New Cross Hospital is a hospital in the Heath Town district of Wolverhampton, West Midlands, England. It is located to the east of the city centre in Wednesfield and is managed by the Royal Wolverhampton NHS Trust.
Airway management is central to the care of critically ill patients, yet it remains one of the most challenging interventions in emergency departments and intensive care units. Patients often present with severe physiological instability, limited cardiopulmonary reserve, and high acuity, while clinicians often work under constraints related to time for preparation, equipment availability, trained workforce, monitoring, and access to advanced rescue techniques. These challenges are particularly pronounced in low- and middle-income countries and other resource-limited or austere environments, where the margin for error is narrow and delays or repeated attempts in airway management may rapidly precipitate hypoxemia, hemodynamic collapse, or cardiac arrest. Although contemporary airway guidelines emphasize structured preparation and rescue pathways, many assume resources that are not consistently available in such settings. This narrative review discusses pragmatic, context-adapted strategies for airway management in constrained environments, with emphasis on physiology-first preparation, appropriate oxygenation and induction techniques, simplified rapid-sequence intubation, and the judicious use of basic airway adjuncts, supraglottic devices, and video laryngoscopy, where available. Adapted difficult airway algorithms, front-of-neck access in the absence of surgical backup, human factors, team training, and ethical considerations are also addressed. This review aims to support safer and effective airway management for critically ill patients in resource-limited emergency and intensive care settings.
On 24 May 2025, the Seventy-Eighth World Health Assembly (WHA78) adopted a resolution recognizing skin diseases as a global public health priority. This reflects a collective commitment from WHO member states to strengthen policies, secure resources and improve care for those affected by skin diseases. This milestone comes a decade after the launch of the Grand Challenges in Global Skin Health initiative (GSHi).
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous, multi-organ syndrome driven by comorbidity-induced systemic inflammation. In acute and critical illness, such as sepsis, acute diastolic dysfunction is common. Its prognostic significance is debated and is complicated by hemodynamic instability and diagnostic challenges.Survivors of acute illness face a long-term risk of major adverse cardiovascular events, yet the transition from critical illness to acquired diastolic dysfunction to chronic HFpEF remains an underexplored area requiring further research.Recent landmark trials have established new therapeutic options for chronic HFpEF, including sodium glucose co-transporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists. Here, we review the pathophysiology of HFpEF across the continuum from chronic stable HFpEF to acute decompensation, identify long-term sequelae, and highlight future advancements.
Abstract Vitiligo is an autoimmune skin disease causing depigmentation and substantial psychosocial burden. With expanding treatment options, robust epidemiological data are needed to contextualize clinical trial adverse events. This study analysed baseline comorbidities and incidence rates of 14 autoimmune outcomes in the largest contemporary English vitiligo cohort to date. This retrospective cohort study used the Clinical Practice Research Datalink (CPRD) Aurum database (≥ 12 years, 2012 to 2023) to identify people with vitiligo and 1 : 5 matched controls. Demographics and comorbidities were described, and incidence rate ratios (IRRs) were estimated using Poisson regression adjusted for age and sex. CPRD primary care data were linked to secondary care, mortality and deprivation records. In total 20 968 individuals with vitiligo were identified and matched to 102 948 unaffected controls. People with vitiligo had a substantial burden of atopic comorbidities and infections at baseline, including allergic rhinitis (16.7%), asthma (15.7%), atopic dermatitis (22.2%) and systemic infections (11.5%). Individuals with vitiligo also showed higher incidence rates for all autoimmune outcomes analysed compared with unaffected controls. Adjusted IRRs (with 95% confidence intervals) confirmed significantly elevated incidence among people with vitiligo for autoimmune thyroiditis (1.98, 1.83–2.14), rheumatoid arthritis (1.68, 1.43–1.96), systemic lupus erythematosus (2.54, 1.49–4.23), Sjögren syndrome (2.85, 1.78–4.49), myasthenia gravis (3.02, 1.11–7.67), systemic sclerosis (9.53, 4.99–19.1), autoimmune blistering diseases (2.09, 1.02–4.03), psoriasis (1.51, 1.29–1.76), pernicious anaemia (2.28, 1.56–3.27) and alopecia areata (3.10, 2.40–3.99). Age stratification at 65 years showed a broadly consistent pattern, although elevated adjusted IRRs for myasthenia gravis and autoimmune blistering diseases were not statistically significant in those aged < 65 years, while associations for autoimmune blistering diseases, psoriasis, pernicious anaemia and alopecia areata were not statistically significant in those aged ≥ 65 years. These findings show that individuals with vitiligo, who have a high burden of atopic comorbidities and infections, may also face a higher risk of diverse autoimmune coexisting conditions compared with matched controls.
