Early menopause in acquired immunodeficiency syndrome.

Premature menopause can occur in women living with human HIV. In this study, we analyzed and reviewed published literature using the PubMed, Cochrane, and Embase databases since the year 1990 using a combination of MeSH terms such as "Early," "Premature," "Menopause," "HIV," and "Hormones." Monitoring and implementation of targeted interventions for premature or early menopause among HIV-infected women might prevent or delay complications such as osteoporosis, cardiovascular diseases, and mental health issues.

Resection of an elusive parathyroid adenoma in the aortopulmonary window.

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcaemia and is caused by a single parathyroid adenoma in the neck in 85% or more of patients. National Institute for Health and Care Excellence (NICE) guidelines published in May 2019 advise that preoperative imaging is offered prior to parathyroid surgery for PHPT if it will inform surgical approach. If imaging, typically a neck ultrasound and a second modality that may use ionising radiation, does not identify the adenoma or is discordant, it is advised that surgery is performed by a surgeon with expertise in the management of unlocalised parathyroid disease.The cure rate in such cases is over 96%. Occasionally, however, PHPT cure can be challenging.A woman in her late 40s presented with bilateral renal calculi and was found to have PHPT. Following false positive imaging and three non-curative surgical procedures, removal of a supernumerary ectopic parathyroid adenoma in the aortopulmonary window via sternotomy achieved definitive cure.

Community immersion project to enhance medical students understanding of the health needs of the most vulnerable in the community.

AIM: A group of eight fourth year medical students formed the 'UBMS public health crew' to conduct a community immersion project within elderly ethnic minority communities. The aim of the study was to understand their health perceptions regarding influenza vaccinations and learn about the enablers and barriers in accessing the vaccination. METHODOLOGY: Interviews were held by the students at community lunch clubs with the help of questionnaires. RESULTS: 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey. CONCLUSION: This project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. RESULTS: 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey. this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. METHODS: Interviews were held by the students at community lunch clubs with the help of questionnaires. 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey which found that this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care. AIM: A group of eight fourth year medical students formed the 'UBMS public health crew' to conduct a community immersion project within elderly ethnic minority communities. The aim of the study was to understand their health perceptions regarding influenza vaccinations and learn about the enablers and barriers in accessing the vaccination. Interviews were held by the students at community lunch clubs with the help of questionnaires. 76 people participated in the focus groups of which 56.5% were Asians and 43% were Irish. Feedback was sought from the students in the form of an online survey which found that this project helped the medical students improve their public health knowledge, gave them an opportunity to interact with members of the community and learn about the health and social problems faced by underserved/vulnerable communities. The students were also able to appreciate the cultural, sociodemographic and psychological determinants of health in an underserved community. Providing such community immersion projects can enable future doctors to be better prepared for care closer to the community and have better insight into patient-centred care.

Management of anastomotic leaks after elective colorectal resections: The East of England experience. A retrospective cohort.

INTRODUCTION: Colorectal anastomotic leaks (AL) are associated with high morbidity and mortality. Management of AL and its intra-operative decision making is often difficult. The aim of this multi-centre study is to explore different management strategies, including different surgical options, and analyse rates and patterns of failure of initial management. METHODS: All consecutive patients who had a confirmed AL after elective colorectal resections from 1st January 2014 to 31st December 2019 were included at seven hospitals across the East of England Region. Morbidity (length of stay, and failures) and mortality were compared across the different management strategies, and survival analyses were performed (Clinicaltrials.gov ID: NCT05000580). RESULTS: Across all seven hospitals, a total of 3391 elective resection were done during the study period. 201 (5.9%) consecutive patients with confirmed AL were included. The initial treatment was conservative in 102(50.7%). 19 patients (9.5%) had a radiological procedure, 80 (39.8%) of patients required surgery as an initial treatment post AL. Of those who initially did not have a surgical intervention (n = 121), 10% (n = 12/121) eventually required laparotomy, 2 additional patients required transanal drainage. Ultimately 45.8% (n = 92/201) of the whole population eventually required a laparotomy. Patients managed conservatively had a shorter LOS when compared to either radiological drainage or surgical patients. Patients with a defunctioning stoma are more likely to have a successful conservative management and shorter LOS. 90-day mortality across the entire population was 8.1%. There were no significant differences in mortality or long-terms survival between the different initial treatment modalities or whether the leak was right or left sided. CONCLUSION: Despite initial conservative, antibiotic and radiological intervention being successful in the majority of patients, two out of five patients will still require a laparotomy and over a quarter of patients will have an end stoma.