British Medical Bulletin

INTRODUCTION: In haematopoietic stem cell transplantation (HSCT), haematopoietic stem cells (HSCs) from a healthy donor replace the patient's ones. Ex vivo HSC gene therapy (HSC-GT) is a form of HSCT in which HSCs, usually from an autologous source, are genetically modified before infusion, to generate a progeny of gene-modified cells. In HSCT and HSC-GT, chemotherapy is administered before infusion to free space in the bone marrow (BM) niche, which is required for the engraftment of infused cells...

INTRODUCTION: Long COVID is a chronic condition that follows after acute COVID-19 and is characterized by a wide range of persistent, cyclic symptoms. SOURCES OF DATA: PubMed search for publications featuring 'Long COVID' or 'post-acute sequelae of COVID-19'. AREAS OF AGREEMENT: Long COVID occurs frequently post-acute COVID-19, with a majority of people experiencing at least one symptom (such as cough, fatigue, myalgia, anosmia and dyspnoea) 4 weeks after infection...

BACKGROUND: Joint hypermobility (JHM) is a common physical trait. It may occur alone or in combination with musculoskeletal (MSK) pain, outside or within more complex phenotypes. Hypermobility spectrum disorders (HSD) are diagnosed in individuals with JHM and related MSK pain, when an alternative diagnosis cannot be identified. Conversely, the Ehlers-Danlos syndrome (EDS) encompasses a group of rare hereditary connective tissue disorders featuring JHM along with other pleiotropic manifestations...

BACKGROUND: Chronic low back pain, common from the sixth decade, negatively impacts the quality of life of patients and health care systems. Recently, mesenchymal stem cells (MSCs) have been introduced in the management of degenerative discogenic pain. The present study summarizes the current knowledge on the effectiveness of MSCs in patients with discogenic back pain. SOURCES OF DATA: We performed a systematic review of the literature following the PRISMA guidelines...

No abstract text is available yet for this article.

INTRODUCTION: Transient bone osteoporosis (TBO) is characterized by persistent pain, loss of function, no history of trauma and magnetic resonance image (MRI) findings of bone marrow edema. SOURCE OF DATA: PubMed, Google scholar, EMABSE and Web of Science were accessed in February 2023. No time constrains were used for the search. AREAS OF AGREEMENT: TBO is rare and misunderstood, typically affecting women during the third trimester of pregnancy or middle-aged men, leading to functional disability for 4-8 weeks followed by self-resolution of the symptoms...

BACKGROUND: Coronavirus disease 2019 (COVID-19) and human immunodeficiency virus (HIV) are intersecting pandemics, with implications for care at an individual and global scale. SOURCES OF DATA: PubMed search with relevant articles and their references reviewed. AREAS OF AGREEMENT: COVID-19 has changed the delivery of care to people living with HIV (PLWH). Vaccines are efficacious and safe for PLWH; patient care for symptomatic COVID-19 is similar to that of people without HIV...

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic resulted in a race to develop effective treatments largely through drug repurposing via adaptive platform trials on a global scale. Drug repurposing trials have focused on potential antiviral therapies aimed at preventing viral replication, anti-inflammatory agents, antithrombotic agents and immune modulators through a number of adaptive platform trials. Living systematic reviews have also enabled evidence synthesis and network meta-analysis as clinical trial data emerge globally...

INTRODUCTION: Ribonucleic acid (RNA) therapeutics are a new class of drugs whose importance is highlighted by the growing number of molecules in the clinic. SOURCES OF DATA: We focus on RNA therapeutics for neurogenetic disorders, which are broadly defined as diseases with a genetic background and with at least one clinical sign affecting the nervous system. A systematic search identified 14 RNA drugs approved by FDA and many others in development. AREAS OF AGREEMENT: The field of RNA therapeutics is changing the therapeutic scenario across many disorders...

INTRODUCTION: Whole-body cryotherapy (WBC) is a controlled exposure of the whole body to cold to gain health benefits. In recent years, data on potential applications of WBC in multiple clinical settings have emerged. SOURCES OF DATA: PubMed, EBSCO and Clinical Key search using keywords including terms 'whole body', 'cryotherapy' and 'cryostimulation'. AREAS OF AGREEMENT: WBC could be applied as adjuvant therapy in multiple conditions involving chronic inflammation because of its potent anti-inflammatory effects...

BACKGROUND: We sought to understand the impact of the COVID-19 pandemic on lipid-lowering therapy prescribing as a potential cause of the excess cardiovascular mortality seen post-pandemic in England. We examined temporal changes over 3 years in the prescribing of high-intensity and non-high-intensity statin therapy and ezetimibe. SOURCES OF DATA: We utilized data available via the National Health Service (NHS) Business Services Authority (NHSBSA) Information Services Data Warehouse, extracting 3 monthly data from October 2018 to December 2021 on high- and low-intensity statin and ezetimibe prescribing, (commencement, cessation or continuation) through each time period of study and those before, and after, the period of interest...

INTRODUCTION: Complex regional pain syndrome (CRPS) is a neurological pain disorder that is challenging to diagnose and manage, resulting in increased morbidity and costs. It most commonly occurs following traumatic injury, such as a fracture, crush injury or surgery. Recent research has evaluated the efficacy of treatments which have contradicted previous hypotheses. This systematic review summarizes these findings to improve clinician's decision-making. SOURCES OF DATA: A comprehensive search of PubMed, MEDLINE and Embase databases from inception through January 2021 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...

INTRODUCTION: loneliness is prevalent worldwide. It is also associated with an increased risk for depression, high blood pressure, cardiovascular disease, stroke and early death. As such, loneliness is a major public health issue. This paper summarizes the salient points clinicians should know and encourages clinicians to assume an active part in the identification, mitigation and prevention of loneliness. SOURCES OF DATA: white papers, academic publications. AREAS OF AGREEMENT: loneliness is a distressful subjective experience, which does not always correlate with social isolation...

INTRODUCTION: 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. SOURCES OF DATA: Pubmed search. AREAS OF AGREEMENT: 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...

INTRODUCTION: The concept of consent in the pediatric setting is complex and confusing. Clinicians and researchers want to know whose consent they should obtain, when a child can provide independent consent and how that is determined. The aim of this article is to establish what produces the justification to proceed with medical or research interventions involving children and the role of consent in that. I clarify concepts such as consent, assent, capacity and competence. SOURCE OF DATA: Literature review...

INTRODUCTION: Micro RNAs (miRNAs) are short non-coding RNAs that act primarily in posttranscriptional gene silencing, and are attracting increasing interest in musculoskeletal conditions. SOURCE OF DATA: Current scientific literature published in PubMed, Google Scholar, Embase and Web of Science databases. AREAS OF AGREEMENT: Recently, the potential of miRNAs as biomarkers for diagnosis and treatment of meniscal injuries has been postulated...

INTRODUCTION: 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. SOURCES OF DATA: PsycInfo, EMBASE and Medline were searched and a systematic approach to data extraction using Normalization Process Theory highlighted key mechanisms and contextual factors. AREAS OF AGREEMENT: Ten interventions from 9 papers, including 371 young people, were included...

INTRODUCTION: Integrated care is an established approach to delivery in parts of the healthcare infrastructure, and an ideal which, it is claimed, should be realized system-wide. Its ethical weight derives from its defence of a view about how healthcare ought to operate. Although the goal of integration is laudable, it is ethically and practically complex, involving trade-offs. SOURCES OF DATA: Considerable evidence attests to widespread enthusiasm for integration, given the need to prevent harm and extend the reach of scarce resources...

INTRODUCTION OR BACKGROUND: Life expectancy is an important summary measure of population health. In the absence of a significant event like war or disease outbreak, trends should, and historically have, increase over time, albeit with some fluctuations. SOURCES OF DATA: Data were extracted from the human mortality database for life expectancy at birth and age 65 years from 1980 to the latest available year for England & Wales, Scotland (Great Britain), France, Spain, Italy, the Netherlands and Germany...

INTRODUCTION: Economic evaluation has an important role to play in the demonstration of value for money of early childhood public health interventions; however, concerns have been raised regarding their consistent application and relevance to commissioners. This systematic review of the literature therefore aims to collate the breadth of the existing economic evaluation evidence of these interventions and to identify the approaches adopted in the assessment of value. SOURCE OF DATA: Recently published literature in Medline, EMBASE, EconLit, Health Management Information Consortium, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Health Technology Assessment, NHS EED and Web of Science...