This study demonstrates that post-operative delirium is associated with a more complicated recovery after a pancreaticoduodenectomy and that older age is independently predictive of its development. Focused screening may allow targeted preventative strategies to be used in the peri-operative period to reduce complications and costs associated with delirium.

We report a potential association between an abnormally raised pregnancy level of alkaline phosphatase (ALP) and intrauterine growth restriction (IUGR). There are few reports of women with abnormally high ALP during pregnancy. However, there is work to suggest an association with placental insufficiency, low birth weight and preterm delivery. In conjunction with a rising ALP, fetal IUGR and intermittent absence of umbilical artery end diastolic flow had evolved. A greatly elevated ALP may be a marker for placental insufficiency and IUGR.

No abstract

Background: Familial Hypercholesterolaemia (FH) is a genetic condition characterised by a lifelong elevation of low-density lipoprotein cholesterol (LDL-c). FH is one of the most common genetic diseases, with an estimated global prevalence of 1 in 250 individuals. However, it is both underdiagnosed and undertreated. Primary care can be a valuable asset for the opportunistic detection and management of FH. Aim: To examine the employed strategies for improving the detection and management of FH in a primary care setting. Method: Six electronic databases (PubMed, The Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, ProQuest, and Scopus) were searched from May - June 2022 for papers published in English following Arksey and O Malleys six-stage scoping review process. Results: The initial search identified 1401 articles and a total of 30 studies were included in this review. A diverse range of methods have been studied for improving identification of FH. Three studies examined reduction in patient LDL-c levels from management in primary care. Two thirds of the studies with primary care management had a significant reduction in patient LDL-c levels. Conclusion: The lack of consistency across the diagnostic criteria and the low number of studies addressing the reduction of patient LDL-c levels are major features of this review. Further research should be conducted to evaluate the effectiveness of the approaches for improving the detection and management of adult patients with FH in a primary care setting.

No abstract