Transcatheter closure of secundum atrial septal defects is well-established, but data on very large defects requiring 40–50 mm occluders remain limited. This multicenter retrospective study evaluated the safety and efficacy of percutaneous closure using large atrial septal occluders.

Patients undergoing atrial septal defect device closure with 40–50 mm occluders from June 2015 to May 2025 at two tertiary centres were analysed. Patients were grouped by device size: Group A (40–42 mm; n = 34) and Group B (44–50 mm; n = 28).

The cohort (n = 62) had a mean age of 42.07 years with female predominance (70.96%). Mean atrial septal defect size was 33.03 mm (thick-to-thick: 38.71 mm), with mean pulmonary artery pressure of 22.33 mmHg and left ventricular end-diastolic pressure of 12.59 mmHg. Aneurysmal septum with thin or deficient posteroinferior rim was common (77.4% and 19.4%, respectively). Procedural success was 93.5%. Device instability or residual flow led to surgical closure in three cases; one had intraprocedural embolisation. Procedural assistance (balloon/device, etc.) was needed in 93.5%. Fenestrated devices were used in four (6.5%) patients—due to severe pulmonary stenosis, diastolic dysfunction, or pulmonary hypertension. “Cobra” configuration and device bulkiness were noted in 9.7% and 6.5%, respectively. Arrhythmias occurred in 25.8%, mostly transient. One patient developed device-related endocarditis, and one late, unrelated death occurred due to intracranial haemorrhage. At a mean follow-up of 29.29 months, outcomes were satisfactory.

Transcatheter closure of large atrial septal defects with 40–50 mm devices is safe and effective with proper anatomical assessment, procedural planning, and vigilant follow-up in selected patients.

This study aimed to investigate whether seasonal epistaxis patterns differ between cases manageable in emergency departments versus those requiring hospital admission and to examine weather parameter correlations by severity category.

A retrospective severity-stratified analysis of 2,201 epistaxis presentations across two UK hospitals (January 2023–December 2024) with comprehensive weather correlation analysis was used.

Emergency department cases (1,762 presentations, 80.1 per cent) peaked in winter (475 cases, 27.0 per cent), while hospital admissions (439 cases, 19.9 per cent) peaked in spring (130 cases, 29.6 per cent). A critical 10°C temperature threshold effectively separated severity categories with high predictive accuracy.

Epistaxis demonstrates opposing seasonal patterns by clinical severity with distinct weather correlation profiles. Emergency departments should prepare for winter volume surges during cold, humid periods, whilst specialist ENT services require enhanced spring capacity during moderate temperature conditions.

External auditory exostosis (surfer’s ear) is a progressive condition of benign hyperostotic overgrowths of the external auditory canal, secondary to repetitive cold-water exposure, in which symptoms correlate to degree of exostosis. Surgical intervention is the only available treatment, most commonly using the osteotome or microdrill, but these carry a risk of sensorineural hearing loss, post-operative stenosis, temporomandibular dysfunction and tympanic membrane perforation.

We describe in detail the Swansea technique, an innovative method of canaloplasty with endoscopic underwater excision of exostoses using a piezoelectric saw and continuous irrigation with 1:1,000,000 adrenaline, with the results from our first 34 procedures.

The inherent properties of the piezoelectric saw reduce the risk of overall complications when compared with traditional methods, whilst the surgical set-up is cost-equivocal and easily implemented in departments with endoscopic capabilities.

The piezoelectric saw is a promising novel technique for the treatment of external auditory exostosis.

We examined cognitive performance in children with complicated mild-severe traumatic brain injury (TBI) versus orthopedic injury (OI) using the National Institutes of Health Toolbox Cognitive Battery (NIH TB-CB).

We recruited children ages 3–18, hospitalized with complicated mild-severe TBI (n = 231) or orthopedic injury (OI, n = 146). Cognition was assessed using the NIH TB-CB at six and twelve months post-injury. We used linear mixed models to assess associations of injury group (TBI versus OI), timepoint (six versus twelve months), and the interaction of injury group and timepoint with NIH TB-CB Total Cognition, Fluid Cognition, and Crystallized Cognition composites, adjusted for sex and socioeconomic status (SES), with Bonferroni correction. We evaluated differences in cognition stratified by injury severity (complicated mild–moderate TBI vs severe TBI) using ANCOVA, adjusting for sex and SES.

Neither injury group nor the interaction of group and timepoint were associated with Total (group: p = 0.50; timepoint*group: p = 0.185), Fluid (group: p = 0.297; timepoint*group: p = 0.842), or Crystallized Cognition (group: p = 0.039; timepoint*group: p = 0.017). However, children with severe TBI performed significantly worse on Fluid and Total Cognition than children with complicated mild–moderate TBI at six months (Fluid: p = 0.004, partial η2 = 0.06, moderate effect, Total: p = 0.012 partial η2 = 0.03, small–moderate effect) and twelve months post-injury (Fluid: p < 0.001, partial η2 = 0.11, moderate–large effect, Total: p = 0.002, partial η2 = 0.06, moderate effect).

The NIH TB-CB detects worse cognitive functioning in children with severe TBI six-twelve months post-injury, largely driven by differences in Fluid Cognition. Our findings suggest the NIH TB-CB may be suitable for monitoring cognition in children with TBI.

This study aimed to compare the outcome of the standard trans-cervical approach and modified trans-cervical approach regarding cosmesis and complications outcomes in a tertiary hospital in Nigeria.

In this study, 25 patients with submandibular salivary gland lesions adjudged not to be malignant neoplasia were included. They were randomised into the two groups by balloting method.

Twelve (48 per cent) patients had the traditional transcervical approach while 13 (52per cent) had the modified approach. There was no statistically significant difference between the groups in terms of general complication, transient paresthesia and wound infection (p > 0.05). The presence of a non-visible scar was reported in almost 85 per cent of patients in the modified trans-cervical approach group compared to 50 per cent in the standard trans-cervical approach group.

Though by observation the modified trans-cervical approach was superior to the standard trans-cervical approach, the differences were statistically insignificant.

To estimate the coexistence of autism spectrum disorder (ASD) traits in an adult sample diagnosed with attention-deficit/hyperactivity disorder (ADHD); to compare individuals with ASD traits to those without, in terms of functionality, quality life and clinical outcomes; to explore the effects of ADHD medication on three main outcomes (clinical, quality of life, and functionality) in those with only ADHD and in those with coexistence of ASD and ADHD

Prospective longitudinal study of an adult sample diagnosed with ADHD. Data were collected on age, gender, medications and on scales: Autism Spectrum Quotient (AQ-10); Adult ADHD Clinical Outcome Scale; Adult ADHD Quality of Life Questionnaire; Weiss Functional Impairment Rating Scale.

A sample of 165 participants was recruited. The AQ-10 showed that almost half, n = 74 (44.8%) of the participants had traits of ASD. Longitudinal analyses demonstrated that people with ADHD and ASD traits have worse clinical outcomes, quality of life, social skills, and family functioning, compared to those with ADHD only.

The study shows a high rate of co-existence of ASD in adults with ADHD. Comorbid ASD traits were associated with poorer overall clinical and functional outcomes, quality of life, social skills, and family functioning. Study limitations with particular reference to dropout rate are considered. Implications for improving services are discussed.

Efficacy of gastric inlet patch (GIP) ablation using argon plasma coagulation (APC) for patients presenting with persistent throat symptoms was evaluated.

Retrospective observational study from a single university hospital. Consecutive patients who had GIP ablation for persistent throat symptoms between 01/10/2018-31/10/2023 were reviewed and patients who met all of the set inclusion and exclusion criteria were included in this study for analysis.

50% (n = 18/36) of patients responded to APC ablation (median follow-up 3 months) with their post-ablation GETS score decreasing by 30-100%. Long-term follow-up results could be obtained from 22 patients (n = 22/36) and 75% (n = 9/12) had their clinical effects maintained (median follow-up 4.5 years; range 2.7–5.8 years).

GIP ablation can be a very effective treatment for patients with persistent throat symptoms with its therapeutic effects long-lasting. Future studies should focus on evaluating the optimal patient selection process for GIP ablation for persistent throat symptoms.

Transcatheter pulmonary valve implantation has emerged as a minimally invasive and preferred therapeutic option for patients with dysfunction of previously repaired right ventricular outflow tracts. The Myval™ Octacor valve is a new device designed for this purpose, though limited reports exist regarding its use in the pulmonary position.

To report the immediate and short-term outcomes of percutaneous pulmonary valve implantation using the Myval™ Octacor valve in patients with severe right ventricular–pulmonary artery conduit or pulmonary valve bioprosthesis dysfunction.

This was a single-centre retrospective review of data obtained from case files.

The Myval™ Octacor valve was used in ten patients with a mean age of 34.5 ± 7.4 years. The median procedure duration and fluoroscopy time were 146 minutes and 30.5 minutes, respectively. The median Z-score for valves used was −0.5. The median right ventricular systolic pressure decreased from 68.5 mmHg pre-procedure to 33 mmHg post-procedure. The median peak instantaneous gradient across the right ventricular outflow tract or conduit decreased from 30 mmHg to 6.5 mmHg. There were no reported incidences of frame fracture, conduit rupture, device embolisation, or endocarditis.

This is the first UK experience of using the new-generation Myval™ Octacor valve in percutaneous pulmonary valve implantation. The results demonstrate the valve’s safety and clinical efficacy, with favourable outcomes in terms of procedural success, haemodynamic improvement, and echocardiographic findings.