https://doi.org/10.1093/bmb/ldad001","url":null,"abstract":"<p><strong>Introduction: </strong>Many children fail to receive the mental health treatments they need, despite strong evidence demonstrating efficacy of brief and low-intensity psychological interventions. This review identifies the barriers and facilitators to their implementation.</p><p><strong>Sources of data: </strong>PsycInfo, EMBASE and Medline were searched and a systematic approach to data extraction using Normalization Process Theory highlighted key mechanisms and contextual factors.</p><p><strong>Areas of agreement: </strong>Ten interventions from 9 papers, including 371 young people, were included. Studies identified organizational demands, lack of implementation strategy and stigma as barriers to implementation, and clear training and plans for implementation as facilitators.</p><p><strong>Areas of controversy: </strong>No standardized implementation outcomes were used across papers so meta-analysis was not possible.</p><p><strong>Growing points: </strong>Barriers and facilitators have been clearly identified across different settings.</p><p><strong>Areas timely for developing research: </strong>Longitudinal studies can identify methods and processes for enhancing long-term implementation and considers ways to monitor and evaluate uptake into routine practice.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"120-131"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9335079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Filippo Migliorini, Francesco Oliva, Joerg Eschweiler, Ernesto Torsiello, Frank Hildebrand, Nicola Maffulli
{"title":"Knee osteoarthritis, joint laxity and PROMs following conservative management versus surgical reconstruction for ACL rupture: a meta-analysis.","authors":"Filippo Migliorini, Francesco Oliva, Joerg Eschweiler, Ernesto Torsiello, Frank Hildebrand, Nicola Maffulli","doi":"10.1093/bmb/ldac029","DOIUrl":"https://doi.org/10.1093/bmb/ldac029","url":null,"abstract":"<p><strong>Introduction: </strong>Patients whose rupture of the anterior cruciate ligament (ACL) can be managed conservatively or undergo reconstruction surgery.</p><p><strong>Source of data: </strong>Current scientific literature published in Web of Science, PubMed and Scopus.</p><p><strong>Areas of agreement: </strong>Several studies published by July 2022 compare surgical and conservative management following ACL rupture. The latest evidence suggests that surgical management may expose patients to an increased risk of early-onset knee osteoarthritis (OA).</p><p><strong>Areas of controversy: </strong>The state of art does not recommend a systematic ACL reconstruction to all patients who tore their ACL. After the initial trauma, surgical reconstruction may produce even greater damage to the intra-articular structures compared to conservative management.</p><p><strong>Growing points: </strong>The state of art does not recommend systematic surgical reconstruction to all patients who tore their ACL. The present study compared surgical reconstruction versus conservative management for primary ACL ruptures in terms of joint laxity, patient reported outcome measures (PROMs) and rate of osteoarthritis.</p><p><strong>Areas timely for developing research: </strong>ACL reconstruction provides significant improvement in joint laxity compared to conservative management, but is associated with a significantly greater rate of knee osteoarthritis, despite similar results at PROM assessment.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"72-87"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9333729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Slowing down or returning to normal? Life expectancy improvements in Britain compared to five large European countries before the COVID-19 pandemic <i>and</i> Monkeypox: a review of the 2022 outbreak","authors":"","doi":"10.1093/bmb/ldad005","DOIUrl":"https://doi.org/10.1093/bmb/ldad005","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"243 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134949124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From the Archive","authors":"","doi":"10.1093/bmb/ldad004","DOIUrl":"https://doi.org/10.1093/bmb/ldad004","url":null,"abstract":"Journal Article From the Archive Get access British Medical Bulletin, Volume 145, Issue 1, March 2023, Page 5, https://doi.org/10.1093/bmb/ldad004 Published: 05 April 2023 Article history Received: 01 March 2023 Published: 05 April 2023","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134949126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raju Ahluwalia, Grace Yip, Martinus Richter, Nicola Maffulli
{"title":"Surgical controversies and current concepts in Lisfranc injuries.","authors":"Raju Ahluwalia, Grace Yip, Martinus Richter, Nicola Maffulli","doi":"10.1093/bmb/ldac020","DOIUrl":"https://doi.org/10.1093/bmb/ldac020","url":null,"abstract":"<p><strong>Introduction: </strong>Lisfranc injuries, not as rare as previously reported, range from ligamentous to complex fracture-dislocations. Anatomical studies have identified a complex of discrete structures, and defined the anatomical characteristics of the Lisfranc joint.</p><p><strong>Sources of data: </strong>A narrative evidence-based review encompassed and analyzed published systematic reviews. Outcomes included clinical and surgical decision-making, including clinical-presentation, diagnosis, pathological-assessment, surgical-management techniques and indications, post-surgical care and comparative outcomes.</p><p><strong>Areas of agreement: </strong>Better understanding of the Lisfranc complex anatomy aids surgical treatment and tactics. Prognosis is related to injury severity, estimated by the number of foot columns affected. Surgical outcome is determined by anatomical reduction for most fixation and fusion techniques. Appropriate treatment allows return to sport, improving outcome scores.</p><p><strong>Areas of controversy: </strong>Identification of Lisfranc injuries may be improved by imaging modalities such as weight-bearing computer tomography. Recent evidence supports dorsal plate fixation as a result of better quality of reduction. In complex injuries, the use of combined techniques such as trans-articular screw and plate fixation has been associated with poorer outcomes, and fusion may instead offer greater benefits.</p><p><strong>Growing points: </strong>Open reduction is mandatory if closed reduction fails, highlighting the importance of understanding surgical anatomy. If anatomical reduction is achieved, acute arthrodesis is a safe alternative to open reduction internal fixation in selected patients, as demonstrated by comparable outcomes in subgroup analysis.</p><p><strong>Areas for developing research: </strong>The current controversies in surgical treatment remain around techniques and outcomes, as randomized controlled trials are infrequent.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"144 1","pages":"57-75"},"PeriodicalIF":6.7,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10422072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Workplace exposure to UV radiation and strategies to minimize cancer risk.","authors":"J W Cherrie, M P C Cherrie","doi":"10.1093/bmb/ldac019","DOIUrl":"https://doi.org/10.1093/bmb/ldac019","url":null,"abstract":"<p><strong>Background: </strong>Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth's surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer.</p><p><strong>Growing points: </strong>Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure.</p><p><strong>Sources of data: </strong>This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure.</p><p><strong>Areas of agreement: </strong>Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited.</p><p><strong>Areas of controversy: </strong>Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes.</p><p><strong>Areas timely for developing research: </strong>Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"144 1","pages":"45-56"},"PeriodicalIF":6.7,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10417482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura O'Donovan, Nicola Jane Williams, Stephen Wilkinson
{"title":"Corrigendum to: Ethical and policy issues raised by uterus transplants.","authors":"Laura O'Donovan, Nicola Jane Williams, Stephen Wilkinson","doi":"10.1093/bmb/ldaa020","DOIUrl":"10.1093/bmb/ldaa020","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"92"},"PeriodicalIF":6.7,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/bmb/ldaa020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The use of long head biceps tendon autograft for massive rotator cuff tears: a PRISMA compliant systematic review.","authors":"Rocco Aicale, Nicola Poeta, Eugenio Savarese, Giulio Bernardini, Francesco Oliva, Nicola Maffulli","doi":"10.1093/bmb/ldac021","DOIUrl":"10.1093/bmb/ldac021","url":null,"abstract":"<p><strong>Introduction: </strong>Rotator cuff tears (RCT) are a common cause of shoulder pain and disability, with massive RCT accounting for 10-40% of all rotator cuff tears.</p><p><strong>Sources of data: </strong>A systematic search of PubMed and Scopus electronic databases was performed up to August 2022, and a total of 17 scientific articles were included in the present PRISMA compliant systematic review.</p><p><strong>Areas of agreement: </strong>Understanding the geometric patterns in RCT is essential to achieve appropriate repositioning of the injured tendons in their anatomic location. The long head of the biceps tendon (LHBT) is usually exposed when defects of the anterolateral corner are present and can be easily used to augment rotator cuff repairs.</p><p><strong>Areas of controversy: </strong>There are no definite guideline regarding the management of massive rotator cuff tears.</p><p><strong>Growing points: </strong>The use of LHBT graft is safe and effective, but technically demanding. All studies were level IV articles of medium to high quality.</p><p><strong>Areas timely for developing research: </strong>Prospective long term follow-up studies and randomized controlled trials are needed, adding imaging evaluation and appropriate clinical outcome measures at follow-up.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"144 1","pages":"76-89"},"PeriodicalIF":6.7,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10409590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}