The Northern Health and Social Care Trust is a health and social care trust responsible for providing services at various health facilities including Antrim Area Hospital, Braid Valley Care Complex, the Causeway Hospital and Mid-Ulster Hospital..
Pregnancy has been posited as a period of unique vulnerability for Intimate Partner Violence (IPV) victimisation. This brief report examined the impact of COVID-19 lockdown on IPV victimisation during pregnancy by measuring post implementation changes in rates, with comparisons to the same period in non-lockdown years. Secondary data analysis of the Northern Ireland Maternity System (NIMATS) database containing pregnancy presentations to maternity services in Northern Ireland between January 2018 to June 2020 (n = 134,499 records) was conducted. Monthly rates of self-reported historical and current IPV disclosures were calculated, and rates of current IPV disclosures were compared across January to June for the years 2018–2020. Historical IPV rates decreased by 5.19
Metabolic dysfunction-associated steatohepatitis (MASH), a potentially progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD), increases risk of fibrosis progression, cirrhosis, and liver-related and cardiometabolic morbidity. The first licensed pharmacotherapies, resmetirom and semaglutide, mark a shift in management but practical guidance for real-world implementation is lacking. The British Association for the Study of the Liver and British Society of Gastroenterology MASLD special interest group developed consensus recommendations on patient selection, lifestyle management, and follow-up for MASLD-MASH-specific pharmacotherapy. 37 participants participated in a Delphi process where draft statements developed in working groups were anonymously rated, discussed, and refined. Consensus (≥80% agreement) was reached for 49 statements. The group agreed on the following general recommendation. Two-step non-invasive tests, including the Fibrosis-4 index and vibration-controlled transient elastography, are recommended to identify patients with presumed stage F2-F3 fibrosis (ie, at-risk MASH). Individuals with liver stiffness more than 10 kPa but without evidence of cirrhosis should be considered eligible for treatment. Lifestyle behaviour change intervention should accompany pharmacological treatment, delivered by suitably trained practitioners without delaying access to medication. Treatment discontinuation is advised with evidence of disease progression, cirrhosis development, or drug-induced liver injury. These recommendations offer pragmatic guidance to clinicians and consensus clinical opinion to regulatory bodies to support equitable and effective use of new MASLD-MASH therapies.
BACKGROUND:The COVID-19 pandemic has been described as a prolonged societal trauma providing new understanding of long-term post-traumatic stress reactions, both generally and in specific at-risk populations. AIMS:The present study examined the longitudinal course of post-traumatic stress disorder (PTSD) symptoms within one of the most high-profile risk groups (i.e. healthcare staff). METHOD:The sample comprised 439 healthcare staff who completed the Northern Ireland longitudinal COVID-19 Staff Wellbeing Survey on a minimum of 3 out of 4 distribution time points. The survey was administered repeatedly over 4 years, spanning both peri- and post-pandemic periods (2020-2023), and contained the Impact of Event Scale-Revised, as well as bespoke items on COVID-19, demographics, occupational issues and support factors. RESULTS:Three distinct classes emerged from a three-class, latent class growth analysis model. A 'resilient' group (74%) displayed symptoms that remained below cut-offs for clinically significant moderate-severe post-traumatic stress throughout the pandemic, whereas a 'recovering' group (23%) exhibited moderate-severe symptoms during the pandemic, which then decreased to subthreshold levels post-pandemic. A key at-risk group was the 'chronic' class (4%), which had moderate-severe post-traumatic stress symptoms peri-pandemic that continued to increase post-pandemic. Significant predictors of the 'recovering' and 'chronic' classes included perception of poor communication within the healthcare organisation; increased exposure to COVID-19 outside their work; and increased personal health risk factors for COVID-19. CONCLUSIONS:Post-pandemic PTSD monitoring and support for healthcare staff may be warranted alongside the development of internal communication strategies within healthcare systems to protect staff and services going forward.
Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the outcomes for relapsed/refractory diffuse large B-cell lymphoma (DLBCL). However, immune effector cell-associated neurotoxicity syndrome (ICANS) remains a concern. Pre-existing neurological disorders such as Parkinson's disease (PD) introduce additional, poorly studied challenges due to the risk of unpredictable complications. We report a 62-year-old man with relapsed DLBCL and pre-existing PD who was treated with lisocabtagene maraleucel. Baseline assessments by neurology, physiotherapy, and speech-language teams enabled tailored monitoring, including use of a modified Immune Effector Cell-Associated Encephalopathy (ICE) score. His dopaminergic regimen was optimised prior to therapy. Following lymphodepletion and CAR-T infusion, he experienced grade 1 cytokine release syndrome, which resolved with tocilizumab and ward-based supportive care. Although a stable partial response was observed on PET-CT scan at 1 and 3 months, the absence of ICANS or PD worsening up to his most recent follow-up on Day +86 suggests that CAR-T therapy can be safely delivered in patients with pre-existing PD when tailored strategies are applied, including a multidisciplinary approach, modified neurotoxicity monitoring, and careful selection of the CAR-T construct. Further studies and longer follow-up are needed to clarify long-term safety in this population.
Current treatment for pulmonary fibrosis is limited to nintedanib and pirfenidone, which slow but do not halt or reverse the progression of the disease. These treatments are widely used globally. Emerging agents, such as nerandomilast, showed positive results in phase 3 trials and was approved in the US in 2025 for idiopathic pulmonary fibrosis and progressive pulmonary fibrosis, but is not yet licensed for clinical use in the UK. As our understanding of the pathogenesis of pulmonary fibrosis advances, so does the potential to develop treatments that more effectively target underlying mechanisms while being safe and well tolerated. Insights into key pathogenic pathways, including epithelial injury, fibroblast activation, extracellular matrix deposition, B and T cell involvement, and dysregulated cytokine signalling pathways, have enabled various therapeutic targets to be explored. Despite the extensive efforts behind each study, many questions remain unanswered. Negative trials are equally important, in providing insights into how future clinical trials can be better designed and targeted. Meanwhile, positive studies show encouraging results and identify potential treatments, all contributing to the overarching goal of not just slowing, but ultimately reversing, fibrosis.
