Objectives: The national early warning score (NEWS) was introduced to improve the detection of, and standardise the assessment of, the severity of acute illness in the National Health Service (NHS). We assessed whether the recommended threshold trigger score of 5 or more in a Critical Care Outreach Team (CCOT) review could accurately predict patients at risk of deterioration following cardiac surgery and patient outcomes. Methods: We investigated adult cardiac surgery patients between October 2019 and December 2021. NEWS 2 parameters triggering CCOT referrals and NEWS 2 parameters < 5 versus ≥5 were compared, and the resulting patient outcomes were evaluated. Results: Over this period, 3710 patients underwent surgery, of whom 162 (4.4%) initiated 193 calls to the CCOT. The mean number of NEWS 2 parameters on CCOT activation was 6.14 ± 2.43 (NEWS 0–16); 34 (20.98%) activations were from patients with NEWS 2 < 5. Low oxygen saturation (SpO₂) (59.3%) and oxygen therapy (83.3%) were the most common physiological parameters raising the score. CCOT activations led to 38 transfers from the ward to the high-dependency unit (HDU) and 18 transfers to the intensive therapy unit (ITU). Cardiac arrest calls were initiated in 12 (7.40%) patients and two culminated in death. Fourteen (8.64%) had emergency resternotomy. The in-hospital mortality rate was 10.5% (17/162) in patients referred to CCOT versus 3.9% (139/3548) in patients who were not (p < 0.001). The in-hospital mortality in patients with NEWS 2 < 5 vs. NEWS ≥ 5 was 17.6% (6/34) versus 8.6% (11/128) (p = 0.126). Conclusions: There was no difference in in-hospital mortality in patients below or above a NEWS 2 of 5, but there was a significant difference in in-hospital mortality in patients reviewed by the CCOT (p < 0.001). Tailoring the threshold score specifically for the cardiac surgical cohort, in conjunction with clinician involvement, may improve outcomes.

Yemen is one of the poorest countries in the world. It suffers from a genuine crisis in all areas, the most important of which is the health sector. Yemen has been suffering from conflicts for the last six years, and a high percentage of the population is dependent on international aid. After the worldwide spread of the SARS-CoV-2 virus, the virus that causes Coronavirus Disease 2019 (COVID-19), the first laboratory-confirmed case was announced in Yemen on April 10, 2020. Since then, as of 22 December 2020, 2,091 confirmed cases and 607 deaths have been reported. These numbers are not trustworthy because many cases are hidden by Houthi rebels (14). Citizens took the necessary precautions out of fear of infection, such as imposing quarantines, closing airports, and restricting public gatherings (1,8,14). Quarantines are only imposed in some cities in the southern part of the country, while the part controlled by Houthi rebels is not well organized in terms of imposing quarantines, and schools were opened due to the lack of technical devices and internet for online education.

Background: A breast mammogram is considered the gold standard modality for breast cancer screening. The sensitivity of breast mammograms is highly linked to mammographic breast density (MBD) which is strongly linked to women's age, ethnicity, and other factors. Higher breast density is considered one of the risk factors for breast cancer development and it can be associated with different pathological and biological features of breast cancer. Methods: This is a retrospective review of 97 women with a diagnosis of breast cancer in a tertiary hospital in Jordan who were diagnosed in the period between 2018 and 2020. We compared patients with a positive status for estrogen (ER) or progesterone (PR) receptors (ER+/PR+) and others with negative receptors (ER-/PR-), in terms of their correlation with MBD. Results: The analysis has included 97 patients. Of which, 87.6% had either a PR+ or an ER+, and 38.1% of patients were positive for HER2/neu protein. The sample mean age was 56.4 and most patients were obese (56.7%). MBD of our cohort was 30.9% (30/97) fatty, 29.9% (29/97) scattered, 23.7% (23/97) heterogeneously dense, and 15.5% (15/97) dense. The ER+/PR+ group was more associated with fatty (35.3% vs 0.0%) and scattered (31.8% vs 25.0%) MBD types than the ER-/PR- group, and less associated with the dense type (9.4% vs 58.3%), and the association was statistically significant (P < 0.001). However, no statistically significant correlation was found between MBD and the HER2/neu protein status. Conclusion: According to our results, ER+/PR+ group patients tend to have fatty and scattered MBD types than the ER-/PR- patients. Larger randomized cohorts should investigate the association between breast cancer biological subtypes and MBD.