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Objectives: Previous studies have also associated cleft palate with increased cholesteatoma risk. Despite this close relation, the incidence of cholesteatoma and associated otologic issues in patients with ectodermal dysplasia types highly associated with cleft palate (EDT-ACPs) has not been formally analyzed. This study provides insight to guide clinicians caring for patients with ED types associated with cleft palate., Methods: Individuals with TP63 disorders and Goltz syndrome/Focal Dermal Hypoplasia in the National Foundation for Ectodermal Dysplasia database were contacted for participation in an online REDCap survey from Sept-Dec '22. Descriptive statistics were generated using SAS JMP Pro 17 statistical software., Results: 65 individuals participated in the survey (response rate approx. 18 %). The median [IQR] age was 22 [14, 43], 41 (63 %) were female, and Ectrodactyly-Ectodermal Dysplasia-Cleft Lip/Palate Syndrome (EEC) was most common (n = 26, 40 %). We found that, among our respondents with a history of cleft palate, the incidence of cholesteatoma was 39 %. Among respondents without a history of cleft palate, the incidence of cholesteatoma was 13 % CONCLUSIONS: Otologic issues, such as cholesteatoma, can have permanent implications including hearing loss that can be minimized by early identification and treatment. The estimated incidence of cholesteatoma among our participants is far above the estimated incidence of cholesteatoma in the general population with and without a history of cleft palate, suggesting an independent contribution of EDT-ACPs to the risk of cholesteatoma., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Digital healthcare offers a huge range of possibilities and may improve the quality of patient care. The traditional paradigm of clinical history, examination, differential diagnosis and treatment may be improved by tools such as machine learning, mobile applications and sensors, wearables, and telehealth. The recent pandemic has accelerated the move towards this future, however, important concerns remain. These include ensuring that new technologies are assessed effectively and are introduced thoughtfully, data are unified into care records, and, ultimately, digital tools are underpinned with appropriate clinical support. Patients must benefit without worsening workload for the clinician. Old barriers may be overcome but new challenges will be faced, in particular, ensuring the promise of better care for those who lack access to smart phones and the internet will be crucial. Clinicians must continue to advocate for patients and their colleagues as we embrace the future of digital healthcare., (© Royal College of Physicians 2022. All rights reserved.)

This case highlights the importance of differentiating between normal physiological changes of pregnancy and symptoms that are pathological. It discusses the presentation of heart failure during pregnancy and the differential diagnoses that should be considered. It also highlights the difficult management decisions that may have to be made in order to protect maternal health.

Introduction: Patients with complex congenital cardiac disease are increasingly surviving to adulthood and many are keen to consider pregnancy. Haemodynamic status should be optimal prior to embarking on pregnancy and for some this may mean surgical intervention to alleviate haemodynamic residua., Methods: We report the successful implantation of a percutaneous pulmonary stent valve into a right atrial to right ventricular conduit in a young woman with a Bjork modification of the Fontan palliation to improve haemodynamics prior pregnancy., Discussion: Catheter interventions offer a low-risk option for the treatment of haemodynamic residua and innovative use of new technologies such as the pulmonary stent valve presents a novel, safe, and effective treatment for such conduit problems.

Psoas abscess is an uncommon presentation on the acute medical take. However recognition and appropriate treatment is essential. This review is designed to highlight the clinical features, microbiology, diagnostic tests and treatment for this condition. In order to illustrate some of the pitfalls and complexities in the management of psoas abscess we have included a case history of a patient who was recently treated in our department.

The regulation of the expression of the interleukin-8 (IL-8) gene in human monocytic cell lines has been investigated. Agents such as interleukin-1 (IL-1) or interferon-gamma (IFN gamma) did not induce increased IL-8 expression in THP-1 or U937 cells. Bacterial lipopolysaccharide endotoxin (LPS) or phorbol myristate acetate (PMA) alone induced suboptimal expression as assessed by Northern blotting; however, preincubation of cells with PMA followed by endotoxin induced much higher levels of IL-8 mRNA. Incubation of the cells with the calcium ionophore A23187 resulted in consistent increased IL-8 gene expression comparable to that of cells treated with endotoxin alone. In addition to inducing IL-8 mRNA this calcium ionophore also induced IL-8 protein synthesis as assessed by immunofluorescence and secretion as detected by ELISA. These results indicate that increases in intracellular calcium result in IL-8 gene expression and protein secretion.

A number of design modifications have been made to an extraction system for use with inhalation anaesthesia techniques in rats and other small laboratory animals. These changes necessitated a re-evaluation of the effectiveness of this equipment in limiting the operator's exposure to the anaesthetic vapours used. With a given fresh gas flow, the halothane vapour concentration in the operator's breathing zone was dependent on the design of the oronasal mask. With the optimum configuration the atmospheric concentration of halothane was less than 1 ppm.