Research Development
Staff Publications
Staff Publications
Find out what your colleagues have been writing. This section features articles published by staff working for St Helens and Knowsley Teaching Hospitals and Halton, Knowsley and St Helens community staff.
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Mersey and West Lancashire Teaching Hospitals Staff
Exploring the prognostic impact of triglyceride-glucose index in critically ill patients with first-ever stroke: insights from traditional methods and machine learning-based mortality prediction
Background The incidence and mortality of first-ever strokes have risen sharply, especially in the intensive care unit (ICU). Emerging surrogate for insulin resistance, triglyceride-glucose index (TyG), has been linked to stroke prognosis. We aims to explore the relationships between TyG with ICU all-cause mortality and other prognosis, and to develop..
| Published: | 18/12/2024 |
| Authors: | Ditchfield. C |
Appendicular intussusception mimicking caecal polyp: A case report.
Pereira, C; Babu, H. (2024). Appendicular intussusception mimicking caecal polyp: A case report.. The Surgeon. [Online]. Available at: doi.org/10.1016/j.surge.2024.12.002 [Accessed 20 December 2024].
| Published: | 15/12/2024 |
| Authors: | Pereira. C, Babu. H |
Considerations for β-lactam antimicrobial continuous infusion. Authors' reply to Massart et al. and Marzaroli et al
Barton, G; Et al. (2024). Considerations for β-lactam antimicrobial continuous infusion. Authors' reply to Massart et al. and Marzaroli et al. Intensive Care Medicine.[Online]. Available at: http://dx.doi.org/10.1007/s00134-024-07724-w [Accessed 19 December 2024].
| Published: | 12/12/2024 |
| Authors: | Barton G |
Relaxin agonists under preclinical and early clinical investigation for the treatment of heart failure
Introduction Acute failure is a critical condition, encompassed by the sudden or progressive onset of symptoms or signs of congestion. The treatment strategies available are mainly supportive and do not improve mortality or long-term outcomes. Therefore, there is a need for alternative novel treatment strategies. In this narrative review, we..
| Published: | 06/12/2024 |
| Authors: | Ajay. H |
Mortality Risk in Patients With Cardiac Complications Following Ischemic Stroke: A Report From the Virtual International Stroke Trials Archive
Background: Cardiac complications may occur in patients following ischemic stroke (stroke-heart syndrome [SHS]). We investigated the mortality risk in patients with SHS and across the SHS manifestations. Methods and results: Data were sought from the VISTA (Virtual International Stroke Trials Archive), an international repository of clinical trials data. We reviewed..
| Published: | 03/12/2024 |
| Authors: | Abdul-Rahim. A |
“Small but mighty” — A radiologists’ primer for ultrasound imaging of the smaller peripheral nerves
Abstract Peripheral nerve imaging is a powerful tool in evaluating peripheral neuropathy. This review aims to provide an overview of the anatomy, clinical significance and pathologies of small peripheral nerves, typically less than 2 mm in diameter. High frequency ultrasound probes offer the best assessment of these nerves whilst permitting real-time..
| Published: | 03/12/2024 |
| Authors: | Iyengar. KP |
Vitamin D and cardiovascular outcomes in multiple sclerosis
Abstract: BACKGROUND: Vitamin D (25(OH)D) deficiency is linked to increased cardiovascular disease (CVD) risk in the general population, but its implications for people with multiple sclerosis (pwMS) remain unexplored. This study aimed to evaluate the association of 25(OH)D with long-term CVD outcomes in pwMS and the impact of..
| Published: | 01/12/2024 |
| Authors: | Abdul-Rahim. A |
The National Joint Registry Data Quality Audit of elbow arthroplasty
Aims: The aim of this audit was to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset for arthroplasty of the elbow. Methods: It was performed in two phases. In Phase 1, the completeness was assessed by comparing the NJR elbow dataset with the NHS England..
| Published: | 01/12/2024 |
| Authors: | Barrett. E, Hitchcock. M, Lipscombe. S, Sepesiova. L, Venugopal. V, Waraich. A, Zreik. NH, Earnshaw. K |
Use of Therapy Outcome Measures (TOMs) and Australian Therapy Outcome Measures (AusTOMs) in community physiotherapy and community occupational therapy services: a scoping review
Purpose: Outcome measures enable benchmarking within and between services, which is essential for ensuring best practice standards. There is limited consensus regarding which outcome measures should be utilised within the community. Therefore, the aim of this scoping review is to provide an overview on the Therapy Outcome Measures (TOMs) and..
| Published: | 30/11/2024 |
| Authors: | Cross. A |
Understanding inequities in access to diabetes technologies in children and young people with type 1 diabetes: Qualitative study of healthcare professionals' perspectives and views
Aims: We explored healthcare professionals' perceptions and understandings of the factors and considerations underlying inequities in technology access in children and young people (CYP) with type 1 diabetes. Methods: We interviewed (n = 29) healthcare professionals working in paediatric diabetes in England recruited from (n = 15) purposively selected sites. We analysed data thematically. Results:..
| Published: | 29/11/2024 |
| Authors: | Ng. SM |
Are trauma and orthopaedic consultant posts decreasing in frequency and increasing in subspecialisation?
Background The needs of the population and changes to the configuration of the NHS affect the role of the Trauma & Orthopaedic (T&O) surgeon. This impacts training and the number of consultant posts available at Certificate of Completion of Training. Aim of this study was to review advertised T&O..
| Published: | 29/11/2024 |
| Authors: | Ansari. SA |
What impact does widening participation to medicine have on the medical workforce in the UK: a scoping review
Purpose: Widening participation in medicine refers to the recruitment policy of encouraging those who are traditionally under-represented in medical school. Whilst research in the UK has investigated the processes around improving participation through recruitment and selection to medical schools, there is less focus around the period after medical school and..
| Published: | 28/11/2024 |
| Authors: | Gendy. D |
Autologous faecal microbiota transplantation via double barrel stoma to treat chronic diversion colitis
Diversion colitis is a common phenomenon affecting patients after defunctioning ileostomy. We present a complex case of diversion colitis where the patient was deemed unsuitable for restorative surgery due to multiple areas of stricturing in a long defunctioned colonic segment. Despite initial treatments with rectally administered topical mesalazine, butyrate enemas..
| Published: | 27/11/2024 |
| Authors: | Tang. J, Habib. F, Rahmdil. M, Apostolou. N |
Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction
Background Placental mesenchymal dysplasia (PMD) is a rare, benign, placental disorder characterised macroscopically by an enlarged multi-cystic placenta. It is a condition associated with a range of reported clinical outcomes and can be misdiagnosed as a molar or partial molar pregnancy given the similarities in clinical presentation. We present an..
| Published: | 25/11/2024 |
| Authors: | Chadwick. T, Davis. J, Bitar. W, Pankaja. S |
An Algorithmic Approach to use Extended Spreader Grafts in Deviated Noses
Background: Restoration of a straight and adequately wide nasal dorsum is challenging in patients with deviated noses. Supporting a reformed septum with an extended spreader graft (ESG) is important for maintaining position. Objective: The study aimed to describe different types of ESG and propose a comprehensive algorithm for using specific..
| Published: | 25/11/2024 |
| Authors: | Iqbal. A |
Reply to Lee et al.: Endovascular Forceps Biopsy of Pulmonary Artery Intimal Sarcoma, A Safer Approach
NA Petrarulo, S; Paul, S et al. (2024). Reply to Lee et al.: Endovascular Forceps Biopsy of Pulmonary Artery Intimal Sarcoma, A Safer Approach. American Journal of Respiratory and Critical Care Medicine. Online ahead of print [Online]. Available at: https://www.atsjournals.org/doi/10.1164/rccm.202410-1948LE?url_ver=Z39.88-2003&..
| Published: | 25/11/2024 |
| Authors: | Paul. S. |
Prognostic effects of glycaemic variability on diastolic heart failure and type 2 diabetes mellitus: insights and 1-year mortality machine learning prediction model
Background: Diastolic heart failure (DHF) and type 2 diabetes mellitus (T2DM) often coexist, causing increased mortality rates. Glycaemic variability (GV) exacerbates cardiovascular complications, but its impact on outcomes in patients with DHF and T2DM remains unclear. This study examined the relationships between GV with mortality outcomes, and developed a..
| Published: | 23/11/2024 |
| Authors: | Ditchfield. C |
Effect of Micronutrients on HIV-Related Clinical Outcomes Among Adults Living With HIV on Antiretroviral Therapy: Systematic Review and Meta-analysis
Context: Micronutrient deficiencies are common and frequently co-occurring among people living with HIV (PLHIV) globally, with consequences for their health and clinical outcomes. Previous reviews of the influence of micronutrient supplementation on HIV outcomes were conducted in the pre-highly active antiretroviral therapy (pre-HAART) era or included both HAART-naive and HAART-experienced..
| Published: | 22/11/2024 |
| Authors: | Oyadiran. OT |
Low-Dose Oral Minoxidil Initiation for Patients With Hair Loss: An International Modified Delphi Consensus Statement
Importance: The results of small studies suggest that off-label use of low-dose oral minoxidil (LDOM) may be safe and effective for patients with hair loss, but larger trials and standardized guidelines are lacking. Objective: To create an expert consensus statement for LDOM prescribing for patients with hair loss. Evidence review:..
| Published: | 20/11/2024 |
| Authors: | Meah. N |
Calcific Enthesitis of Lateral Patellofemoral Ligament: A Rare Cause of Anterolateral Knee Pain
Abstract Hydroxyapatite deposition disease is a common musculoskeletal pathology that often affects rotator cuff tendons in the shoulder joint. Here, we present the first documented case of acute calcific enthesitis involving the lateral patellar retinaculum, specifically the lateral patellofemoral ligament (LPFL). A 35-year-old male presented with insidious onset atraumatic pain..
| Published: | 19/11/2024 |
| Authors: | Iyengar. KP |
Machine learning for stroke in heart failure with reduced ejection fraction but without atrial fibrillation: A post-hoc analysis of the WARCEF trial.
Abstract: Background: The prediction of ischaemic stroke in patients with heart failure with reduced ejection fraction (HFrEF) but without atrial fibrillation (AF) remains challenging. Our aim was to evaluate the performance of machine learning (ML) in identifying the development of ischaemic stroke in this population. Methods: We performed a post-hoc..
| Published: | 18/11/2024 |
| Authors: | Abdul-Rahim. A |
Recurrence of Retinopathy of Prematurity Following Anti-vascular Endothelial Growth Factor (Anti-VEGF) Therapy: A Systematic Review and Meta-Analysis.
Abstract: Retinopathy of prematurity (ROP) is a neovascular disorder which affects premature infants and can lead to childhood blindness. Treatment includes laser photocoagulation and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections, both effective options. However, laser photocoagulation can lead to refractive errors, while anti-VEGF therapy can result in disease recurrence...
| Published: | 08/11/2024 |
| Authors: | Dablouk. M |
COVID-19 vaccination-related delayed adverse events among people with rheumatoid arthritis: results from the international COVAD survey
This study aimed to assess COVID-19 vaccination-related AEs in patients with rheumatoid arthritis (RA), in the COVID-19 Vaccination in Autoimmune Diseases (COVAD)-2 study. An online international cross-sectional survey captured self-reported data on COVID-19 vaccination-related adverse events (AEs) in people with RA, autoimmune diseases (AIDs; rheumatic [r] and non-rheumatic [nr])..
| Published: | 06/11/2024 |
| Authors: | Nune. A |
A Systematic Review of the Learning Curves of Novices and Trainees to Achieve Proficiency in Laparoscopic Skills: Virtual Reality Simulator Versus Box Trainer
Abstract Laparoscopic surgery, established in the 1980s, has become a primary treatment method across various surgical specialities due to its advantages over open surgery, including shorter recovery times and fewer complications. Mastery of laparoscopic skills is essential for novice and junior trainees, who must develop hand-eye coordination, depth perception, and..
| Published: | 03/11/2024 |
| Authors: | Nallathamby. K, Hristova. M |
Incident dementia in ischaemic stroke patients with early cardiac complications: A propensity-score matched cohort study
Introduction The risk of dementia in patients with stroke-heart syndrome (SHS) remains unexplored. Patients and methods Retrospective analysis using the TriNetX network, including patients with ischaemic stroke from 2010 to 2020. These patients were categorised into two groups: those with SHS (heart failure, myocardial infarction, ventricular fibrillation, or Takotsubo cardiomyopathy within 30 days..
| Published: | 02/11/2024 |
| Authors: | Abdul-Rahim. A |
UK Foot and Ankle Thromboembolism (UK-FATE).
Abstract Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot..
| Published: | 01/11/2024 |
| Authors: | Lever. C, Bansod. V, Iyengar. KP, Wadood. A, McMillan. L |
Effect of GLP-1 receptor agonists on weight and cardiovascular outcomes: A review.
Abstract: Diet and lifestyle modifications remain the foundation of obesity treatment, but they have historically proven insufficient for significant, long-term weight loss. As a result, there is a high demand for new pharmacologic treatments to promote weight loss and prevent life-threatening diseases associated with obesity. Researchers are particularly interested in 1..
| Published: | 01/11/2024 |
| Authors: | Altaf. R |
Initial blood pressure and adverse cardiac events following acute ischaemic stroke: An individual patient data pooled analysis from the VISTA database
Background Adverse cardiac events following ischaemic stroke (stroke-heart syndrome, SHS) pose a clinical challenge. We investigated the association between initial blood pressure at stroke presentation and the risk of SHS. Methods We utilised data from the Virtual International Stroke Trials Archive (VISTA). We defined SHS as the incidence of cardiac..
| Published: | 30/10/2024 |
| Authors: | Abdul-Rahim. A |
Nanomaterials in point-of-care diagnostics: Bridging the gap between laboratory and clinical practice.
Abstract The integration of nanomaterials into biosensing technologies represents a paradigm shift in medical diagnostics and environmental monitoring, marking a significant advancement in the field. This comprehensive review examines the role of nanomaterials, such as gold nanoparticles, carbon nanotubes, graphene, and quantum dots, in enhancing the performance of biosensors. These..
| Published: | 28/10/2024 |
| Authors: | Iyengar. KP |
Nanomaterials in point-of-care diagnostics: Bridging the gap between laboratory and clinical practice.
Abstract The integration of nanomaterials into biosensing technologies represents a paradigm shift in medical diagnostics and environmental monitoring, marking a significant advancement in the field. This comprehensive review examines the role of nanomaterials, such as gold nanoparticles, carbon nanotubes, graphene, and quantum dots, in enhancing the performance of biosensors. These..
| Published: | 28/10/2024 |
| Authors: | Iyengar. KP |
Cerebral Venous Sinus Thrombosis Following Varicella Infection: A Case Report
Abstract A 38-year-old man presented to the emergency department with a severe frontal headache, which began three days prior without visual, speech, or balance disturbances. His past medical history was unremarkable, apart from raised cholesterol. He confirmed a recent primary Varicella-zoster virus infection (chicken pox) two weeks prior. Clinical examination..
| Published: | 26/10/2024 |
| Authors: | Dablouk. M |
Eosinophilic Dermatosis of Haematological Malignancy
Nallathamby, K; Moss, K et al. (2024). Eosinophilic Dermatosis of Haematological Malignancy. Clinical and Experimental Dermatology. Pub online 25 Oct, p.llae469. [Online]. Available at: https://doi.org/10.1093/ced/llae469 [Accessed 31 October 2024]
| Published: | 25/10/2024 |
| Authors: | Nallathamby. K, Moss. K |
Outcome Measures in intellectual disability: A Review and narrative synthesis of validated instruments.
Abstract: Background: Outcome measurement is essential to determine the effectiveness of health interventions and improve the quality of services. The interplay of social, individual, and biological factors makes this a complex process in the psychiatry of people with intellectual disability (PwID). Aim: Review of outcome measures which are validated in..
| Published: | 25/10/2024 |
| Authors: | Kumar. M |
Navigating dual challenges: a qualitative study of adolescents and caregivers perceptions in managing type 1 diabetes and neurodiversity.
Quinn M.; Padi D.; Day H.; Hubbard R.; Finnigan L.; Rowe L.; Kyprios H.; Unsworth L.; Pintus D.; McCaffrey L.; Bray D.; Ng S.M. (2024). Navigating dual challenges: a qualitative study of adolescents and caregivers perceptions in managing type 1 diabetes and neurodiversity. Hormone Research in Paediatrics. p.1. [Online]. Available at:..
| Published: | 25/10/2024 |
| Authors: | Quinn M, Day. H, Hubbard. R, Finnigan L, Rowe. L, Kyprios H, Unsworth. L, Pintus D, McCaffrey L, Bray D, Ng. SM, Padi. D |
Context, clarity and conversation: Spotting the Signs updated toolkit
No abstract available Daurat JL, Ashby J, Thomson-Glover R. Context, clarity and conversation: Spotting the Signs updated toolkit. Sex Transm Infect. 2024 Oct 17;100(7):474. doi: 10.1136/sextrans-2024-056213. PMID: 39419514.
| Published: | 17/10/2024 |
| Authors: | Thomson-Glover. R |
Challenging anticoagulation decisions in atrial fibrillation: a narrative review
Abstract Atrial fibrillation (AF) is common and warrants consideration of oral anticoagulant (OAC) medication. Usually, the decision is straightforward, following the pathway outlined in the European Society of Cardiology’s guideline; however, certain situations fall outside of this evidence base – such as a diagnosis of subclinical AF made via implanted..
| Published: | 16/10/2024 |
| Authors: | Abdul-Rahim. A |
Anatomy and pathology of adductor canal (Hunter’s canal)
Abstract Adductor canal (Hunter’s canal) pathologies are often underdiagnosed, with the saphenous nerve being the most commonly affected. While uncommon, involvement of the femoral artery and vein can cause severe and irreversible complications if not detected early. Significant attention must be given to adductor canal pathologies because the musculoaponeurotic..
| Published: | 13/10/2024 |
| Authors: | Iyengar. KP |
Stroke-heart syndrome and early mortality in patients with acute ischaemic stroke using hierarchical cluster analysis: An individual patient data pooled analysis from the VISTA database
Background The patient clinical phenotypes at particularly high risk for early cardiac complications after a recent acute ischaemic stroke (AIS), that is, stroke-heart syndrome (SHS), remain poorly defined. We utilised hierarchical cluster analysis to identify specific phenotypic profiles associated with this risk. Methods We gathered data on patients with AIS..
| Published: | 13/10/2024 |
| Authors: | Abdul-Rahim. A |
Establishing postgraduate education in urology for nurses and the non-medical workforce using a partnership model
Phillips, E. (2024). Establishing postgraduate education in urology for nurses and the non-medical workforce using a partnership model. British Journal of Nursing. 33(18), pp.S28-S29. [Online]. Available at: https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2024.0352 [Accessed 17 October 2024]
| Published: | 11/10/2024 |
| Authors: | Phillips. E |
Eccentric ripple sign of BAARISh - a new sign of venous pseudoaneurysm
Abstract Superficial venous pseudoaneurysm is rare. Prompt diagnosis is essential to formulate management plan and decrease morbidity. We describe a novel Eccentric Ripple sign of BAARISh for diagnosing venous pseudoaneurysm. Kanani, A; Iyengar, KP et al. (2024). Eccentric ripple sign of BAARISh - a new sign of venous pseudoaneurysm. Journal of..
| Published: | 10/10/2024 |
| Authors: | Iyengar. KP |
Anatomical Variations of the Bifurcation Levels of the Common Carotid Artery and Superior Thyroid Artery
Background Variations in the carotid arterial system significantly impact atherosclerosis's clinical and surgical management, which predominantly occurs at arterial bifurcations. Objectives This study aimed at evaluating anatomical variations in the bifurcation levels of the common carotid artery (CCA) and the superior thyroid artery (STA), emphasizing clinical relevance. Methods This was..
| Published: | 09/10/2024 |
| Authors: | Abdelrahim. M |
Intraosseous regional antibiotic prophylaxis in total joint arthroplasty (TJA): Systematic review and meta-analysis
Background A major catastrophic adverse event after total joint arthroplasty surgery (TJA) is the periprosthetic joint infection (PJI). In the recent years, regional antibiotic prophylaxis has gained momentum as a novel infection control strategy in total knee arthroplasty (TKA), with different purported benefits over systemic administration. The current article was..
| Published: | 03/10/2024 |
| Authors: | Iyengar. KP |
Age, anticoagulants, hypertension and cardiovascular genetic traits predict cranial ischaemic complications in patients with giant cell arteritis
Objectives This project aimed to determine whether cranial ischaemic complications at the presentation of giant cell arteritis (GCA) were associated with pre-existing cardiovascular (CV) risk factors, CV disease or genetic risk of CV-related traits. Methods 1946 GCA patients with clinicodemographic data at GCA presentation were included. Associations between pre-existing CV-related traits (..
| Published: | 03/10/2024 |
| Authors: | Graham. D (Collaborator), Dawson. J (Collaborator) |
Incidence and Outcomes of Patients With Early Cardiac Complications After Intracerebral Hemorrhage: A Report From VISTA
Background The incidence and outcomes of early cardiac complications in patients with intracerebral hemorrhage (ICH) are poorly understood. These cardiac complications may be part of the so-called stroke-heart syndrome in patients with ICH. We investigated this issue in an individual patient data pooled analysis from an international repository of clinical..
| Published: | 02/10/2024 |
| Authors: | Abdul-Rahim. A |
Dapagliflozin's Role in Heart Failure: An Overview of Clinical Trial Evidence
Heart failure (HF) has become a global health threat, necessitating the development of novel treatment options to address this crisis. Sodium-glucose co-transporter-2 (SGLT2) inhibitors, such as dapagliflozin, may offer significant advantages in the treatment of HF, particularly in patients with reduced ejection fraction (HFrEF). This systematic review combines the findings..
| Published: | 02/10/2024 |
| Authors: | Ahmed. Z |
Residual Risks of Thrombotic Complications in Anticoagulated Patients with Atrial Fibrillation
Background Assessment of residual thromboembolic risk in patients with atrial fibrillation (AF) prescribed oral anticoagulants (OACs) remains unexplored. We performed hierarchical cluster analysis to identify phenotypic profiles of these patients and their risks of residual thromboembolic events. Methods We utilised data from non-valvular AF patients on OACs, as documented in..
| Published: | 25/09/2024 |
| Authors: | Abdul-Rahim. A |
The impacts of climate change on health in persons with Spinal Cord Injuries (SCI)
The poster is available as a PDF https://www.knowledge-nw.nhs.uk/media/StaffPublications/ISCoS2024/1.%20Poster_%20Yannis Dionyssiotis, Y; Lennon, A; Alexander, M; Silva, C; Uddin, T (2024, September 24). Climate Change and Spinal Cord Injuries: Developing an informed action plan: The impacts of climate change on health in persons with Spinal..
| Published: | 24/09/2024 |
| Authors: | Silva. C |
The emotional toll of climate change for persons with spinal cord injury
The poster is available as a PDF https://www.knowledge-nw.nhs.uk/media/StaffPublications/ISCoS2024/2.%20Poster_%20Aisling Lennon, A; Dionyssiotis Y; Alexander, M; Silva, C; Uddid T (2024, September 24). Climate Change and Spinal Cord Injuries: Developing an informed action plan: The emotional toll of climate change for persons with spinal cord..
| Published: | 24/09/2024 |
| Authors: | Silva. C |
How does health care contribute to climate change and what can we do about it?
The poster is available as a PDF https://www.knowledge-nw.nhs.uk/media/StaffPublications/ISCoS2024/3.%20Poster_%20Carla Silva, C; Dionyssiotis, Y; Lennon, A; Alexander, M; Uddin, T (2024, September 24). Climate Change and Spinal Cord Injuries: Developing an informed action plan: How does health care contribute to climate change and what can..
| Published: | 24/09/2024 |
| Authors: | Silva. C |
P075 Awake upper limb plastic surgery list – evaluation of a well established service shows good patient satisfaction and time efficiency
Background and Aims Undertaking procedures under regional anaesthesia (RA) avoids the risks, side effects and longer recovery associated with general anaesthesia (GA). There is a regular upper limb plastic surgery list at Whiston Hospital where patients have procedures under RA alone with no sedation, predominantly a brachial plexus block plus..
| Published: | 24/09/2024 |
| Authors: | Ashe. M, Mukhtar. K, Murtagh. L |
EP058 Sonoclub North West – Improving the provision of regional anaesthesia skills of trainee anaesthetists
Background and Aims Regional anaesthesia is a core element of the Royal College of Anaesthetists curriculum and a key component as part of an independent anaesthetists practice (1,2). In our region, provision of regional anaesthesia training can be variable, therefore we created Sonoclub North West, targeting UK anaesthesia trainees aiming to..
| Published: | 24/09/2024 |
| Authors: | Hanumanthu. G |
EP056 Introduction of a thoracic trauma protocol including implementation of an erector spinae plane (ESP) catheter service in a busy district general hospital
Background and Aims Following a previous audit into the management of rib fracture patients over 12 months (Jan-Dec 2021) an updated thoracic trauma protocol was introduced including offering a new ESP catheter service. We completed a re-audit of all rib fracture patients over a 12 month period to assess the impact, with audit..
| Published: | 24/09/2024 |
| Authors: | Harwood. S, Ashe. M, Plant. K, Geetha. V, Senathirajah. A |
OP070 Greenhouse emissions associated with general or regional anaesthesia for open reduction and internal fixation of distal radius fractures
Background and Aims Total intravenous anaesthesia (TIVA) and regional anaesthesia (RA) have been touted as environmentally preferable alternatives to volatile anaesthesia, however few studies have investigated the relative environmental impact of these anaesthetic techniques. Methods A retrospective observational database study was conducted, in which theatre billing records were obtained. For..
| Published: | 24/09/2024 |
| Authors: | Mukhtar. K |
The “Mustache sign:” An ancillary radiological sign for detecting L5/S1 spondylolisthesis
Introduction and Aims Grade 1 spondylolisthesis can be challenging to detect on magnetic resonance imaging (MRI), particularly for spinal surgeons and radiologists with limited experience interpreting spinal MRIs. This study aims to describe a unique sign described as a “mustache sign,” which may assist in detecting subtle Grade I spondylolisthesis on..
| Published: | 23/09/2024 |
| Authors: | Iyengar. KP |
Lumbar offset distance: A simplified metric for evaluation of the lumbar spine alignment
Background A healthy lower back is essential for optimal spinal function and overall wellness. Magnetic resonance imaging (MRI) has become the gold standard in assessing lumbar spine disease. This article aims to evaluate the precision and efficacy of the lumbar offset distance (LOD) as a novel MRI parameter designed to..
| Published: | 23/09/2024 |
| Authors: | Iyengar. KP |
Identifying Research Priorities in Limb Reconstruction Surgery in the United Kingdom
Introduction Limb reconstruction surgery (LRS) has a wide range of clinical applications within orthopaedic and trauma surgery. We sought a consensus view from limb reconstruction healthcare practitioners across the United Kingdom to help guide research priorities within LRS. Our aim is to guide future clinical research in LRS, and assist..
| Published: | 23/09/2024 |
| Authors: | Saldanha. K |
Continuous infusion of beta-lactam antibiotics in critically ill patients with sepsis: implementation considerations
No abstract available Barton, G., Rickard, C.M. & Roberts, J.A. Continuous infusion of beta-lactam antibiotics in critically ill patients with sepsis: implementation considerations. Intensive Care Med (2024). https://doi.org/10.1007/s00134-024-07650-x
| Published: | 23/09/2024 |
| Authors: | Barton. G |
Calcific Myonecrosis of the Leg: A Clinical and Diagnostic Dilemma
Background: Calcific myonecrosis (CMN) is a rare condition, often considered to be a late sequela of antecedent trauma. Case Report: We describe here our experience in managing a 56-year-old male referred with a painless swelling on the lateral aspect of the left lower leg with a suspicion of a tumour...
| Published: | 21/09/2024 |
| Authors: | Iyengar. KP |
1076O Primary analysis of the EORTC 1208 Minitub trial: Prospective registry of sentinel node (SN) positive melanoma patients with minimal SN tumor burden
Background Retrospective studies have shown the prognostic value of SN tumor burden (van der Ploeg et al. JCO 2011). There are different ways to assess SN tumor burden, e.g. as the microanatomic location (Dewar et al. JCO 2004) or the diameter of the largest deposit (van Akkooi et al. Ann Oncol 2006)...
| Published: | 20/09/2024 |
| Authors: | Brackley. P |
Use of a Dedicated Questionnaire to Assess Buccal Mucosal Graft Morbidity in Urethral Reconstruction
Introduction Buccal mucosa grafts (BUMG) are used in urethral reconstruction. Although 1st described in 1894 it has only become popular since the early 90s. It easy to harvest with ideal graft properties. Potential complications associated with donor site harvest include oral numbness, delayed mouth opening and pain. Methods All urethral reconstruction..
| Published: | 20/09/2024 |
| Authors: | Rauf. A, Shkoukani. ZW, Omar. AM, Floyd Jr. MS |
Perineal Urethrostomy
Introduction Perineal urethrostomy represents an excellent option for patients with pan urethral stricture disease who are unfit for major reconstruction. Methods With the scrotum sewn up, the base and ischial tuberosities are marked. Methylene blue is injected and massaged down the urethra. An inverted U-shaped incision is made along the..
| Published: | 20/09/2024 |
| Authors: | Pina. IM, Floyd Jr. MS |
Outcomes of Staged Urethroplasty for Distal Urethral BXO: The Whiston Hospital Experience
Introduction Distal urethral disease due to balanitis xerotica obliterans is managed by staged urethroplasty. The first stage involves urethrectomy and replacement of the diseased urethral plate with a buccal graft. The second stage involves tubularisation and reconstructing the urethra. The purpose of this study was to analyse the final outcomes..
| Published: | 20/09/2024 |
| Authors: | Pina. IM, Floyd Jr. MS |
Letter to the Editor: Low-dose oral minoxidil for the treatment of monilethrix: A retrospective review
Darchini-Maragheh, E; Meah, N et al. (2024). Letter to the Editor: Low-dose oral minoxidil for the treatment of monilethrix: A retrospective review. JEADV: Journal of the European Academy of Dermatology & Venereology. pub online 18 Sep. [Online]. Available at: https://doi.org/10.1111/jdv.20329 [Accessed 2 October 2024]
| Published: | 18/09/2024 |
| Authors: | Meah. N |
Tales from the community menopause clinic
Rook, D; Temple, R et al. (2024). Tales from the community menopause clinic. Post Reproductive Health. pub online 18 Sep. [Online]. Available at: https://doi.org/10.1177/20533691241285637 [Accessed 2 October 2024].
| Published: | 18/09/2024 |
| Authors: | Temple. R |
Adapting the WHO hand hygiene ‘reminders in the workplace’ to improve acceptability for healthcare workers in maternity settings worldwide: a mixed methods study
Introduction Hand hygiene is key in preventing healthcare-associated infections, but it is challenging in maternity settings due to high patient turnover, frequent emergencies and volume of aseptic procedures. We sought to investigate if adaptions to the WHO hand hygiene reminders could improve their acceptability in maternity settings globally, and use..
| Published: | 17/09/2024 |
| Authors: | Thompson. A |
Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study
Background People presenting to the ED with acute severe headache often undergo investigation to exclude subarachnoid haemorrhage (SAH). International guidelines propose that brain imaging within 6 hours of headache onset can exclude SAH, in isolation. The safety of this approach is debated. We sought to externally validate this strategy and evaluate..
| Published: | 17/09/2024 |
| Authors: | Al-Qudah. A, Zone. A, Jewitt. C, Fuller. R, Booth. S, Rimmer. C, Haslam. Z |
Outcomes with single-agent gilteritinib for relapsed or refractory FLT3-mutant AML after contemporary induction therapy
Abstract Gilteritinib is the current standard of care for relapsed or refractory FLT3-mutated AML in many countries, however outcomes for patients relapsing after contemporary first-line therapies (intensive chemotherapy with midostaurin, or non-intensive chemotherapy with venetoclax) are uncertain. Moreover, reported data on toxicity and healthcare resource use is limited. Here..
| Published: | 12/09/2024 |
| Authors: | Loizou. E |
Assessing the current role of AP and Bernageau view radiographs in measurement of glenoid bone loss in patients with recurrent shoulder dislocation...
Background Evaluation of glenoid bone loss following recurrent anterior shoulder dislocations is normally performed using cross sectional imaging. Objectives To assess how anteroposterior (AP) and Bernageau view radiographs compare to computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy for evaluating glenoid bone loss in patients with recurrent anterior shoulder..
| Published: | 12/09/2024 |
| Authors: | Iyengar. KP |
Decoding the hidden realm: Molecular pioneering unravelling osteoarticular tuberculosis diagnosis
Abstract Osteoarticular tuberculosis (TB), a form of extrapulmonary tuberculosis, refers to the involvement of Mycobacterium tuberculosis (M.tb) in the bones and joints. While pulmonary tuberculosis is the most common form, osteoarticular TB represents a relatively rare but significant manifestation, accounting for approximately 1–3% of all TB cases. Accurate and timely..
| Published: | 12/09/2024 |
| Authors: | Iyengar. KP |
Early statin use is associated with improved survival and cardiovascular outcomes in patients with atrial fibrillation and recent ischaemic stroke...
Introduction Statins reduce recurrent stroke and cardiovascular events in patients with non-cardioembolic stroke. The benefits of statins in patients with AF and recent IS remain unclear. We aimed to investigate the benefits of statins in patients with AF and recent IS. Patients and methods This retrospective, cohort study was conducted..
| Published: | 10/09/2024 |
| Authors: | Hill. AM, Irving G, Abdul-Rahim. A |
Management of paediatric elbow injuries, where is the equipoise? A UK and Ireland wide international survey of practice
No abstract available. Aldridge P, Rout R, Parish R, Roland D, Perry DC, Lyttle MD; Paediatric Emergency Research in the United Kingdom & Ireland (PERUKI). Management of paediatric elbow injuries, where is the equipoise? A UK and Ireland wide international survey of practice. Arch Dis Child. 2024 Sep 10:archdischild-2024-327051. doi: 10.1136/archdischild-2024..
| Published: | 10/09/2024 |
| Authors: | O'Leary. C, Gardner. S |
EP366 A single surgeon experience of total extraperitoneal inguinal hernia repair in a district general hospital
Methods This was a retrospective review of a prospectively collected and maintained data on elective TEP hernia repairs. All theatre list has been collected prospectively. All patient who had inguinal hernia repair between 2004 and 2021 has been identified from the list. The notes of all Patients who had laparoscopic hernia repair..
| Published: | 09/09/2024 |
| Authors: | Elshazy. M, Jmor. S |
Evaluating the impact of differing completion rates of a face-to-face DIABETES self-management education programme on Patient Reported Outcome measures (DIABETES PRO): A feasibility trial protocol
Introduction: Structured diabetes self-management education (DSME) is internationally recommended for people with type 2 diabetes to support self-management and to prevent associated long-term complications. 'Attendance' at DSME is currently benchmarked as having completed a registration form and at least one active engagement with programme content, and 'completion' measured against ≥60% completion, despite..
| Published: | 05/09/2024 |
| Authors: | Lewis. G |
The SAInT study: a protocol for a randomized controlled trial of steroid injection for subacromial pain syndrome using the anterolateral versus posterior approach
Aims: Steroid injections are used for subacromial pain syndrome and can be administered via the anterolateral or posterior approach to the subacromial space. It is not currently known which approach is superior in terms of improving clinical symptoms and function. This is the protocol for a randomized controlled trial (RCT)..
| Published: | 03/09/2024 |
| Authors: | Kwaees. T A |
GESTATIONAL DIABETES MELLITUS PREVENTION: A COMMENTARY.
Abstract: Gestational diabetes mellitus (GDM) poses a significant global health challenge. Well-established risk factors include a body mass index (BMI) above 30, maternal age over 40, previous GDM instances, a history of delivering babies weighing over 4.5kg, and specific ethnic backgrounds. This commentary discusses the Cochrane umbrella review by Griffith, et al., (2020)..
| Published: | 01/09/2024 |
| Authors: | Gallagher. C |
Painful Ankle due to Impingement Between the Medial Malleolus and Navicular
Introduction: A plethora of pathologies can cause medial ankle pain. Material and methods: We present a case of 66-year-old male with medial ankle pain. Result: Bilateral CTEV (Congenital talipes equino varus) with impingement between the navicular and medial malleolus was present, which was contributing to medial ankle pain. Conclusion: One..
| Published: | 29/08/2024 |
| Authors: | Iyengar. KP |
Optimizing scapulothoracic injections: the role of hand positioning in enhancing procedural ease.
Abstract Introduction: Pathologies of the scapulothoracic articulation may lead to painful symptoms such as crepitus and bursitis. While conservative treatments are preferred, persistent symptoms may require image-guided injections. This study aims to determine the optimal hand positioning during ultrasound to maximize the distance between the scapula and thoracic wall, and..
| Published: | 28/08/2024 |
| Authors: | Iyengar. KP |
Construction of a decision model for donor testing in cases of suspected antibody-mediated transfusion-related-acute-lung-injury
Abstract Objective: To propose a rational basis for donor testing in cases of suspected antibody-mediated transfusion-related lung injury (AMT). Background: Anti-leukocyte antibodies in donated blood are established causes of transfusion-related lung injury (TRALI). However, the question of whether to test donors for antibodies is not identical to whether the case..
| Published: | 26/08/2024 |
| Authors: | Malhotra. P |
Impact of bridging thrombolysis versus endovascular thrombectomy alone on outcomes in anticoagulated patients with atrial fibrillation and acute ischaemic stroke
Background and purpose The impact of bridging thrombolysis prior to endovascular thrombectomy (EVT) compared to EVT alone on intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH), and death in anticoagulated atrial fibrillation (AF) patients with acute ischaemic stroke (AIS) is not well defined. Methods A retrospective study was conducted using data from..
| Published: | 23/08/2024 |
| Authors: | Abdul-Rahim. A |
BAASIK technique: an innovative single needle technique of performing shoulder corticosteroid injections
The novel BAASIK (B-Botchu,Bipin, A-Agrawal, A-Ankit, S- Sindhura, I-Iyengar, K- Kapil) technique is a combined ultrasound-guided injection into the subacromial-subdeltoid (SASD) bursa and the biceps tendon sheath to treat shoulder pain associated with biceps tendonitis/tendinopathy, subacromial bursitis, rotator cuff impingement or to determine the source of shoulder pain...
| Published: | 22/08/2024 |
| Authors: | Iyengar KP |
The management of acute complete ruptures of the ulnar collateral ligament of the thumb
Aims: Complete ruptures of the ulnar collateral ligament (UCL) of the thumb are a common injury, yet little is known about their current management in the UK. The objective of this study was to assess the way complete UCL ruptures are managed in the UK. Methods: We carried out a..
| Published: | 22/08/2024 |
| Authors: | Knowles L, Lipscombe. S |
Felty Syndrome Presented With Candida albicans Lung Abscess Without Arthritis: A Case Report
Abstract Felty syndrome (FS) is a late manifestation of severe active rheumatoid arthritis (RA). A high index of suspicion or FS is needed in patients who present with neutropaenia and splenomegaly with no initial or obvious identifiable cause. We present the case of a 52-year-old who presented with a one-week..
| Published: | 16/08/2024 |
| Authors: | Abdelrahim. M |
Uncommon Expression of Osteochondroma in the Wrist: A Case Report
Introduction Osteochondroma (OC) is a common benign bone tumor that usually arises from the metaphyseal region of long bones. Rarely, it can present in atypical locations such as the wrist and posing diagnostic challenges. Case Report We present a 42-year-old female with an incidental finding of OC on the volar..
| Published: | 15/08/2024 |
| Authors: | Srinivasan. PA, Pullagura. M, Selvarajan. RM, Patel. S, Ganapathy. R |
Breakthrough SARS-CoV-2 infection in fully vaccinated patients with systemic lupus erythematosus: results from the COVID-19 Vaccination in Autoimmune Disease (COVAD) study
Objective To determine the occurrence of breakthrough COVID-19 infections (BIs) in patients with systemic lupus erythematosus (SLE) compared with patients with other rheumatic autoimmune diseases (rAIDs), patients with non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs). Methods The study was based on data from 7035 fully vaccinated respondents to the online..
| Published: | 13/08/2024 |
| Authors: | Nune. A |
Coccygeal Tumors Unveiled: Retrospective Cohort Analysis from a Tertiary referral Centre
Background Isolated tumours affecting the coccyx are infrequent, with only a handful of documented cases in the literature. Herein, we highlight the most extensive consecutive case series involving various isolated coccyx tumours with varied clinical presentations and imaging features. Material and Methods A retrospective search of our tertiary Orthopaedic oncology..
| Published: | 13/08/2024 |
| Authors: | Iyengar. KP |
Causes of sudden unexpected death in infants with and without pre-existing conditions: a retrospective autopsy study
Objective: We investigated sudden unexpected death in infancy (SUDI) autopsy data from 1996 to 2015 inclusive, comparing findings from infants with and without pre-existing medical conditions. Design: Large, retrospective single-centre autopsy series. Setting: Tertiary paediatric hospital, London, UK. Methods: Non-identifiable autopsy findings were extracted from an existing research database for infants older..
| Published: | 13/08/2024 |
| Authors: | Cattermole R |
Unveiling the spiral groove: a journey through clinical anatomy, pathology, and imaging
Aim To review the anatomy of the spiral groove, its clinical significance, and the imaging characteristics of common pathologies affecting this area, highlighting the strengths of different imaging modalities. Materials and methods A comprehensive review of the spiral groove anatomy and its clinical implications and an evaluation of various imaging..
| Published: | 12/08/2024 |
| Authors: | Iyengar. KP |
Use and impact of virtual resources for peer support by young adults living with cancer: A systematic review.
Abstract: Background: Young adults (YA) with cancer often have unmet psychosocial needs. The impact of peer support delivered in an online format to fulfil these needs in the populations of YA with cancer has not been thoroughly examined. Methods: We searched Cochrane Central Register of Controlled Trials, CINAHL, Embase, and..
| Published: | 08/08/2024 |
| Authors: | Hunter-Smith. A |
Prognostic factors for outcomes following surgical stabilization of rib fractures: A review of the literature
Abstract Rib fractures are a common injury following blunt thoracic trauma, often resulting in high levels of morbidity and mortality. With the ageing global population, the incidence of rib fractures is expected to increase, posing a significant burden on healthcare systems worldwide. With advancements in surgical techniques and pioneering research..
| Published: | 05/08/2024 |
| Authors: | Fitzpatrick. A |
Revisiting surgical margins for invasive breast cancer patients treated with breast conservation therapy - Evidence for adopting a 1 mm negative width
Clinical trials have demonstrated conclusively the non-inferiority of breast-conserving surgery followed by breast radiation therapy (BCT) compared with mastectomy for the treatment of early-stage invasive breast cancer (BC). The definition of the required surgical margin to ensure adequate removal of the cancer by BCT to obtain an acceptable low local..
| Published: | 03/08/2024 |
| Authors: | Chagla. L |
Revisional bariatric surgery following sleeve gastrectomy: a meta-analysis comparing Roux-en-Y gastric bypass and one anastomosis gastric bypass
Abstract: Introduction: The number of bariatric operations is increasing each year. Sleeve gastrectomy is the most popular procedure; however, it often requires revision surgery because of insufficient weight loss, weight regain or gastro-oesophageal reflux disease (GORD). The most popular revisional procedures are Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric..
| Published: | 31/07/2024 |
| Authors: | Alfred. J |
Stroke-heart syndrome: Incidence and clinical outcomes of cardiac complications following intracerebral haemorrhage
Introduction Newly diagnosed cardiovascular complications following an ischaemic stroke, termed stroke-heart syndrome, are common and associated with worse outcomes. Little is known regarding stroke-heart syndrome in relation to intracerebral haemorrhage (ICH). This study aimed to investigate the incidence and 5-year major adverse cardiovascular events (MACE; acute myocardial infarction, ischaemic stroke,..
| Published: | 30/07/2024 |
| Authors: | Abdul-Rahim. A |
Transcatheter arterialization of the deep veins: 1-year outcomes of PROMISE-UK study
Abstract: Approximately 20% of the general population over the age of 55 years have peripheral arterial disease (PAD), which is the main cause of leg amputations in the UK National Health Service (NHS) and other healthcare systems1,2. An estimated 20% of those with symptomatic PAD progress to develop chronic limb-threatening ischaemia (CLTI), the..
| Published: | 30/07/2024 |
| Authors: | Lechareas. S |
Breast cancer in pregnancy: a comprehensive review of diagnosis, management, and outcomes.
Conclusions: BC during pregnancy presents a complex challenge, requiring personalized diagnosis and treatment. Multidisciplinary care and timely interventions are essential for optimal outcomes for both mother and child. Ongoing research offers hope for improved strategies and outcomes in the future. Surgical management of BC during pregnancy requires a delicate balance..
| Published: | 30/07/2024 |
| Authors: | Otey. N |
A Six-year review of deaths, a district general hospital’s experience: reflection and learning.
Abstract Objectives: Neonatal and paediatric mortality has remained a challenge worldwide, despite significant improvements in antenatal, neonatal and paediatric care. Case reviews and acting on lessons learned remain a powerful training tool in paediatrics. This is a single centre, retrospective review of all neonatal and paediatric mortality cases in order..
| Published: | 30/07/2024 |
| Authors: | Chilukuri. L, Abdelaziz. M |
Home oxygen for bronchopulmonary dysplasia – Are we safely discharging?.
Abstract Objectives: The British Thoracic Society (BTS) guidelines for home oxygen suggests that ‘Infants can be discharged from SCBU with mean oxygen saturations of >93%. The saturations should not fall below 90% for more than 5% of the recording’.1 However, the American Thoracic Society (ATS) recommend a more conservative approach, allowing less than 5%..
| Published: | 30/07/2024 |
| Authors: | Macfarlane. K, Ewart. R, Chilukuri. L |
6653 Embedding paediatric inequalities thinking and practice in a paediatric department – journey from a lone warrior to community of practice to improve outcomes.
Abstract Objectives: The purpose of this abstract is to detail the journey of a paediatrician/core20plus5 ambassador in embedding paediatric health inequalities (HI) thinking and practice in a hospital paediatric department. The aim is to share the learning and resources to improve success of similar endeavours. Methods: An initial..
| Published: | 30/07/2024 |
| Authors: | Mariguddi. S |
Isolated spontaneous non-insertional tear of the iliopsoas tendon in an elderly patient: significance of ultrasound imaging
Isolated spontaneous tears in the non-insertional portion of the iliopsoas tendon without any underlying injury are uncommon, especially among elderly individuals. We describe the case of an 88-year-old man who experienced right groin pain caused by a spontaneous non-insertional tear in the iliopsoas tendon identified through ultrasound and confirmed via..
| Published: | 26/07/2024 |
| Authors: | Iyengar. KP |
Chatbots and Their Applications in Medical Fields: Current Status and Future Trends: A Scoping Review
Background and Aim: Chatbots are computer programs, which are devised to simulate conversations through voice or textual interactive forms. These applications offer multiple benefits in patient education, clinical decision-making, interpersonal communication, research activities, data analysis and administrative affairs. The present scoping review aims to analyse the current role, pitfalls, challenges..
| Published: | 25/07/2024 |
| Authors: | Iyengar. KP |
Recurrent fractures in a teen with osteopetrosis
Abstract not available. Vaisha, R.; Iyengar, KP. et al. (2024). Recurrent fractures in a teen with osteopetrosis. BMJ Case Reports. 17(7), p.-. [Online]. Available at: https://doi.org/10.1136/bcr-2024-260383 [Accessed 30 July 2024].
| Published: | 24/07/2024 |
| Authors: | Iyengar. KP |
Metastatic Adenocarcinoma of the Prostate Masquerading as a Splenic Flexure Colonic Polyp: A Diagnostic Conundrum
Abstract Metastasis of prostate cancer to the gastrointestinal tract is infrequently described in the literature, with only a limited number of cases reporting metastasis to the rectum. We present a rare case of a 74-year-old man initially presenting with symptomatic anemia and weight loss. A colonoscopy revealed a sessile polyp..
| Published: | 19/07/2024 |
| Authors: | Shkoukani. ZW, Chamsin A, Abdulmajed. MI |
GIBPS technique-a novel sequential technique of performing shoulder corticosteroid injections.
Abstract: The introduction of the xxxxxxxx (GIBPS) technique represents a patient-centric novel and innovative method of ultrasound guided corticosteroid injection targeting the Glenohumeral joint (GHJ) and the Subacromial-Subdeltoid (SASD) bursa in a sequential manner, in the same setting. By integrating the two different sites of injection into a single technique,..
| Published: | 17/07/2024 |
| Authors: | Iyengar. KP |
Evaluating acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23)
Abstract Performance within acute medicine services is impacted by ongoing pressures on acute care services. Data from the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23), was used to assess performance of acute medicine services compared to key clinical quality indicators, comparing performance by initial assessment location. Data was analysed for 8213..
| Published: | 15/07/2024 |
| Authors: | Varia. R |
Global prevalence and correlates of mpox vaccine acceptance and uptake: a systematic review and meta-analysis.
Abstract Background: Vaccination has been recommended as one of the most potent ways of controlling the mpox (formerly, monkeypox) outbreak, particularly among high-risk groups. Here, we evaluated the prevalence of mpox vaccine acceptance and uptake globally. Methods: We searched multiple databases for peer-reviewed studies published in English from May 2022 to 25..
| Published: | 09/07/2024 |
| Authors: | Tijjani. B |
The role of multimodality imaging in the selection and management of patients treated with cytoreductive surgery and HIPEC.
Abstract: Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) is the mainstay of potentially curative surgical treatment for malignancies that have spread to peritoneal surfaces. This surgical procedure is however associated with high morbidity and appropriate patient selection and planning is therefore essential. Available multimodality imaging techniques include..
| Published: | 08/07/2024 |
| Authors: | John. V, Kim. K |
Impact of SARS-CoV-2 on male reproductive system and fertility.
Abstract Objective: Evaluate the impact of SARS-CoV-2 on male fertility. Design: Comprehensive analysis of studies exploring virus presence, inflammation, and altered semen parameters. Result(s): While some studies report absence of SARS-CoV-2 in semen, others highlight testicular injury, inflammation, and potential viral orchitis. Scrotal discomfort and altered sperm parameters indicate..
| Published: | 06/07/2024 |
| Authors: | Sajjad. S G |
Letter to editor re: (2024) Smoking is not associated with wound complications in augmented urethroplasty: a NSQIP analysis. Int Urol Nephrol. https://doi.org/10.1007/s11255-024-04085-7 by Cahill et al.
No abstract available. Day, A.W.; Floyd, M.S. et al. (2024). Letter to editor re: (2024) Smoking is not associated with wound complications in augmented urethroplasty: a NSQIP analysis. Int Urol Nephrol. https://doi.org/10.1007/s11255-024-04085-7 by Cahill et al. International Urology and Nephrology. [Online]. Available at: https://..
| Published: | 05/07/2024 |
| Authors: | Day. AW, Omar. AM, Floyd Jr. MS |
Transition between paediatric and adult diabetes healthcare services: An online global survey of healthcare professionals’ experiences and perceptions
Introduction Youth with diabetes should transition from paediatric to adult diabetes services in a deliberate, organized and cooperative way. We sought to identify healthcare professionals’ (HCPs) experiences and perceptions around transition readiness planning, policies and procedures, and the actual transfer to adult services. Methods Data were collected via an online..
| Published: | 04/07/2024 |
| Authors: | Ng. SM |
Sciatic Nerve Entrapment from Cerclage Wiring in Intramedullary Nail Fixation
Cerclage wiring may be used to optimize the stability of intramedullary nail or plate fixations in comminuted proximal femoral fractures, periprosthetic fractures, and other selected cases. In this article, we presented a novel case of iatrogenic sciatic nerve entrapment from cerclage wiring used to supplement intramedullary nail fixation. We also..
| Published: | 04/07/2024 |
| Authors: | Iyengar. KP |
247 Prophylactic Use of 3D Intraperitoneal Mesh in the Prevention of Parastomal Hernia in Permanent Colostomies After Rectal Cancer Resection
Background Parastomal hernia (PSH) is the most common complication of stomas associated with significant morbidity. Prophylactic mesh in preventing PSH is less well studied, and evidence is conflicting. We compare PSH rates in patients in whom 3D intraperitoneal mesh was and was not used prophylactically in a cohort of rectal..
| Published: | 03/07/2024 |
| Authors: | Ngo V, Rajendiran A, Ferrie S, Chadwick M |
Natriuretic Peptides to Classify Risk of Atrial Fibrillation Detection After Stroke: Analysis of the BIOSIGNAL and PRECISE Cohort Studies.
Background and Objectives Prolonged cardiac monitoring (PCM) increases atrial fibrillation (AF) detection after ischemic stroke, but access is limited, and it is burdensome for patients. Our objective was to assess whether midregional proatrial natriuretic peptide (MR-proANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) could classify people who are unlikely to have..
| Published: | 01/07/2024 |
| Authors: | Abdul-Rahim. A |
Luschka’s tubercle and snapping scapula syndrome: an anatomical and clinical discourse.
Snapping Scapula Syndrome (SSS) is an uncommon orthopaedic disorder characterised by audible crepitations and disrupted shoulder kinematics due to pathological interactions within the tissues between the scapula and ribcage. One rare cause of SSS is the presence of Luschka’s Tubercle, a bony prominence located on the costal surface of..
| Published: | 01/07/2024 |
| Authors: | Iyengar. KP |
Use of the Therapy Outcome Measure in community intermediate care: results of a service evaluation
Background/Aims Outcome measures are essential in clinical practice to demonstrate patient improvement and secure funding for services. The purpose of this service evaluation was to explore levels of patient improvement as measured by the Therapy Outcome Measure in a community intermediate care team. Methods A total of 232 patients who..
| Published: | 01/07/2024 |
| Authors: | Cross. A |
P29 Utilising cytosponge to reduce the post-covid gastroscopy backlog
Introduction The post-Covid-19 era brought about significant challenges in relation to the waiting times for endoscopy procedures. Resources were re-directed to the front-line resulting in a temporary cessation of non-urgent endoscopy services. Delays to endoscopy provision can have a devastating effect on the prognosis of oesophagogastric cancers. Innovative test such..
| Published: | 01/07/2024 |
| Authors: | Norris. G, Brunskill. L, Dickinson. K, McClements. D |
Spontaneous pneumomediastinum and surgical emphysema presenting as rhinolalia following ecstasy ingestion: a case report.
Abstract: Background: We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use. Case presentation: This case presents a 17-year-old white male experiencing rhinolalia following ecstasy ingestion at a rave. Subsequent chest X-ray revealed extensive surgical emphysema, along with a..
| Published: | 28/06/2024 |
| Authors: | Prada. C, Ross. M |
BT16 BT17 Dermatology advice and guidance: a service evaluation.
Abstract: We wish to present a service evaluation undertaken of the regional dermatology advice and guidance (A&G) service provided within our locale. As part of the national Elective Care Transformation Programme, A&G services were created, primarily as a consultant dermatologist-led service prior to referral. This was designed to..
| Published: | 28/06/2024 |
| Authors: | Hickey. S, Ellison. J |
A global survey to assess practice of laboratory testing in alopecia areata by hair specialists.
Abstract: Alopecia areata (AA) is a common, immune-mediated, nonscarring alopecia associated with increased risk of other autoimmune conditions such as thyroid disease. Risk of cardiovascular disease in AA is contentious, but is relevant in the era of Janus kinase (JAK) inhibitor therapy. Rarely, nutritional deficiency and infective disorders, such as..
| Published: | 28/06/2024 |
| Authors: | Meah. N |
P010 Eosinophilic dermatosis of haematological malignancy mimicking insect bite-like reaction in a patient with chronic lymphocytic leukaemia: a case report..
Abstract: We present a case of a patient presenting with severe insect bite-like reactions in her skin with underlying chronic lymphocytic leukaemia (CLL). A 71-year-old woman was diagnosed with CLL in 2017 after presenting with a low-level lymphocytosis. She has never required treatment for CLL and remains under active observation in..
| Published: | 28/06/2024 |
| Authors: | Nallathamby. K, Moss. K |
Imaging in shoulder arthroplasty: Current applications and future perspectives
Shoulder arthroplasty has become a standard surgical procedure for treating a variety of complex shoulder disorders, including those with degenerative and traumatic aetiologies. The ever-improving success rates of shoulder arthroplasty could be attributed to advancements in endoprosthesis design, improvements in the biomechanics of endoprosthetic components, and improvements in surgical techniques...
| Published: | 26/06/2024 |
| Authors: | Iyengar. KP |
Irreducible Complex Posterior Elbow Dislocation with Varus Posteromedial Rotary Instability – A Case Report
Introduction Elbow dislocations, particularly those associated with varus posteromedial rotary instability, are relatively uncommon. We present the case of a 25-year-old male initially managed nonoperatively for a posterior elbow dislocation, who subsequently experienced irreducible re-dislocation with characteristic fractures of the anteromedial facet and tip of the coronoid, indicative of varus..
| Published: | 24/06/2024 |
| Authors: | Rana. A |
Reperfusion therapies in patients with acute ischaemic stroke and atrial fibrillation: data on safety and effectiveness from a multi-centre cohort study
Conclusion: Patients with AF and AIS treated with reperfusion therapies had a significantly higher rate of good functional outcome and lower rates of mortality compared to those patients with AF and AIS who had undergone conservative treatment. Cancelloni, V; Abdul-Rahim, A. H; Et al. (2024). Reperfusion therapies in patients with acute..
| Published: | 22/06/2024 |
| Authors: | Abdul-Rahim. A |
Telehealth Versus In-person Musculoskeletal Physiotherapy Assessment: A Comparison of Specific Outcomes
Aim To test the hypothesis that MSK physiotherapy assessment through telehealth results in different outcomes relative to in-person assessment. Methods *This is a retrospective evaluation of two large sample groups of patients assessed within an NHS MSK service by senior and advanced practitioner physiotherapists.* To represent in-person physiotherapy assessments, 3 months..
| Published: | 21/06/2024 |
| Authors: | Hallinan. D |
Development and external validation of the ‘Global Surgical-Site Infection’ (GloSSI) predictive model in adult patients undergoing gastrointestinal surgery
Background Identification of patients at high risk of surgical-site infections may allow surgeons to minimize associated morbidity. However, there are significant concerns regarding the methodological quality and transportability of models previously developed. The aim of this study was to develop a novel score to predict 30-day surgical-site infection risk after..
| Published: | 21/06/2024 |
| Authors: | Kaul. A, Blacker. S, Parakh. J |
Authors’ Response: The Accuracy of the Multimodal Large Language Model GPT-4 on Sample Questions From the Interventional Radiology Board Examination
Ariyaratne, S; Iyengar, KP et al. (2024). Authors’ Response: The Accuracy of the Multimodal Large Language Model GPT-4 on Sample Questions From the Interventional Radiology Board Examination. Academic Radiology. epub 20 June. [Online]. Available at: https://doi.org/10.1016/j.acra.2024.05.025 [Accessed 27 June 2024]
| Published: | 20/06/2024 |
| Authors: | Iyengar. KP |
A Systematic Review to Summarise and Appraise the Reporting of Surgical Innovation: a Case Study in Robotic Roux-en-Y Gastric Bypass
Abstract Robotic Roux-en-Y gastric bypass (RRYGB) is an innovative alternative to traditional laparoscopic approaches. Literature has been published investigating its safety/efficacy; however, the quality of reporting is uncertain. This systematic review used the Idea, Development, Exploration, Assessment and Long-term follow-up (IDEAL) framework to assess the reporting quality of available..
| Published: | 19/06/2024 |
| Authors: | Purves. R |
Advancing orthopaedic trauma care through WhatsApp: An analysis of clinical and non-clinical applications, challenges, and future directions.
Abstract: The integration of WhatsApp, a widely-used instant messaging application (IMA), into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years. This paper explores the multifaceted role of WhatsApp in orthopaedics, focusing on its clinical and non-clinical applications, advantages, disadvantages, and future prospects...
| Published: | 18/06/2024 |
| Authors: | Iyengar. KP |
Major burns in adults: a practice review
Abstract There are approximately 180 000 deaths per year from thermal burn injury worldwide. Most burn injuries can be treated in local hospitals but 6.5% require specialist burn care. The initial ED assessment, resuscitation and critical care of the severely burned patient present significant challenges and require a multidisciplinary approach. The management of..
| Published: | 17/06/2024 |
| Authors: | Gwyn-Jones. A, Afolabi. T, Bonney. S, Gurusinghe. D, Tridente. A, Nee. P |
Open reduction of irreducible elbow dislocations due to varus posteromedial rotary instability may require addressing capsular interposition, ligament repair, and coronoid fixation for optimal outcome.
Abstract Introduction: Elbow dislocations, particularly those associated with varus posteromedial rotary instability, are relatively uncommon. We present the case of a 25-year-old male initially managed nonoperatively for a posterior elbow dislocation, who subsequently experienced irreducible re-dislocation with characteristic fractures of the anteromedial facet and tip of the coronoid, indicative of..
| Published: | 16/06/2024 |
| Authors: | Rana. A |
Systematic Review and Meta‐Analysis of Prehospital Machine Learning Scores as Screening Tools for Early Detection of Large Vessel Occlusion in Patients with Suspected Stroke
Background Enhanced detection of large vessel occlusion (LVO) through machine learning (ML) for acute ischemic stroke appears promising. This systematic review explored the capabilities of ML models compared with prehospital stroke scales for LVO prediction. Methods and Results Six bibliographic databases were searched from inception until October 10, 2023. Meta‐analyses pooled..
| Published: | 14/06/2024 |
| Authors: | Hill. AM |
ISPAD Annual Conference Highlights 2023
Ng, SM; Day, H; Hubbard, R; Alexopoulou, V et al. (2024). ISPAD Annual Conference Highlights 2023. Hormone Research in Paediatrics. Pub online 11 Jun. [Online]. Available at: https://doi.org/10.1159/000539749 [Accessed 31 October 2024].
| Published: | 11/06/2024 |
| Authors: | Ng. SM, Day. H, Hubbard. R, Alexopoulou. V |
AB1645-PARE Disease flares in patients with rheumatoid arthritis following covid-19 breakthrough infection: result from COVAD e-survey study
Abstract: Background: COVID-19 has been suggested as a possible trigger of disease flares in patients with rheumatoid arthritis (RA). However, factors associated with disease flares remain unknown. Objectives: This study aimed to identify factors associated with disease flares in patients with RA following COVID-19. Methods: We selected patients with RA..
| Published: | 10/06/2024 |
| Authors: | Nune. A |
POS1316 The impact of mental health comorbidities on quality of life in patients with idiopathic inflammatory myopathies: a COVAD-2 study
Abstract: Background: Idiopathic inflammatory myopathies (IIM) encompass a group of disorders characterized by muscle inflammation, weakness, and varying levels of systemic involvement. These conditions profoundly impact patients’ quality of life (QoL) due to their chronic nature, physical impairments, and accompanying mental health challenges. Recent literature has highlighted the prevalence of..
| Published: | 10/06/2024 |
| Authors: | Nune. A |
Supraspinous Fossa: Anatomy and Pathology
Abstract Supraspinous fossa is an important location in the periscapular region, which houses important structures such as the supraspinatus muscle and the suprascapular nerve. The supraspinous fossa can be affected by pathologies involving its contents (supraspinatus muscle and suprascapular nerve), osseous boundary (scapular body, distal clavicle, and spinous process), or..
| Published: | 06/06/2024 |
| Authors: | Iyengar. KP |
Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients
Background Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase-signal transducer and activator of transcription (JAK–STAT) pathway is implicated in the pathogenesis of..
| Published: | 03/06/2024 |
| Authors: | Meah. N |
P228 Multicentre review of lung microbiome for patients with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor
Background Respiratory tract infections are a leading cause of morbidity in children with cystic fibrosis(CF). The introduction of the highly effective modulator elexacaftor-tezacaftor-ivacaftor (ETI) has been shown to be clinically effective in terms of improved lung function, decreased symptoms and improved CFTR function. The results on the microbiome are..
| Published: | 01/06/2024 |
| Authors: | Rajkumar. D, Ramachandran. S, Redfern. S, Kandasamy. S, Chilukuri. L, Prasad. A |
31 North west leadership schools: inspiring and developing the healthcare leaders of the future
Introduction The North West Leadership Schools (NWLS) are an initiative of NHS England North West (NHS England NW). Each year we run a series of free, virtual evening events to inspire and develop leadership skills in medical and dental trainees of all specialties and grades across the North West region...
| Published: | 31/05/2024 |
| Authors: | Brady. A |
Working on the Clinical Frontline During the COVID-19 Pandemic: The Perceptions and Experiences of Hospital Chaplains
Abstract: Hospital chaplaincy teams played a vital role during the COVID-19 pandemic, but the full depth of their experiences and personal impacts is not fully known. This UK study was advertised using social media platforms, local press outlets and chaplaincy professional bodies. An electronic survey was completed by 63 hospital chaplains,..
| Published: | 30/05/2024 |
| Authors: | Abrams. M |
Shining a Light in COVID-19 Darkness: The Impact of Hospital Chaplaincy Teams on Healthcare Professionals.
Abstract Introduction: The World Health Organization officially declared COVID-19 a global pandemic in March 2020, resulting in travel restrictions, closure of non-essential shops and services, and the discontinuation of elective healthcare. The escalation of the pandemic impacted on hospital healthcare professionals, who experienced the deaths of colleagues and unprecedented changes in..
| Published: | 30/05/2024 |
| Authors: | Abrams. M |
Intra-articular steroids for the treatment of coxarthrosis; a retrospective cohort study comparing three contrast techniques.
Conclusion: Air arthrogram is an effective method of confirming injection placement in hip IAS for coxarthrosis and the use of a contrast agent (e.g., Iohexol) may not be required. Non-contrast techniques may produce longer duration of symptomatic relief in non-smokers and in older patients. Kwaees, T A; Barter, R;..
| Published: | 29/05/2024 |
| Authors: | Kwaees. T A, Barter. R, Venugopal. V, Joseph. A D, Pydisetty. R |
A rare cardiac mass
A new systolic heart murmur was identified in a woman in her mid-60s during a preoperative assessment (fig 1). She had completed a course of radiotherapy and chemotherapy for rectal cancer (stage T4b N1b M0), followed by uncomplicated elective robotic low anterior resection and laparoscopic ileostomy. Ali, H;..
| Published: | 23/05/2024 |
| Authors: | Ali. H, Gasimmalla. O |
Evaluation of the impact of a nephrologist led acute kidney Injury clinic in a large district general hospital.
Abstract Background and Aims: Acute kidney injury (AKI) has a significant impact on inpatient hospital admissions costing the NHS in the UK an estimated £1bn. Hospitalisation complicated by AKI results in increased length of stay and mortality and up to a fifth of discharged patients are readmitted to hospital within 30..
| Published: | 23/05/2024 |
| Authors: | Khandaker. M, Rahman. S |
Could ChatGPT Pass the UK Radiology Fellowship Examinations?.
Abstract: Rationale and Objectives: Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI) tool which utilises machine learning to generate original text resembling human language. AI models have recently demonstrated remarkable ability at analysing and solving problems, including passing professional examinations. We investigate the performance of ChatGPT on some..
| Published: | 22/05/2024 |
| Authors: | Iyengar. KP |
Cubital tunnel syndrome: anatomy, pathology, and imaging.
Abstract: Cubital tunnel syndrome (CuTS) is the second most common peripheral neuropathy in the upper limb. It occurs due to ulnar nerve compression within the fibro-osseous cubital tunnel at the elbow joint. Although CuTS is typically diagnosed clinically and with electrodiagnostic studies, the importance of imaging in evaluating the condition..
| Published: | 18/05/2024 |
| Authors: | Iyengar. KP |
Quantifying postoperative recovery using wearable activity monitors following abdominal wall surgery: The AbTech trial
Purpose This work aimed to investigate the validity of wearable activity monitors (WAMs) as an objective tool to measure the return toward normal functional mobility following abdominal wall surgery. This was achieved by quantifying and comparing pre- and postoperative physical activity (PA). Methods A multicenter, prospective, observational cohort study was..
| Published: | 17/05/2024 |
| Authors: | Pritchard-Jones. R |
Guidelines on the diagnosis and management of patent foramen ovale (PFO) after stroke
Abstract Patent foramen ovale (PFO) is frequently identified in young patients with cryptogenic ischaemic stroke. Potential stroke mechanisms include paradoxical embolism from a venous clot which traverses the PFO, in situ clot formation within the PFO, and atrial arrhythmias due to electrical signalling disruption. The purpose of this guideline is..
| Published: | 16/05/2024 |
| Authors: | Abdul-Rahim. A |
An annual review of key advances in evidence-based plastic surgery, A synopsis from the leads of the BAPRAS Research & Innovation, Education, and Trainees Committees
Abstract: Understanding and practising evidence-based medicine is crucial in delivering optimal patient care in Plastic Surgery. It can be incredibly challenging for Plastic Surgeons with a demanding clinical workload to keep up to date with research and regulatory advances within the field. This is particularly difficult given the rate of..
| Published: | 16/05/2024 |
| Authors: | Pritchard-Jones. R |
Guidelines on the diagnosis and management of patent foramen ovale (PFO) after stroke.
Conclusion: In patients with PFO-related stroke aged 18–60 years, PFO closure plus time-limited antiplatelet therapy is the recommended strategy for secondary prevention of recurrent stroke, with a low rate of complications. Further RCTs are required to test whether and in which patients over 60 years of age with stroke and PFO should..
| Published: | 16/05/2024 |
| Authors: | Abdul-Rahim. A |
European Stroke Organisation (ESO) Guidelines on the diagnosis and management of patent foramen ovale (PFO) after stroke
Patent foramen ovale (PFO) is frequently identified in young patients with cryptogenic ischaemic stroke. Potential stroke mechanisms include paradoxical embolism from a venous clot which traverses the PFO, in situ clot formation within the PFO, and atrial arrhythmias due to electrical signalling disruption. The purpose of this guideline is to..
| Published: | 16/05/2024 |
| Authors: | Abdul-Rahim. A |
Assessment of Needlestick and Sharps Injuries (NSSIs) Amongst Orthopaedic Surgeons in Clinical Practice: A Pan-India Cross-Sectional Study
Introduction Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV)..
| Published: | 16/05/2024 |
| Authors: | Iyengar. KP |
Beyond Face Arm and Speech Test (Beyond FAST), a predicted probability-based stroke identification scale
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/ Background and aims Despite its widespread usage in stroke identification, the FAST test exhibits modest accuracy. This study assesses the effectiveness of integrating additional clinical parameters to distinguish strokes and stroke mimics. Methods..
| Published: | 15/05/2024 |
| Authors: | Abdul-Rahim. A, Maducolil. JE, Hume. C, Iijima. A |
Early statin use for secondary prevention in patients with atrial fibrillation and recent ischaemic stroke
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/ Background and aims We investigated the benefits of early statin use for secondary prevention of ischaemic stroke (IS) in patients with AF. Methods We conducted a propensity score matched analysis using data within..
| Published: | 15/05/2024 |
| Authors: | Hill. AM, Irving G, Abdul-Rahim. A |
Left atrial appendage occlusion versus direct oral anticoagulants in the prevention of ischaemic stroke in patients with atrial fibrillation
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/ Background and aims Existing randomised controlled trials assessing the safety and efficacy of left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) were of relatively small sample size, or included patients who could..
| Published: | 15/05/2024 |
| Authors: | Irving G, Hill. AM, Abdul-Rahim. A, Elsheikh. S |
Risk of tumour seeding in patients with liver lesions undergoing biopsy with or without concurrent ablation: meta-analysis
Abstract: Liver biopsies are fundamental for research purposes to plan personalized therapies1. Needle tract seeding is often raised as a concern during liver biopsies2. It occurs during withdrawal of a needle, where malignant cells get displaced along the needle tract. The risk of seeding associated with liver biopsies remains uncertain...
| Published: | 15/05/2024 |
| Authors: | Maducolil. JE |
Are relative contraindications for unicompartmental knee replacements in medial compartment osteoarthritis really contraindications?.
Conclusion: BMI maybe an important patient factor in predicting post operative OKS at 2–5 years. This is beneficial to surgeons for patient selection in medial UKR. Patellofemoral wear doesn't appear to impact on post operative functional outcomes. This supports the theory that patient who suffer from patellofemoral wear, as well as..
| Published: | 13/05/2024 |
| Authors: | Myatt. D, Ankers. T |
Bridging the digital divide: The UNBIASED national study to unravel the impact of ethnicity and deprivation on diabetes technology disparities in the United Kingdom
Ng, SZ et al. (2024). Bridging the digital divide: The UNBIASED national study to unravel the impact of ethnicity and deprivation on diabetes technology disparities in the United Kingdom. Diabetic Medicine. epub 8 May. [Online]. Available at: https://doi.org/10.1111/dme.15346 [Accessed 17 May 2024]
| Published: | 08/05/2024 |
| Authors: | Ng. SM |
Letter to the editor RE: Management of Anterior Urethral Stricture: A survey of Contemporary Practice of Iranian Urologists
Abstract We read with interest the recent paper by Hosseini et al detailing the management practice of Iranian Urologists towards the management of anterior urethral stricture disease. Please find our letter to the editor regarding this. Harrison, NL; Omar, AM; Floyd Jr, MS. (2024). Letter to the editor RE: Management of..
| Published: | 08/05/2024 |
| Authors: | Harrison. NL, Omar. AM, Floyd Jr. MS |
Long-term assessment of the NHS hybrid closed-loop real-world study on glycaemic outcomes...
Abstract Hybrid closed-loop (HCL) systems seamlessly interface continuous glucose monitoring (CGM) with insulin pumps, employing specialised algorithms and user-initiated automated insulin delivery. This study aimed to assess the efficacy of HCLs at 12 months post-initiation on glycated haemoglobin (HbA1c), time-in-range (TIR), hypoglycaemia frequency, and quality of life measures among children..
| Published: | 03/05/2024 |
| Authors: | Ng. SM |
Predictors of post-operative complications following immediate implant-based breast reconstruction - a single centre experience
Introduction Post-operative complications are common in breast cancer patients who underwent immediate implant-based breast reconstruction following risk reduction mastectomy. This study aimed to determine patient and intraoperative factors that increased risk of post-operative complications. Method(s) 161 patients underwent immediate implant-based breast reconstruction at North Manchester General Hospital Breast Surgery Unit..
| Published: | 01/05/2024 |
| Authors: | Shahrokhi. N |
The impact of body mass index on pathological complete response following neoadjuvant chemotherapy in operable breast cancer
Introduction Breast cancer being a global health concern, with an incidence and mortality rate of 11.7% and 6.9% respectively. Pathological complete response (PCR) post-neoadjuvant chemotherapy (NACT) is associated with improved survival outcomes. 63.5% of adults in the United Kingdom have an elevated body mass index (BMI). Objective(s) We aimed to compare pathological..
| Published: | 01/05/2024 |
| Authors: | Jaiswal. R, Blower. E, Innes. H, Sripadam. R, Yiannoullou. P, Chagla. L |
The association of breast surgery ASPIRE - Breast pain pathway rapid evaluation project: Study update
Background Breast pain accounts for 20-40% of new referrals to breast units with multiple pathways for patient management. This prospective multi-centre service evaluation, supported by the ABS, aims to assess the safety and patient satisfaction of different Breast Pain-only Pathways (BPPs). Method(s) All UK breast units were invited to..
| Published: | 01/05/2024 |
| Authors: | Chagla. L |
An evaluation of a simulation-based training programme to support final-year medical students in their preparation for foundation-year prescribing practice
Introduction Prescribing is a high-risk and error prone activity with doctors reporting a lack of preparedness for prescribing practice,[1] with potential for simulation-based training (SBT) to enhance prescribing skill development.[2] To support preparation for prescribing practice, a team-based SBT programme was developed for final-year medical students. Aim To determine the..
| Published: | 29/04/2024 |
| Authors: | Lloyd M, Lea N, Zaman S, Bennett N |
A mixed methods evaluation of the appropriateness of hospital on-call pharmacy service use
Introduction Most English hospitals provide out-of-hours pharmacy support via an ‘on-call pharmacist’.[1] There is scant published literature characterising these services. Prior research[2] suggests a significant number of calls may be inappropriate requests for non-urgent medication or information readily available elsewhere. Delaying while the on-call pharmacist is unnecessarily contacted may avoidably..
| Published: | 29/04/2024 |
| Authors: | Brush. A, Lloyd M |
Clarity in the law is needed to stop physical punishment of children
Removing the “reasonable punishment” defence and prohibiting corporal punishment of children can help to reduce family violence, says Andrew Rowland.
| Published: | 25/04/2024 |
| Authors: | Rowland. A |
P046 The influence of deprivation in the outcomes of Psoriatic Arthritis within the UK - utilising Outcomes of Treatment in Psoriatic Arthritis Study Syndicate data
Background/Aims Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy, which affects approximately 30% of patients with psoriasis and is associated with a high degree of morbidity. The introduction of biological disease-modifying antirheumatic drugs (bDMARDs) revolutionised treatment strategies for patients with PsA, however response is not universal. Deprivation and its associated..
| Published: | 24/04/2024 |
| Authors: | Graham D, Abernethy R, Clewes A, Dawson J |
Medical photography and the reconstructive urologist: A 6-month prospective study
Abstract Medical photography has multiple, important roles. The education of medical practitioners, documentation of disease, response to treatment, research, publication, intraoperative recording and trauma documentation all rely on medical photography. Additionally, there are important medicolegal implications pertaining to medical photography across many medical disciplines. Other than specific image use to..
| Published: | 23/04/2024 |
| Authors: | Pina. IM, Omar. AM, Floyd Jr. MS |
The need to educate on effective reflective practice for international medical graduates
Khan, AA; Patel, P; Rachid, A. (2024). The need to educate on effective reflective practice for international medical graduates. Medical Teacher. epub 22 Apr. [Online]. Available at: https://doi.org/10.1080/0142159X.2024.2344620 [Accessed 3 May 2024]
| Published: | 22/04/2024 |
| Authors: | Patel. P |
Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach
Abstract This study hypothesizes that depression mediates the association between exposure to stigma and medication non-adherence in people living with HIV (PLHIV). We recruited 372 PLHIV from the Stigma, health-related Quality of life, antiretroviral Adherence, and Depression among people living with HIV (SQuAD-HIV) project, a multicenter cross-sectional study conducted between October 2021..
| Published: | 21/04/2024 |
| Authors: | Makama. B T |
The diagnosis and management of systemic autoimmune rheumatic disease-related interstitial lung disease: British Society for Rheumatology guideline scope.
Abstract: Interstitial lung disease (ILD) is a significant complication of many systemic autoimmune rheumatic diseases (SARDs), although the clinical presentation, severity and outlook may vary widely between individuals. Despite the prevalence, there are no specific guidelines addressing the issue of screening, diagnosis and management of ILD across this diverse group...
| Published: | 18/04/2024 |
| Authors: | Dawson. J |
Endobronchial Ultrasound-guided Cryobiopsy of Pulmonary Artery Intimal Sarcoma
Link: https://www.atsjournals.org/doi/abs/10.1164/rccm.202309-1633IM Petrarulo, S; Paul, S; et al. (2024). Endobronchial Ultrasound-guided Cryobiopsy of Pulmonary Artery Intimal Sarcoma. American journal of respiratory and critical care medicine. [Online]. Available at: http://dx.doi.org/10.1164/rccm.202309-1633IM [Accessed 25 April 2024].
| Published: | 16/04/2024 |
| Authors: | Paul. S. |
Effectiveness of AI-powered Chatbots in responding to orthopaedic postgraduate exam questions—an observational study
Abstract: Purpose This study analyses the performance and proficiency of the three Artificial Intelligence (AI) generative chatbots (ChatGPT-3.5, ChatGPT-4.0, Bard Google AI®) and in answering the Multiple Choice Questions (MCQs) of postgraduate (PG) level orthopaedic qualifying examinations. Methods A series of 120 mock Single Best Answer’ (SBA) MCQs with four possible..
| Published: | 15/04/2024 |
| Authors: | Iyengar. KP |
Letter to editor re: Chen et al. (2024) Management of spinal cord injury patients with neurogenic lower urinary tract dysfunction...
Day, AW; Ravichandran, S; Khadr, RN; Floyd Jr, MS. (2024). Letter to editor re: Chen et al. (2024) Management of spinal cord injury patients with neurogenic lower urinary tract dysfunction using minimally invasive and surgical therapies in Taiwan. Int Urol Nephrol 56:1205–1216. International Urology and Nephrology. epub 13 Apr. [Online]. Available at: https://link...
| Published: | 13/04/2024 |
| Authors: | Day. AW, Ravichandran. S, Khadr. RN, Floyd Jr. MS |
Radiological angle assessment of Haglund’s deformity: validation on Magnetic Resonance Imaging
Abstract Purpose Haglund’s deformity, an abnormality at the postero-superior corner of the calcaneus is a common cause of posterior heel pain. To date numerous measurements of radiological angles related to the calcaneus have been proposed to differentiate between symptomatic and asymptomatic patients with the deformity. Traditionally, these measurements have..
| Published: | 12/04/2024 |
| Authors: | Iyengar. KP, Budair. B |
Medication-related osteonecrosis of the jaw: Shortfalls in UK-based guidance for management of established cases
Letter to the Editor. Dawar, Heather. (2024). Medication-related osteonecrosis of the jaw: Shortfalls in UK-based guidance for management of established cases. Oral Surgery. 17(4), p.393. [Online]. Available at: https://doi.org/10.1111/ors.12888 [Accessed 11 October 2024].
| Published: | 09/04/2024 |
| Authors: | Dawar. H |
Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease
Abstract One in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (COVID), yet disease phenotypes and mechanisms are poorly understood1. Here we profiled 368 plasma proteins in 657 participants ≥3 months following hospitalization. Of these, 426 had at least one long COVID symptom and 233 had fully recovered...
| Published: | 08/04/2024 |
| Authors: | Tridente. A |
Low-dose oral minoxidil improves hair length and global hair density in short anagen syndrome.
https://www.jaad.org/article/S0190-9622(24)00567-X/abstract Moussa, A; Meah, N; Et al. (2024). Low-dose oral minoxidil improves hair length and global hair density in short anagen syndrome. Journal of the American Academy of Dermatology.[Online]. Available at: https://doi.org/10.1016/j.jaad.2024.03.040 [Accessed 25 April 2024].
| Published: | 06/04/2024 |
| Authors: | Meah. N |
Right-sided meralgia paresthetica from lateral femoral cutaneous nerve neuroma
Abstract Meralgia Paresthetica (MP) causes outer thigh discomfort, numbness, and tingling. Compression or injury to the Lateral Femoral Cutaneous Nerve (LFCN), which gives sensory innervation to outer aspect of the thigh. It frequently gets impinged beneath the inguinal ligament resulting in in sensory impairment in the distribution of LFCN. Compression..
| Published: | 04/04/2024 |
| Authors: | Iyengar. KP |
Neurostimulation for treatment of post-stroke impairments
Abstract Neurostimulation, the use of electrical stimulation to modulate the activity of the nervous system, is now commonly used for the treatment of chronic pain, movement disorders and epilepsy. Many neurostimulation techniques have now shown promise for the treatment of physical impairments in people with stroke. In 2021, vagus nerve stimulation..
| Published: | 03/04/2024 |
| Authors: | Abdul-Rahim. A |
A practical evidence-based approach to management of type 2 diabetes in children and young people (CYP): UK consensus
Background Type 2 diabetes in young people is an aggressive disease with a greater risk of complications leading to increased morbidity and mortality during the most productive years of life. Prevalence in the UK and globally is rising yet experience in managing this condition is limited. There are no consensus guidelines..
| Published: | 02/04/2024 |
| Authors: | Ng. SM |
Cantilever Failure of Modular Uncemented Femoral Revision Stem in Patients with Poor Proximal Femoral Support; How to avoid it?
Objectives Revision hip arthroplasty is a major surgical challenge and is even more difficult in cases with a deficient proximal femur. Modular uncemented cone body revision femoral stems were introduced as a solution. They have the advantage of optimising joint kinematics by allowing the variable degrees of version, offset and..
| Published: | 02/04/2024 |
| Authors: | Mohan. R, Gudena. R |
Clinical features of type 1 diabetes in older adults and the impact of intermittently scanned continuous glucose monitoring: An Association of British Clinical Diabetologists (ABCD) study
Aims To evaluate the clinical features and impact of flash glucose monitoring in older adults with type 1 diabetes (T1D) across age groups defined as young-old, middle-old, and old-old. Materials and Methods Clinicians were invited to submit anonymized intermittently scanned continuous glucose monitoring (isCGM) user data to a secure web-based..
| Published: | 01/04/2024 |
| Authors: | Saunders. S |
Fludarabine, Cytarabine, Granulocyte Colony-Stimulating Factor, and Idarubicin With Gemtuzumab Ozogamicin Improves Event-Free Survival...
Purpose To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. Patients and Methods One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one..
| Published: | 01/04/2024 |
| Authors: | Gharib. M, Nicholson. T |
Multiple transfusion request audit.
Abstract: Introduction: This audit addresses practices concerning multiple blood transfusion requests of more than three units of blood, focusing on patients at Whiston Hospital, UK. Our findings highlight issues of inadequate documentation in blood transfusions, resource waste, and suggest potential process improvements. Motivation: Blood transfusions are common in hospitals but..
| Published: | 01/04/2024 |
| Authors: | Shahidianakbar. M, Bickley. E, Chahwale. P |
Waiting Times in Prostate Cancer Diagnosis and Treatment: A Ten-Year Experience in A Nigerian Teaching Hospital
Introduction Prostate cancer is still the leading male cancer and the leading cause of cancer deaths in Nigeria, and other low- and middle-income countries (LMIC) in Sub-Saharan Africa. Early diagnosis is essential to ensuring prompt treatment and reducing morbidity and mortality. Reducing the waiting times for diagnosis and treatment is..
| Published: | 29/03/2024 |
| Authors: | Okeke. CJ |
Response to: ChatGPT’s limited accuracy in generating anatomical images for medical
Ajmera, P; Iyengar, KP; et al. (2024). Response to: ChatGPT’s limited accuracy in generating anatomical images for medical. Skeletal Radiology. epub 20 Mar. [Online]. Available at: https://doi.org/10.1007/s00256-024-04656-w [Accessed 19 April 2024]
| Published: | 20/03/2024 |
| Authors: | Iyengar. KP |
Surgical Preparedness Index in Orthopaedics During the Coronavirus Disease 2019 (COVID-19) Pandemic.
Abstract The coronavirus disease 2019 (COVID-19) pandemic has increased the vulnerability of routine surgical procedures and elective surgery preparedness all over the world, with the suspension of most elective surgeries during the pandemic and the backlog of patients currently on waiting lists, especially in publicly funded healthcare systems. On average, at..
| Published: | 12/03/2024 |
| Authors: | Iyengar. KP |
Safe usage of Mini 'C'-arm in operating room environment: Implications for clinical practice
Background: Mini 'C'-arm machine is an advanced medical imaging device used primarily for intraoperative imaging during surgical, orthopaedic and emergency care procedures. Since the technology is based on ionising radiation, safe usage of Mini 'C'-arm machine is mandatory to protect patients and operating personnel. Objective: The main objective is to..
| Published: | 10/03/2024 |
| Authors: | Iyengar. KP |
Clinical and Immunological Profile of Systemic Lupus Erythematosus: A 5-year Retrospective Analysis from Northeast India
Objective Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with a wide range of clinical manifestations having considerable variation in clinical features that are influenced by ethnic, sociocultural, and geographical factors. This disease primarily affects young women aged between 18 and 35 years. The aim of this present study was to..
| Published: | 01/03/2024 |
| Authors: | Nune. A |
Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study
Objectives: We aimed to explore current practice and interregional differences in the treatment of idiopathic inflammatory myopathies (IIMs). We triangulated these observations considering countries' gross national income (GNI), disease subtypes, and symptoms using patient-reported information. Methods: A cross-sectional ancillary analysis of the 'COVID-19 vaccination in auto-immune disease' (COVAD) e-survey containing..
| Published: | 01/03/2024 |
| Authors: | Nune. A |
HIV-negative Kaposi sarcoma manifesting as foot lesion in a patient with diabetes mellitus: a case study
Abstract Kaposi’s sarcoma caused by Kaposi’s sarcoma-associated virus, is a rare malignancy in the general population with unique features. However, clinical presentation on the feet can mimic a diabetic foot ulcer. Here we describe the case of a 63-year-old male with type 2 diabetes, who presented with a lesion..
| Published: | 22/02/2024 |
| Authors: | Millette. D |
Introducing the pause after the death of a patient in critical care
Abstract This article describes the implementation of holding a minute’s silence when a patient dies in Southport Critical Care Unit. It describes the rationale for the initiative, as well as the words used, and the outcomes for staff and relatives of recently deceased patients when all are given an..
| Published: | 19/02/2024 |
| Authors: | Pinnington. M, Westwood. A |
Introducing the pause after the death of a patient in critical care
Abstract This article describes the implementation of holding a minute’s silence when a patient dies in Southport Critical Care Unit. It describes the rationale for the initiative, as well as the words used, and the outcomes for staff and relatives of recently deceased patients when all are given an..
| Published: | 19/02/2024 |
| Authors: | Pinnington. M, Westwood. A |
The clinical significance of indeterminate pulmonary nodules in patients with primary bone sarcoma: a systematic review
Objective To report the incidence of indeterminate pulmonary nodules (IPN) and the rate of progression of IPNs to metastasis in patients with primary bone cancers. We also aimed to evaluate clinical or radiological parameters that may identify IPNs more likely to progress to metastatic disease and their effect on overall..
| Published: | 12/02/2024 |
| Authors: | Iyengar. KP |
Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered
Background Breast pathology reporting, especially for breast cancer, has evolved through the years, from terse succinct diagnostic conclusions with scant histological details to the current comprehensive reporting guidelines issued by major pathology colleges and bodies, including the International Collaboration on Cancer Reporting. Pathology elements included in reporting guidelines are evidence..
| Published: | 08/02/2024 |
| Authors: | Chagla. L |
Exploring the potential of ChatGPT in the peer review process: An observational study
Background Peer review is the established method for evaluating the quality and validity of research manuscripts in scholarly publishing. However, scientific peer review faces challenges as the volume of submitted research has steadily increased in recent years. Time constraints and peer review quality assurance can place burdens on reviewers, potentially..
| Published: | 03/02/2024 |
| Authors: | Iyengar. KP |
Teleophthalmology at a primary and tertiary eye care network from India: environmental and economic impact
Objective: To evaluate the environmental and economic impact of teleophthalmological services provided by a primary (rural) and tertiary (urban) eyecare network in India. Methods: This prospective study utilised a random sampling method, and administered an environmental and economic impact assessment questionnaire. The study included 324 (primary: 173; tertiary: 151) patients who received teleconsultations..
| Published: | 22/01/2024 |
| Authors: | Ravindrane. R |
An evaluation of AI generated literature reviews in musculoskeletal radiology
Purpose The use of artificial intelligence (AI) tools to aid in summarizing information in medicine and research has recently garnered a huge amount of interest. While tools such as ChatGPT produce convincing and naturally sounding output, the answers are sometimes incorrect. Some of these drawbacks, it is hoped, can be..
| Published: | 12/01/2024 |
| Authors: | Iyengar. KP |
Value of chemical shift imaging in the evaluation of neural foramen stenosis
Background Chemical shift Magnetic Resonance Imaging (MRI) is often routinely acquired to assess a spectrum of spinal lesions due to its ability versatility to obtain rapid sequences at the expense of spatial resolution images. It is one of the quickest sequences to acquire at the expense of spatial resolution. Objective..
| Published: | 08/01/2024 |
| Authors: | Iyengar. KP |
Nutrition counselling and clinical outcomes in HIV: A systematic review and meta-analysis
Background: People living with the HIV (PLHIV) are at an increased risk of various diseases due to a weakened immune system, particularly if they are naïve or poorly adherent to antiretroviral therapy (ART). Nutrients play a critical role in improving immune health, especially among this population. We systematically reviewed..
| Published: | 29/12/2023 |
| Authors: | Oyadiran. OT |
Creating evidence-based engaging online learning resources in neuroanatomy
Online anatomical resources are rising in popularity since the COVID-19 pandemic, but the pedagogical principles and effectiveness of their use remain unclear. This article aims to demonstrate evidence-informed ways in which fellow educators can create engaging online learning resources in clinical neuroanatomy and compare the effectiveness of text-based and online..
| Published: | 17/12/2023 |
| Authors: | Woodward C |
Acute care models for older people living with frailty: a systematic review and taxonomy
Background The need to improve the acute care pathway to meet the care needs of older people living with frailty is a strategic priority for many healthcare systems. The optimal care model for this patient group is unclear. Methods A systematic review was conducted to derive a taxonomy of acute..
| Published: | 05/12/2023 |
| Authors: | Green. C |
Acute care models for older people living with frailty: a systematic review and taxonomy
Background The need to improve the acute care pathway to meet the care needs of older people living with frailty is a strategic priority for many healthcare systems. The optimal care model for this patient group is unclear. Methods A systematic review was conducted to derive a taxonomy of acute..
| Published: | 05/12/2023 |
| Authors: | Green. C |
Internet analytics of an innovative digital educational resource of type 1 diabetes HelloType1 in local languages
Background There is minimal data of health outcomes for Type 1 Diabetes (T1D) in Southeast Asia (SEA) where government funding of insulin and blood glucose monitoring either do not exist or is limited. The full impact of Covid-19 pandemic on the national economies of SEA remain unknown. In the midst..
| Published: | 16/11/2023 |
| Authors: | Ng. SM |
Health-related quality of life following TAVI or cardiac surgery in patients at intermediate and low risk: a systematic review and meta-analysis
Abstract Recent randomised trials have shown that clinical outcomes with transcatheter aortic valve implantation (TAVI) are non-inferior to surgical aortic valve replacement (SAVR) in patients with symptomatic aortic stenosis at intermediate to low risk. Health-related quality of life (HrQoL) outcomes in these patient groups remain uncertain. A systematic search of..
| Published: | 06/11/2023 |
| Authors: | Labib. A |
Author response to: Comment on: Will collaborative publishing with ChatGPT drive academic writing in the future?
Purpose The use of artificial intelligence (AI) tools to aid in summarizing information in medicine and research has recently garnered a huge amount of interest. While tools such as ChatGPT produce convincing and naturally sounding output, the answers are sometimes incorrect. Some of these drawbacks, it is hoped, can be..
| Published: | 13/09/2023 |
| Authors: | Iyengar. KP |
Author response to: Comment on: Will collaborative publishing with ChatGPT drive academic writing in the future?
Purpose The use of artificial intelligence (AI) tools to aid in summarizing information in medicine and research has recently garnered a huge amount of interest. While tools such as ChatGPT produce convincing and naturally sounding output, the answers are sometimes incorrect. Some of these drawbacks, it is hoped, can be..
| Published: | 13/09/2023 |
| Authors: | Iyengar. KP |
Authors’ response to the Letter to the Editor
Ariyaratne, S; Iyengar, KP; et al. (2023). Authors’ response to the Letter to the Editor. Skeletal Radiology. 52, p.2491. [Online]. Available at: https://doi.org/10.1007/s00256-023-04418-0 [Accessed 19 April 2024]
| Published: | 29/07/2023 |
| Authors: | Iyengar. KP |
Authors’ response to the Letter to the Editor
Ariyaratne, S; Iyengar, KP; et al. (2023). Authors’ response to the Letter to the Editor. Skeletal Radiology. 52, p.2491. [Online]. Available at: https://doi.org/10.1007/s00256-023-04418-0 [Accessed 19 April 2024]
| Published: | 29/07/2023 |
| Authors: | Iyengar. KP |
Association between mouth rinse use and changes in blood pressure: A systematic review and meta-analysis with trial sequential analysis
Introduction Previous randomized controlled trials have shown that the use of antiseptic mouth rinses not only eradicates oral bacteria but also disrupts their ability to convert nitrate to nitrite, which is the key molecule in regulating blood pressure (BP). Objective This study aimed to evaluate the association between the use..
| Published: | 24/07/2023 |
| Authors: | Nizam. MNM |
Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis
Ariyaratne, S; Iyengar, KP; et al. (2023). Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis. Skeletal Radiology. 52(.), p.2489. [Online]. Available at: https://doi.org/10.1007/s00256-023-04405-5 [Accessed 19 April 2024]
| Published: | 18/07/2023 |
| Authors: | Iyengar. KP |
Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis
Ariyaratne, S; Iyengar, KP; et al. (2023). Authors’ response to the Letter to the Editor: Re-evaluating the role of AI in scientific writing: a critical analysis. Skeletal Radiology. 52(.), p.2489. [Online]. Available at: https://doi.org/10.1007/s00256-023-04405-5 [Accessed 19 April 2024]
| Published: | 18/07/2023 |
| Authors: | Iyengar. KP |
What’s this?
Paracha, M; Cheema, K.T.; Et al. (2021). What’s this?. InnovAiT: Education and inspiration for general practice. 14(9), p.579. [Online]. Available at: doi.org/10.1177/17557380211001091 [Accessed 19 December 2024].
| Published: | 19/08/2021 |
| Authors: | Cheema. K.T |
St Helens and Knowsley Hospital Staff - Publications pre April 2024
Use of Botulinum Toxin Injections in the Treatment of Cold Intolerance
Abstract There is currently no consensus on the treatment of cold intolerance in extremities in post-trauma patients. We aim to present two cases where botulinum toxin type A injections were used to improve symptoms of cold intolerance. Botulinum toxin type A (Allergan) was injected into the area around the palmar..
| Published: | 28/03/2024 |
| Authors: | Sigamoney KV, Naji S, Hassan Z, McArthur P |
Diffuse Lichen Planopilaris Masquerading as Diffuse Alopecia Areata
Introduction Lichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia that represents a form of follicular lichen planus. Case Presentation We describe a case of coexisting diffuse LPP and female pattern hair loss masquerading as diffuse alopecia areata in a 32-year-old female. Discussion In complex cases such as this, dermoscopy-guided..
| Published: | 25/03/2024 |
| Authors: | Meah N |
Poster 80: Developing a hospital based transition MDT in an acute teaching hospital
Introduction Moving from Paediatrics to an Adult setting is difficult for any patient and family. Having been involved with a particular young adult, I was made very aware. Moving from paediatrics palliative care to adult care is huge. Being admitted to an adult ED or AMU will be traumatic and..
| Published: | 18/03/2024 |
| Authors: | Thompson A, Beck D |
Leg Lymphoedema After Inguinal and Ilio-Inguinal Lymphadenectomy for Melanoma: Results from a Prospective, Randomised Trial
Background The Evaluation of Groin Lymphadenectomy Extent for Melanoma (EAGLE FM) study sought to address the question of whether to perform inguinal (IL) or ilio-inguinal lymphadenectomy (I-IL) for patients with inguinal nodal metastatic melanoma who have no clinical or imaging evidence of pelvic disease. Primary outcome measure was disease-free survival..
| Published: | 17/03/2024 |
| Authors: | Pritchard-Jones R |
Evaluating the utility of quantitative pupillometry in a neuro-critical care setting for the monitoring of intracranial pressure
Introduction Assessment of the pupillary light reflex (PLR) is key in intensive care monitoring of neurosurgical patients, particularly for monitoring intracranial pressure (ICP). Quantitative pupillometry using a handheld pupillometer is a reliable method for PLR assessment. However, many variables are derived from such devices. We therefore aimed to assess the..
| Published: | 02/03/2024 |
| Authors: | Gul W |
Carbon dioxide laser for precise and bloodless contouring of soft tissue ahead of skin grafting–A case example of technique and benefits
Abstract Scarring is a dynamic development as a result of the wound healing process. Post-burn scars are often hypertrophic in nature and thus exhibit a much thicker and firmer scar, often leading to contractures. Various strategies have been implemented by burns surgeons to endeavour to mitigate and improve such symptoms..
| Published: | 22/02/2024 |
| Authors: | Moori P, Cappuyns L, Shokrollahi K |
How can technology be used to support communication in palliative care beyond the covid-19 pandemic
Background Developments in digital health have the potential to create new opportunities for healthcare professionals support delivery of palliative care. Globally, many palliative care professionals used digital health innovations to support communication with staff, patients and caregivers, during COVID-19 pandemic. However, there is limited data about the views of palliative..
| Published: | 14/02/2024 |
| Authors: | Thompson A |
Accuracy of PET/CT in the diagnosis of pelvic lymph node metastases in melanoma: A subgroup analysis of the evaluation of groin lymphadenectomy extent for metastatic melanoma (EAGLE-FM) trial
Background PET/CT is widely used in the staging of patients with melanoma groin lymph node (LN) metastases. This study aims to utilise prospectively collected data to determine the accuracy of this modality in the diagnosis of pelvic metastases in those patients with known inguinal LN involvement. Russell, M; Pritchard-Jones,..
| Published: | 14/02/2024 |
| Authors: | Pritchard-Jones R |
Albumin Levels and Risk of Early Cardiovascular Complications After Ischemic Stroke: A Propensity-Matched Analysis of a Global Federated Health Network
Background No studies have investigated the association between albumin levels and the risk of early cardiovascular complications in patients with ischemic stroke. Methods Retrospective analysis with a federated research network (TriNetX) based on electronic medical records (International Classification of Diseases-Tenth Revision-Clinical Modification and logical observation identifiers names and codes) mainly..
| Published: | 07/02/2024 |
| Authors: | Abdul-Rahim A |
The Alopecia Areata Severity and Morbidity Index (ASAMI) Study
Importance Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact. Objective To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI). Evidence..
| Published: | 07/02/2024 |
| Authors: | Meah N |
Mechanical circulatory support and its implications for anaesthesia and critical care
Abstract Mechanical circulatory support is an increasingly important strategy for the treatment of a subset of patients with acute heart failure. Use of extracorporeal circuits with pumps and oxygenators to augment cardiac function can be immediately lifesaving, whereas implantable therapies can allow patients, with advanced heart disease, to resume near..
| Published: | 04/02/2024 |
| Authors: | Downes C |
Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants in the Prevention of Ischaemic Stroke in Patients with Atrial Fibrillation
Introduction Existing randomised controlled trials assessing the safety and efficacy of left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) were of relatively small sample size, or included patients who could receive oral anticoagulant treatment after device implantation. We compared the outcomes of patients with newly diagnosed AF who received..
| Published: | 02/02/2024 |
| Authors: | Elsheikh S, Irving G, Hill AM, Abdul-Rahim A |
Exploration of the circulating human secretome through protein quantitative trait analysis...
Background Glucocorticoid monotherapy remains the principal treatment for giant cell arteritis (GCA), yet concurrent toxicity and adverse effects highlight the need for targeted therapies and improved risk stratification. Previous work suggests that evidence of genetic association can improve success rates in clinical trials and identify biomarkers for risk assessment, particularly..
| Published: | 21/01/2024 |
| Authors: | Dawson G |
Acceptability and feasibility of an app to prepare children for a blood test: An exploratory cohort study.
Conclusion: Xploro was reported as being a useful and engaging self-directed child-friendly information app for children having a planned blood test which helped children know what was going to happen and improved their experiences of having a blood test. Bray, L; May Ng, Sze; Pyke, L; Et al. (2024). Acceptability and..
| Published: | 05/01/2024 |
| Authors: | Sze May N G, Pyke L |
Ten-Year Analysis of Bacterial Colonisation and Outcomes of Major Burn Patients with a Focus on Pseudomonas aeruginosa
Abstract: A retrospective descriptive study included patients admitted with severe burns over the course of 10 years (2008–2018). Across all patients, there were 39 different species of bacteria, with 23 species being Gram-negative and 16 being Gram-positive bacteria, with also five different species of fungi cultured. Pseudomonas aeruginosa was the most commonly isolated organism, with 57.45%..
| Published: | 25/12/2023 |
| Authors: | Gomersall J, Mortimer K, Hassan D, Shokrollahi K |
Ibrutinib as first line therapy for mantle cell lymphoma: A multicentre, real-world UK study
Abstract During the Covid-19 pandemic, ibrutinib +/- rituximab was approved in England for initial treatment of mantle cell lymphoma (MCL) instead of immunochemotherapy. As limited data are available in this setting, we conducted an observational cohort study evaluating safety and efficacy. Adults receiving ibrutinib +/- rituximab for untreated MCL were..
| Published: | 21/12/2023 |
| Authors: | Nicholson T |
Changes in prescribing of psychotropic vs some physical health medication in primary care through the COVID-19 pandemic
Introduction The COVID-19 pandemic globally impacted healthcare provision. Prescribing changes in common medications can be used as a marker for new diagnoses. We describe how the prescribing of specific psychotropics was impacted by the pandemic. Methods Primary Care Prescribing data for different classes of drugs from March 2017 to February 2022 were..
| Published: | 21/12/2023 |
| Authors: | Narayanan RP |
The importance of creating a positive learning environment for student nurses
Thomas, V. (2023). The importance of creating a positive learning environment for student nurses: the value of good quality nurse education and the influence this has in future practice. Dermatological Nursing. 22(4), pp.29-31
| Published: | 19/12/2023 |
| Authors: | Thomas V |
Validation of the brain injury associated visual impairment - impact questionnaire (BIVI-IQ)
Purpose The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke..
| Published: | 19/12/2023 |
| Authors: | Hepworth LR, Liptrot M |
Discussion: Immediate Breast Reconstruction in Skin-Reducing Mastectomy with Prepectoral Polyurethane (PU) Implant Covered with an Autologous Dermo-Adipose Flap.
Taghizadeh, R. (2024). Discussion: Immediate Breast Reconstruction in Skin-Reducing Mastectomy with Prepectoral Polyurethane (PU) Implant Covered with an Autologous Dermo-Adipose Flap. Aesthetic Plastic Surgery. 48(15), pp.2839-2841. [Online]. Available at: http://dx.doi.org/10.1007/s00266-023-03760-x [Accessed 14 August 2024].
| Published: | 13/12/2023 |
| Authors: | Taghizadeh R |
Social determinants of health and clinical outcomes among patients with atrial fibrillation: evidence from a global federated health research network
Abstract: To investigate the relationship between SDoH and adverse events in a large multinational AF cohort. Design Retrospective study utilizing a global federated health research network (TriNetX). Methods Patients with AF were categorized as socially deprived defined according to ICD codes based on three SDoHs: (i) extreme poverty; (ii) unemployment;..
| Published: | 07/12/2023 |
| Authors: | Abdul-Rahim A |
Social determinants of health and clinical outcomes among patients with atrial fibrillation: evidence from a global federated health research network
Background Few studies have investigated the role of social determinants of health (SDoH) in patients with atrial fibrillation (AF). Aim To investigate the relationship between SDoH and adverse events in a large multinational AF cohort. Design Retrospective study utilizing a global federated health research network (TriNetX). Methods Patients with AF..
| Published: | 07/12/2023 |
| Authors: | Abdul-Rahim A |
Letter to the editor regarding are plastic surgery trainees accurate assessors of their own microsurgical skill?
Abstract We read with interest the article ‘Are Plastic Surgery Trainees Accurate Assessors of Their Own Microsurgical Skill?’1 as we are surgical trainees currently honing our microsurgical skills. Masterton, G; Evans, N. (2024). Letter to the editor regarding are plastic surgery trainees accurate assessors of their own microsurgical skill?. JPRAS Open. 39,..
| Published: | 06/12/2023 |
| Authors: | Masterton G, Evans N |
Analysis from the Society for Acute Medicine Benchmarking Audit 2022 and comparison with performance 2019 - 2021
Abstract Urgent and emergency care services face increasing pressure, impacting patient care. We evaluated the performance of acute medicine services, assessing clinical quality indicators for unplanned medical admissions to acute hospital services. 152 acute UK hospital services accepting unplanned admissions to acute and general internal medicine completed a day-of-care survey incorporating..
| Published: | 01/12/2023 |
| Authors: | Varia R |
Do we fully understand the impact of cosmetic surgery on our NHS and are we planning for the increased burden?
Abstract We read with interest the article “Managing complications following cosmetic surgery after the COVID pandemic: A study of a year at a NHS plastic surgery unit” 1 ; given we too work within a NHS plastic surgery unit. Masterton, G; Evans, N. (2024). Do we fully understand the impact of cosmetic surgery..
| Published: | 01/12/2023 |
| Authors: | Masterton G, Evans N |
Multi-nodal basin drainage in lower limb melanoma
Summary Lymph node status is an important factor that influences outcomes in melanoma. Whilst certain anatomical areas have multiple-nodal basin drainage, limb melanomas are thought to have more predictable lymphatic drainage patterns, with lower limb melanomas reliably draining to the corresponding ipsilateral inguinal lymph node basin with occasional popliteal drainage...
| Published: | 24/11/2023 |
| Authors: | Hague A, Platford B, Rehman S, Howes A, Brackley P |
Assessing and further developing age-appropriate information for young people about reporting suspected adverse drug reactions
Aims The Medicines and Healthcare products Regulatory Agency Yellow Card scheme (YCS) is the UK's system that collects spontaneous reports about suspected adverse drug reactions (ADRs). Reporting of suspected ADRs by young people (age
| Published: | 22/11/2023 |
| Authors: | Woodward C |
The impact of socioeconomic deprivation on the prevalence of gestational diabetes: An observational study
Background Approximately 3.5% of pregnancies in the United Kingdom are complicated by gestational diabetes mellitus (GDM). Risk factors for this mirror those contributing to type 2 diabetes (T2DM). Though socioeconomic status (SES) is presumed to contribute to GDM, evidence in the United Kingdom is limited. In this unique study, we explored..
| Published: | 14/11/2023 |
| Authors: | Kohli S |
Atrial Fibrillation and Stroke: State-of-the-art and future directions
Introduction Stroke is a major complication of atrial fibrillation (AF). About 25% of ischaemic stroke are cardio-embolic in origin; AF is the most common cause of those.1 Nonvalvular AF carries a 5-fold increased risk of stroke,2 while AF related to mitral stenosis increases the risk of stroke by 20-fold.3 The attributable..
| Published: | 31/10/2023 |
| Authors: | Elsheikh S, Hill AM, Irving G, Abdul-Rahim A |
Haemorrhagic cholecystitis in a young patient, complicated by gallbladder perforation and choledocholithiasis
Abstract Haemorrhagic cholecystitis is a rare condition associated with a high risk of morbidity and mortality. Its pathophysiology is thought to be due to gallbladder wall erosion and infarction secondary to inflammation, which subsequently leads to haemorrhage into the gallbladder lumen or the peritoneal cavity. There is no current official..
| Published: | 29/10/2023 |
| Authors: | Harrison NL |
Initiation of continuous renal replacement therapy versus intermittent hemodialysis...
Background There is controversy regarding the optimal renal-replacement therapy (RRT) modality for critically ill patients with acute kidney injury (AKI). Method We conducted a secondary analysis of the STandard versus Accelerated Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial to compare outcomes among patients who initiated RRT with either..
| Published: | 10/10/2023 |
| Authors: | Tridente A, Harrop C, Shuker K |
Small bowel obstruction secondary to phytobezoar in a patient with myotonic dystrophy
Abstract A male patient in his 30s, with myotonic dystrophy (DM), presented to the emergency department with abdominal pain and vomiting. CT imaging revealed a soft tissue lesion in the terminal ileum causing small bowel obstruction (SBO). The patient underwent diagnostic laparoscopy which allowed identification and removal of the obstructing..
| Published: | 05/10/2023 |
| Authors: | Harrison NL, Santoro G, Samad A, Ellerby N |
Ancient genomes illuminate Eastern Arabian population history and adaptation against malaria
Abstract The harsh climate of Arabia has posed challenges in generating ancient DNA from the region, hindering the direct examination of ancient genomes for understanding the demographic processes that shaped Arabian populations. In this study, we report whole genome sequence data obtained from four Tylos-period individuals from Bahrain. Their genetic..
| Published: | 01/10/2023 |
| Authors: | Aloraifi F |
Is the Current Cut Point for Glycated Haemoglobin (HbA1c) Correct for Diagnosing Diabetes Mellitus in Premenopausal Women? Evidence to Inform Discussion
Abstract Women are on average diagnosed with diabetes mellitus at later age than men but have higher mortality. As the diagnosis of diabetes mellitus is primarily based on HbA1c, the use of a non-specific reference range and cut point for diabetes mellitus that does not account for gender differences..
| Published: | 30/09/2023 |
| Authors: | Green L |
Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit
Aim To describe a UK-wide re-audit of the 2019 Royal College of Radiologists (RCR) audit evaluating patient-related data and organisational infrastructure in the radiological reporting of vertebral fragility fractures (VFFs) on computed tomography (CT) studies and to assess the impact of a series of RCR interventions, initiated to raise VFF awareness,..
| Published: | 29/09/2023 |
| Authors: | Retnasingam G |
Letter to the editor: Comparison of perineal urethrostomy versus augmentation urethroplasty in anterior urethral stricture disease.
Pina, IM; Omar, A; Floyd Jr MS. (2023). Letter to the editor: Comparison of perineal urethrostomy versus augmentation urethroplasty in anterior stricture disease. Urologia Journal. Epub 23 September [Online]. Available at: https://dx.doi.org/10.1177/03915603231199809 [Accessed 04 January 2023]
| Published: | 23/09/2023 |
| Authors: | Pina IM, Omar A, Floyd Jr MS |
Society for Acute Medicine’s Patients: Learning from Experience Report (SAM-PLER) A service evaluation of patient reported experience in Acute Medicine – establishing the feasibility of a quality improvement collaborative
Abstract Patient reported experience measures (PREMS) are a key part of measured quality. There is no tool currently used in the UK in Acute Medicine. On the 8th of September 2022 10 units based in England, Scotland and Wales collected data for the validated PREM, alongside the EQ-5D and variables from..
| Published: | 23/09/2023 |
| Authors: | Varia R |
Video 2: 2nd stage Urethroplasty for distal Urethral BXO
Introduction 2nd stage Urethroplasty involves tubularising the new urethral plate over a catheter, fashioning a new meatus and closing the distal urethra. Typically, this occurs 9 months after a 1st stage BUMG replacement. Methods Meatal apposition is assessed and distal urethral calibre gauged with a sound. The inner and outer urethral..
| Published: | 23/09/2023 |
| Authors: | Pina IM, Floyd Jr MS |
Demographics and Outcomes of 1st stage BUMG Urethroplasty for BXO: The Whiston Hospital experience
Abstract There is currently no consensus on the treatment of cold intolerance in extremities in post-trauma patients. We aim to present two cases where botulinum toxin type A injections were used to improve symptoms of cold intolerance. Botulinum toxin type A (Allergan) was injected into the area around the palmar..
| Published: | 23/09/2023 |
| Authors: | Pina IM, Floyd Jr MS |
Anastomotic Urethroplasty: The Whiston Hospital experience
Introduction Recurrent bulbar strictures under 2 cm are treated with anastomotic urethroplasty. The purpose of this study was to analyse the aetiologies and validated outcomes of anastomotic urethroplasty in a tertiary centre Methods All anastomotic urethroplasties performed by a single Urologist were analysed. Age, prior urethrotomies, presence of a suprapubic catheter,..
| Published: | 23/09/2023 |
| Authors: | Floyd Jr MS |
A Longitudinal Clinical Trajectory Analysis Examining the Accumulation of Co-morbidity in People with Type 2 Diabetes (T2D) Compared with Non-T2D Individuals.
Abstract Type 2 diabetes mellitus (T2D) is commonly associated with an increasing complexity of multimorbidity. While some progress has been made in identifying genetic and non-genetic risk factors for T2D, understanding the longitudinal clinical history of individuals before/after T2D diagnosis may provide additional insights. Methods In this..
| Published: | 14/09/2023 |
| Authors: | Narayanan RP |
Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries
Background This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing..
| Published: | 13/09/2023 |
| Authors: | Kaul A |
A second update on mapping the human genetic architecture of COVID-19
Extract Investigating the role of host genetic factors in COVID-19 severity and susceptibility can inform our understanding of the underlying biological mechanisms that influence adverse outcomes and drug development1,2. Here we present a second updated genome-wide association study (GWAS) on COVID-19 severity and infection susceptibility to SARS-CoV-2 from the COVID-19..
| Published: | 07/09/2023 |
| Authors: | Shuker K, Tridente A |
Mortality from diabetic kidney disease before and during the COVID pandemic
Background and aims We have previously published 5-and 10-year audits from our UK diabetes kidney clinic reporting outcomes comparable to those in landmark trials of diabetic kidney disease in broadly similar patients. This 2023 (20-year) audit again showed practice consistent with NICE, ADA and Kidney Disease Improving Global Outcomes guidelines, but..
| Published: | 04/09/2023 |
| Authors: | Lewis GA, Cardwell J, Hardy KJ |
Real world safety of methoxyflurane analgesia in the emergency setting: a comparative hybrid prospective-retrospective post-authorisation safety study.
Abstract Low-dose analgesic methoxyflurane (Penthrox R) was approved in Europe for emergency relief of moderate to severe pain in conscious adults with trauma in 2015. A comparative post-authorisation safety study (PASS) was conducted to assess the risk of hepatotoxicity and nephrotoxicity with methoxyflurane during routine clinical practice. Methods This was a..
| Published: | 30/08/2023 |
| Authors: | Kataria H |
Evaluation of the 'Clicky' Hip in the Diagnosis of Developmental Dysplasia of the Hip (DDH).
Abstract Early detection of developmental dysplasia of the hip (DDH) is associated with improved outcomes of conservative treatment. Therefore, we aimed to evaluate the use of a 'clicky' hip as an indication for secondary assessment as per the British Society for Children's Orthopaedic Surgery (BSCOS) consensus statement. Method Prospective cohort..
| Published: | 30/08/2023 |
| Authors: | Ross M |
205 Single-Centre Review on Incisional Hernia After Laparoscopic Anterior Resection: What Is the Ideal Incision for Specimen Extraction?
Abstract Midline incision was reported as the common site of incisional hernia (IH) after hand-assisted laparoscopic anterior resection (LAR). There is no consensus on the ideal site for specimen extraction. Our aim was to compare the rate of IH at various specimen extraction sites at our institution. Method We retrospectively..
| Published: | 30/08/2023 |
| Authors: | Win M, Ngo V, Jeyam T, Rajaganeshan R |
An Audit to Evaluate the Prevalence and Efficiency of the 'Acute Abdomen Pathway' Proforma Used in a Large District General Hospital.
Abstract The 'acute abdomen pathway' was introduced with the aim of early identification of patients with an acute abdomen and once identified to increase the efficiency of imaging, senior review and if required surgical intervention. We audited how this pathway was being used by clerking doctors and its benefits to..
| Published: | 30/08/2023 |
| Authors: | Ross M, Kalaiselvan R, Yasin U, Gul A |
The Patient Demographic Details of Referrals for Risk Reducing Breast Surgery and Reconstruction to St Helen's and Knowsley Teaching Hospitals Over a 5 Year Period.
Abstract Breast cancer is the most common cause of cancer in women affecting 1 in 7 women in the UK. Hereditary breast cancers are present in up to 10% of all cases and are most commonly related to BRCA gene mutations. Bilateral risk reducing mastectomy (RRM) +/- reconstruction is the most effective strategy..
| Published: | 30/08/2023 |
| Authors: |
Handwritten Operative Note Compliance in Plastic Surgery.
Abstract Accurate and comprehensive documentation of operations is crucial to optimise patient care. Omissions may cause compromised management, or medicolegal issues. A closed-loop audit was completed at a plastic surgery centre to identify whether Royal College of Surgeons (RCS) standards were met. It aimed to identify and address limitations of..
| Published: | 30/08/2023 |
| Authors: | Harper-Machin A |
Incidence of Incisional Hernia Post-Colorectal Liver Metastasis Resection - a Longitudinal Radiological Cohort Study.
Abstract The aim of this study is to determine the incidence and time to development of incisional hernia (IH) in post partial hepatectomy (PH) for colorectal liver metastases (CRLM) patients to enable surgeons to prepare and accurately consent patients for the operations. Method The radiological images and reports of all..
| Published: | 30/08/2023 |
| Authors: | Adams S |
220 A Systematic Review on Under-Recognized Condition: Duodenogastric Reflux After Cholecystectomy
Aim Midline incision was reported as the common site of incisional hernia (IH) after hand-assisted laparoscopic anterior resection (LAR). There is no consensus on the ideal site for specimen extraction. Our aim was to compare the rate of IH at various specimen extraction sites at our institution. Method We retrospectively..
| Published: | 30/08/2023 |
| Authors: | Win M |
Lack of regional pathways impact on surgical delay: Analysis of the Orthopaedic Trauma Hospital Outcomes–Patient Operative Delays (ORTHOPOD) study
Introduction Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital..
| Published: | 22/08/2023 |
| Authors: | Wharton D, Rana A, McAllister R, Sasi S, Thomas T, Lever C, Sood A, Moss M, Khatir M |
A study to investigate genetic factors associated with weight gain in people with diabetes: analysis of polymorphisms in four relevant genes
Abstract Background Weight change is often seen in people with diabetes. We investigated the effects of genes associated with weight change/glucose handling/insulin-signalling. Materials/methods DNA from diabetes individuals and non-diabetes individuals, plus clinical data, were available from the DARE study (n = 379 individuals: T1D n = 111; T2D n = 222;..
| Published: | 15/08/2023 |
| Authors: | Narayanan RP |
Hybrid Closed-Loop Therapy in Adults With Type 1 Diabetes and Above-Target HbA1c: A Real-world Observational Study
Abstract Objective We explored longitudinal changes associated with switching to hybrid closed-loop (HCL) insulin delivery systems in adults with type 1 diabetes and elevated HbA1c levels despite the use of intermittently scanned continuous glucose monitoring (isCGM) and insulin pump therapy. Research Design and Methods We undertook a pragmatic, preplanned observational..
| Published: | 11/08/2023 |
| Authors: | Furlong NJ |
Hallux Varus
Introduction Hallux varus is a clinical condition characterized by medial deviation of the great toe at metatarsophalangeal (MTP) joint. This condition may present with varying degrees of severity, causes, and symptoms. Adult acquired hallux varus deformity is commonly iatrogenic, commonly resulting from surgery for hallux valgus. A patient may have..
| Published: | 08/08/2023 |
| Authors: | Munir U, Morgan S |
Performance of admission pathways within acute medicine services: Analysis from the Society for Acute Medicine Benchmarking Audit 2022 and comparison with performance 2019 - 2021.
Abstract Urgent and emergency care services face increasing pressure, impacting patient care. We evaluated the performance of acute medicine services, assessing clinical quality indicators for unplanned medical admissions to acute hospital services. 152 acute UK hospital services accepting unplanned admissions to acute and general internal medicine completed a day-of-care survey incorporating..
| Published: | 03/08/2023 |
| Authors: | Varia R |
Cohort study of short-term outcomes after ACL-reconstruction using autograft with internal brace reinforcement versus isolated autograft demonstrating no significant difference
Abstract Background The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft failure is the concern and ensuring a durable initial graft with rapid integration is crucial. Graft augmentation with implantable devices (internal brace reinforcement) is a technique purported to reduce the risk of rupture and hasten..
| Published: | 29/07/2023 |
| Authors: | Mohan R, Kwaees TA, Thomas T, Pydisetty R |
Association Between Depression and Anxiety Status With Uptake of Colorectal Cancer Screening Among US Adults: A Population-Level Study
Background Individuals with different mental disorders tend to experience higher rates of colorectal cancer (CRC)-related mortality compared to the general population. Discrepancies in CRC screening behaviors have been suggested as a potential contributing factor to this difference in mortality. However, existing evidence on this topic has been inconclusive and..
| Published: | 29/07/2023 |
| Authors: | Nwachukwu O |
Association Between Depression and Anxiety Status With Uptake of Colorectal Cancer Screening Among US Adults: A Population-Level Study.
Abstracts Individuals with different mental disorders tend to experience higher rates of colorectal cancer (CRC)-related mortality compared to the general population. Discrepancies in CRC screening behaviors have been suggested as a potential contributing factor to this difference in mortality. However, existing evidence on this topic has been inconclusive and..
| Published: | 29/07/2023 |
| Authors: | Nwachukwu O |
Preputial advancement flap for delayed urethrocutaneous fistula of the glans following urethral insertion of an ‘AAA’ battery
Abstract Introduction Foreign body insertion associated with sexual gratification is known as polyembolokoilomania. Following removal of the foreign body, long-term complications are infrequently seen. Whilst conservative and endoscopic approaches usually suffice, in extreme cases open surgical approaches are required. We describe an unusual case of polyembolokoilomania in a 25-year-old male..
| Published: | 25/07/2023 |
| Authors: | Atayi AA, Omar A, Floyd Jr MS |
MANAGEMENT OF OSTEOARTHRITIS AND JOINT PROBLEMS IN SEMI-RURAL INDIA.
Abstract This is a retrospective presentation of patients who were treated under the author's care in Eastern India over a period of 13 years. The aim of the this study was to identify and addressing the difficulties faced by the patients in accessing appropriate care and the obstacles in educating and..
| Published: | 21/07/2023 |
| Authors: | Naraen A |
Carpal Tunnel Decompression Under Wide Awake Local Anaesthesia No Tourniquet Technique (WALANT): A Cost Effective and Outcome Analysis
Abstract Introduction Wide-awake local anaesthesia with no tourniquet (WALANT) technique is cost-effective, resource-friendly, and safe. This can be used as an alternative to hand surgery procedures in outpatient units. It can be performed in clinics or operating rooms. Methods We retrospectively evaluated the outcomes of WALANT for carpal tunnel decompression (..
| Published: | 19/07/2023 |
| Authors: | Khan S |
PP-306 An adipose derived decellularised extracellular matrix as a biomaterial for tissue engineering of soft tissue
Introduction Vascularised tissue transplants are currently used to reconstruct soft tissue defects caused by trauma, cancer or infection but is not without its limitations and risks. Decellularised extracellular matrix are tissues that have been processed to remove cellular content whilst retaining its network of structural proteins, glycoproteins and adhesion proteins,..
| Published: | 17/07/2023 |
| Authors: | Yong L |
Commentary on: Repair of Congenitally Defective Types of Earlobe Clefts With Residual Lobular Tissue: A Convenient and Effective Surgical Technique
Extract Innovation in surgical technique is a cornerstone of advancing surgical care. The authors describe a new surgical technique that utilizes residual lobular tissue anterior and inferior to the ear to form a new earlobe.1 The authors believe that this approach brings a number of advantages including a fuller, more..
| Published: | 13/07/2023 |
| Authors: | Shokrollahi K |
Stroke–heart syndrome: mechanisms, risk factors, and adverse cardiovascular events
Extract New-onset cardiovascular complications following an ischaemic stroke, hereafter termed stroke–heart syndrome, are a major medical challenge of the 21st century, yet are under-recognized and under-researched.1,2 Acutely, stroke–heart syndrome associates with poorer functional prognosis and increased mortality following stroke.3 In the long term, stroke–heart syndrome associates with..
| Published: | 28/06/2023 |
| Authors: | Hill AM |
Machine-learning derived heart and brain age are independently associated with cognition
Cameron, A.C.; Lip, Y.H.; Abdul-Rahim, AH. (2023). Machine-learning derived heart and brain age are independently associated with cognition. European Journal of Neurology. epub 23 June(.), p... [Online]. Available at: https://doi.org/10.1111/ene.15953 [Accessed 26 June 2023]
| Published: | 23/06/2023 |
| Authors: | Abdul-Rahim A |
P039 Adult onset Varicella zoster infection presenting as probable Mpox (Monkeypox)
Introduction A 56 year old cis-male who has sex with men (MSM) presented to our semi-rural Genitourinary Medicine (GUM) service with fever, rigors, arthralgia, lymphadenopathy, headache and rash. He had recently returned from Gran Canaria and was triaged as a probable case of Mpox. Methods He had a past medical history..
| Published: | 20/06/2023 |
| Authors: | Okecha E, Reddin J, Harrison S, McKiernan J, Bateman A, Fishwick L, Thomson-Glover R |
P165 Rates of isolated extragenital chlamydia trachomatis and neisseria gonorrhoeae in heterosexual patients attending a sexual health clinic
Abstract Introduction BASHH guidance advises offering testing at extra genital sites for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) dependant on sexual history in heterosexual males and females. We examined the roll out of offering routine additional extragenital testing in heterosexual patients attending the sexual health clinic. Methods Genitourinary Medicine..
| Published: | 20/06/2023 |
| Authors: | Okecha E, Ahmed A, Fishwick L, Thomson-Glover R |
External validation of the Oldham composite Covid-19 associated mortality model (OCCAM), a prognostic model for death in patients hospitalised with Covid-19
Objective External validation of the Oldham Composite Covid-19 associated Mortality Model (OCCAM), a prognostic model for Covid-19 mortality in hospitalised patients comprised of age, history of hypertension, current or previous malignancy, admission platelet count < 150 × 103/µL, admission CRP ≥ 100 µg/mL, acute kidney injury (AKI), and radiographic evidence of > 50% total lung field..
| Published: | 19/06/2023 |
| Authors: | McLeneghan D |
732 An audit of admission into a high-dependency unit of a large district general hospital. Is there compliance with national guidance?
Abstract Objective To audit the reasons for admission to the Paediatric high dependency unit (PHDU) using the Paediatric critical care society (PCCS) criteria for PHDU admission (1). To review the demography of children admitted and the duration of admission. Method This was a retrospective audit of children < 18 years old admitted to..
| Published: | 19/06/2023 |
| Authors: | Kayode-Awe O, Garr R |
369 The role of children’s hospitals in reducing health inequalities: a review of organisational policies
Abstract Objectives Health inequalities are ‘avoidable, unfair and systematic differences in health between different groups of people’, including differences in access to care and quality of healthcare received.1 The Children’s Hospital Alliance (CHA) is a group of English children’s hospitals, collaborating through the National Paediatric Accelerator Programme.2 This..
| Published: | 19/06/2023 |
| Authors: | Brennan L |
P26 Standardising outpatient care for primary biliary cholangitis patients in a hospital trust
Abstract Introduction Primary biliary cholangitis (PBC) is a progressive autoimmune mediated cholangiopathy. There are well recognised treatments for both the underlying disease and symptom control highlighted by British Society of Gastroenterology (BSG) guidelines. Anecdotally, clinical practice does not reflect this. One likely reason is that patients are seen in various..
| Published: | 18/06/2023 |
| Authors: | Zhang M, Fox M |
P250 RNASeq identifies differential gene expression in colorectal and duodenal adenomas in familial adenomatous polyposis (FAP)
Abstract Introduction Familial adenomatous polyposis (FAP) is an autosomal dominant condition caused by a germline mutation in the APC gene (Campos et al., 2015). Patients develop hundreds to thousands of polyps along their intestinal tract in the second and third decades of life (Vasen et al., 2008). Without prophylactic colectomy, the lifetime..
| Published: | 18/06/2023 |
| Authors: | Fedail A |
P40 Re-engagement of haemochromatosis service users to provide best practice
Abstract Introduction Haemochromatosis is a medical condition that causes patient to absorb too much iron from their diet. This can accumulate around the body over time, damaging many organs and eventually causing disease. Inheritance of a faulty gene is responsible for an increase in the amount of iron in the..
| Published: | 18/06/2023 |
| Authors: | Allcoat A |
Opioid use and associated factors in 1676 patients with inflammatory bowel disease: a multicentre quality improvement project
Objective Despite its association with poorer outcomes, opioid use in inflammatory bowel disease (IBD) is not well characterised in the UK. We aimed to examine the extent of opioid use, the associated factors and the use of mitigation techniques such as pain-service review and opioid weaning plans among individuals with..
| Published: | 14/06/2023 |
| Authors: | Bassi A |
Current concepts in the management of “Terrible Triad” injuries of the elbow
Abstract Terrible triad injuries of the elbow are complex injuries which can result in long term complications and significant disability. They must be identified correctly, and managed appropriately in order to maximise functional outcomes. A clear understanding of the bony and ligamentous anatomy is essential to plan appropriate surgical reconstruction..
| Published: | 14/06/2023 |
| Authors: | Franklin M |
1056-P: Impact of Individualized HbA1c Target Setting on Diabetes-Distress, Self-Efficacy, Well-Being, and HbA1c
Abstract American Diabetes Association guidelines emphasize the importance of individualized HbA1c target setting in glycemic management, but little is known of the impact of target-setting on patient well-being. We randomized 50 adults (type 1 or 2) to receive HbA1c targets 5 mmol/mol (0.5%) above or below current value and evaluated impact on..
| Published: | 13/06/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, Lewis GA, Hardy KJ |
Risk of myocardial infarction and ischemic stroke in individuals with first-diagnosed paroxysmal vs. non-paroxysmal atrial fibrillation under anticoagulation
Aims There is conflicting evidence on whether the type of atrial fibrillation (AF) is associated with risk of cardiovascular events, including acute myocardial infarction (MI) and ischemic stroke. The aim of the present study was to investigate whether the risk of MI and ischemic stroke differs between individuals with first-diagnosed..
| Published: | 07/06/2023 |
| Authors: | Abdul-Rahim A |
Epilepsy-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications in patients with Epilepsy
Background The risks of cardiovascular events(CVEs) in people with epilepsy(PWE) are not well understood. Objectives To establish the short- and long-term burden of CVEs in PWE. Methods Electronic health records from a global federated health research network(TriNetX) were used to establish a cohort of PWE. Primary outcomes..
| Published: | 07/06/2023 |
| Authors: | Abdul-Rahim A |
P 12.018 Specialist Palliative Care at the Front Door
Background and aims At a time of significant pressure within the NHS, patients with palliative care needs often present to the emergency department in crisis. This makes the ED an important site for specialist palliative care assessment. It is widely recognised that 40 million people a year globally will require palliative..
| Published: | 07/06/2023 |
| Authors: | Howarth S, Thompson A, Beck D |
Association between enteral feeding and gastrointestinal complications in children receiving extracorporeal life support...
Background Extracorporeal life support is an accepted treatment modality for children with severe cardiac and/or respiratory dysfunction. However, after a period of inadequate gut perfusion, clinicians are often reluctant to initiate enteral nutrition. Methods This was a retrospective cohort study in a single large pediatric intensive care unit in..
| Published: | 31/05/2023 |
| Authors: | Tse C |
Morton Neuroma
Introduction Morton neuroma is a compressive neuropathy of the forefoot interdigital nerve. Neuropathy is mainly due to compression and irritation at the plantar aspect of the transverse intermetatarsal ligament. It is not a true neuroma as the condition is degenerative rather than neoplastic. It is also referred to as Morton..
| Published: | 22/05/2023 |
| Authors: | Munir U, Morgan S |
Delayed diagnosis of a scaling genodermatosis
Description A man in his early 60s presented to the dermatology clinic with a lifelong history of dry, scaling skin. He had congenital deafness but no other medical problems. He had received a diagnosis of ichthyosis vulgaris several years ago and was treating the condition with topical emollients. Further questioning..
| Published: | 17/05/2023 |
| Authors: | Harnett C, Al-Jubouri M, Meah N |
642 Impact of bridging therapy vs endovascular thrombectomy alone on outcomes in anticoagulated patients with atrial fibrillation presenting with mild-moderate ischaemic stroke
Background and aims The aim was to assess the impact of bridging intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT), compared to EVT alone, in anticoagulated patients with atrial fibrillation (AF) presenting with mild-moderate acute ischaemic stroke. Method(s) A retrospective analysis (01/09/2018-01/09/2022) using a global health research network was conducted...
| Published: | 16/05/2023 |
| Authors: | Abdul-Rahim A |
The Optimal Management for People with Acute Stroke and Minor Deficits: Intravenous Thrombolysis or Medical Management?
Cameron, AC and Abdul-Rahim, AH. (2023). The Optimal Management for People with Acute Stroke and Minor Deficits: Intravenous Thrombolysis or Medical Management?. Thrombosis and Haemostasis. e-pub 12 May(.), p... [Online]. Available at: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2077-5642 [Accessed 12 June 2023].
| Published: | 12/05/2023 |
| Authors: | Abdul-Rahim A |
O132 Preliminary results of radiofrequency ablation for haemorrhoidal disease at a district general hospital
Introduction Haemorrhoidal disease (HD) is a common perianal condition. There is still limited data on the role of minimally invasive surgery for HD. The aim of our study was to report the outcome of radiofrequency ablation of haemorrhoids under local anaesthetic (RAFAELO) at our institution. Methods 23 patients who had a..
| Published: | 10/05/2023 |
| Authors: | Win M, Ngo V, Rajaganeshan R |
Use of volar distal radius plate dorsally for wrist arthrodesis in patients with upper limb spasticity: A retrospective
Summary Standard wrist arthrodesis implants are generally designed for adult joints with arthritis. They are often too big for patients with limb spasticity who generally tend to have osteopenic and smaller bones for their age, resulting in high complication rates. We previously described the novel use of volar distal radius..
| Published: | 07/05/2023 |
| Authors: | Bamal R, Sultan R, Cappuyns L, Hassan Z, McArthur P |
A bibliometric analysis of publication trends in UK plastic surgery
Introduction Publication is seen as the pinnacle of academia and is actively encouraged from an early stage in a junior doctor's career. It forms the bedrock of evidence-based practice, allowing clinicians and researchers to share experiences which may lead to an improvement in patient outcomes. High quality research with robust..
| Published: | 27/04/2023 |
| Authors: | Khalil K |
P281 Impact of pre-pregnancy counselling on HbA1c level and pregnancy outcomes in women with pre-existing diabetes
Aims The aim of our study was to assess uptake of pre-pregnancy counselling and its impact on HbA1c level. We looked to establish whether lower HbA1c levels and counselling improved outcomes in pregnant women with pre-existing diabetes. Methods Electronic record of all pregnant women with pre-existing diabetes booked..
| Published: | 25/04/2023 |
| Authors: | Collings S, Christian S, Pankaja S, McNulty S, Davies H, Milne R, Gallagher CG, Bujawansa S |
P280 Impact of introducing an intensive support package alongside continuous glucose monitoring on neonatal outcomes and...
Aims The National Diabetes in Pregnancy Audit in 2020 demonstrated that the percentage increase of women with type 1 diabetes under our service achieving an HbA1c
| Published: | 25/04/2023 |
| Authors: | Milne R, McNulty S, Pankaja S, Davies H, Gallagher CG, Christian S, Bujawansa S |
P277 Patient and public involvement (PPI) exploring the experiences of women with gestational diabetes...
Aim Gestational Diabetes (GDM) affects 1 in 23 UK pregnancies and can lead to adverse maternal & neonatal outcomes. PPI empowers those affected by a condition to influence future care. The aim of this project was to explore the experiences of GDM care for a group of women and their partners attending a..
| Published: | 25/04/2023 |
| Authors: | Gallagher CG, Christian S, Pankaja S, McNulty S, Davies H, Milne R, Bujawansa S |
P137 Follow up screening for diabetes after gestational diabetes 2019 versus 2022
Aims NICE guidelines for screening state that all GDM patients should be screened for diabetes at 6 to 12 weeks postpartum. Previous published data have given a national rate of less than 20% [1]. Our previously published data showed a 45% follow up [2]. We re-reviewed our screening rate after the interventions of: discussion with and..
| Published: | 25/04/2023 |
| Authors: | McNulty S, Milne R, Gallagher CG, Pankaja S, Christian S, Davies H, Bujawansa S |
A62 (P227) Risk of 12-month mortality following a severe inpatient hypoglycaemic event...
Aims At our Trust, all severe inpatient hypoglycaemic episodes in individuals with diabetes (defined as a hypoglycaemic episode requiring injectable treatment) are reported to NaDIA-Harms (National Diabetes Inpatient Audit). We conducted a detailed review of the care of all these events to improve patient safety. In this study, we assessed..
| Published: | 25/04/2023 |
| Authors: | Taylor J, Michaels S, Hatton DA, Caton K, Cardwell J, Hardy KJ, Strong AJ, Bujawansa S |
P303 Explicit glycated haemoglobin goals improve subsequent HbA1c levels with no impact on health-related quality of life
Background National guidelines recognise the importance of individualising HbA1c targets. Many people with diabetes agree to have their targets re-evaluated in consultations in response to specific characteristics. Aims We aimed to evaluate the impact of relaxed or stretch HbA1c goals on subsequent HbA1c levels and health-related quality..
| Published: | 25/04/2023 |
| Authors: | McNulty S, Westall S, Narayanan RP, Irving G, Furlong NJ, Bujawansa S, Cardwell J, Hardy KJ |
P302 Glycated haemoglobin targets: The experiences and views of people with diabetes and diabetes healthcare professionals
Background National guidelines highlight the importance of individualising HbA1c targets. Little is known about the experiences of people with diabetes and diabetes healthcare professionals (HCPs) on the use of HbA1c targets. We explored the experiences of adults with diabetes and diabetes HCPs on the use of glycated haemoglobin..
| Published: | 25/04/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty SJ, Bujawansa S, Cardwell J, Hardy KJ |
P300 Setting explicit glycated haemoglobin goals improves diabetes-related distress, self-efficacy and wellbeing
Background High levels of diabetes-related distress and low levels of self-efficacy and wellbeing are associated with poorer outcomes in people with diabetes. Aims We evaluated the impact of relaxed or stretch HbA1c targets on diabetes-related distress, self-efficacy and wellbeing in adults with type 1 or type 2 diabetes. Methods We randomised 50..
| Published: | 25/04/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty S, Bujawansa S, Balafshan T, Cardwell J, Hardy KJ |
A new protocol for improving immediate monitoring of skin-island free flap with near-infrared spectroscopy and ultrasound
Background Postoperative monitoring is essential for detecting early complications and improving the salvage rate of free flaps. We propose a new protocol for free flap monitoring based on the combination of near-infrared spectroscopy (NIRS) and ultrasound. Methods All free flaps with a skin paddle were included and divided into two..
| Published: | 20/04/2023 |
| Authors: | Taghizadeh R |
446 A qualitative exploration using focus groups, of the perceived barriers and enablers of hospital pharmacists to participating in simulation based training
Introduction The role of hospital pharmacists has changed significantly over the past decade with a need for further educational interventions to support their professional development. Simulation based training (SBT) is widely used by other healthcare professionals to enhance skill acquisition and performance (1). However, the use of SBT does not appear..
| Published: | 13/04/2023 |
| Authors: | Lea N, Lloyd M, Bennett N |
Phalangeal and Metacarpal Fractures in Children: A 10-Year Comparison of Factors Affecting Functional Outcomes in 313 Patients
Data It is widely believed that fractures in children have excellent clinical outcomes due to their capacity to remodel. There are, however, certain fractures that require careful management to avoid long-lasting functional impairment. Functional outcomes following hand fractures in children are poorly studied. Materials and Methods We performed a retrospective..
| Published: | 11/04/2023 |
| Authors: | Nolan G |
Switching between tofacitinib and baricitinib in alopecia areata: A review of clinical response
Kazmi, A; Moussa, A; Meah, M et al. (2023). Switching between tofacitinib and baricitinib in alopecia areata: A review of clinical response. Journal of the American Acadamy of Dermatology. epub 05 April. [Online]. Available at: https://doi.org/10.1016/j.jaad.2023.03.041 [Accessed 28 April 2023]]
| Published: | 04/04/2023 |
| Authors: | Meah N |
Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study
Purpose The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources. Methods This multicentre, multinational cohort study recruited 6045 patients..
| Published: | 03/04/2023 |
| Authors: | Pushdary KH |
Critical care pharmacy workforce: a 2020 re-evaluation of the UK deployment and characteristics
Introduction Critical care pharmacists improve the quality and efficiency of medication therapy whilst reducing treatment costs where they are available. UK critical care pharmacist deployment was described in 2015, highlighting a deficit in numbers, experience level, and critical care access to pharmacy services over the 7-day week. Since then, national workforce..
| Published: | 31/03/2023 |
| Authors: | Barton G |
Stroke in Atrial Fibrillation and Other Atrial Dysrhythmias
Purpose of Review Atrial fibrillation (AF) is a major risk factor for systemic embolism and ischaemic stroke. Furthermore, AF-related strokes are associated with higher mortality, greater disability, longer hospital stays and lower rates of hospital discharge than strokes caused by other reasons. The aim of this review to summarise the..
| Published: | 28/03/2023 |
| Authors: | Abdul-Rahim A |
A Review of Emerging Factor XI inhibitors
Introduction Whilst the introduction of direct oral anticoagulants (DOACs) has improved the prevention of thromboembolic events, there is still a need for safer anticoagulants. This is particularly so, for specific populations of patients, such as those with an increased bleeding risk or those with severely reduced kidney function. People with..
| Published: | 16/03/2023 |
| Authors: | Elsheikh S |
Wide-Awake Local Anesthesia No Tourniquet (WALANT) for Flexor Tendon Repairs...
Background The coronavirus disease 2019 (COVID-19) pandemic forced many changes. In our unit, there was a significant shift from traditional anesthesia (TA) which included general or regional anesthesia, to Wide-Awake Local Anesthesia No Tourniquet (WALANT) for the treatment of flexor tendon injuries. Zones I and II injuries have always been a..
| Published: | 15/03/2023 |
| Authors: | Bamal R, Bastouros E, Nolan G, Griffiths S, Bell D |
165 A NICE accredited guideline for the management of malignant ascites
Introduction Ascites is the accumulation of fluid in the peritoneal cavity, often associated with a poor quality of life and poor prognosis. There is limited national guidance on management of malignant ascites .This guideline has been produced to enable healthcare professionals to make evidence-based, patient-centred decisions about the management of..
| Published: | 14/03/2023 |
| Authors: | McLintock S, Evans K |
Long-term Management Considerations for Retinal Artery Occlusion and Cardiovascular and Cerebrovascular Mortality
Extract In this issue of JAMA Network Open, Hwang et al1 report a population-based, retrospective, cohort study using the Korean National Health Insurance Service claims database to determine the incidence of retinal artery occlusion (RAO), and its associated rate (and cause) of death compared with the general population. RAO has 2..
| Published: | 10/03/2023 |
| Authors: | Abdul-Rahim A |
Prophylactic intravenous gentamicin with sedation-free cystoscopic injection of BoNT-A
Objectives To determine whether administration of single dose prophylactic intravenous gentamicin prior to intravesical injection of botulinum toxin type A (BoNT-A) is associated with adverse extravesical neuromuscular effects in idiopathic overactive bladder syndrome. Patients and methods A retrospective analysis of 220 consecutive idiopathic overactive bladder patients following sedation-free flexible cystoscopic injection..
| Published: | 02/03/2023 |
| Authors: | Chamsin A, Floyd Jr MS, Samsudin A, Omar A |
Heart was the key to the diagnosis
Extract We present the case of a man in his 70s who was referred to gastroenterology with several months’ history of offensive smelling loose stools and weight loss. He underwent a standard panel of initial investigations including colonoscopy for his chronic diarrhoea. Colonoscopy was reported as normal and the results..
| Published: | 28/02/2023 |
| Authors: | Watters C |
The Effect of the COVID-19 Pandemic on HbA1c Testing
Introduction Studies show that the COVID-19 pandemic disproportionately affected people with diabetes and those from disadvantaged backgrounds. During the first 6 months of the UK lockdown, > 6.6 M glycated haemoglobin (HbA1c) tests were missed. We now report variability in the recovery of HbA1c testing, and its association with diabetes control..
| Published: | 22/02/2023 |
| Authors: | Green L |
#217 Parallel Session - Aid Experience in the Real-World - in the United Kingdom
Abstract AID experience in the real‐world in the United Kingdom Background Hybrid closed loop (HCL) technology automates insulin delivery and improves outcomes in people living with Type 1 diabetes. We report real‐world outcomes from adults with Type 1 diabetes with raised HbA1c despite insulin pump therapy and flash glucose..
| Published: | 21/02/2023 |
| Authors: | Furlong NJ |
Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing
Aims The COVID-19 pandemic, and the focus on mitigating its effects, has disrupted diabetes healthcare services worldwide. We aimed to quantify the effect of the pandemic on diabetes diagnosis/management, using glycated haemoglobin (HbA1c) as surrogate, across six UK centres. Methods Using routinely collected laboratory data, we estimated the..
| Published: | 17/02/2023 |
| Authors: | Green L |
Tranexamic acid use in meningioma surgery – A systematic review and meta-analysis
Abstract Tranexamic Acid (TXA) has been used in medical and surgical practice to reduce haemorrhage. The aim of this review was to evaluate the effect of TXA use on intraoperative and postoperative outcomes of meningioma surgery. A systematic review and meta-analysis was conducted in accordance with the PRISMA statement and..
| Published: | 14/02/2023 |
| Authors: | Keshwara S |
Potential Embolic Sources in Embolic Stroke of Undetermined Source in Patients with Patent Foramen Ovale: Look Harder.
ElSheikh, S; Lip, GYH; Abdul-Rahim, AH. (2023). Potential Embolic Sources in Embolic Stroke of Undetermined Source in Patients with Patent Foramen Ovale: Look Harder. Cerebrovascular Diseases. epub 7 Feb, [Online]. Available at: https://doi.org/10.1159/000529105 [Accessed 17 February 2023].
| Published: | 07/02/2023 |
| Authors: | Elsheikh S, Abdul-Rahim A |
The management of developmental dysplasia of the hip in children aged under three months
Aims A national screening programme has existed in the UK for the diagnosis of developmental dysplasia of the hip (DDH) since 1969. However, every aspect of screening and treatment remains controversial. Screening programmes throughout the world vary enormously, and in the UK there is significant variation in screening practice and treatment..
| Published: | 01/02/2023 |
| Authors: | Mavrotas J |
Antiplatelet Agents and Oral Anticoagulant Use in Patients with Atrial Fibrillation and Carotid Artery Disease After First-Time Ischaemic Stroke
Introduction People with atrial fibrillation (AF) frequently have competing mechanisms for ischaemic stroke, including extracranial carotid atherosclerosis. The objective of this study was to determine associations between use of oral anticoagulants (OACs) plus antiplatelet agents (APA) after ischaemic stroke and outcomes for patients with AF and carotid artery disease. Methods..
| Published: | 24/01/2023 |
| Authors: | Hill AM |
Accuracy of a tool to prioritise patients awaiting elective surgery: an implementation report
Study objective The objective of this study was to evaluate the accuracy of a new elective surgery clinical decision support system, the ‘Patient Tacking List’ (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. Methods We constructed ROC curves based on risk predictions produced by the tool and..
| Published: | 20/01/2023 |
| Authors: | Pritchard-Jones R |
Trichorrhexis nodosa improving with oral minoxidil: a case report
McFeely, O; Meah, N; Sinclair, R; Wall, D. (2023). Trichorrhexis nodosa improving with oral minoxidil: a case report. Clinical and Experimental Dermatology. epub 19 Jan. [Online]. Available at: https://doi.org/10.1093/ced/llad019 [Accessed 21 February 2023]
| Published: | 19/01/2023 |
| Authors: | Meah N |
Short And Long Term Outcomes After Surgical Resection Of Tumours Of The Splenic Flexure – A Two Institutions’ Experience
Background This study was conducted as a part of our service evaluation of colorectal resections. Our primary outcomes were 30 day mortality, 90 day mortality, complication rate and recurrence rates at 3 and 5 years. The secondary outcomes were lymph node harvest >12 and length of stay. Methodology Retrospective data collection from a prospectively maintained..
| Published: | 17/01/2023 |
| Authors: | Rajendiran A |
Giant cell arteritis causing multifocal ischaemic stroke with normal erythrocyte sedimentation rate: a case report
Introduction Giant cell arteritis (GCA), a medium-to-large-vessel vasculitis affecting the over-50s, is a rare cause of ischaemic stroke, favouring the vertebrobasilar circulation. Erythrocyte sedimentation rate (ESR) is often used to help exclude the diagnosis but this is not always reliable. We discuss a case of ischaemic stroke due to..
| Published: | 17/01/2023 |
| Authors: | Kaul A, Seed A, Cooney L |
A multicentre observational cohort study of cardiovascular risk and outcomes following stroke: The Liverpool-Heart And bRain Project (L-HARP)
Introduction Improving risk prediction models for adverse outcomes following stroke, such as atrial fibrillation (AF), recurrent stroke, and cognitive impairment and dementia, would help target secondary prevention and other intervention strategies. The primary aim of the Liverpool-Heart And bRain Project (L-HARP) is to establish a prospective cohort study of adults..
| Published: | 17/01/2023 |
| Authors: | Hill AM, Choi S, Elsheikh S, Sagris D, Alobaida M |
019 Nil by mouth and peri-operative medicines administration in trauma and emergency surgery patients
Background An 88-year-old woman attends theatre for dynamic hip screw (DHS) 2 days after a trip and fall, delayed due to clinical pressures. BP, usually well controlled, is through the roof and her atrial fibrillation (AF) is no longer rate controlled; her anaesthetic risk is now considerably greater than prior to..
| Published: | 10/01/2023 |
| Authors: | Dunn J |
Improving family experience through better communication for postoperative patients
Background It is with great stress and anxiety that relatives wait until they get some news about their loved ones being back from a surgical procedure [1]. We aimed to implement a system to improve patient and relative experience through a gesture of updating the relatives about the general condition of..
| Published: | 10/01/2023 |
| Authors: | Jayan N, Khirwadkar R |
Atrial fibrillation and stroke
Introduction Stroke is one of the leading causes of mortality and morbidity globally. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is set to reach epidemic proportions. AF is associated with a five-fold increase in risk of stroke. Strokes caused by AF more often are fatal or..
| Published: | 08/01/2023 |
| Authors: | Hill AM, Abdul-Rahim A |
Evaluation of Huawei smart wearables for detection of atrial fibrillation in patients following ischemic stroke: The Liverpool-Huawei stroke study.
Background Atrial fibrillation (AF) often remains undetected following stroke. Documenting AF is critical to initiate oral anticoagulation, which has proven benefit in reducing recurrent stroke and mortality in patients with AF. The accuracy and acceptability of using smart wearables to detect AF in patients following stroke is unknown. Methods The..
| Published: | 06/01/2023 |
| Authors: | Choi S, Elsheikh S |
Endovascular treatment for ischemic stroke patients with and without atrial fibrillation, and the effects of adjunctive pharmacotherapy: a narrative review
Introduction Endovascular thrombectomy (EVT) is associated with good clinical outcomes in patients with ischemic stroke, but the impact of EVT on clinical outcomes in patients with ischemic stroke with and without atrial fibrillation (AF), and the effect of adjunctive pharmacological therapies with EVT, remains unclear. Areas covered The goal of..
| Published: | 01/01/2023 |
| Authors: | Hill AM |
Mystery of Joint Pain: Is It Rheumatoid Arthritis (RA) or Hereditary Hemochromatosis (HH)?
Abstract A 58-year-old lady with a previous diagnosis of rheumatoid arthritis (RA) was referred to Rheumatology to manage her joint pains. On evaluation, it was noted that the lady did not have any signs of synovial inflammation. The patient had a negative anti-cyclic citrullinated peptide (anti-CCP) (
| Published: | 28/12/2022 |
| Authors: | Chit Su HM |
Do preoperative leukocyte and neutrophil levels have a predictive value on the complications of hypospadias repair in children?
Objective Surgeons observed that the outcomes after the same repair technique in the same type of hypospadias performed by the same surgeon may be different. There may be some indeterminate factors that influence the results such as subclinical inflammation. Our study evaluated the predictor values of inflammatory hematologic parameters on..
| Published: | 27/12/2022 |
| Authors: | Adali E |
Commentary on “An assessment of urethral radiation exposure in the treatment of endometrial and rectal cancers”
Abstract This retrospective cohort study was aimed at comparing urethral radiation exposure during two common radiotherapy modalities. Vaginal brachytherapy (VBT) is commonly used to treat endometrial cancer, with external beam radiation (EBRT) therapy used to treat rectal cancer. The study hypothesised that urethral radiation dose varies between these two modalities...
| Published: | 15/12/2022 |
| Authors: | Harrison NL |
Classification of Systemic Lupus Erythematosus Using Raman Spectroscopy of Blood and Automated Computational Detection Methods
Abstract The aim of this study was to explore the proof of concept for using Raman spectroscopy as a diagnostic platform in the setting of systemic lupus erythematosus (SLE). We sought to identify unique Raman signatures in serum blood samples to successfully segregate SLE patients from healthy controls (HC). In..
| Published: | 14/12/2022 |
| Authors: | Nugent L |
O.15 Pulse dye LASER - treatments can be safely delivered without formal test patching in children
Introduction Pulse dye LASER (PDL) traditionally requires test patching prior to full treatment, to assess for efficacy and side effects. In our unit, in children under age 6, this requires a general anaesthetic. The aim of this study was to ascertain whether results of test patching change settings chosen for subsequent..
| Published: | 14/12/2022 |
| Authors: | Naji S |
Purpuric lesions in the large bowel
Abstract A 54-year-old woman presented with a 1-week history of a rash starting in her feet. This was associated with arthralgia and myalgia. Her bowel habit was initially unchanged; however, she developed bloody diarrhoea shortly after admission to the hospital. She had no constitutional symptoms. Her medical history included myocardial..
| Published: | 07/12/2022 |
| Authors: | Kiladze G, Cannan R, McClements D, Brice R |
Outcomes in patients with ischaemic stroke undergoing endovascular thrombectomy: Impact of atrial fibrillation
Objectives Endovascular thrombectomy (EVT) is associated with good clinical outcomes in ischaemic stroke, but the risk of intracerebral haemorrhage (ICH) and mortality remains common following ischaemic stroke. The effect of concomitant atrial fibrillation (AF) on clinical outcomes following acute ischaemic stroke in patients receiving EVT remains unclear. The aim is..
| Published: | 05/12/2022 |
| Authors: | Hill AM, Harrison S, Lip G |
Faricimab for treatment of diabetic macular oedema
Abstract Diabetic macular oedema (DME) is a common cause of sight impairment in people with diabetes. Twenty-seven percent of people with type 1 diabetes develop DME within nine years of the disease onset. For people with type 2 diabetes, 25.4% of insulin dependent and 13.9% of those who do not use insulin have DME...
| Published: | 05/12/2022 |
| Authors: | Kovacova A |
Development of guidance for initiation and deprescribing PPI
Abstract It is important to consider whether the risks outweigh the benefits in long term proton pump inhibitor as there has been increasing use of PPIs in hospital settings and community especially in elderly care. Data collection was done on the patients admitted to care of elderly wards in Whiston..
| Published: | 05/12/2022 |
| Authors: | Thein M |
Post-stroke visual impairment: how big is the problem, how do we identify it, what we can do about it, and why does it matter?
In the UK, 100,000 new strokes occur each year, with 1.3 million stroke survivors. This article will focus on post-stroke visual impairment, discussing topics of how common it is, how it can be detected, possible management options and how it impacts stroke survivors. Hepworth, L.R. (2022). Post-stroke visual impairment: how big is..
| Published: | 01/12/2022 |
| Authors: | Hepworth LR |
Cross-specialty identification of the JAK1 inhibitor trial agent filgotinib as a potential therapy for alopecia areata
Fagan, N; Doherty, Meah, N; Sinclair, R; Wall, D. (2022). Cross-specialty identification of the JAK1 inhibitor trial agent filgotinib as a potential therapy for alopecia areata. British Journal of Dermatology. epub 25 Nov. [Online]. Available at: https://doi.org/10.1093/bjd/ljac103 [Accessed 21 February 2023]
| Published: | 25/11/2022 |
| Authors: | Meah N |
Re: Do no harm: the role of perioperative heparin in urethroplasty. Lee et al. IUN (2022)
Jones, R.E; Omar, A.M; Garth, L.E; Floyd Jr; Michael S. (2022). Re: Do no harm: the role of perioperative heparin in urethroplasty. Lee et al. IUN (2022). International Urology and Nephrology. 55(2), pp.321-322. [Online]. Available at: https://link.springer.com/article/10.1007/s11255-022-03417-9 [Accessed 20 February 2023]
| Published: | 22/11/2022 |
| Authors: | Jones R |
Patient-reported outcome measures (PROMs) in stone surgery: A multi-centre study of patient experience of flexible ureteroscopy (fURS) versus extracorporeal shockwave lithotripsy (SWL)
Objectives To compare patient-reported outcome measures (PROMs) for patients with symptomatic renal stone disease treated by flexible ureterorenoscopy (fURS) and shockwave lithotripsy (SWL). Introduction Historically, surgical outcomes are measured by surgeon-specific outcomes such as ‘stone-free rates’. More recently, there is increasing emphasis on PROMs to ascertain a patient’s perspective..
| Published: | 18/11/2022 |
| Authors: | Hughes K |
Separating the components of an abdominal wall fellowship
Abstract Complex abdominal wall reconstruction is an emerging subspecialty yet, despite the abundance of abdominal wall hernias requiring treatment and the increasing complexity of this type of surgery, there are few opportunities for surgeons to gain subspecialist training in this field. In this paper we discuss the need for focused..
| Published: | 14/11/2022 |
| Authors: | Adams ST, Scott M, West C |
Impact of COVID-19 policies on perceptions of loneliness in people aged 75 years and over in the cognitive function and aging study (CFAS II)
Background The COVID-19 pandemic and associated social distancing measures have profoundly impacted society and social contact patterns, with older people disproportionately affected. Concerns have been raised about a resulting pandemic of loneliness in older people, although the current evidence is mixed. This study provides a unique perspective on the prevalence..
| Published: | 12/11/2022 |
| Authors: |
CXR-Net: A Multitask Deep Learning Network for Explainable and Accurate Diagnosis of COVID-19 Pneumonia from Chest X-ray Images
Abstract Accurate and rapid detection of COVID-19 pneumonia is crucial for optimal patient treatment. Chest X-Ray (CXR) is the first-line imaging technique for COVID-19 pneumonia diagnosis as it is fast, cheap and easily accessible. Currently, many deep learning (DL) models have been proposed to detect COVID-19 pneumonia from CXR images...
| Published: | 09/11/2022 |
| Authors: | Lechareas S, Tridente A |
COVID-19 related myopericarditis and cardiac tamponade: a diagnostic conundrum
Abstract We report the case of a 45-year-old man presenting with worsening shortness of breath and chest tightness on a background of type 2 diabetes mellitus, hypertension and stable angina. He felt generally unwell and had a productive cough two weeks prior to presentation. Initial examination found quiet heart sounds and..
| Published: | 09/11/2022 |
| Authors: | Meah NA, Wai H, Bhamidipati K |
Patient satisfaction with telephone consultations in cardiology outpatients during the COVID-19 pandemic
Abstract The COVID-19 pandemic required a radical change in healthcare delivery methods, including the remote delivery of many outpatient services. We aimed to understand patient satisfaction with telephone consultations. Patients who had undergone a cardiology telephone consultation between 24 February and 19 July 2021 were asked to complete a survey. The survey assessed..
| Published: | 09/11/2022 |
| Authors: | Goodall J, Katira R |
Emergency Urology procedures during the COVID-19 pandemic in the UK: A 3-month prospective study
Objective COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency surgical care. Specific to Merseyside, Tier 4, Tier 2 and Tier 5 restrictions were introduced in late 2020 and early 2021. The purpose of this study was to examine the nature and workload of emergency urological..
| Published: | 08/11/2022 |
| Authors: | Georgiou M, Ridzuan-Allen A, Chamsin A, Siddiqui Z, Tolofari S, Ejikeme C, Jones R, Napier-Hemy TP, Rotas S, Hughes KE, Khattak AQ, McCabe JE, Omar A, Mistry R, Samsudin A, Gana HB, Floyd Jr MS |
A Comparative Study of Symptoms, Nasal Eosinophilia and Pulmonary Function Tests Before and After Short Term Treatment with Corticosteroid Nasal spray in Patients with Allergic Rhinitis
Abstract Allergic rhinitis has been on the rise because of urbanization and major population shift in addition to changes in the particulate matter in the atmosphere. Intranasal corticosteroid sprays are recommended as first-line prescription treatment in all cases of allergic rhinitis. The propensity of co-existing non-apparent lower airway hyper-responsiveness is..
| Published: | 08/11/2022 |
| Authors: | Pai KM, Pai HS |
A comparison of age-banded and weight-based oral paracetamol dosing in hospitalized children
Introduction The British National Formulary for Children contains two dosing strategies for oral paracetamol; age-banded dosing for pain and pyrexia or weight-based dosing for post-operative pain. Only weight-based is used in our hospital. The aim of this study was to compare these dosing strategies using weights from a pediatric inpatient..
| Published: | 03/11/2022 |
| Authors: | Wright K |
Safety and effectiveness of ustekinumab in elderly Crohn’s disease patients
Objective Anti-tumour necrosis factor (TNF) agents are associated with increased infection risk among elderly IBD patients, but little is known about non anti-TNF biologics in this cohort. We examined the safety and effectiveness of ustekinumab in elderly Crohn’s patients. Methods This retrospective multi-centre cohort study included Crohn’s patients ≥60..
| Published: | 01/11/2022 |
| Authors: | Liaros A |
Perceptions of arthritis glove wear of patients with rheumatoid arthritis and persistent hand pain
Introduction Arthritis gloves are prescribed in rheumatoid arthritis (RA) to reduce hand pain, stiffness, and improve hand function. As part of a randomised controlled trial, this study investigated participants' perceptions of wearing arthritis gloves. Method Participants with RA and persistent hand pain (n = 206) were randomly assigned and prescribed either loose-fitting..
| Published: | 31/10/2022 |
| Authors: | Hough Y |
Psychometric and biomedical outcomes of glycated haemoglobin target-setting in adults with type 1 and type 2 diabetes
Background The disease burden of diabetes can have wide-ranging implications on patients’ psychological well-being and health-related quality of life. Glycated haemoglobin targets are commonly used to guide patient management in diabetes to reduce the future risk of developing diabetes complications, but little is known of the psychological impact of glycated..
| Published: | 27/10/2022 |
| Authors: | Westall S, Narayanan RP, Irving G, Hardy KJ |
Letter to the Editor re: Evaluation of the Clinical Effects of Abobotolinum Toxin A (Dysport) Injection
Gadelrab, M; Chamsin, A; Khadr, R; Omar, AM; Floyd Jr, MS. (2022). Letter to the Editor re: Evaluation of the Clinical Effects of Abobotolinum Toxin A (Dysport) Injection in the Treatment of Neurogenic Lower Urinary Tract Dysfunction. Urology Journal. epub 25 October(.), p.7345. [Online]. Available at: https://journals.sbmu.ac.ir/urolj/..
| Published: | 25/10/2022 |
| Authors: | Gadelrab M, Chamsin A, Omar A, Floyd Jr MS |
Morton Neuroma
Continuing Education Activity Morton neuroma is a compressive neuropathy of the interdigital nerve in the forefoot due to compression and constant irritation at the plantar aspect of the transverse intermetatarsal ligament. It is not a true neuroma as the condition is degenerative rather than neoplastic. It is also referred to..
| Published: | 25/10/2022 |
| Authors: | Munir U, Morgan S |
An intertriginous hyperpigmented macular eruption
Abstract A 23-year-old woman presented with a hyperpigmented intertriginous eruption unresponsive to topical steroids and to topical and systemic antifungals. Histopathological assessment demonstrated patchy inflammatory infiltrate at the demoepidermal junction with pigment incontinence. Harnett, C; Meah, N; Low, SE; Eustace, K. (2022). An intertriginous hyperpigmented macular eruption. Clinical and Experimental Dermatology. 47(12),..
| Published: | 14/10/2022 |
| Authors: | Harnett C, Meah N, Low SE, Eustace K |
P-135 First experience with a new closed incision negative pressure wound therapy, Prevena TM
Aim Surgical site infection (SSI) contributes a significant proportion of post operative morbidity in patients undergoing abdominal wall reconstruction (AWR). PrevenaTM closed incision negative pressure wound therapy (ciNPT) has been demonstrated to reduce SSI rates in the elective and emergency laparotomy setting. However, there is no evidence for PrevenaTM use..
| Published: | 13/10/2022 |
| Authors: | Dixon S, Benson A, Kalaiselvan R, Kanwar S, Samad A, Pritchard-Jones R, West C, Scott M |
Augmented Reality–Assisted Design of Local Flaps: A New Practical and Educational Tool in the Field of Plastic Surgery
Abstract: Augmented reality (AR) is a new and promising technology that has been incorporated into several aspects of our everyday life, including surgery. Examples of its application throughout various fields of surgery, although most of them are in experimental stage, have already been demonstrated and published. In this article, we..
| Published: | 10/10/2022 |
| Authors: | Kyriazidis I, Jones C, Shokrollahi K, Benson A |
OC-022 Maintaining an elective abdominal wall reconstruction service during the COVID 19 pandemic
Aim Elective surgery services suffered significantly due to the COVID-19 pandemic. The aim of this study was to analyse the impact and outcomes of abdominal wall reconstruction (AWR) performed during the COVID-19 pandemic, assessing safety and sustainability. Material & Methods A retrospective review of all patients undergoing AWR in a single..
| Published: | 10/10/2022 |
| Authors: | Dixon S, Benson A, Kalaiselvan R, Kanwar S, Samad A, Pritchard-Jones R, West C, Scott M |
P0490 Opioid exposure in IBD and associated factors: a UK prospective multicentre audit of 1362 patients
Introduction Opioid exposure in inflammatory bowel disease (IBD) is associated with premature mortality, yet exposure in IBD increasing. International guidelines have been introduced to rationalise opioid use. While opioids may improve acute pain, long term exposure is rarely beneficial and is associated with side effects.We conducted a multicentre audit..
| Published: | 09/10/2022 |
| Authors: | Bassi A |
Hormone therapy for uterine and endometrial development in women with premature ovarian insufficiency
Background Premature ovarian insufficiency (POI) is a clinical syndrome resulting from loss of ovarian function before the age of 40. It is a state of hypergonadotropic hypogonadism, characterised by amenorrhoea or oligomenorrhoea, with low ovarian sex hormones (oestrogen deficiency) and elevated pituitary gonadotrophins. POI with primary amenorrhoea may occur as a..
| Published: | 06/10/2022 |
| Authors: | Vinayagam S |
Hormone therapy for uterine and endometrial development in women with premature ovarian insufficiency
Background Premature ovarian insufficiency (POI) is a clinical syndrome resulting from loss of ovarian function before the age of 40. It is a state of hypergonadotropic hypogonadism, characterised by amenorrhoea or oligomenorrhoea, with low ovarian sex hormones (oestrogen deficiency) and elevated pituitary gonadotrophins. POI with primary amenorrhoea may occur as a..
| Published: | 06/10/2022 |
| Authors: | Vinayagam S |
Antibiotic Review Kit for Hospitals (ARK-Hospital): a stepped wedge cluster randomised controlled trial
Background Strategies to reduce antibiotic overuse in hospitals depend on prescribers taking decisions to stop unnecessary antibiotic use. There is scarce evidence for how to support these decisions. We evaluated a multifaceted behaviour change intervention (ie, the antibiotic review kit) designed to reduce antibiotic use among adult acute general medical..
| Published: | 04/10/2022 |
| Authors: | Gray K |
Augmented Reality–Assisted Design of Local Flaps: A New Practical and Educational Tool in the Field of Plastic Surgery
Abstract Augmented reality (AR) is a new and promising technology that has been incorporated into several aspects of our everyday life, including surgery. Examples of its application throughout various fields of surgery, although most of them are in experimental stage, have already been demonstrated and published. In this article, we..
| Published: | 03/10/2022 |
| Authors: | Kyriazidis I, Jones C, Shokrollahi K, Benson A |
Stroke-heart syndrome: sex-specific incidence, risk factors, and major adverse cardiovascular events in 486,515 patients
Background Newly diagnosed cardiovascular complications post-stroke, termed stroke-heart syndrome, are common and associate with worsened prognosis. Purpose To investigate the sex-specific incidence and 5-year major adverse cardiovascular events following stroke-heart syndrome, stratified by pre-existing risk factors (sex, age, obesity, hypertension, type 2 diabetes mellitus, and high LDL cholesterol). Methods A retrospective..
| Published: | 03/10/2022 |
| Authors: | Hill AM |
Hallux Varus
Continuing Education Activity Hallux varus is a clinical condition characterized by medial deviation of the great toe at the metatarsophalangeal (MTP) joint. This condition has multiple etiologies and patients may present with various symptoms and with varying severity of hallux varus. Adult acquired hallux varus deformity is commonly iatrogenic, occurring..
| Published: | 25/09/2022 |
| Authors: | Munir U, Morgan S |
Electrochemotherapy for the treatment of cutaneous squamous cell carcinoma: The INSPECT experience (2008-2020)
Introduction Cutaneous squamous cell carcinoma (cSCC) is a frequent skin cancer with a high risk of recurrence characterized by tumor infiltration and, in advanced cases, a poor prognosis. ECT (electrochemotherapy) is an alternative treatment option for locally advanced or recurrent cSCC that is unsuitable for surgical resection. In this study,..
| Published: | 20/09/2022 |
| Authors: | Pritchard-Jones R |
Signposts to the Promised Land in Alopecia Areata
Abstract Alopecia areata (AA) is an autoimmune disease of the hair and nails. Although genotype alters the risk, the etiology remains unclear. AA typically presents as one or more hairless patches; however, full loss of scalp hair occurs in about 15% of patients (Cranwell et al., 2019; Ikeda, 1965). The relative ease in..
| Published: | 18/09/2022 |
| Authors: | Meah N |
Signposts to the Promised Land in Alopecia Areata
Clinical Implications Costs associated with emerging therapies will require disease severity to be redefined. The Severity of Alopecia Tool score was not predictive of life quality. Patient-reported outcomes provide a more accurate depiction of diminished life quality. Wall, D; Rees, H; Bokhari, L; Meah, N; York, K; Sinclair, R. (2023). Signposts..
| Published: | 18/09/2022 |
| Authors: | Meah N |
Can a prostate biopsy be safely deferred on PI-RADS 1,2 or 3 lesions seen on pre-biopsy mp-MRI?
Introduction Multi-parametric magnetic resonance imaging (mp-MRI) is currently used to triage patients with suspected prostate cancer, before deciding on prostate biopsies. In our study, we evaluated normal and equivocal pre-biopsy mp-MRIs to see whether it is safe to avoid biopsy with such findings. Methods A retrospective study was conducted at..
| Published: | 13/09/2022 |
| Authors: | Hosny K |
Differential attainment and recruitment to Intensive Care Medicine Training in the UK, 2018–2020
Background Differences exist among doctors in examination performance, clinical and academic career progression, and prevalence of performance assessment by professional regulatory bodies. Some of these differences have been reported in relation to individual characteristics. The purpose of this study is to establish whether any specific individual characteristics are associated with..
| Published: | 12/09/2022 |
| Authors: | Tridente A |
A Randomized Trial of Enteral Glutamine for Treatment of Burn Injuries
Background Glutamine is thought to have beneficial effects on the metabolic and stress response to severe injury. Clinical trials involving patients with burns and other critically ill patients have shown conflicting results regarding the benefits and risks of glutamine supplementation. Methods In a double-blind, randomized, placebo-controlled trial, we assigned patients..
| Published: | 09/09/2022 |
| Authors: | Shokrollahi K |
Current practice and surgical outcomes of neoadjuvant chemotherapy for early breast cancer: UK NeST study.
Abstract: oadjuvant chemotherapy (NACT) is increasingly being used to treat early breast cancer, and offers several advantages, including reducing the extent of breast and axillary surgery, and providing an in vivo assessment of tumour sensitivity to treatment1–4. Clinical trials have identified tumour subgroups with high rates of pCR. A pCR..
| Published: | 09/09/2022 |
| Authors: | Alfred J, Lennon H |
P014 Video assisted anal fistula treatment (VAAFT): A 5 year review
Aim VAAFT is claimed to be the only technique that allows the surgeon to see inside the anal fistula tract and locate the internal opening using an endoscope light. It is designed to only affect the fistula tract and there preserve sphincter function and faecal continence. Our aim was to..
| Published: | 06/09/2022 |
| Authors: | Alfred J, Santoro G, Beggs R, Brookes J, Rajaganeshan R |
P066 Incisional hernia rate following laparoscopic anterior resection. Does extraction site matter?
Aim Incisional hernia are an established complication following abdominal surgery. There is limited data available on the relationship between formation of an incisional hernia and choice of extraction site for patients undergoing a laparoscopic anterior resection. This study aimed to determine the prevalence of incisional hernia following this operation and..
| Published: | 06/09/2022 |
| Authors: | Botzenhardt E, Clifford R, Rajaganeshan R |
Implications for sequencing of biologic therapy and choice of second anti-TNF in patients with inflammatory bowel disease: Results from the IMmunogenicity to Second Anti-TNF therapy (IMSAT) therapeutic drug monitoring study
Background Anti-drug antibodies are associated with treatment failure to anti-TNF agents in patients with inflammatory bowel disease (IBD). Aim To assess whether immunogenicity to a patient's first anti-TNF agent would be associated with immunogenicity to their second, irrespective of drug sequence Methods We conducted a UK-wide, multicentre, retrospective cohort study..
| Published: | 29/08/2022 |
| Authors: | Chandy R, Baig D, Jagdish R |
287 Retrospective Review of a Single Surgeon 5-Year Experience of Paediatric Breast Reconstruction
Aim This case series reviews the presentation, clinical and surgical management of paediatric breast cases undertaken by a single surgeon. The series demonstrates the powerful role of lipomodelling when used with breast reshaping techniques to achieve good outcomes and avoid the need to commit young patients to breast implants. Method..
| Published: | 19/08/2022 |
| Authors: | Nelson A, Taghizadeh R, Hassan D |
622 Tranexamic Acid Use in Meningioma Surgery – a Systematic Review and Meta-Analysis
Aim Meningioma surgery is associated with increased intraoperative bleeding and transfusion requirement. Tranexamic Acid (TXA) has been used in medical and surgical practice to reduce haemorrhage. This review aimed to evaluate the effect of TXA use on bleeding and transfusion requirement, and functional outcomes in meningioma surgery. Method A systematic..
| Published: | 18/08/2022 |
| Authors: | Keshwara S |
945 Usefulness of Skull X-Ray in diagnosis and management of craniosynostosis and suspected NAI in children less than 4 years, results of three years retrospective observational study
Aims Evidence for the indications of skull X rays (SXR) in children is limited. There is substantial evidence to suggest that children are more susceptible to the effects of ionizing radiation than adult. The risks from exposure to ionizing radiation are dependent on the age at which exposure occurs, and..
| Published: | 17/08/2022 |
| Authors: | Ahmad A, Hamed Z, Vataha K, Abdelaziz M |
67 The occurrence of contaminated blood culture in paediatric unit in DGH, simple intervention to prevent cost and unnecessary treatment
Aims Micro-organisms are present on the skin surface of patients, staff and the immediate patient environment which can result in contamination of blood cultures. Contamination can lead to inappropriate treatment, prolonged hospital stay, increased cost (estimated: £5000/contaminated culture), family and patient inconvenience and it affect mandatory surveillance data and protocols...
| Published: | 17/08/2022 |
| Authors: | Mohamed A, Vardhan M |
853 Disseminating new clinical guidance during a pandemic
Aims Establishing an innovative method of disseminating a new bronchiolitis guideline in a tertiary paediatric hospital. The ripple effect of the Covid-19 pandemic and subsequent lockdown periods on the paediatric population has been far reaching.1 With isolation drawing to a close, we saw a resurgence of patients presenting to hospital..
| Published: | 17/08/2022 |
| Authors: | Cocks Z |
905 Comparison of prednisolone vs dexamethasone in acute asthma and viral induced wheeze
Aims Early oral corticosteroid therapy is recommended in the treatment of acute asthma exacerbations in children. BTS/SIGN guidelines recommend that children with severe symptoms of viral induced wheeze (VIW) should still receive oral steroids, and that it is advisable in moderately severe cases without a previous diagnosis of asthma...
| Published: | 17/08/2022 |
| Authors: | Humphreys S, Lisboa L, Chilukuri L |
784 Review of bronchopulmonary dysplasia services in the North West of England
Aims Bronchopulmonary dysplasia (BPD) or neonatal chronic lung disease is the commonest adverse outcome in very premature neonates. BPD incidence is increasing unlike other prematurity associated conditions and despite advances in aetiological understanding. BPD incurs substantial healthcare costs which extend beyond initial hospitalisation, such as home oxygen therapy, recurrent admissions..
| Published: | 17/08/2022 |
| Authors: | Krishnamurthy S, Chilukuri L |
1224 Audit of neonatal hypoglycaemia in Whiston Hospital and study of incidental hypoglycaemia during sepsis screen
Aims Babies at risk of hypoglycaemia should be identified at birth and placed on a care pathway that includes early commencement of feeds, regular glucose monitoring and clinical assessment. Our hospital has a hypoglycaemia policy for managing these babies and this project aims to examine current local practice through auditing..
| Published: | 17/08/2022 |
| Authors: | Alexopoulou V (STHK), Green J, Garr R |
1074 Surgical care closer to home: is it up to the mark?
Aims Paediatric surgery is challenging and training in this area is subspecialised including anaesthesia and post operative care. The Royal College of Surgeons Standards of Surgical care for Children, 2013 supports the ‘provision of care closer to home’ in patients with access to appropriate level of care. Typically this is district..
| Published: | 17/08/2022 |
| Authors: | Maddipati T, Chilukuri L, Abdelaziz M |
677 GP with Extended Remit (GPwER) in Paediatrics-Ensuring children and young people are seen in the right place, at the right time, by the right person
Aims The GPwER for paediatrics manages a defined cohort of paediatric conditions in a community setting, ensuring patients are seen at the right time, in the right place by the right clinician. By bringing the skills of a generalist to a specialist area, care is delivered to children & young people..
| Published: | 17/08/2022 |
| Authors: | Chang R, Abdelaziz M, Barrow A |
A survey of UK critical care pharmacists research involvement and associated barriers
Introduction Pharmacist led research provides evidence of impact of safe, effective and economic advanced pharmaceutical care in critical care medicine. Examples include impact of extracorporeal therapies on drug handling1; sedation delirium management2; medication safety3 and broader pharmacist interventions.4 The New Zealand Hospital Pharmacist Association (NZPHA), Society of Pharmacists of Australia (..
| Published: | 15/08/2022 |
| Authors: | Barton G |
TU8.10 Should patients with a predicted NELA mortality of 5–10% be managed on ICU? An audit of the management of high-risk laparotomies as per NELA Guidelines
Aims The National Emergency Laparotomy Audit (NELA) has been pivotal in improving the care of patients undergoing emergency laparotomy. One key recommendation is ‘high-risk’ patients are managed on ICU post-operatively. We aimed to identify if there was a difference in outcomes between ‘high-risk patients’ (predicated NELA mortality >5%) managed on ICU..
| Published: | 09/08/2022 |
| Authors: | Banks J, Macadam R |
Invited Discussion on: “Comparison of Classic Mastopexy Method Versus Double-pedicled Auto-augmentation Mastopexy with with Conic-Shaped Modified Inferior Butterfly Flap".
Taghizadeh, R. (2022). Invited Discussion on: “Comparison of Classic Mastopexy Method Versus Double-pedicled Auto-augmentation Mastopexy with with Conic-Shaped Modified Inferior Butterfly Flap". Aesthetic Plastic Surgery. epub 4 August(.), p... [Online]. Available at: https://doi.org/10.1007/s00266-022-03016-0 [Accessed 16 August 2022]
| Published: | 04/08/2022 |
| Authors: | Taghizadeh R |
Review of Burn Resuscitation: is Plasmalyte® A Comparable Alternative to Ringer’s Lactate?
Abstract Ringer’s lactate has been the most widely used fluid for burn resuscitation for decades. Plasmalyte®, a newer balanced crystalloid, is gaining popularity for use in the critically ill, including patients with burns. This popularity is partly due to the fact that Plasmalyte® theoretically offers a favourable metabolic profile,..
| Published: | 02/08/2022 |
| Authors: | Cappuyns L, Tridente A, Stubbington Y, Shokrollahi K |
Medical Student Perspectives on Undergraduate Oncology Education in the UK
Aims The British Oncology Network for Undergraduate Societies (BONUS) surveyed students who attended an oncology revision day to determine their views on the current quantity, quality and type of curriculum-based oncology teaching they have experienced. Materials and methods Students attending two BONUS revision days received a questionnaire assessing their experience..
| Published: | 01/08/2022 |
| Authors: | Keshwara S |
National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK
Introduction Keratinocyte or non-melanoma skin cancer (NMSC) is the most common malignancy worldwide, encompassing basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). The mainstay of treatment for NMSC is excision. The likelihood of recurrence is directly related to achieving tumour-free margins. Just 1 per cent of BCCs recur where..
| Published: | 27/07/2022 |
| Authors: | Nolan G, Pritchard-Jones R |
The frequency and clinical significance of centromere enumeration probe 17 alterations in human epidermal growth factor receptor 2 immunohistochemistry-equivocal invasive breast cancer
Background and Aims Keratinocyte or non-melanoma skin cancer (NMSC) is the most common malignancy worldwide, encompassing basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). The mainstay of treatment for NMSC is excision. The likelihood of recurrence is directly related to achieving tumour-free margins. Just 1 per cent of BCCs..
| Published: | 25/07/2022 |
| Authors: | Chagla LS |
Clinical Outcomes and Risk Stratification of Early-Stage Melanoma Micrometastases From an International Multicenter Study
Purpose Indications for offering adjuvant systemic therapy for patients with early-stage melanomas with low disease burden sentinel node (SN) micrometastases, namely, American Joint Committee on Cancer (AJCC; eighth edition) stage IIIA disease, are presently controversial. The current study sought to identify high-risk SN-positive AJCC stage IIIA patients who are more..
| Published: | 18/07/2022 |
| Authors: | Nolan G, Pritchard-Jones R |
Retrospective Review of Arthroplasty Radiographs: How to Define an Adequate Radiograph
Introduction Adequacy of postoperative hip and knee radiographs has a direct impact on its interpretation. We undertook a quality improvement project by creating local standards to meet the arthroplasty team expectations for a satisfactory radiograph. The purposes of the study are 1. Assessment of the adequacy of radiographs according to defined..
| Published: | 09/07/2022 |
| Authors: | Khan S |
Editorial commentary: COVID-19 and COVID-19 vaccination: Observations on thrombosis and thrombocytopenia
Elsheikh, S; Lip, GYH. (2022). Editorial commentary: COVID-19 and COVID-19 vaccination: Observations on thrombosis and thrombocytopenia. Trends in Cardiovascular Medicine. 32 (5), 257-258
| Published: | 08/07/2022 |
| Authors: | Elsheikh S |
BONUS: the National Oncology Network for Students and Junior Doctors
The British Oncology Network for Undergraduate Societies (BONUS) is a national oncology network for medical students and junior doctors. The network aims to promote careers and education in clinical, medical, surgical and interventional oncology, a subspeciality of interventional radiology, and is, therefore, a ‘pan-oncology society’ [[1]]. Both a recent Royal College..
| Published: | 07/07/2022 |
| Authors: | Keshwara S |
BONUS: the National Oncology Network for Students and Junior Doctors
The British Oncology Network for Undergraduate Societies (BONUS) is a national oncology network for medical students and junior doctors. The network aims to promote careers and education in clinical, medical, surgical and interventional oncology, a subspeciality of interventional radiology, and is, therefore, a ‘pan-oncology society’ [[1]]. Both a recent Royal College..
| Published: | 07/07/2022 |
| Authors: | Keshwara S |
Whole-genome sequencing reveals host factors underlying critical COVID-19
Abstract Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of..
| Published: | 07/07/2022 |
| Authors: | Greer S, Shuker K, Tridente A |
Desmoplastic trichoepithelioma: an uncommon adnexal tumour with a predilection for cosmetically sensitive sites
Introduction Desmoplastic trichoepithelioma is an uncommon adnexal tumour (Rahman et al, 2020) predominantly affecting young women in cosmetically sensitive sites (Mamelak et al, 2010). Detection is often incidental and histological diagnosis can be impeded by biopsies that are insufficiently deep (Mamelak et al, 2010). Clinically and histologically it can mimic morphoeic basal cell..
| Published: | 06/07/2022 |
| Authors: | Morton J |
Physical therapy for facial nerve paralysis (Bell's palsy): An updated and extended systematic review of the evidence for facial exercise therapy
Objective To conduct a systematic review of the effectiveness of facial exercise therapy for facial palsy patients, updating an earlier broader Cochrane review; and to provide evidence to inform the development of telerehabilitation for these patients. Data Sources MEDLINE, EMBASE, CINAHL, Cochrane Library, PEDro and AMED for relevant studies published..
| Published: | 05/07/2022 |
| Authors: | Martin H |
H17: Botulinum toxin: from lethal adversary to dermatological sensation – how the power of poison was harnessed
Abstract Botulinum toxin, produced by the bacterium Clostridium botulinum, is a remarkably versatile agent. Its dermatological applications include the treatment of both hyperhidrosis and rhytides, and its myriad of medical functions are numerous and far reaching. Yet, capable of inducing paralysis and subsequent death, its origins belie the reputation it..
| Published: | 05/07/2022 |
| Authors: | Winters S |
BI27: Two cases of capecitabine-induced subacute cutaneous lupus erythematosus
Abstract Capecitabine-induced subacute cutaneous lupus erythematosus is a documented but seemingly underappreciated phenomenon. We report our experience of two cases reviewed in a specialist immunochemotherapy dermatology clinic. A 73-year-old woman with a background of stage 4 oesophageal cancer presented with a rapidly progressive pruritic eruption. She had received one cycle of..
| Published: | 05/07/2022 |
| Authors: | Winters S, Hindle E |
E 389 - Survey of Bronchopulmonary Dysplasia (BPD) Services in Twenty Hospitals in the North West Region of England
Abstract The purpose of this report is to analyze the functioning of BPD services, in accordance with evidence-based medicine, in a range of North West hospitals and then suggesting changes to the service if needed. To enable this, the authors have designed a standardized questionnaire to interview the hospitals which..
| Published: | 30/06/2022 |
| Authors: | Chilukuri L, Maddipati T |
E 389 - Survey of Bronchopulmonary Dysplasia (BPD) Services in Twenty Hospitals in the North West Region of England
Abstract The purpose of this audit is to assess the efficacy of single dose oral dexamethasone in preventing acute readmissions in comparison with a three-day course of oral prednisolone. A new local guideline was introduced in 2019, that recommends the use of single dose oral dexamethasone for management of asthma in..
| Published: | 30/06/2022 |
| Authors: | Chilukuri L, Humphreys S, Lisboa L, Maddipati T |
P23 Comparative safety and effectiveness of ustekinumab and vedolizumab in elderly crohn’s disease patients
Background Anti-TNF agents are effective in treating elderly Crohn’s disease (CD) patients but its use is limited by increased risk of infections and treatment discontinuation. Evidence for safety and efficacy of non-anti-TNF biologics in the elderly is limited. We aimed to compare the safety and effectiveness of ustekinumab and..
| Published: | 19/06/2022 |
| Authors: | Liaros A |
O16 Gastrostomy placement in MND: the impact of weight loss and respiratory compromise
Introduction Motor neurone disease (MND) is a neurodegenerative condition causing progressive deterioration of muscle weakness that affects breathing, movement and swallowing. The Progas study1 is the largest study in recent years focussing on nutrition in MND, demonstrating that 30 day mortality post PEG (percutaneous endoscopic gastrostomy) insertion was 10.7 times higher in..
| Published: | 19/06/2022 |
| Authors: | Roberts S, Theis V, Clark K |
O15 Benefits of gastrostomy tract dilatation following gastrostomy tube displacement
Introduction It is estimated that 2% of gastrostomies will become displaced in the first 10 months of placement and 37% within five years.1 Replacement of a displaced gastrostomy tube should only be attempted 4 weeks after initial placement, as prior to this, the tract may not be fully formed and the risk of misplacement..
| Published: | 19/06/2022 |
| Authors: | Roberts S, Theis V, Clark K |
Prevention and management of post-deep inferior epigastric perforator flap abdominal bulge
Background Abdominal bulge in the absence of a hernia is a known complication following free abdominal flap breast reconstruction and can be associated with significant aesthetic and functional morbidity. This study aims to review the impact of permanent subrectus mesh placement on the incidence of post-DIEP bulge. Methods All patients..
| Published: | 17/06/2022 |
| Authors: | Jakeman M, Barnes J, Taghizadeh R |
992 Results of a pilot HIV/Frailty Clinic - can comprehensive geriatric assessment benefit frail people living with HIV?
Introduction Frailty has been recognised among people living with human immunodeficiency virus (HIV) and will become more prevalent in coming years given treatment success (Pathai et al J Gerontol A Biol Sci Med Sci 2014;69:833–842). Assessment of frailty and its common syndromes through comprehensive geriatric assessment (CGA) is routinely delivered by..
| Published: | 14/06/2022 |
| Authors: | Morrow H, Horner M, Thomson-Glover R |
P1141: Ibrutinib and rituximab as first line therapy for mantle cell lymphoma: a multicentre, real-world UK study
Background Ibrutinib (IBR) is an oral covalent Bruton tyrosine kinase inhibitor (BTKi), licensed for treatment of relapsed or refractory mantle cell lymphoma (MCL). Under NHS interim Covid-19 agreements in England, IBR with or without rituximab (R) was approved for the frontline treatment for MCL patients (pts) as a safer alternative..
| Published: | 14/06/2022 |
| Authors: | Nicholson T |
Commentary on: Utilization of Free Soft Tissue Grafts in Otoplasty: A Simple Yet Effective Way to Avoid Suture Extrusion
Extract The authors have summarized their experience from over 200 cases relating to soft-tissue interposition between postauricular skin and suture knots in suture-based otoplasty.1 Suture extrusion is one of the most common complications in procedures that utilize concho-mastoid or concho-scaphal sutures. Therefore, any intervention that reduces this complication should be seriously..
| Published: | 11/06/2022 |
| Authors: | Shokrollahi K |
P10-9 Correlation of Hounsfield units and stone volume with LASER time in stone surgery
Introduction Time taken for stone disease surgeries are variable and can be unpredictable. Appropriate planning of cases and theatre lists improves efficiency, saves costs, and prevents cancellations. This study aims to determine if Hounsfield units (HU) and stone volume (SV) has a correlation with various factors, in particular LASER time...
| Published: | 10/06/2022 |
| Authors: | Agarwal K, McCabe JE |
Developing priorities for quality improvement in acute medicine using a modified Delphi method
Introduction The SAM Quality Improvement Committee (SAM-QI), set up in 2016, has worked over the last year to determine the priority Acute Medicine QI topics. They have also discussed and put forward proposals to improve QI training for Acute Medicine professionals. Methods A modified Delphi process was completed over four rounds..
| Published: | 09/06/2022 |
| Authors: | Varia R, Rigby A |
The scope for radiology to contribute to the NHS net zero target: findings from a survey of radiology staff in the UK
Aim To assess attitudes towards the climate emergency among radiology staff and to identify current practices that may contribute towards the National Health Service (NHS) net zero target. Materials and methods An online survey of radiology staff was conducted assessing current attitudes to the climate emergency. Further questions focused on..
| Published: | 07/06/2022 |
| Authors: | Gendy D, Zaman S |
P04 Adverse events following immunization (AEFI) with COVID-19 vaccines: case series and literature review
Abstract There currently exists no formal consensus on advice given to patients who have experienced an adverse event following immunization (AEFI) (WHO definition) following COVID-19 vaccination. The incidence of vaccine-related cutaneous events is only likely to increase with the UK launching subsequent vaccine doses as part of the mass vaccination..
| Published: | 03/06/2022 |
| Authors: | Walsh ML, Trehan P |
Assessing the required glenoid peg penetration in native scapula when bone graft is used during primary and revision shoulder arthroplasty
Aims Achieving purchase in native glenoid bone is essential for the stability of the glenoid baseplate when bone graft is used to address bone loss in both primary and revision shoulder arthroplasty procedures. The aim of this study is to assess the required depth of the baseplate peg in native..
| Published: | 01/06/2022 |
| Authors: | Makki D |
Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Pregnant Women: A Systematic Review of Cohort Studies
Abstract: Aims. The aim of this systematic review is to identify and appraise pharmacological options available for management of ADHD in pregnant women and adverse effects of ADHD medications on pregnancy and foetus (malformations or long-term effects). Methods. Systematic review of prospective or retrospective cohort studies, available on this topic..
| Published: | 01/06/2022 |
| Authors: | Surendran I |
Corticosteroids for the treatment of Kawasaki disease in children
Background Kawasaki disease (KD), or mucocutaneous syndrome, is the leading cause of childhood‐acquired heart disease in high‐income countries. There is much controversy on how best to treat children with KD and in particular who may benefit from additional treatment beyond the standard intravenous immunoglobulin (IVIG) and aspirin, such..
| Published: | 27/05/2022 |
| Authors: | Green J |
Metastatic melanoma to the heart causing ventricular tachycardia: looking beyond the troponin
Abstract: A man in his mid-50s presented with palpitations, chest pain and syncope. After initial workup for a non-ST elevation myocardial infarction, a CT scan revealed metastatic melanoma. The malignancy was infiltrating his right ventricle, resulting in recurrent ventricular tachycardia. Although initially hard to manage, his arrhythmias were eventually..
| Published: | 25/05/2022 |
| Authors: | Goodall J, Beveridge NER, Rasoul D, Bhamidipati K |
Digital screening for postnatal depression: mixed methods proof-of-concept study
Background: Depression during the postnatal year is prevalent in mothers (17%) and fathers (9%), and suicide is the leading cause of maternal death in this period. Lifelong costs and consequences of untreated postnatal depression (PND) are high due to impacts on infants as well as parents. We aimed to improve access to..
| Published: | 23/05/2022 |
| Authors: | Agass R |
Medical Student Perspectives on Undergraduate Oncology Education in the UK
Influence of MRI use on surgical outcomes in lobular breast cancer Aims The British Oncology Network for Undergraduate Societies (BONUS) surveyed students who attended an oncology revision day to determine their views on the current quantity, quality and type of curriculum-based oncology teaching they have experienced. Materials and methods Students..
| Published: | 18/05/2022 |
| Authors: | Keshwara S |
Restoration of smile: The role of the masseteric to facial nerve transfer in facial reanimation
Objectives The masseteric nerve has become a popular donor nerve for transfer in facial reanimation surgery. Results are comparable to, if not better than other nerve transfer techniques. This article describes the use of a masseteric to facial nerve transfer for facial reanimation in a group of patients with facial..
| Published: | 17/05/2022 |
| Authors: | Snashall E, Harper-Machin A, Martin H |
Variability in Test Interval Is Linked to Glycated Haemoglobin (HbA1c) Trajectory over Time
Aims: We previously showed that the glycated haemoglobin (HbA1c) testing frequency links to diabetes control. Here, we examine the effect of variability in test interval, adjusted for the frequency, on change in HbA1c (ΔHbA1c). Materials & Methods: HbA1c results were collected on 83,872 people with HbA1c results..
| Published: | 16/05/2022 |
| Authors: | Green L |
Evaluation of the Indications for Sentinel Node Biopsy in Early-Stage Melanoma with the Advent of Adjuvant Systemic Therapy
Background Patients presenting with early-stage melanoma (AJCC pT1b-pT2a) reportedly have a relatively low risk of a positive SNB (~5–10%). Those patients are usually found to have low-volume metastatic disease after SNB, typically reclassified to AJCC stage IIIA, with an excellent prognosis of ~90% 5-year survival. Currently, adjuvant systemic therapy is..
| Published: | 13/05/2022 |
| Authors: | Nolan G, Pritchard-Jones R |
Epidemiology of Neonatal Acute Respiratory Distress Syndrome: Prospective, Multicenter, International Cohort Study
Objectives Age-specific definitions for acute respiratory distress syndrome (ARDS) are available, including a specific definition for neonates (the “Montreux definition”). The epidemiology of neonatal ARDS is unknown. The objective of this study was to describe the epidemiology, clinical course, treatment, and outcomes of neonatal ARDS. Design Prospective, international, observational, cohort..
| Published: | 10/05/2022 |
| Authors: | Tridente A |
Nephrogenic metaplasia in a female person with spinal cord injury
Introduction Chronic irritation caused by urinary catheter may predispose to metaplastic changes in the bladder and very rarely, nephrogenic metaplasia. Case presentation A 53-year-old lady with T-2 paraplegia and urethral catheter drainage for 27 years presented with haematuria. MRI of pelvis, performed seven years ago, showed a 10 cm intramural fibroid within..
| Published: | 09/05/2022 |
| Authors: | Hasan NU |
Developing a burn-specific peri-operative checklist: Version zero, a starting point
Winning poster presentation in the Care category at the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction: The World Health Organization (WHO) surgical safety checklist is a widely applied tool in surgical practice aimed at identifying potential faults..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Holme H, Mandal A, Gurusinghe D, Shokrollahi K |
Photodynamic antimicrobial chemotherapy coupled with the use of the photosensitizers methylene blue and temoporfin as a potential novel treatment for Staphylococcus aureus in burn infections
Winning poster presentation in the Research category at the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Aim This study aimed to assess the antimicrobial efficacy of methylene blue (MB) - and temoporfin-mediated PACT against both Gram+ve and..
| Published: | 04/05/2022 |
| Authors: | Shokrollahi K |
Aesthetic tattoos as a treatment adjunct for scars from burns & trauma: A literature review and treatment approach
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Aesthetic tattoos are extremely common in the UK and around the world. Medical tattoos have been employed in a variety of subspecialties across burns and plastic..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Khaw R, Shokrollahi K |
Burn fluid resuscitation using plasmalyte®: Is it a safe replacement for ringers lactate and what is the potential cost saving?
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Fluid resuscitation remains the basis of early burn management. Both the type and volume of fluids can impact the outcome of burn patients. Appropriate fluid resuscitation..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Tridente A, Stubbington Y, Shokrollahi K |
A service evaluation of the Cosmetic camouflage service at a UK regional plastic surgery department
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction The negative impact of scars and cutaneous dermatoses including vitiligo and rosacea are well known. Cosmetic camouflage is one potentially helpful intervention and involves the application..
| Published: | 04/05/2022 |
| Authors: | Oke S, Cappuyns L, Shokrollahi K |
Further perspectives on burns from E-cigarette battery explosions: a public health concern
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Electronic cigarettes (e-cigarettes) are a fairly recent invention which substitutes conventional cigarettes. The use of e-cigarettes is on the rise as these devices are often marketed..
| Published: | 04/05/2022 |
| Authors: | Stone S, Cappuyns L, Philip L, Gurusinghe D, Shokrollahi K |
Overcoming challenges around wounds and wound dressings in burn patients requiring nerve conduction studies
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Conclusions Through collaborative efforts a new protocol and a SOP are being developed which address the logistics around performing the tests in patient who have unhealed burns..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Murray E, Gurusinghe D, Deshpande M, Nwe M, Shokrollahi K |
A patient’s perspective of extravasation injury treated at a burns centre
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Aim We sought to understand better the patient experience and journey in the aftermath of an extravasation injuries and how care pathways for these patients might be..
| Published: | 04/05/2022 |
| Authors: | Hussien M, Cappuyns L, Murgatroyd E, Eccles L, Shokrollahi K |
The role of burns professionals in public health awareness and strategies to prevent burns
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction A number of plants and other naturally occurring substances have been shown to cause skin irritation or cutaneous chemical burns. In many of these cases the..
| Published: | 04/05/2022 |
| Authors: | Ebbs S, Cappuyns L, Giannopoulos I, Mandal A, Gurusinghe D, Shokrollahi K |
Hypothermia in severe burns presenting at a regional burns centre
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Conclusions Our study demonstrates a link between hypothermia and mortality but not whether this link is causative. Our study also demonstrates a link between TBSA and hypothermia...
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Philip L, Ramadan S, Ebbs S, Gurusinghe D, Shokrollahi K |
An audit of ward-level pain management at a regional burn centre: Is the National standard adequate?
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Aims To audit pain management practice at ward level against set national standards. To gauge the adequacy of that standard. To assess the true effectiveness of pain..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Ramadan S, Gurusinghe D, Shokrollahi K |
The Peroneus Brevis muscle flap for distal third tibia reconstruction in burns and trauma – a non-microsurgical and expeditious technique offering rapid wound healing of a complex wound.
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Reconstructive options for defects of the distal third of the tibia are often limited, challenging and cited as requiring free tissue transfer. Local options can be..
| Published: | 04/05/2022 |
| Authors: | Cappuyns L, Gurusinghe D, Bell D, Shokrollahi K |
Is the use of a powered dermatome an aerosol-generating procedure (AGP)? Implications for personal protection against COVID-19 virus.
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Many healthcare workers have contracted SARS-CoV-2 during the pandemic, many cases of which have resulted in severe illness and death. No studies have assessed the potential..
| Published: | 04/05/2022 |
| Authors: | Kyriazidis I, Shokrollahi K, Zack-Williams SDL, Jones C, Murgatroyd E, Gurusinghe D |
Ulnar nerve compression at the elbow secondary to burn related heterotopic ossification – a case report and literature review of management options
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Heterotopic ossification (HO) is a poorly understood pathological process which can complicate the management of burns. It is thought to be mediated by tissue hypoxia amongst..
| Published: | 04/05/2022 |
| Authors: | Ramadan S, Cappuyns L, Shokrollahi K, Gurusinghe D |
Preliminary experience of HDR Brachytherapy for treatment of keloid scars
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Keloids are challenging with significant recurrence External beam radiotherapy has been effective in recurrent keloids but with significant exposure. Brachytherapy allows for surgical excision of keloids..
| Published: | 04/05/2022 |
| Authors: | Wahal A, Gurusinghe D, Shokrollahi K |
Use of DERMABOND® PRINEO® Skin Closure System to optimise results of excision and direct closure in acute burns
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Primary excision and direct closure of deep/full thickness burn is historically contraindicated due to purported risk of complications. Self -adhering mesh (Prineo™ and glue (Dermabond™..
| Published: | 04/05/2022 |
| Authors: | Wahal A, Cappuyns L, Gurusinghe D, Shokrollahi K |
Tangential excision and skin grafting for sever chronic ulcerative allergic reaction to tattoo pigment. A case report and review of literature in the context of a European ban on coloured pigment tattoos
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction Tattooing is used in both recreationally and for scar management including burn patients to disguise burn scar knowledge about the clinical spectrum, pathogenesis and treatment of..
| Published: | 04/05/2022 |
| Authors: | Wahal A, Cappuyns L, Stubbington Y, Gurusinghe D, Shokrollahi K |
Giant Hogweed: The role of burns professionals in public health awareness and strategies to prevent burns
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf Introduction A number of plants and other naturally occurring substances have been shown to cause skin irritation or cutaneous chemical burns. In many of these cases the..
| Published: | 04/05/2022 |
| Authors: | Ebbs S, Cappuyns L, Giannopoulos I, Mandal A, Gurusinghe D, Shokrollahi K |
Influence of MRI use on surgical outcomes in lobular breast cancer
Introduction Lobular carcinomas account for around 10% of invasive breast cancers. Accuracy of pre-operative evaluation can be troublesome. NICE guidelines recommend MRI "to assess the tumour size if breast-conserving surgery is being considered for invasive lobular cancer". However, each additional investigation introduces cost and potentially prolongs the treatment pathway, which is..
| Published: | 02/05/2022 |
| Authors: | Wadsworth P, Rimmer L, Sepesiova L, Fong J, Kiernan T, Harris O |
Feasibility of breast lesion localisation using Sirius Pintuition
Introduction Impalpable breast cancers can be localised using different techniques. Recently, magnetic seed localisation systems have been developed and shown to offer benefits over traditional wire guided techniques. This study aims to assess the feasibility of a new seed localisation device, Sirius Pintuition, at St Helen's and Knowsley NHS Trust. ..
| Published: | 02/05/2022 |
| Authors: | Foster R, Bathla S, Harris O, Jois RHS, Kiernan T, Ray A, Chagla LS |
Reverse abdominoplasty advancement flap: An effective and low morbidity reconstruction option for the radical mastectomy patient
Introduction Radical mastectomy (RM) is indicated for patients with locally uncontrolled breast carcinoma or angiosarcoma of the breast, for either local control or with curative intent. Flap coverage is routinely offered using pedicled or free flap reconstruction, committing the patient to a long post-operative recovery and risks significant donor site..
| Published: | 02/05/2022 |
| Authors: | Hunter-Smith A |
Formalised mentorship within oncoplastic breast surgery training - Is it indicated? A systematic review
Introduction Oncoplastic breast surgery places unique psychosocial and multi-disciplinary demands upon its trainees. As such, a healthy balance of personal and professional spheres are necessary to cultivate resiliency, emotional intelligence and self-awareness. Whilst the UK is a global leader in oncoplastic breast surgery training, no current trainee self-development scheme exists..
| Published: | 02/05/2022 |
| Authors: | Hunter-Smith A, Chagla LS |
Preparing to survive: Improving outcomes for young women with breast cancer
Introduction Young women with breast cancer (YWBC) have unique needs compared to their older-age counterparts, due to life-stage at diagnosis; often yet to start a family, responsible for young children, and/or in the midst of career progression. Interventions to address this are limited. We aimed to understand the unmet..
| Published: | 01/05/2022 |
| Authors: | Hunter-Smith A |
P115 Optimising obstetric care in high BMI patients: should we offer elective caesarean sections based on BMI?
Introduction Obesity in the obstetric population is increasing. Obese patients pose obstetric and anaesthetic challenges, contributing to maternal and fetal morbidity and mortality [1]. Our maternity department is increasingly busy, with 4000 deliveries/year. More women with high BMIs are booking, and increasingly require involvement of the anaesthetic team, especially out-of-hours, when..
| Published: | 01/05/2022 |
| Authors: | Robinson E, John S, Singh P |
Implementation of a telemedicine service to provide skin cancer care in a tertiary plastic surgery unit during COVID-19 – a comprehensive review
Background In response to the COVID-19 pandemic, our tertiary skin cancer service had to adapt rapidly to reduce hospital footfall. Consequently, all clinic appointments for skin cancer patients were converted to telephone consultations. This study aims to provide a comprehensive review of this new service. Methods This study consisted of..
| Published: | 23/04/2022 |
| Authors: | Jakeman M, Khaw R, Zack-Williams SDL, Brackley P |
The utility of the lateral orbital orbicularis propeller flap in periocular reconstruction
Aims: The lateral orbital orbicularis propeller flap (LOOP) is a propeller flap raised on a non-axial orbicularis oculi pedicle. Once mastered, it is speedy to raise, extremely reliable, and capable of transposing thin, supple, and relatively hairless skin and subcutis from the temple region to the periocular region. We aim..
| Published: | 21/04/2022 |
| Authors: | Parneet G, Defty C, Morton J |
The individualisation of glycaemic targets in response to patient characteristics in type 2 diabetes: a scoping review
Background Evidence and guidelines increasingly support an individualised approach to care for people with type 2 diabetes and individualisation of glycaemic targets in response to patient factors. Methods We undertook a scoping review of the literature for evidence of factors impacting upon glycated haemoglobin target individualisation in adults with type 2 diabetes...
| Published: | 20/04/2022 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty S, Bujawansa S, Hardy KJ |
Athena speciality certificate examination case for cyclical angioedema in a young female
Harnett, C; Drumm, C; Meah, N; Eustace, K. (2022). Athena speciality certificate examination case for cyclical angioedema in a young female. Clinical and Experimental Dermatology. epub 11 April
| Published: | 11/04/2022 |
| Authors: | Harnett C, Meah N, Eustace K |
Athena Speciality Certificate Examination case for cutaneous allergy
Abstract We present a case of cyclical periorbital angio-oedema, and highlight the appropriate investigations to support the clinical diagnosis of this rare dermatosis. Harnett, C; Drumm, C; Meah, N; Eustace, K. (2022). Athena Speciality Certificate Examination case for cutaneous allergy. Clinical and Experimental Dermatology. epub 11 Apr
| Published: | 11/04/2022 |
| Authors: | Harnett C, Meah N, Eustace K |
Two years of Freestyle Libre (FSL) use: impact on glycaemic control and hypoglycaemia awareness in people with diabetes
Background and Aims We have previously shown beneficial effectsof FSL monitoring on glycaemic control and hypoglycaemia awareness in people living with diabetes. In this study we investigate the long term (≥ 2 years) effect of FSL on glycaemic control and hypoglycaemia awareness. Methods Clinicians from 106 NHS hospitals in the U.K. submitted..
| Published: | 11/04/2022 |
| Authors: | Furlong NJ |
Subspecialist abdominal wall reconstruction services in Canada
Extract Recent years have seen considerable increases in both the demand for, and complexity of, ventral hernia repairs. This has led to calls for abdominal wall surgery to become a recognized subspecialty in the United States and Europe, with some centres responding by forming specialized, multidisciplinary teams for abdominal wall..
| Published: | 08/04/2022 |
| Authors: | Adams ST |
The British Orthopaedic Surgery Surveillance study: slipped capital femoral epiphysis
Aims The aim of this study was to inform the epidemiology and treatment of slipped capital femoral epiphysis (SCFE). Methods This was an anonymized comprehensive cohort study, with a nested consented cohort, following the the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) framework. A total of 143 of 144 hospitals treating SCFE..
| Published: | 01/04/2022 |
| Authors: | Lipscombe. S |
The British Orthopaedic Surgery Surveillance study: Perthes' disease
Aims The aim of this study was to evaluate the epidemiology and treatment of Perthes’ disease of the hip. Methods This was an anonymized comprehensive cohort study of Perthes’ disease, with a nested consented cohort. A total of 143 of 144 hospitals treating children’s hip disease in the UK participated over..
| Published: | 01/04/2022 |
| Authors: | Lipscombe. S |
Patients’ experience of a nutrition MDT clinic
Abstract The nutrition multi-disciplinary (MDT) clinic at a district general hospital (DGH) runs monthly and includes a gastroenterology consultant, dietitian and nutrition nurse specialist. Patients that are seen typically have complex nutritional problems including gastroparesis and short bowel syndrome and require review by multiple members of the MDT. 29 Patients attended..
| Published: | 01/04/2022 |
| Authors: | Roberts S, Tyrer J, Theis V |
A multidisciplinary approach to reducing percutaneous endoscopic gastrostomy tube site infections within 30 days of placement
Abstract Percutaneous endoscopic gastrostomy (PEG) site infection is a known complication of PEG tube placement. Whilst difficult to know the true incidence of PEG site infections as rates vary1, it is thought that infection rates fluctuate between 5% and 25%2. Thirty day infection rates form part of an annual audit of PEG..
| Published: | 01/04/2022 |
| Authors: | Roberts S, Clark K, Theis V, Tyrer J |
Stroke-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications Following Stroke
Background The risk of major adverse cardiovascular events is substantially increased following a stroke. Although exercise-based cardiac rehabilitation has been shown to improve prognosis following cardiac events, it is not part of routine care for people following a stroke. We, therefore, investigated the association between cardiac rehabilitation and major adverse..
| Published: | 31/03/2022 |
| Authors: | Hill AM |
BSH22-PO108 Tranexamic Acid use to improve outcomes in Meningioma Surgery
Introduction Meningioma surgery is associated with intraoperative bleeding and large transfusion requirement. Tranexamic Acid (TXA) has been used in medical and surgical practice to reduce haemorrhage. This review aimed to evaluate the effect of TXA use on operative and postoperative outcomes. Methods A systematic review and meta-analysis was conducted in..
| Published: | 31/03/2022 |
| Authors: | Keshwara S |
BSH22-EP74 The emerging advanced nurse practitioner role in haematology
Abstract Advanced nurse practitioners (ANPs) are experienced healthcare professionals often considered to be ‘the link’ between medicine and nursing. The position carries a high degree of autonomy and complex decision-making, supported by a master’s degree. ANPs are integral members of the multi-professional team with a significant contribution to the..
| Published: | 31/03/2022 |
| Authors: | Jackson R, Keegan D |
BSH22-PO118 The future of Outpatient Haematology: Self Supported Follow-up (SSFU) for patients with Chronic Lymphocytic Leukaemia (CLL) and Monoclonal Gammopathy of Undetermined Significance (MGUS)
Abstract The primary aim of face to face follow-up is to recognise early disease relapse or progression and to identify physical or psychological concerns, the latter often being overlooked during increasingly busy clinics. Due to advances in diagnostics and treatments, current follow-up models are proving unsustainable, with most haematological conditions..
| Published: | 31/03/2022 |
| Authors: | Jackson R |
Analysing electronic prescribing data to detect potential undocumented adverse reactions to medications
Objectives Identifying instances where medications have been discontinued due to an adverse/allergic reaction however the patients’ allergy status has not been updated appropriately. Data were evaluated in an established electronic prescribing and medicines administration system within a medium-sized teaching hospital. Methods Details of all medications stopped due to allergic..
| Published: | 30/03/2022 |
| Authors: | Logan B, Hill AM |
Society for Acute Medicine Benchmarking Audit 2021 (SAMBA21): assessing national performance of acute medicine services
Introduction The Society for Acute Medicine Benchmarking Audit 2021 (SAMBA21) took place on 17th June 2021, providing the first assessment of performance against the Society for Acute Medicine's Clinical Quality Indicators (CQIs) within acute medical units since the start of the COVID-19 pandemic. Methods All acute hospitals in the UK were invited..
| Published: | 28/03/2022 |
| Authors: | Varia R |
Length of stay in Acute Medical Admissions: Analysis from the Society for Acute Medicine Benchmarking Audit
Introduction Medical admissions to hospital represent a diverse range of patients, from those managed on ambulatory pathways through Same Day Emergency Care (SDEC) services, to those requiring prolonged inpatient admission. An understanding of current patterns of admission through acute medicine services and patient factors associated with longer hospital admission is..
| Published: | 28/03/2022 |
| Authors: | Varia R |
P181 Diabetes nurse specialist–led glucose balance telephone support clinic associated with improved HbA1c
Aims Foot ulceration is a major burden for patients with diabetes, with a lifetime risk of up to 34%, and precedes most amputations. Hyperglycaemia is associated adverse outcomes and improving glycaemic control is key. We report the effect of diabetes specialist nurse (DSN) - led telephone support on glycaemic balance in..
| Published: | 23/03/2022 |
| Authors: | Cairns J, Pendlebury H, Sullivan H, Lee C, Furlong NJ |
P244 Planning services for people with type 2 diabetes: Is incidence still increasing
Aims Government plans for integrated care systems and integrated care boards are a welcome move towards more joined-up diabetes care between the NHS and local authorities, between health and social care and between specialist, community and primary care services. To plan effectively, for example, structured education for all newly diagnosed..
| Published: | 23/03/2022 |
| Authors: | Westall S, Mitchell L, Cardwell J, Furlong NJ, Narayanan RP, Bujawansa S, Balafshan T, Hardy KJ, McNulty S |
P124 Covid-19 pandemic associated with three-fold increase in demand for diabetes specialist advice
Aims The covid-19 pandemic was associated with legally restricted public movement (lockdowns) and reduced access to face-to-face consultation for diabetes in primary and specialist care. The aim of this study was to assess the impact of the pandemic on requests for specialist telephone support. Methods Retrospective analysis of calls for..
| Published: | 23/03/2022 |
| Authors: | Archer N, Westall S, Cardwell J, Furlong NJ, Narayanan RP, Bujawansa S, Balafshan T, Hardy KJ, McNulty S |
P243 Digital diabetes care: How well equipped are patients and what do they think about it
Aims Covid-19 precipitated an abrupt shift to non-face-to-face (digital) consultation. Some believe that this was overdue and that digital is better for many patients. Our aim was to establish the extent to which people with diabetes were equipped to manage digital consultation and what they felt about it. Methods We..
| Published: | 23/03/2022 |
| Authors: | Westall S, Mitchell L, Cardwell J, Furlong NJ, Narayanan RP, Bujawansa S, Balafshan T, Hardy KJ, McNulty S |
P169 Service evaluation to determine the reason for increased gestational diabetes (GDM) referrals following SARS-CoV-2 pandemic
Aims England and Wales report on average, 700,000 annual pregnancies. From these 5% are complicated with hyperglycaemia with 87.5% of these Gestational diabetes (GDM). Pregnant women living with obesity are at higher risk of developing GDM. There is a linear relationship between glucose and adverse pregnancy outcomes. We noted a marked increase in..
| Published: | 23/03/2022 |
| Authors: | Gallagher CG, Milne R, Davies H, McNulty S, Pankaja S, Bujawansa S |
P98 Variability in test interval is linked to glycated haemoglobin (HbA1c) trajectory over time in people with diabetes
Introduction Frequency of HbA1c testing links to outcome in terms of HbA1c control in diabetes. The influence of the variability of test-retest interval on HbA1c change needs to be determined. Methods HbA1c results were collected from laboratory records on 3,872 people: HbA1c results at baseline and 5..
| Published: | 23/03/2022 |
| Authors: | Green L |
P91 Top to toe examination: An audit to assess the documentation of a foot exam for those admitted to hospital under medicine with diabetes
Background 10% of people with diabetes will suffer from a diabetes foot condition at some point. Those with diabetes related foot disease have high morbidity and mortality rate. They are at higher risk of pressure ulcers and other diabetes related complications such as heart disease or stroke. Patients with neuropathy and..
| Published: | 23/03/2022 |
| Authors: | Sullivan H, Westall S, Furlong NJ, McNulty S, Balafshan T, Narayanan RP, Bujawansa S, Hardy KJ, Pendlebury H |
P88 Recognition and management of hyperglycaemia at the front door: A retrospective audit and QI project conducted in Accident and Emergency (A&E) and Acute Medicine Unit (AMU) of a large district general hospital
Background Hyperglycaemia frequently occurs in acutely unwell patients and its improper recognition and treatment leads to undesirable consequences, including diabetic emergencies and impaired recovery. Morbidity and mortality for this group can be improved through early disease detection and treatment modification, and the acute admission window represents an important opportunity to..
| Published: | 23/03/2022 |
| Authors: | Cho S |
P147 Quick reference insulin safety medicine binder: A change in practice in St Helens & Knowsley Teaching Hospitals NHS Trust
Aim Despite national initiatives to improve practice, the National Diabetes Inpatient Audit (NADIA) 2019 still reported high levels of medication and insulin errors. A quick reference insulin safety binder was produced to promote insulin safety and support registered nurses whilst undertaking medication rounds. The binder is an eye catching, easy to..
| Published: | 23/03/2022 |
| Authors: | Strong AJ, Michaels S, Cardwell J, Bujawansa S |
P145 Service evaluation examining the understanding of breastfeeding among women with diabetes
Aims Breastfeeding is beneficial for a mother, baby and society. Enhancing breastfeeding rates has potential to save lives and drive improvements in public health. Breastfed babies have a lower risk of developing childhood-onset diabetes. On average breastfeeding rates in St Helens are between 26.5% and 31.6% at 6-8 weeks. The aim of..
| Published: | 23/03/2022 |
| Authors: | Gallagher CG, Bujawansa S, Milne R, Michaels S, McNulty S, Westall S |
P143 Non-attendance at structured type 2 diabetes education increases with deprivation
Aims Inequalities exacerbate poor health outcomes in diabetes. Structured education in type 2 diabetes is the cornerstone of supported self-management, but many people with newly diagnosed type 2 diabetes in the UK are not offered structured education and non-attendance in those accepting an offer of structured education is high. The aim of..
| Published: | 23/03/2022 |
| Authors: | Cardwell J, Mitchell L, Westall S, McNulty S, Furlong NJ, Narayanan RP, Bujawansa S, Balafshan T, Hardy KJ |
P257 Focus groups to explore the views of carbohydrate counting education sessions
Aims To identify key themes in adults with type 1 diabetes about their views on insulin-carbohydrate counting education (ICE) sessions using focus groups. Methods We used a qualitative methodology utilising individual, semi-structured, taped, transcribed and analysed focus groups with individuals who previously attended an ICE session. Four focus groups were conducted..
| Published: | 23/03/2022 |
| Authors: | Edon E, Westall S, Gallagher CG |
P193 Therapeutic inertia: Do patients get to target dose after glucagon-like peptide-1 receptor agonist (GLP-1-RA) initiation
Aims A recent primary care database study (J Rachman, Eli Lilly & Co) suggests that only about half of UK patients initiated on subcutaneous semaglutide (Ozempic) reach target maintenance dose. To assess the extent to which these data represent UK practice, we audited semaglutide dose optimisation and metabolic outcomes in our..
| Published: | 23/03/2022 |
| Authors: | Cardwell J, Edon E, Westall S, McNulty S, Furlong NJ, Narayanan RP, Bujawansa S, Balafshan T, Hardy KJ |
Dermatological manifestations of cardiac conditions
Abstract Various cardiac disorders seen in general and acute medicine have dermatological manifestations that may provide critical clues to the underlying disease. This review will discuss the important dermatological signs seen in cardiac conditions. We believe greater interdisciplinary liaison will improve our understanding of the link between the dermatological and..
| Published: | 23/03/2022 |
| Authors: | Katira R |
Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review
Abstract Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers..
| Published: | 15/03/2022 |
| Authors: | Tridente A |
The Whiston Snare Technique for Loop Extraction of Stents (WHISTLES)
Background While ureteric stent removal remains a frequently performed endourological procedure stent migration either proximally or distally can present the endourologist with a significant intraoperative dilemma. In cases where the stent is of large calibre or impacted into the mucosa of the ureter, retrieval may prove refractory to traditional approaches...
| Published: | 14/03/2022 |
| Authors: | Floyd Jr MS, Samsudin A |
COVID-19 and COVID-19 vaccination: Observations on thrombosis and thrombocytopenia
Elsheikh, S; Lip, G.Y.H.. (2022). COVID-19 and COVID-19 vaccination: Observations on thrombosis and thrombocytopenia. Trends in Cardiovascular Medicine. epub 12 Mar.
| Published: | 12/03/2022 |
| Authors: | Elsheikh S |
Multiple Eruptive Clear Cell Acanthomas Successfully Treated with CO2 Laser Ablation
Abstract Clear cell acanthoma (CCA) is a rare, benign epidermal lesion of clear glycogen-containing keratinocytes. The exact etiology is unknown. Although CCA usually appear as solitary lesions, cases of multiple CCAs have also been described. The rare eruptive CCA variant describes cases with more than 30 lesions. Current therapeutic evidence for..
| Published: | 03/03/2022 |
| Authors: | Ngan K, Crema J, Defty C |
229 A Systematic Review Protocol Examining the Role of Immobilisation in Hand Infections
Aim Hand infections are common and varied, leading to long-term complications when managed poorly. Splinting of the hand in a position of safe immobilisation (POSI) is frequently used to avoid complications including pain and stiffness, however it is not a universally accepted technique because the effects of splinting in hand..
| Published: | 28/02/2022 |
| Authors: | Nolan G |
125 Surgical Outcomes and Graft Use in Quadriceps & Patella Tendon Rupture Repairs
Aim Quadriceps and patella tendon ruptures are relatively uncommon injuries affecting approximately 1% and 0.5% of the population respectively. The literature surrounding preferable surgical technique, graft implant used, and surgical outcomes are relatively obscure. We audited all quadricep and patella tendon repairs within the trust to identify whether they have the same..
| Published: | 28/02/2022 |
| Authors: | West C, Kwaees TA |
124 Administration of Fascia Iliaca Block to Patients Who Have Suffered a Neck of Femur Fracture
Aim Hip fractures are the most common serious injury affecting elderly people and are associated with a total cost to the health and social services over £1 billion per year. This injury takes approximately 1% of the NHS budget. Furthermore current 30-day mortality rate is 6.5% so has serious implications for patients. NICE..
| Published: | 28/02/2022 |
| Authors: | West C, Wright C |
Validation of the OAKS prognostic model for acute kidney injury after gastrointestinal surgery
Background Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two..
| Published: | 16/02/2022 |
| Authors: | Chadwick M, El-Taji OM, Rimmer L, Matthews J, Cheng J, Anderson L |
0028 Acid ceramidase: A potential biomarker for locally advanced rectal cancer? (RSM Prize Winner)
Purpose/Background We have previously utilized proteomic and immuno-histochemical data to validate that high levels of acid ceramidase (AC) expression confers poorer neoadjuvant response in rectal cancer. Biological (siRNA, plasmid and CRISPR) AC manipulation altered radiosensitivity in-vitro. We aimed to assess the radiosensitising effect of pharmacological AC inhibitions and elucidate..
| Published: | 15/02/2022 |
| Authors: | Clifford R |
P083 IMPACT – ReCaP: rectal cancer management during the COVID-19 pandemic
Purpose/Background With enhanced strain on healthcare systems and avoidance of routine surgery and systemic therapy during the COVID-19 period due to increased morbidity and mortality alternative oncological approaches have been employed. We aimed to determine the variation in strategies adopted nationally across the United Kingdom (UK) and long-term associated..
| Published: | 15/02/2022 |
| Authors: | Clifford R |
Moulded cast compared with K-wire fixation after manipulation of an acute dorsally displaced distal radius fracture: the DRAFFT 2 RCT
Background Patients with a displaced fracture of the distal radius are frequently offered surgical fixation. Manipulation of the fracture and moulded plaster casting is an alternative treatment that avoids metal implants, but evidence of its effectiveness is lacking. Objective To compare functional outcomes, quality-of-life outcomes, complications and resource use among..
| Published: | 11/02/2022 |
| Authors: | Lipscombe. S |
Implant-Based Reconstruction following Mastectomy in Patients Who Have Had a Previous Breast Augmentation
Background Breast augmentation is the most commonly performed cosmetic procedure, and increasingly women in this group present with breast cancer or request risk-reducing surgery, but their optimal management is unclear. The authors explored the clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation and compared..
| Published: | 09/02/2022 |
| Authors: | Kiernan T, Clifford R, Chagla LS, Iqbal A |
O79 A survey of physiotherapists’ confidence in treating patients following shoulder surgery and their behaviour surrounding seeking support
Purpose A prior service evaluation of physiotherapy musculoskeletal provision was conducted at a five hospital site, single trust, multi-surgeon service of all elective shoulder surgery patients. The data analysis from this revealed wide variation in the number of treatment sessions between, and within, subgroups of surgeries. The current study aimed..
| Published: | 08/02/2022 |
| Authors: | Hodson K |
P215 Shoulder stabilisation surgery: Exploring patient satisfaction and barriers to physiotherapy engagement
Purpose Evaluation of physiotherapy provision following elective shoulder stabilisation surgery revealed variation in the number of treatment sessions attended by patients. Patient non-attendance following stabilisation surgery is a recurrent problem and has implications on the success of patient functional outcomes. The aim was to investigate physiotherapy therapeutic satisfaction and identify..
| Published: | 08/02/2022 |
| Authors: | Hodson K |
Eye problems in people with diabetes: more than just diabetic retinopathy
Abstract While diabetic retinopathy and maculopathy are leading causes of premature visual loss in people with diabetes, other retinal and non-retinal pathology should be considered in the differential diagnosis. These include issues with both eye movement and vision, and can be split into: those which are extraocular, including orbital cellulitis..
| Published: | 01/02/2022 |
| Authors: | Kovacova A |
Implant-Based Reconstruction following Mastectomy in Patients Who Have Had a Previous Breast Augmentation
Background Breast augmentation is the most commonly performed cosmetic procedure, and increasingly women in this group present with breast cancer or request risk-reducing surgery, but their optimal management is unclear. The authors explored the clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation and compared..
| Published: | 01/02/2022 |
| Authors: | Kiernan T, Clifford R, Chagla LS, Iqbal A |
Common, low-frequency, rare, and ultra-rare coding variants contribute to COVID-19 severity
Abstract The combined impact of common and rare exonic variants in COVID-19 host genetics is currently insufficiently understood. Here, common and rare variants from whole-exome sequencing data of about 4000 SARS-CoV-2-positive individuals were used to define an interpretable machine-learning model for predicting COVID-19 severity. First, variants were converted into separate..
| Published: | 18/01/2022 |
| Authors: | Tridente A, Shuker K |
Letter to the editor re: Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures
McNicholas, DP; Omar, AM; Khadr, RN; Floyd, MS Jr. (2022). Letter to the editor re: Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures: should the novel methods become the new standard in radiological diagnosis of urethral stricture disease? Mikolaj et al., IJUN (October 2021). International Urology and..
| Published: | 13/01/2022 |
| Authors: | Omar A, Floyd Jr MS |
Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence
Purpose There are no universally agreed guidelines regarding which types of physical activity are safe and/or recommended in the perioperative period for patients undergoing ventral hernia repair or abdominal wall reconstruction (AWR). This study is intended to identify and summarise the literature on this topic. Method(s) Database searches..
| Published: | 13/01/2022 |
| Authors: | Adams ST |
Clinical Characteristics of COVID-19 Patients in a Regional Population With Diabetes Mellitus: The ACCREDIT Study
Objective To identify clinical and biochemical characteristics associated with 7- & 30-day mortality and intensive care admission amongst diabetes patients admitted with COVID-19. Research Design and Methods We conducted a cohort study collecting data from medical notes of hospitalised people with diabetes and COVID-19 in 7 hospitals within the Mersey-Cheshire region from 1..
| Published: | 13/01/2022 |
| Authors: | Narayanan RP, Furlong NJ, Westall S |
Advances in hair growth
Abstract Hair is a deeply rooted component of identity and culture. Recent articles in this series have focused on scientific evidence relating to hair growth and new insights into the pathogenesis and mechanism of hair loss. This article reviews emerging evidence that has advanced our understanding of hair growth in..
| Published: | 12/01/2022 |
| Authors: | Meah N |
Recurrence and Metachronous Disease in Children with Benign Ovarian Tumors: A Systematic Review of the Literature
Aim The majority of ovarian tumors in children are benign, with good prognosis following complete resection. Little is published on the incidence of tumor recurrence and metachronous disease, and follow-up management of children with benign ovarian tumors (BOTs) remains a matter of debate. This systematic review aimed to evaluate the..
| Published: | 11/01/2022 |
| Authors: | Smith C |
054 Evaluation of the regional anaesthesia service provided for upper-limb plastic surgery
Background This study evaluates the impact of preoperative education on the length of hospital stay after foot and ankle surgery. There are several studies on the benefits of preoperative education prior to hip and knee arthroplasty, especially their role in facilitating early discharges. But studies on the benefits of foot..
| Published: | 11/01/2022 |
| Authors: | Murtagh L, Mukhtar K |
Nonaesthetic Applications for Botulinum Toxin in Plastic Surgery
Extract We applaud the original article “Nonaesthetic Applications for Botulinum Toxin in Plastic Surgery,”1 which aims to highlight the evolution of the alternative uses of botulinum toxin by the plastic surgery community. It succeeds in providing an overview of the range of indications, using an evidence-based approach for the benefit..
| Published: | 10/01/2022 |
| Authors: | Gill P, Henry A, Hassan Z, McArthur P |
Non-randomised comparison of efficacy and side effects of bicalutamide compared with LHRH analogues in combination with radiotherapy in the xxxxxx trial
Background XXXXX is a randomised trial evaluating moderately hypofractionated radiotherapy for treatment of localised prostate cancer. 97% of participants had concurrent short course hormone therapy (HT), either Luteinising Hormone Releasing Hormone analogues (LHRHa) or bicalutamide 150mg daily. This exploratory analysis compares efficacy and side effects in a non-randomised comparison. Method(s) 2700..
| Published: | 08/01/2022 |
| Authors: | Malik Z |
Nonrandomized Comparison of Efficacy and Side Effects of Bicalutamide Compared With Luteinizing Hormone-Releasing Hormone (LHRH) Analogs in Combination With Radiation Therapy in the CHHiP Trial
Purpose CHHiP is a randomized trial evaluating moderately hypofractionated radiation therapy for treatment of localized prostate cancer. Of all participants, 97% of them had concurrent short-course hormone therapy (HT), either luteinizing hormone-releasing hormone analog (LHRHa) or 150 mg of bicalutamide daily. This exploratory analysis compares efficacy and side effects in a nonrandomized..
| Published: | 08/01/2022 |
| Authors: | Malik Z |
Reading a preoperative CT scan to guide complex abdominal wall reconstructive surgery
Abstract Computed tomography (CT) scanning is the imaging modality of choice when planning the overall management and operative approach to complex abdominal wall hernias. Despite its availability and well-recognised benefits there are no guidelines or recommendations regarding how best to read or report such scans for this application. In this..
| Published: | 05/01/2022 |
| Authors: | West C, Scott M, Benson A |
CT perfusion: stroke, seizure or both?
Abstract An 88-year-old male with a history of hypertension, ischaemic heart disease and Bell's palsy presented with symptoms and signs of an acute ischaemic stroke. National Institutes of Health Stroke Scale (NIHSS) was 19 at presentation, indicative of potential large vessel occlusion. The initial CT scan revealed evidence of small vessel..
| Published: | 30/12/2021 |
| Authors: | Elnagi F |
Letter to the Editor re: An unusual case of LUTS in an adolescent man; a case report and literature review
Napier-Hemy, T; Georgiou, M; Omar, AM; Floyd, MS Jr. (2021). Letter to the Editor re: An unusual case of LUTS in an adolescent man; a case report and literature review, J Clin Urol March 2021. Journal of Clinical Urology. epub 29 Dec
| Published: | 29/12/2021 |
| Authors: | Georgiou M, Omar A, Floyd Jr MS |
Colorectal resections during the COVID-19 pandemic: a national survey of practice during first lockdown
Introduction The first wave of the COVID-19 pandemic led to an unprecedented time for the management of colorectal cancer, with uncertainty as to cancer-specific risks and the circumventing of gold standard oncological strategies. Our study aimed to acquire a snapshot of the practice of multidisciplinary team (MDT) management and variability..
| Published: | 23/12/2021 |
| Authors: | Rajput K, Clifford R, Rajaganeshan R, Kalaiselvan R |
Foot school: Preoperative education before day case elective foot and ankle surgery reduces the length of stay after surgery
Background This study evaluates the impact of preoperative education on the length of hospital stay after foot and ankle surgery. There are several studies on the benefits of preoperative education prior to hip and knee arthroplasty, especially their role in facilitating early discharges. But studies on the benefits of foot..
| Published: | 23/12/2021 |
| Authors: | Thomas T, Khan S, Saldanha K, Morgan S, Stott R |
Can we check serum lithium levels less often without compromising patient safety?
Background Lithium is viewed as the first-line long-term treatment for prevention of relapse in people with bipolar disorder. Aims This study examined factors associated with the likelihood of maintaining serum lithium levels within the recommended range and explored whether the monitoring interval could be extended in some cases. Method We..
| Published: | 17/12/2021 |
| Authors: | Green L |
P-O03 The Management of Gallbladder Polyps at a Single Trust: Are we compliant with European Guidelines?
Background Gallbladder polyps affect approximately 5% of the global population, with rates highest in those of Indian descent. 10% of polyps will have malignant potential based on their size or rapid growth rate, which are associated with a poor 5-year survival once advanced of less than 25%. As gallbladder polyps are common but..
| Published: | 16/12/2021 |
| Authors: | Jamieson E, Short C, Clifford R, Rajput K |
Hallux varus: A literature review
Abstract Hallux varus is a rare foot deformity due to iatrogenic, post-traumatic, idiopathic, inflammatory, spontaneous, or congenital pathologies. Acquired hallux varus, in particular, iatrogenic type, is the commonest. The primary pathology is the abnormal musculotendinous forces secondary to soft tissue or bony imbalance exerting varus deforming force. Understanding the anatomy..
| Published: | 15/12/2021 |
| Authors: | Dhotare S, Morgan S |
Perspectives From a Regional Plastic Surgery Centre on Evidence for the Purported Link Between SGLT2 Inhibitors and Fournier's Gangrene
Introduction The recent report issued by the MHRA indicating an association of Sodium glucose linked transporter type 2 (SGLT2) Inhibitors with the contraction of Fournier's Gangrene (FG), has been drawn with insufficient supporting evidence and without an adequately powered study to make any meaningful assertions or recommendations. We aimed to look..
| Published: | 10/12/2021 |
| Authors: | Asmar O, Mandal A, Tridente A, Hardy KJ, Shokrollahi K |
Insights from the Association of British Clinical Diabetologists (ABCD) Nationwide Audit
Background Dose Adjustment For Normal Eating (DAFNE) is the gold standard National Institute for Health and Care Excellence (NICE) recommended structured education programme that promotes self-management in people living with type 1 diabetes (T1D). We have recently shown that FreeStyle Libre (FSL) is associated with improved haemoglobin A1c (HbA1..
| Published: | 09/12/2021 |
| Authors: | Furlong NJ |
Fellowship review: Training interface group (TIG) fellowship in mohs surgery
Abstract Mohs surgery in the United Kingdom has traditionally been performed by dermatologists and as such training and exposure for surgeons has been limited. To address this, a 6-month fellowship in Mohs micrographic surgery has been established for surgical trainees as part of the Training Interface Group (TIG) fellowship programme...
| Published: | 06/12/2021 |
| Authors: | Gill P, Tehrani H |
Online prescribing for sexually transmitted infections – what’s on offer? An evaluation of internet pharmacies based in the United Kingdom
Background Online pharmacies offer an alternative approach for patients to manage their sexual health. Our aim was to determine the type of antimicrobials sold as treatment for sexually transmitted infections (STIs) by UK internet pharmacies and if providers were adhering to national guidelines. Methods A search engine results page (SERP)..
| Published: | 02/12/2021 |
| Authors: | Okecha E |
A novel plastic surgery simulation model for medical students
Extract Despite most training programs moving towards competency-based training programs 1 , the Halstedian principle of “See one, do one, and teach one,” still often applies to Surgery. The learning curve in Plastic Surgery can be challenging, including a melange of advanced skills and complex decision making, on a background of substantial..
| Published: | 29/11/2021 |
| Authors: | Lymperopoulos NS, Shokrollahi K |
Frontal Fibrosing Alopecia survey of severity assessment methods in routine clinical practice
Background Lack of validated and responsive outcome measures in the management of Frontal Fibrosing Alopecia (FFA) significantly limits our ability to assess disease progression and treatment response over time. Objectives The aim of this study was to understand how FFA extent and progression is currently assessed in UK specialist centres,..
| Published: | 21/11/2021 |
| Authors: | Meah N |
Management of Seymour Fractures in Children and Adolescents: A Systematic Review and Meta-Analysis
Purpose Seymour fractures are injuries with a potentially high risk of infection and osteomyelitis. The optimal management of this pediatric open fracture is unknown. We performed a systematic review and meta-analysis to summarize the best evidence for these fractures and determine their optional management based on primary clinical studies. Methods..
| Published: | 19/11/2021 |
| Authors: | Nolan G |
Fatal Co-infections with SARS-CoV-2 and Legionella pneumophila, England
Abstract Both Legionella pneumophila and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause pneumonia. L. pneumophila is acquired from water sources, sometimes in healthcare settings. We report 2 fatal cases of L. pneumophila and SARS-CoV-2 co-infection in England. Clinicians should be aware of possible L. pneumophila infections among SARS-CoV-2 patients. Chalker,..
| Published: | 09/11/2021 |
| Authors: | Adler H, Ball R |
Phenotypic spectrum of serious cutaneous only adverse event following immunisation with COVID-19 vaccines
Abstract A phenotypic plethora of exclusively cutaneous adverse events following immunisation (AEFI) with COVID-19 vaccines have been described. Currently, there is no formal consensus on advice given to affected individuals, pertaining to their subsequent COVID-19 vaccines, which is increasingly pertinent as countries such as the United Kingdom launch a further..
| Published: | 08/11/2021 |
| Authors: | Trehan P, Hanna-Bashara L, Walsh ML |
Phenotypic spectrum of serious cutaneous-only adverse event following immunization with COVID-19 vaccines: a multicentre case series and literature review
Abstract A phenotypic plethora of exclusively cutaneous adverse events following immunisation (AEFI) with COVID‐19 vaccines have been described. Currently, there is no formal consensus on advice given to affected individuals, pertaining to their subsequent COVID‐19 vaccines, which is increasingly pertinent as countries such as the United Kingdom launch a further..
| Published: | 08/11/2021 |
| Authors: | Walsh ML, Trehan P |
PTU-84 Accelerated accreditation for bowel cancer screening colonoscopist in cheshire and merseyside
Introduction In 2020, as the COVID pandemic spread through the UK, Bowel Cancer screening invitations were paused. In Cheshire and Merseyside (C & M) there were as many as 100,000 patients waiting for their invitations. In addition, there were a large number of patients who had already been tested but waiting for colonoscopy..
| Published: | 07/11/2021 |
| Authors: | Bassi A |
PTH-17 The virtual referral triage clinic – A beneficial change in practice?
Introduction Due to the COVID 19 pandemic gastroenterology elective activities were suspended in March 2020. When elective services were reinstated, social distancing imposed within the Trust resulted in a significant loss in traditional F2F (face to face) clinic capacity. A Consultant led Virtual Referral Triage Clinic (VRTC) was introduced with the..
| Published: | 07/11/2021 |
| Authors: | Priestley S, Liaros A |
PMO-36 Safety and efficacy of ustekinumab for Crohn’s disease in the elderly population
Introduction The rising incidence of inflammatory bowel disease (IBD) worldwide and an ageing population has led to a marked increase in elderly IBD patients. Anti-tumour necrosis factor (TNF) agents are associated with an increased risk of serious infections and treatment discontinuation among elderly IBD patients; little is known about non..
| Published: | 07/11/2021 |
| Authors: | Liaros A |
PTU-50 Watch and wait, a rational management for lower gastrointestinal bleeding in the elderly?
Introduction Many patients presenting to hospital with lower gastrointestinal bleeding (LGIB) are elderly and co-morbid. British Society of Gastroenterology (BSG) guidelines recommend LGI endoscopy for all patients admitted with LGIB. As the majority of LGIB ceases spontaneously and risks of endoscopy increase with patient age, a ‘watch and wait’ management..
| Published: | 07/11/2021 |
| Authors: | Baig D |
PTH-55 Next available please: real world waiting times and availability of endoscopy for lower gastrointestinal bleeding
Introduction Current British Society of Gastroenterology (BSG) guidelines recommend all patients admitted to hospital with lower gastrointestinal bleeding (LGIB) undergo an inpatient colonoscopy on the next available list as part of providing a 7-day endoscopy service. The real-world availability of a 7-day service and adherence to this guidance is unknown...
| Published: | 07/11/2021 |
| Authors: | Baig D |
PTH-109 The bottom line: real world management of acute lower gastrointestinal bleeding compared to BSG guidelines
Introduction Lower gastrointestinal bleeding (LGIB) is a common hospital presentation, from self-limiting per-rectal bleeding to a life-threatening haemorrhage. British Society of Gastroenterology (BSG) acute LGIB guidelines define a clear management approach including risk stratification for patient management. However, real-world management of LGIB in relation to this guidance is currently unknown...
| Published: | 07/11/2021 |
| Authors: | Baig D |
Venetoclax with Azacitidine or Low Dose Cytarabine As an Alternative to Intensive Chemotherapy in Fit Adults during the COVID19 Pandemic
Background Based on early evidence of a high rate of coronavirus mortality in patients with acute myeloid leukaemia (AML) undergoing intensive chemotherapy (IC), the national health service (NHS) in the United Kingdom temporarily made venetoclax available as an alternative therapy, with the aim of reducing both mortality and healthcare resource..
| Published: | 05/11/2021 |
| Authors: | Loizou E |
Providing community intravenous therapy during the COVID-19 pandemic
Abstract Community Intravenous Therapy is well established in most regions of the United Kingdom. Although there are national Good Practice Recommendations detailing the service provision of Outpatient Parenteral Antibiotic Therapy (OPAT), examples of extended service delivery of other therapies are limited. This article describes the growth of the community IV..
| Published: | 01/11/2021 |
| Authors: | Hodgkins P |
EP.FRI.763 Impact of COVID-19 on the rates of emergency laparotomies at an acute general hospital in the United Kingdom
Aims The aim of this study was to analyse if the COVID-19 pandemic had any effect on the number of emergency laparotomies performed each month at a single NHS Foundation Trust. Method This single-centre retrospective observational study included all patients that underwent an emergency laparotomy that was registered as part..
| Published: | 28/10/2021 |
| Authors: | Wright C, Kirkham S, Millward A, Macadam R |
EP.FRI.50 Morbidity of presumed temporary loop de-functioning stomas in patients with colorectal cancer
Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma...
| Published: | 28/10/2021 |
| Authors: | Alfred J, MacDonald S, Kalaiselvan R |
Photodynamic antimicrobial chemotherapy coupled with the use of the photosensitizers methylene blue and temoporfin as a potential novel treatment for Staphylococcus aureus in burn infections
Abstract Photodynamic antimicrobial chemotherapy (PACT) is a novel alternative antimicrobial therapy that elicits a broad mechanism of action and therefore has a low probability of generating resistance. Such properties make PACT ideally suited for utilization in localized applications such as burn wounds. The aim of this study was to determine..
| Published: | 27/10/2021 |
| Authors: | Shokrollahi K |
Hip Hemiarthroplasty: The Misnomer of a Narrow Femoral Canal and the Cost Implications
Objective Hemiarthroplasty has been identified as the treatment of choice for displaced intracapsular femoral neck fractures. A modular prosthesis is sometimes preferred for its sizing options in narrow femoral canals, despite its higher cost and no advantage in clinical outcomes. Thus, in this study, we investigated the factors affecting surgeons’..
| Published: | 22/10/2021 |
| Authors: | Choudhry N |
The authors’ reply re: The role of teleconsultation in the management of suspected skin malignancy in plastic surgery
Dear Sir, Thank you for your comments with regards to our letter 1. The decision to deviate from the planned operative procedure on the day was made by the operating surgeon. The operating surgeon was not blinded to the participant allocation method (teleclinic vs face to face) as that would imply..
| Published: | 22/10/2021 |
| Authors: | Plonczak AM, Koysombat K, West C |
Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis
Aims The COVID-19 pandemic, and the focus on mitigating its effects, has disrupted diabetes healthcare services worldwide. We aimed to quantify the effect of the pandemic on diabetes diagnosis/management, using glycated haemoglobin (HbA1c) as surrogate, across six UK centres. Methods Using routinely collected laboratory data, we estimated the..
| Published: | 13/10/2021 |
| Authors: | Green L |
Nonserious Infections in Patients With Rheumatoid Arthritis
Objective To describe the frequency and predictors of nonserious infections (NSI) and compare incidence across biologic agents within the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA). Methods The BSRBR-RA is a prospective observational cohort study. An NSI was defined as an infection that did not require hospitalization..
| Published: | 13/10/2021 |
| Authors: | Abernethy R |
Dermatology COVID-19 Registries: Updates and Future Directions
Freeman, EE; Meah, N et al. (2021). Dermatology COVID-19 Registries: Updates and Future Directions. Dermatologic Clinics. 39 (4), 575-585
| Published: | 12/10/2021 |
| Authors: | Meah N |
1549 Patient Perception on Hand Trauma Management Through a Plastic Surgery Trauma Clinic
Aim We assessed patient perceptions of hand trauma management through a plastic surgery trauma clinic. We also assessed effects of educating patients about outcomes of their condition on their desire to have prompt surgery. Method A prospective survey review was conducted at our plastic surgery trauma clinic. Patients included were..
| Published: | 12/10/2021 |
| Authors: | Khan M, Iqbal A |
60 The Effect of the 2020 COVID-19 Pandemic on Periprosthetic Joint Infection in Hip Fracture Surgery
Aim To assess whether this change of practice had an effect on the infection rate in hip fracture surgery. Method An audit was conducted to assess the re-operation rate on hip fracture patients over the three months of the initial “lockdown” (23rd March to 23rd May 2020) and compared to the 2..
| Published: | 12/10/2021 |
| Authors: | Hillier D, MacDonald S, Emms N, Howard N |
100 Assessing the Admission Proforma: A Multi-Cycle Audit Evaluating the Quality of Documentation of The Burns Admission Proforma At the Regional Mersey Burn Unit
Introduction A thoroughly completed Burns Proforma can provide vital information for the effective management of a burn and enables the sharing of information with other members of the multidisciplinary team. Aim We aimed to assess the quality of record-keeping of the new Burns Proforma, compared it with the previous cycle,..
| Published: | 12/10/2021 |
| Authors: | Mandal A, Shokrollahi K |
99 Perfecting the Proforma – A Full-Cycle Audit on The Quality of Documentation of The Hand Trauma Proforma At the Regional Plastic Surgery Department
Aim We aimed to assess the quality of record-keeping of the departments hand trauma proforma, identify areas of improvement, and to implement and assess the quality of an updated proforma. Method Data from 101 parameters was collected for 20 patients undergoing surgery for an upper limb injury in November 2019. An updated proforma..
| Published: | 12/10/2021 |
| Authors: | Phillips B, Hosain M, Bell D |
1350 Wide-Awake Local Anaesthetic No Tourniquet (WALANT) Vs General/Regional Anaesthetic for Flexor Tendon Injuries: A Single-Centre, Retrospective Cohort Study
Aim Flexor tendon repairs are commonly performed under general/regional anaesthesia. Wide-awake local anaesthetic no tourniquet (WALANT) has potential advantages including the ability to test the repair intra-operatively; removal of the risks of general anaesthesia; no aerosol generation, thus reducing COVID-19 transmission risk. An ongoing systematic review identified no comparative..
| Published: | 12/10/2021 |
| Authors: | Greasley L, Nolan G, Bamal R, Bell D |
1234 Emergency Urology Procedures During COVID-19 Pandemic: A 2 Monthly Prospective Study
Introduction COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency care. Specific to Merseyside Tier 4 and Tier 2 restrictions were introduced in late 2020. At the onset of the pandemic in the Spring, elective work ceased, and emergency admissions were minimal. The purpose..
| Published: | 12/10/2021 |
| Authors: | Georgiou M, Ridzuan-Allen A, Chamsin A, Tolofari S, Ejikeme C, Jones R, Siddiqui Z, Napier-Hemy TP, Rotas S, Hughes KE, Khattak AQ, McCabe JE, Omar A, Mistry R, Samsudin A, Gana HB, Floyd Jr MS |
1082 Are Trauma and Orthopaedics Consultant Posts Decreasing in Frequency and Increasing in Subspecialisation?
Aim Changes to the configuration of the NHS Trauma Services in T&O and the level of subspecialisation are changing and could impact training and the number of consultant posts available at CCT. The aim of this study was to review the number of T&O Consultant posts and determine..
| Published: | 12/10/2021 |
| Authors: | Ansari SA |
742 Transurethral LASER Ablation (TULA): A Safe and Well Tolerated Procedure for The Treatment of Bladder Tumours Up To 4cm In Diameter in An Outpatient Setting
Aim Traditionally the management of recurrent non-muscle invasive bladder cancer (NMIBC) involves rigid cystoscopy and bladder biopsies/tumour resection under general/regional anaesthesia. As a result, many frail patients endure frequent anaesthetics and therefore are at increased risk of adverse outcomes including cognitive decline. Discontinuation of anti-platelet/anti-coagulation is not..
| Published: | 12/10/2021 |
| Authors: | Siddiqui Z, Morland L, Speakman S, Birley R, Hughes KE |
968 Delivering Human Factors and Non-Technical Skills Training Using Interactive Online Platforms in the COVID Era
Aim To evaluate the impact and effectiveness of an interactive online human factors (HF) and non-technical skills (NTS) course delivered to Core Surgical Trainees during the COVID-19 pandemic Method A 1-day HF and NTS course was conducted online, using the Zoom platform, to Core Surgical Trainees in the North West...
| Published: | 12/10/2021 |
| Authors: | Nolan G |
255 Relationship between acute urinary retention episode and risk of death in men
Introduction Acute urinary retention (AUR) is a urological emergency, with incidence increasing with age, being highest amongst men over 70 years. Such adverse events need to be managed properly to avoid complications. Studies have highlighted the association between urinary retention and death. Advancing age and co-morbidities are the two significant factors..
| Published: | 12/10/2021 |
| Authors: | Ejikeme C |
1118 Implementation of a neonatal daily review sheet on a post-natal ward
Background The paediatric team review babies daily on the busy post-natal ward located within the maternity unit. It was noted that there was lack of clarity in the daily documentation regarding neonates. Current documentation was in a folder comprised of multiple documents written on randomly assorted continuation sheets. There is..
| Published: | 11/10/2021 |
| Authors: | Garr R, Scowcroft R, Vataha K |
1042 Does the use of technology improve glycosylated haemoglobin levels in children with type 1 diabetes mellitus (T1DM)?
Background The 2017/18 National Paediatric Diabetes Audit (NPDA) in the U.K. reported that on average, insulin pump users with continuous glucose monitors achieved lower HbA1c levels compared to manual glucose checks. Objectives This study involves children and young people (CYP) aged below 19 years with Type 1 Diabetes Mellitus (T1DM)..
| Published: | 11/10/2021 |
| Authors: | Yasso K |
1388 Evaluation of availability of specialist psychological services for paediatric cystic fibrosis patients in district general hospitals and tertiary centres. Archives of Disease in Childhood
Background Cystic Fibrosis (CF) is a life-limiting genetic disorder. Given the chronic, progressive and disabling nature of CF, it is well recognised that living with CF can have an emotional and psychological impact. A significant number of CF patients report experiencing stress, anxiety, low mood and difficulties in managing their..
| Published: | 11/10/2021 |
| Authors: | Prasad A |
1172 Umblical granulomas: A pinch of salt dries it up
Background An umbilical granuloma is an overgrowth of tissue that usually occurs when the umbilical stump has fallen off. It occurs commonly in the neonatal period usually after Day 15 of life. Parents usually describe a fleshy mass and persistent cumbersome discharge from the umbilical area. The potential risk of omphalitis..
| Published: | 11/10/2021 |
| Authors: | Igboekwu T, Ahmad I |
447 Risk factors for limb ischaemia during femoral arterial catheterisation in the neonatal intensive care unit
Background Intravascular arterial access is used during neonatal intensive care for continuous accurate monitoring of arterial blood pressure and for reliable blood gas measurements. Common vascular access sites are the umbilical arteries (UAC) and some peripheral arteries. When these routes are not available, a femoral artery catheter can be inserted (..
| Published: | 11/10/2021 |
| Authors: | Turner L |
1345 Sharp rise in new onset type 2 diabetes in a large DGH post lockdown
Background Type 2 diabetes in children is on the rise in the UK alongside childhood obesity. NPDA 2018/19 data reported that the percentage of children and young people with Type 2 diabetes managed in Paediatric Diabetes Units (PDU) in UK has risen from 1.3% in 2012/13 to 2.6% in 2018/19. Pietrobeli et al 2020 reported that after the..
| Published: | 11/10/2021 |
| Authors: | Thomas E, Upadrasta S |
PO557 Faecal immunochemical test (FIT) in secondary care: Prioritising lower GI two week wait patients during the COVID-19 pandemic
Introduction FIT provides a safe, rapid and accurate way to determine a patient’s risk of having a lower GI cancer and it may possibly be used to exclude cancer for patients with negative result. It will reduce primary care referrals by enabling GPs to determine likelihood of lower GI..
| Published: | 11/10/2021 |
| Authors: | Bassi A |
The Role of Indocyanine Green Fluorescence Angiography in Complex Abdominal Wall Reconstruction
Background Indocyanine green fluorescence angiography (ICGFA) is a technique for assessing vascularity and perfusion which has multiple proven applications across a variety of surgical procedures. Studies have been performed assessing its potential role in evaluating skin flap viability in complex abdominal wall reconstruction (CAWR) in order to avoid postoperative surgical..
| Published: | 08/10/2021 |
| Authors: | Adams ST, West C |
Could you become a chief nurse information officer?
Abstract During the first wave of the pandemic, I was working as a diabetes specialist nurse at St Helens and Knowsley Teaching Hospitals NHS Trust. When seeing patients face to face was deemed too high risk, a lot of my clinical practice shifted to remote working, with patient consultations carried..
| Published: | 07/10/2021 |
| Authors: | Hayes N |
Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb
Summary Mohs Micrographic Surgery (MMS) is primarily recognised for use in facial tumours,however it should also be considered to aid excision of tumours of the hand, wherepreservation of tissue and maintenance of function are key factors. Mohs surgery canserve to facilitate decision making both by the patient and surgeon...
| Published: | 06/10/2021 |
| Authors: | Wain R, Lloyd-Hughes H, Tehrani H, Nayar R |
'Teach Trolley' teaching: A simple solution to teaching during a pandemic?
Background The impact of the COVID-19 pandemic on medical education has been widely documented [1] but its effect on workplace training for healthcare professionals is yet to be determined. As the pandemic eases, opportunities for formal teaching outside of the clinical environment may remain limited with the need to escalate elective..
| Published: | 22/09/2021 |
| Authors: | Pal S, Robinson E, Longley C, Jain N |
Intrathecal diamorphine vs. fentanyl-lidocaine-ketamine infusion for laparoscopic bowel resection
Background Departmentally, fentanyl-lidocaine-ketamine (FKC) infusion (10 mug.ml-1 fentanyl, 1 mg.ml-1 ketamine, 10 mg.ml-1 lidocaine) at a rate of 1-2 mg.kg-1.h-1 of lidocaine [1] is being used for bowel resections. We sought to compare patient outcomes between peri-operative FKC infusion versus intrathecal diamorphine (ITD). Methods This is a retrospective review..
| Published: | 22/09/2021 |
| Authors: | Lightburn T, Little R, Raftery S, Dixit T |
Gentamicin double-dosing in Confidential Enquiry into Perioperative Deaths theatre at a Trust using a hybrid prescribing system
Background Gentamicin is commonly used in prophylaxis of peri-operative infection. It has a narrow therapeutic index, necessitating careful dose adjustment, and is usually administered once daily. Patients undergoing emergency surgery may have received gentamicin pre-operatively during resuscitation, conservative management, or treatment of a comorbid infection. At the Trust audited, a..
| Published: | 22/09/2021 |
| Authors: | Jones B, Saggar A |
FC6.6 Use of lateral DEXA scanning for identifying and monitoring vertebral fractures in patients affected by Duchenne Muscular Dystrophy
Introduction International guidelines for management of Duchenne Muscular Dystrophy (DMD) advise active screening for vertebral fractures (VF), complications of which include pain, scoliosis and impact on ambulation. Vertebral fracture assessment (VFA) is a technique of visualising thoracic and lumbar vertebrae with a lateral view on dual energy X-ray absorptiometry (DEXA)..
| Published: | 22/09/2021 |
| Authors: | Turner L |
Repair of Large Hiatal Hernias With the Use of Mesh and Autologous Platelet-Rich Plasma
Background According to recent studies, large hiatal hernias (HH) can be associated with a lower content of type-I and type-III collagen in the phrenoesophageal ligament (POL). We therefore hypothesize that the use of a mesh implant with autologous platelet-rich plasma (PRP) for repair of large HH would have a positive..
| Published: | 21/09/2021 |
| Authors: | Patel R |
Assessment and management of fatigue in patients with cancer
Background Fatigue is a common and debilitating symptom experienced by patients with life limiting illness. Aim(s) To audit clinical practice against regional standards and to use outcomes to update regional standards and guidelines. Methods A systematic literature review of the management of fatigue in cancer patients was performed. The..
| Published: | 20/09/2021 |
| Authors: | Hynes J |
A rare case of pulmonary haemosiderosis associated with coeliac disease: Lane Hamilton syndrome
Introduction Idiopathic pulmonary haemosiderosis (IPH) is a rare disorder characterised by haemoptysis, diffuse alveolar infiltrates and iron deficiency anaemia. Even rarer is the Lane Hamilton syndrome where IPH is associated with coeliac disease. Background(s) A 37 year old woman presented with haemoptysis and breathlessness. Computerised tomography pulmonary angiogram showed multiple..
| Published: | 15/09/2021 |
| Authors: | Low SE |
Dissecting the outcomes of anterior resections in a high-volume center
Purpose To analyse outcomes of patients undergoing anterior resections in a high-volume colorectal unit as proposed by the ACPGBI guidelines. Methods Retrospective analysis of 218 patients, undergoing anterior resections between January 2017 and December 2019. Results Median age was 67 years (IQR: 58–76), including 9 emergency resections. Indications were benign disease in 49 patients and malignancy in 169; 55..
| Published: | 15/09/2021 |
| Authors: | Rowe AK, Adderley A, Samad A, Javed M |
Impact of Mucopexy during Trans-Anal Haemorrhoidal Dearterialization on Post-operative pain and Recurrence in Hemorrhoidal Disease
Background Single center experience of trans-anal haemorrhoidal dearterialization (THD) with and without mucopexy; evaluating differences in recurrence, pain and post-operative complications Method Retrospective analysis of all patients undergoing THD between October 2014-September 2016, with and without mucopexy procedure depending on clinical need. Primary outcome was symptom recurrence; this was evaluated during..
| Published: | 15/09/2021 |
| Authors: | Kearsey C, Javed M, Rajaganeshan R |
Predictors of continuous positive airway pressure (CPAP) response in severe hypoxaemic respiratory failure due to COVID-19 pneumonitis
Abstract CPAP is advocated as a bridge to invasive mechanical ventilation (IMV) in severe COVID-19 pneumonitis. Its effectiveness in preventing intubation is unknown. We aimed to evaluate the outcomes COVID-19 patients suitable for IMV receiving CPAP following failure of standard oxygen therapy and predictors of CPAP response. We performed a..
| Published: | 14/09/2021 |
| Authors: | Thompson J |
Morbidity of presumed temporary loop de-functioning stomas in patients with colorectal cancer
Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma...
| Published: | 13/09/2021 |
| Authors: | Alfred J, MacDonald S, Kalaiselvan R |
Case report-malignant adenomyoepithelioma: A rare tumour of the breast
Background: We present a case report of a 45 year old female who presented with bilateral breast masses and one of these was shown to be a rare primary breast tumour. Malignant adenomyoepithelioma (AME-M) exhibits a classic biphasic proliferation of epithelial and myoepithelial cells, either or both of which have undergone..
| Published: | 08/09/2021 |
| Authors: | Stevenson J, Kiernan T, McKeown D, Innes H, Shaw M |
The Risk of Bleeding Complications in Intra-Articular Injections and Arthrocentesis
Abstract Novel oral anticoagulants (NOACs) are increasingly prescribed blood-thinning medication. Surpassing Warfarin, NOACs are more favored and extensively used in paroxysmal atrial fibrillation, acute coronary syndrome, and in elderly patients. Well-known benefits of novel oral anticoagulants include predictable pharmacokinetics, pharmacodynamics, and shorter half-life. However, as with any anticoagulant, there are..
| Published: | 06/09/2021 |
| Authors: | Khan S |
The Surgical Art Face©: Developing a Bespoke Multimodal Face Model for Reconstructive Surgical Education
Abstract Surgical and educational challenges exist in relation to the teaching of facial reconstructive surgery due to the complexities of the facial landscape and training models available. This chapter will describe the development and implementation of alternative modes of teaching facial reconstructive techniques in a multi-disciplinary setting, pioneered by Surgical..
| Published: | 04/09/2021 |
| Authors: | Harper-Machin A |
To support safe provision of mechanical thrombectomy services for patients with acute ischaemic stroke
This document supersedes the existing professional multisociety consensus guidance published in 2015. It has been produced in order to respond to the considerable volume of relevant new high-quality trial evidence that has become available since September 2015. It should be emphasised that this document remains applicable to all constituent nations of the..
| Published: | 03/09/2021 |
| Authors: | Hill AM |
Book review: Plastic and Reconstructive Surgery of Burns—An Atlas of New Techniques and Strategies
Mandal, A; Shokrollahi, K. (2021). Plastic and Reconstructive Surgery of Burns—An Atlas of New Techniques and Strategies (Book review). Annals of Plastic Surgery. 87 (3), 238.
| Published: | 01/09/2021 |
| Authors: | Mandal A, Shokrollahi K |
307- Clinical characteristics of COVID-19 patients in a regional population with diabetes: the ACCREDIT study
Background and aims Diabetes is associated with greater COVID-19 morbidity and mortality. However, it is unclear if characteristics specific to this cohort affect the prognosis of COVID-19. ACCREDIT study explored clinical and biochemical characteristics associated with 7- & 30-day mortality and intensive care amongst diabetes patients hospitalised with COVID-19. Materials and..
| Published: | 01/09/2021 |
| Authors: | Narayanan RP |
Laparoscopic colorectal resections during the COVID-19 pandemic – business as usual?
Introduction To analyse the outcomes of major colorectal resections performed during the COVID-19 pandemic, to assess safety and explore all precautionary measures. Method All patients who underwent major elective colorectal resections at St Helens and Knowsley Teaching Hospital NHS Trust between 24th March 2020 (the date that the Royal Colleges of..
| Published: | 31/08/2021 |
| Authors: | Kalaiselvan R, Scott M, Samad A |
034 Colorectal cancer resections during COVID-19: to do or not to do?
Introduction Ascertaining the practice of colorectal cancer (CRC) resections during the COVID-19 pandemic in England and Wales. Method A list of all colorectal multi-disciplinary teams (MDTs) was obtained from the National Bowel Cancer Audit (NBOCA) database. A survey was designed using Google Forms and emailed to at least one consultant..
| Published: | 30/08/2021 |
| Authors: | Barter R, Kalaiselvan R |
Management of acute scaphoid fractures: a pragmatic approach for the non-specialist
Abstract Scaphoid fractures are common and can cause significant morbidity if treated incorrectly. Thus, a working knowledge of the initial assessment and management of scaphoid fractures by non-specialists is crucial to allow quick diagnosis and avoid potentially catastrophic complications of scaphoid fracture. This article summarises the anatomy of the scaphoid,..
| Published: | 30/08/2021 |
| Authors: | Ansari SA |
Combination of Pembrolizumab with Electrochemotherapy in Cutaneous Metastases from Melanoma
Simple Summary Electrochemotherapy (ECT) combines a cytotoxic agent with locally applied electric pulses to enhance its antitumor effect. Over the last 15 years, ECT has been safely applied to patients with skin metastases in combination with other oncologic treatments and, more recently, with systemic immunotherapy. In this study, we aimed to..
| Published: | 25/08/2021 |
| Authors: | Pritchard-Jones R |
Ethnicity and breast cancer in the UK: Where are we now?
Abstract Outcomes from breast cancer for women in the UK have improved significantly over recent decades. These gains are largely attributable to a combination of earlier diagnosis and access to treatments delivered to patients by the National Health Service irrespective of cost. Ethnic minority groups make up almost fifteen percent..
| Published: | 23/08/2021 |
| Authors: | Chagla LS |
Interstitial granulomatous dermatitis associated with myelofibrosis
Phillips, D; Qazi, E; Low, SE; Khirwadkar, N; Ngan, K. (2021). Interstitial granulomatous dermatitis associated with myelofibrosis. British Journal of Hospital Medicine. 82 (8), 1
| Published: | 17/08/2021 |
| Authors: | Low SE, Ngan K |
Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis
Objective To investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA). Methods We analysed the COVID-19 Global Rheumatology Alliance physician registry (from 24 March 2020 to 12 April 2021). We investigated b/tsDMARD use for RA at the clinical onset of COVID-19 (..
| Published: | 12/08/2021 |
| Authors: | Chadwick L |
Cutaneous manifestations secondary to panitumumab therapy
Lavery, MJ; Forsysth, L; Forsyth, L. (2021). Cutaneous manifestations secondary to panitumumab therapy. Clinics in Dermatology. epub 08 Aug
| Published: | 08/08/2021 |
| Authors: | Lavery MJ, Hindle E |
A Review of Four Practice Guidelines of Inflammatory Bowel Disease
Abstract Inflammatory bowel disease (IBD) is a term that encompasses conditions characterized by chronic inflammation of the gastrointestinal tract (GIT). It includes Crohn's disease and ulcerative colitis. Major scientific organizations interested in gastrointestinal systems or GIT-focused organizations worldwide release guidelines for diagnosing, classifying, managing, and treating IBD. However, there are..
| Published: | 03/08/2021 |
| Authors: | Olusoji R |
Letter to the Editor re Gration, 'From indwelling Foley to fail safe voiding: Proposed changes in design and thinking'
Pina, IM; Khattak, AS; Omar, AM; Floyd Jr, MS. (2021). Letter to the Editor re Gration, 'From indwelling Foley to fail safe voiding: Proposed changes in design and thinking', Journal of Clinical Urology, 4 November 2020. Journal of Clinical Urology. epub 2 Aug
| Published: | 02/08/2021 |
| Authors: | Pina IM, Khattak AS, Omar A, Floyd Jr MS |
The Cheshire & Merseyside Collaborative trainee-led on-call service: a review of safety and efficiency
Aim To assess safety and efficiency of the Cheshire & Merseyside Collaborative, the largest trainee led on-call service in the UK, based on discrepancy rates and time taken to issue reports. Materials & Methods All studies reported by the collaborative in a 4-week period were evaluated for discrepancy and the time taken..
| Published: | 01/08/2021 |
| Authors: | Wide J |
Psychological distress and trauma during the COVID-19 pandemic
Extract Editor—There have now been two major pandemic response phases in the UK and Ireland: one in the spring of 2020 and one in the winter of 2020/21. This has placed an unprecedented strain on frontline healthcare workers.1,2 Earlier research during the first pandemic response identified high rates of psychological distress..
| Published: | 01/08/2021 |
| Authors: | Ramazany M, Langston S, Abela N |
Research news in clinical context
Extract Regular use of an antibacterial mouthwash does not prevent oropharyngeal gonococcal infection The double-blind Oral Mouthwash use to Eradicate GonorrhoeA (OMEGA) trial randomised men who have sex with men to rinse and gargle at least once daily for 60 s with either an antibacterial mouthwash (Listerine; n=219) or a mouth..
| Published: | 19/07/2021 |
| Authors: | Thomson-Glover R |
Surgical fixation of the adult distal radius fracture: when and why?
Abstract Distal radius fractures (DRF) are common. They have a bimodal distribution typically occurring as a high-energy injury in the young or a low-energy injury in the older patient with osteoporosis. With the number of DRF predicted to rise, it is important to know how to manage DRF appropriately. The..
| Published: | 15/07/2021 |
| Authors: | Chan C, Lipscombe. S |
The COVID-19 Pandemic: Implications for Medical Students and Plastic Surgery Residency Applicants
Kiely, AL; Nolan, GS. (2021). The COVID-19 Pandemic: Implications for Medical Students and Plastic Surgery Residency Applicants. Plastic and Reconstructive Surgery. 148 (1), 153-154
| Published: | 12/07/2021 |
| Authors: | Nolan G |
Metformin-associated lactic acidosis
Abstract A 58-year-old female with known type 2 diabetes mellitus continued to take her usual medications, including metformin, an ACE inhibitor and a non-steroidal anti-inflammatory drug, while suffering from diarrhoea and vomiting. On presentation to the emergency department, she was found to have a profound lactic acidosis, cardiovascular instability and acute..
| Published: | 08/07/2021 |
| Authors: | Fadden E, Longley C, Mahambrey T |
A retrospective observational study to evaluate the clinical outcomes and routine management of patients with chronic lymphocytic leukaemia...
Summary Idelalisib (IDL) is an oral first-in-class phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor approved for chronic lymphocytic leukaemia (CLL) alongside rituximab (R) since 2014. However, little data exist on routine practice. The RETRO-idel was a protocol-led, retrospective study of 110 patients [n = 27 front-line (1L)] who received IDL-R. The primary end-point was clinical..
| Published: | 08/07/2021 |
| Authors: | Nicholson T |
Mapping the human genetic architecture of COVID-19.
Abstract: The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological..
| Published: | 08/07/2021 |
| Authors: | Tridente A |
Quality: What does it mean in Acute Medicine and how do we measure it?
Abstract Acute Medicine is a specialty that is not defined by a single organ system and sits at the interface between primary and secondary care. In order to document improvements in the quality of care delivered a system of metrics is required. A number of frameworks for measurements exist to..
| Published: | 06/07/2021 |
| Authors: | Varia R |
Intrauterine contraception
Abstract Key content An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD) or intrauterine contraception (IUC) offers reliable long-acting reversible contraception; however, some patients can be hesitant to choose this option because of misconceptions about side effects and perceived complications. A comprehensive knowledge of IUC is required to..
| Published: | 05/07/2021 |
| Authors: | Phelan N |
CPC12: Eosinophilic dermatosis of haematological malignancy
Extract A 73‐year old man presented with a 10‐month history of a generalized pruritic eruption. No close contacts had a rash or itch. There was no history of weight loss, loss of appetite or B symptoms. The general practitioner had given oral prednisolone to good effect, but the rash soon..
| Published: | 01/07/2021 |
| Authors: | Lavery MJ, Low SE, MacBeth K |
Influence of Wrap Fixation Technique on the Results of Fundoplication
Background Different techniques of wrap fixation in laparoscopic Nissen fundoplication (LNF) have been proposed with of the aim to reduce the complications, but the optimal technique is yet to be determined. The aim of our prospective study was to evaluate several techniques of wrap fixation and determine whether the application..
| Published: | 29/06/2021 |
| Authors: | Patel R |
Identifying and managing eating disorders in type 1 diabetes mellitus: An all-Wales study
Background Co-morbid diabetes and eating disorders have a particularly high mortality, significant in numbers and highly dangerous in terms of impact on health and wellbeing. However, not much is known about the level of awareness, knowledge and confidence amongst healthcare professionals regarding co-morbid Type 1 Diabetes Mellitus (T1DM) and eating..
| Published: | 23/06/2021 |
| Authors: | Spector-Hill I |
Evaluating a competency assessment framework for ANPs
Abstract Advanced nurse practitioners play a vital role in delivering high-quality care to patients attending the acute medical unit and must be highly skilled and competent. In the absence of national standards, a structured competency assessment framework was developed and its usefulness then evaluated in a teaching hospital. The framework..
| Published: | 23/06/2021 |
| Authors: | Puravady S |
Rare ECG finding in a patient with severe hypercalcaemia
A man in his late 60s with a significant history of decompensated alcohol-related liver disease was admitted to hospital with a 2-week history of increasing jaundice and pruritus as well as confusion, drowsiness and a decreased exercise tolerance. Routine bloods revealed an exceptionally elevated corrected calcium level which peaked at 5.17 ..
| Published: | 21/06/2021 |
| Authors: | Chaplin G, Malik A, Katira R |
P10-7 Establishing a transurethral LASER ablation (TULA) service during the Covid-19 pandemic
Introduction Traditionally the management of non-muscle invasive bladder cancer (NMIBC) involves rigid cystoscopy and bladder biopsies/tumour resection under general/regional anaesthesia. The COVID-19 pandemic forced hospitals to reduce operating lists and increase bed availability. An outpatient TULA service was recently started at our trust. TULA is performed via a..
| Published: | 21/06/2021 |
| Authors: | Siddiqui Z, Morland L, Speakman S, Birley R, Hughes K |
P3-3 Tolerability of Rezūm steam ablation using transrectal ultrasound guided periprostatic nerve block
Introduction Rezūm is a widely adopted minimally invasive treatment for LUTS BPH. It is conventionally performed under GA, regional anaesthesia or heavy sedation. Performing it in a safe and tolerable way under local anaesthesia would be advantageous for treating high risk patients and allow administration in an outpatient setting...
| Published: | 21/06/2021 |
| Authors: | Napier-Hemy TP, Starmer B, McCabe JE |
Predictors of diabetes-related distress before and after FreeStyle Libre-1 use
Aim To identify the baseline demographic and clinical characteristics associated with diabetes-related distress (DRD) and factors associated with improvement in DRD after initiating use of the FreeStyle Libre (FSL) in people living with type 1 diabetes (T1D). Methods The study was performed using baseline and follow-up data from the Association..
| Published: | 17/06/2021 |
| Authors: | Furlong NJ |
Re: Flexible cystoscopy and laser stone fragmentation via Mitrofanoff stoma: A case series
Pina, IM; Omar, AM; Davies, MC; Floyd Jr, MS. (2021). Re: Flexible cystoscopy and laser stone fragmentation via Mitrofanoff stoma: A case series (Conway et al., J Clin Urol Feb 21). Journal of Clinical Urology. epub 16 Jun
| Published: | 16/06/2021 |
| Authors: | Pina IM, Omar A, Floyd Jr MS |
Comparing tolerability of local anaesthetic transperineal and transrectal prostate biopsies
Objectives Local anaesthetic transperineal prostate biopsies have been demonstrated as tolerable. However, to date, the tolerability has not been directly compared to the standard of care for transrectal biopsy. We set out to prospectively compare the tolerability of local anaesthetic transperineal and transrectal prostate biopsies. Patients and methods All patients..
| Published: | 16/06/2021 |
| Authors: | Starmer B, McCabe JE |
Impact of the coronavirus pandemic and national lockdown on a lung cancer service – opportunities for innovation
Background Timely diagnosis and access to treatment are key factors in improving outcomes in lung cancer. The emergence of the coronavirus pandemic posed unprecedented challenges, with impacts felt across the entire care pathway from presentation to diagnosis and access to treatment. Objective(s): To compare referrals and outcomes for key..
| Published: | 16/06/2021 |
| Authors: | Malhotra P, McIntosh A, Peers V |
The consequences of unnecessary requesting and reporting of the direct antigloblin test in neonates
Background: BSH (British Society of Haematology) guidelines recommend that the Direct Antiglobulin Test (DAT) is only requested when clinically indicated in neonates. Prophylactic anti-D (PAD) administered routinely to Rh D Negative mothers during pregnancy can cause a positive DAT in the neonate that is not clinically relevant as PAD does..
| Published: | 15/06/2021 |
| Authors: | Bonney S, Pannikodu E, Samani S, McNulty J, Chunara U |
Reducing waiting lists for laparoscopic cholecystectomy: An intensive approach to aid COVID-19 recovery
Background Laparoscopic cholecystectomy is one of the most frequently performed operations in the United Kingdom, commonly due to symptomatic gallstones. Delay between diagnosis and definitive surgical intervention often leads to a significant readmission rate, growing financial burden and increased complexity of the ultimate surgical intervention. Resource reallocation and reduced operational..
| Published: | 14/06/2021 |
| Authors: | Clifford R, Rajput K, Naing CY, MacDonald K, Pantak T, Kaul A |
Invited Discussion on: Management of Nipple Areola Deformity
Taghizadeh, R. (2021). Invited Discussion on: Management of Nipple Areola Deformity. Aesthetic Plastic Surgery. 45 (4), 1416-1418
| Published: | 11/06/2021 |
| Authors: | Taghizadeh R |
2388 Multidisciplinary management of pregnancy with ruptured splenic artery aneurysm in a DGH
Objective We report a case of ruptured splenic artery aneurysm in pregnancy which is a rare clinical entity often missed antenatally and diagnosed on laparotomy for other suspected causes of intraabdominal haemorrhage. This case highlights the importance of maintaining a high index of suspicion and multidisciplinary approach to achieve good..
| Published: | 09/06/2021 |
| Authors: | Mathur P, Jones F, D'Costa D, Srivastava N, Idama TO |
X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis
Background & Aims Genome-wide association studies in primary biliary cholangitis (PBC) have failed tofind X chromosome (chrX) variants associated with the disease. Here, we specificallyexplore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease. Methods We performed a chrX-wide association study, including genotype data from 5 genome-wideassociation studies (from Italy,..
| Published: | 01/06/2021 |
| Authors: | McLindon J |
Acute urinary retention in a 27-year-old male secondary to benign prostatic hyperplasia
Introduction Benign prostatic hyperplasia (BPH) is common in the ageing male. Clinical manifestations like retention impact on a patient’s quality of life. Alterations in androgen activity at the androgen receptor complex level in the prostate contribute to prostatic hyperplasia with the highest incidence occurring in males in their 70’s...
| Published: | 19/05/2021 |
| Authors: | Napier-Hemy TP, Floyd Jr MS, McNulty S, Omar A, Mistry R, Gana HB |
91 An audit of COVID-19 Awareness and Public Health Message Effectiveness in the Hospital Setting Over the Course of the Pandemic
Introduction An audit of healthcare workers investigated the effectiveness of Public Health England’s (PHE) information campaign across COVID’s timeline and assess knowledge between job roles. Method IData was collected across 3 cycles in 3 hospitals. A questionnaire assessed four domains: symptoms; spread; risk factors and the means to reduce transmission...
| Published: | 04/05/2021 |
| Authors: | John S |
Letter to the Editor re: Peacock et al. Urological issues in cyclists
Khattak, AS; Pina, IM; Omar, AH; Floyd, JS Jr. (2021). Letter to the Editor re: Peacock et al. Urological issues in cyclists. J Clin Urol November 2020. Journal of Clinical Urology
| Published: | 03/05/2021 |
| Authors: | Khattak AS, Pina IM, Omar A, Floyd Jr MS |
P179. Comparing roll and magseed in management of impalpable breast lesions a single unit experience
Background Screening and the use of Neoadjuvant therapy has increased the number of breast lesions requiring localisation. The search for the ideal technique is still on. ROLL (Radioisotope guided Occult Lesion Localisation) is a reliable technique though not widely available, Magnetic Seed, is a new alternative. These two techniques have..
| Published: | 01/05/2021 |
| Authors: | Jois RHS, Pushdary KH, Patnam V, Gupta N, Kiernan T, Bathla S, Ray A, Harris O, Chagla LS |
14. Factors leading to the late diagnosis and poor outcomes of breast cancer in Matabeleland South and the Bulawayo Metropolitan Provinces in Zimbabwe
Introduction Breast cancer (BC) is the leading cause of female cancer deaths in Africa, and in Zimbabwe, >80% present with advanced disease. A grant-funded Needs Analysis (NA) was carried out to determine the causes for delayed diagnosis and poor BC outcomes in Bulawayo and Matabeleland South, and to investigate possible solutions...
| Published: | 01/05/2021 |
| Authors: | Chagla LS |
A service evaluation to assess the dietary management of hospitalised patients with diabetes receiving enteral nutrition
Background There has been a big drive from the UK government and Diabetes UK to provide improved psychological care for patients with diabetes. In addition to the emotional burden of having diabetes, people with type 1 and type 2 diabetes have higher levels of anxiety and depression than the general population. We..
| Published: | 18/04/2021 |
| Authors: | Gallagher CG, Westall S, Langan E, Narayanan RP, McNulty S, Bujawansa S, Mitchell L, Archer N, Hardy KJ |
Validation of the factors influencing family consent for organ donation in the UK
Summary Between 2013 and 2019, there was an increase in the consent rate for organ donation in the UK from 61% to 67%, but this remains lower than many European countries. Data on all family approaches (16,896) for donation in UK intensive care units or emergency departments between April 2014 and March 2019 were extracted from the..
| Published: | 16/04/2021 |
| Authors: | Tridente A |
A5 (P240) Reduced exercise activity is associated with increased anxiety in type 1 but not type 2 diabetes
Aims Increased physical activity and a healthy lifestyle underpin efforts to prevent type 2 diabetes and are cornerstones in managing type 1 and type 2 diabetes. Not only is reduced activity associated with risk of weight gain and adverse metabolism, but it is also mooted to be associated with impaired psychological wellbeing. We..
| Published: | 14/04/2021 |
| Authors: | Westall S, Narayanan RP, Sullivan H, Bujawansa S, Furlong NJ, McNulty S, Cardwell J, Mitchell L, Jackson J, Hardy KJ |
P167 Perceived problems in diabetes do not correlate with levels of anxiety and depression in a validated structured diabetes education programme
Aims Diabetes-related distress, anxiety and depression are all highly prevalent in people with diabetes. The Problem Areas In Diabetes (PAID) and Hospital Anxiety and Depression Score (HADS) questionnaires can be used to measure these domains. We evaluated the impact of structured education on each of these. Method People with diabetes..
| Published: | 14/04/2021 |
| Authors: | Westall S, Narayanan RP, Langan E, Gallagher CG, Bujawansa S, McNulty SJ, Furlong NJ, Sullivan H, Hardy KJ |
P166 The impact of local, validated structured education programmes on self-care activities in people with diabetes
Background Better glycaemic control is exhibited in patients with higher self-care abilities. The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire measures diabetes self-care activities. As part of a local, validated structured education programme, we measure the SDSCA scores before and after completing structured education. Scores are outputted as ‘number of..
| Published: | 14/04/2021 |
| Authors: | Furlong NJ, Westall S, Cardwell J, Jackson J, Cairns J, Mitchell L, Bujawansa S, McNulty S, Narayanan RP, Hardy KJ |
P252 The impact of a validated structured education programme on diabetes-related distress in patients with type 1 diabetes
Background and Aim People with type 1 diabetes experience varying degrees of the emotional burden of diabetes and its treatments. The Problem Areas in Diabetes (PAID) questionnaire can be used to evaluate this domain. As part of a local, validated structured education programme for people with type 1 diabetes, baseline and endpoint..
| Published: | 14/04/2021 |
| Authors: | Narayanan RP, Westall S, Sullivan H, Cardwell J, Langan E, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Hardy KJ |
P164 The impact of a local, validated structured education programme on anxiety and depression in people with diabetes
Background People with type 1 and type 2 diabetes experience greater degrees of anxiety and depression than the general population. The Hospital Anxiety Depression Scale (HADS) can evaluate this. Scores ≥8 on HADS-A (anxiety) or HADS-D (depression) indicate potential cases of anxiety or depression. Methods As part of a validated structured education programme,..
| Published: | 14/04/2021 |
| Authors: | Narayanan RP, Westall S, Sullivan H, Cardwell J, Cairns J, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Hardy KJ |
BSH2021-PO-115 The effect of an ambulatory care pathway on management of anaemia in a district general hospital
Abstract The burden of iron deficiency anaemia (IDA) is reflected by the rising number of emergency admissions related to IDA and reports of the monumental cost of managing the condition as an inpatient. The National Health Service spends approximately £55 million per annum on IDA-related non-elective admissions, many of which could..
| Published: | 14/04/2021 |
| Authors: | Bonney S |
A service evaluation to assess the dietary management of hospitalised patients with diabetes receiving enteral nutrition
Background Hospitalised patients with diabetes receiving enteral nutrition (EN), require a management plan from an established multidisciplinary team, including dietitians and diabetes specialist nurses(1). Optimizing glucose control in these patients is associated with better outcomes(2). However, EN may increase the risk of complications such as hyper/hypoglycaemia events(2). There is..
| Published: | 13/04/2021 |
| Authors: | Gallagher CG, Langan E, Blakeman S, Love J |
Malignant Melanoma: a Case of Mistaken Identity—Case Report
Abstract Incidence of malignant melanoma in the UK has quadrupled since the 1970s, accounts for 90% of skin cancer mortality and is the second most common cancer in people younger than age 50 [11]. Atypical melanoma is often mistaken clinically for other skin tumours such as pigmented basal cell carcinoma, pyogenic granuloma or..
| Published: | 10/04/2021 |
| Authors: | Khaw R |
Toward the Rapid Diagnosis of Sepsis
Abstract This paper reports the detection of the inflammatory and sepsis-related biomarker, interleukin-6 (IL-6), in human blood plasma using functionalized screen-printed electrodes (SPEs) in conjunction with a thermal detection methodology, termed heat-transfer method (HTM). SPEs are functionalized with antibodies specific for IL-6 through electrodeposition of a diazonium linking group and..
| Published: | 01/04/2021 |
| Authors: | Tridente A |
Mechanical circulatory support and its implications for anaesthesia and critical care
Abstract Mechanical circulatory support is an increasingly important strategy for the treatmentof a subset of patients with acute heart failure. Use of extracorporeal circuits withpumps and oxygenators to augment cardiac function can be immediately lifesaving, whereasimplantable therapies can allow patients, with advanced heart disease, to resume nearnormal lives. Options for..
| Published: | 01/04/2021 |
| Authors: | Downes C |
Colchicine in coronary artery disease
Abstract Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Inflammation has been seen to be a key feature of atherosclerosis and CAD, with a raised C-reactive protein being a marker of poor prognosis. Thus, the role of anti-inflammatory agents has been investigated in CAD. Colchicine..
| Published: | 29/03/2021 |
| Authors: | Katira R |
An international survey on aminoglycoside practices in critically ill patients
Background While aminoglycosides (AG) have been used for decades, debate remains on their optimal dosing strategy. We investigated the international practices of AG usage specifically regarding dosing and therapeutic drug monitoring (TDM) in critically ill patients. We conducted a prospective, multicentre, observational, cohort study in 59 intensive-care units (ICUs) in 5 countries..
| Published: | 19/03/2021 |
| Authors: | Barton G |
Impact of the UK COVID‐19 pandemic on HbA1c testing and its implications for diabetes diagnosis and management
Extract Letter to the Editor Diabetes mellitus (DM) is a risk factor for poor outcome in patients with COVID‐19.1 However, the focus on mitigating the effects of SARS‐CoV‐2 has resulted in many routine healthcare services, including blood test monitoring in conditions such as DM, being disrupted. We recently explored..
| Published: | 19/03/2021 |
| Authors: | Green L |
The role of teleconsultation in the management of suspected skin malignancy in plastic surgery during COVID-19 outbreak
Abstract The COVID-19 pandemic has had a profound impact on the provision of skin cancer treatment in the UK. To preserve the service, the department transformed the outpatient skin cancer clinic into teleclinic service. This study examines the safety and efficacy of a teleclinic consultation, in comparison to a face-to-face..
| Published: | 18/03/2021 |
| Authors: | Koysombat K, Plonczak AM, West C |
Neuromuscular blocking drugs in the critically ill
The pharmacology of neuromuscular blocking drugs (NMBDs) in the critically ill was reviewed in this journal 15 yrs ago. However, the clinical indications for the use of these drugs in such patients in the intervening period has evolved considerably. This article provides an update on the current indications and evidence base..
| Published: | 18/03/2021 |
| Authors: | Welhengama C |
78 A Quality Improvement Project on Oxygen Administration Within the Geriatrics COVID-19 Cohort Ward
Introduction Due to the COVID-19 pandemic, many medical and surgical wards were reassigned as COVID-19 cohort wards to accommodate the number of patients admitted with the virus. Nurses and healthcare assistants (HCAs) from various departments and backgrounds were redeployed to these areas. Within the geriatrics population, patients with severe COVID-19..
| Published: | 16/03/2021 |
| Authors: | Hickey L, Liu AKL, Kawafi K, Gowda V |
Cardiac Electrophysiology Clinics
Essa, H; Hill, AM; Lip, GYH. (2021). Atrial Fibrillation and Stroke. Cardiac Electrophysiology Clinics. 13 (1), 243-255.
| Published: | 16/03/2021 |
| Authors: | Hill AM |
The right to take risk: are we practising informed consent during the COVID pandemic?
Dear Editor Since the beginning of the global pandemic there has been a paternalistic approach to consenting patients for surgery. This is both because of guidance from overseeing organizations, and individual concern about significant morbidity and mortality. The first wave of the pandemic saw a shift towards less surgery in..
| Published: | 13/03/2021 |
| Authors: | Davidson T, Singh V, Kalaiselvan R, Rajaganeshan R |
A mixed-methods evaluation of the impact of a pharmacist-led feedback pilot intervention on insulin prescribing in a hospital setting
Aims To explore the impact of a prescribing feedback intervention on insulin prescribing. Methods This was a mixed-methods study in a hospital setting. An insulin prescribing feedback intervention was delivered verbally and in writing to twelve doctors. Insulin prescribing error frequency was compared to ten doctors who had not received..
| Published: | 13/03/2021 |
| Authors: | Lloyd M, Bennett N, Wilkinson A, Furlong NJ, Cardwell J, Michaels S |
Collaborative Overview of coronaVIrus impact on ORTHopaedic training in the UK (COVI - ORTH UK)
Introduction COVID-19 was declared a pandemic by the World Health Organization on the 11th of March 2020 with the NHS deferring all non-urgent activity from the 15th of April 2020. The aim of our study was to assess the impact of COVID-19 on Trauma and Orthopaedic trainees nationally. Methods Trauma and Orthopaedic (..
| Published: | 10/03/2021 |
| Authors: | Choudhry N, Hillier D, Khan S, Nagy MT, Ormsby N |
Acute Management of Thermal Hand Burns in Adults
Introduction Advances in the evidence base of acute thermal hand burns help to guide the management of these common injuries. The aim of this literature review was to evaluate recent evidence in the field over 10 years. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols methodology was used..
| Published: | 05/03/2021 |
| Authors: | Dargan D, Stubbington Y, Shokrollahi K |
Delay in Initial Debridement for Open Tibial Fractures
Background The current consensus regarding the management of open fracture indicates that the initial debridement should be performed within the first 6 hours after injury. Unfortunately, in Pakistan, the emergency medical services are not well-established and patient arrival at the hospital is delayed the majority of the time. In this study,..
| Published: | 05/03/2021 |
| Authors: | Khan S |
Recommendations for influenza vaccination in burns patients based on a systematic review of the evidence
Abstract Severe burn injury is a serious systemic insult that can lead to life threatening secondary infections. Immunosuppression, inhalation injury and prolonged length of hospital stay are factors which predispose patients to severe respiratory tract infections. Furthermore, evidence shows that burns can put one at risk of infection long after..
| Published: | 03/03/2021 |
| Authors: | Philip L, Mortimer K, Shokrollahi K |
Genetic mechanisms of critical illness in COVID-19
Abstract Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244..
| Published: | 03/03/2021 |
| Authors: | Tridente A, Shuker K |
Theatre ventilation
Abstract Introduction Owing to the COVID-19 pandemic, there has been significant disruption to all surgical specialties. In the UK, units have cancelled elective surgery and a decrease in aerosol generating procedures (AGPs) was favoured. Centres around the world advocate the use of negative pressure environments for AGPs in reducing the..
| Published: | 01/03/2021 |
| Authors: | Theodorou C, Simpson GS |
Atrial Fibrillation and Stroke
Abstract Atrial fibrillation (AF) is the most common cardiac arrythmia and a major cause of stroke, heart failure, sudden death, and cardiovascular morbidity. AF increases risk of thromboembolic stroke via stasis in the left atrium and subsequent embolization to the brain. In patients with acute ischemic stroke, it is essential..
| Published: | 01/03/2021 |
| Authors: | Hill AM |
Invited Discussion on: “The Use of Semi-absorbable Mesh and Its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction”
Taghizadeh, R. (2021). Invited Discussion on: “The Use of Semi-absorbable Mesh and Its Impact on Donor-Site Morbidity and Patient-Reported Outcomes in DIEP Flap Breast Reconstruction”. Aesthetic Plastic Surgery. epub 19 Feb
| Published: | 19/02/2021 |
| Authors: | Taghizadeh R |
Cervical screening uptake and rates of cervical dysplasia
Objectives To compare cervical screening attendance and cytology (high- and low-grade cervical dysplasia [HGCD and LGCD]) between women with RA and the English general population and between biologic DMARD (bDMARD)-naïve and exposed women. Methods The British Society for Rheumatology Biologics Register for RA (BSRBR-RA), a national prospective study..
| Published: | 15/02/2021 |
| Authors: | Abernethy R |
Fever in a patient with osteomyelitis: the diagnosis could be serotonin syndrome
Abstract Awareness of rare differential diagnoses of common clinical presentations helps promote early detection and prompt management of serious conditions. A 54-year-old man, with an infected non-union following a high tibial osteotomy, presented with an acutely discharging abscess to his proximal tibia. He was generally unwell with a Staphylococcus aureus..
| Published: | 05/02/2021 |
| Authors: | Gould M, Harrison WD, Cahill-Kearns A, Barton G |
Cannabinoid hyperemesis syndrome as a cause of recurrent vomiting in type 1 diabetes
Abstract Abdominal pain and vomiting are common presentations to the emergency medical ward. Management of recurrent abdominal pain and vomiting can be difficult, especially in patients who have diabetes. People with diabetes can present with vomiting and abdominal pain that can cause a diagnostic dilemma. Are the symptoms due to..
| Published: | 01/02/2021 |
| Authors: | Balafshan T |
Does methotrexate cause progressive fibrotic interstitial lung disease?
Abstract The aim is to evaluate the published evidence on whether methotrexate (MTX) use causes progressive fibrotic interstitial lung disease (fILD). This PRISMA-compliant systematic review has been registered electronically with PROSPERO 2018 ID CRD42018087838, Centre of review and dissemination at the University of York. A total of 29 articles met the inclusion..
| Published: | 29/01/2021 |
| Authors: | Dawson J, Quah E, Amoasii C, Mudawi T |
Diagnosing Omenn syndrome
Abstract Omenn syndrome is a rare combined immunodeficiency mostly associated with RAG1 and RAG2 mutations; the clinical manifestations are well‐described and include neonatal erythroderma. Mortality due to opportunistic infections is a serious risk, and a timely diagnosis with a skin biopsy is an important part of the diagnostic workup...
| Published: | 29/01/2021 |
| Authors: | Walsh ML, Eustace K |
Coronavirus infection in hip fractures (CHIP) study
Aims Despite the COVID-19 pandemic, incidence of hip fracture has not changed. Evidence has shown increased mortality rates associated with COVID-19 infection. However, little is known about the outcomes of COVID-19 negative patients in a pandemic environment. In addition, the impact of vitamin D levels on mortality in COVID-19 hip..
| Published: | 28/01/2021 |
| Authors: | Chan C |
Evaluating the Possibility of Translating Technological Advances
Abstract Lactate is widely measured in critically ill patients as a robust indicator of patient deterioration and response to treatment. Plasma concentrations represent a balance between lactate production and clearance. Analysis has typically been performed with the aim of detecting tissue hypoxia. However, there is a diverse range of processes..
| Published: | 28/01/2021 |
| Authors: | Tridente A |
Maternal temperature in emergency caesarean section (MATES)
Background Temperature regulation in women undergoing emergency caesarean section is a complex topic about which there is a paucity of evidence-based recommendations. The adverse effects of inadvertent peri-operative hypothermia are well described. Hyperthermia is also associated with adverse neonatal outcomes, an increased risk of obstetric intervention and increased treatment for..
| Published: | 27/01/2021 |
| Authors: | Cochrane A |
Palmar psoriasis or missed BCC?
Abstract Case report A 76-year-old Caucasian woman with a history of previous BCCs excised from the head and legs was referred from the dermatology team with a biopsy proven superficial BCC to the left palm. The patient had presented to the dermatology team with the same lesion 7 years prior to..
| Published: | 21/01/2021 |
| Authors: | Ramadan S, Sharma N, Hassan Z |
Current process and outcomes of the surgical management of LUTS due to benign prostatic enlargement: how consistent are we?
Objective In view of changing landscape of surgical treatment for LUTS secondary to BPE, this audit was undertaken to assess key aspects of the processes and outcomes of the current interventional treatments for BPE, across different units in the UK. Materials and method A multi-institutional snapshot audit was conducted for..
| Published: | 17/01/2021 |
| Authors: | McCabe JE |
Predicting the length of stay at admission for emergency general surgery patients a cohort study
Introduction Predicting length of stay (LOS) is beneficial to patients and the health service. When a prolonged LOS is predicted, it gives the opportunity for focused therapies and allocation of resources to reduce this period. In emergency general surgery (EGS) there has been limited investigation of variables that may be..
| Published: | 16/01/2021 |
| Authors: | Raybould S |
Implementation of the ‘TAKE STOCK’ Hot Debrief Tool in the ED: a quality improvement project
Abstract Hot debriefing (HoD) describes a structured team-based discussion which may be initiated following a significant event. Benefits may include improved teamwork, staff well-being and identification of learning opportunities. Existing literature indicates that while staff value HoD following significant events, it is infrequently undertaken in practice. Internationally, several frameworks for..
| Published: | 13/01/2021 |
| Authors: | Langston S, Matthews J |
Serum lithium test requesting across three UK regions: an evaluation of adherence to monitoring guidelines
Background Bipolar disorder is the fourth most common mental health condition, affecting ~ 1% of UK adults. Lithium is an effective treatment for prevention of relapse and hospital admission, and is widely recommended as a first-line treatment. We previously showed in other areas that laboratory testing patterns are variable with sub-optimal conformity..
| Published: | 12/01/2021 |
| Authors: | Green L |
Novel use of distal radius plates for wrist arthrodesis in upper limb spasticity
Abstract Wrist arthrodesis is commonly performed to improve wrist position, flexion crease hygiene and appearance in patients with spastic upper limbs. These patients often have smaller bones and large commercially available implants lead to complications such as prominence of plate, pain and periprosthetic fractures. Authors hypothesized that Medartis® distal radius..
| Published: | 12/01/2021 |
| Authors: | Bamal R, McArthur P |
Accuracy in completing theatre listing forms
Introduction The numbers of cancer-related cases are increasing every day. There is a high turnover of patients on the elective lists. The theatre listing form is an important document to complete as it entails details of the procedure, type of anaesthesia, type of skin cancer patient has and many more...
| Published: | 11/01/2021 |
| Authors: | Adjei B, Hassan D, Mostafa A, Ramadan S, Benson A |
Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis
Background This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR). Methods MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and..
| Published: | 09/01/2021 |
| Authors: | Kearsey C, Rajaganeshan R |
Clinical and cost effectiveness of arthritis gloves in rheumatoid arthritis (A-GLOVES)
Background Arthritis (or compression) gloves are widely prescribed to people with rheumatoid arthritis and other forms of hand arthritis. They are prescribed for daytime wear to reduce hand pain and improve hand function, and/or night-time wear to reduce pain, improve sleep and reduce morning stiffness. However, evidence for their..
| Published: | 08/01/2021 |
| Authors: | Hough Y |
Re: Uretero-inguinal hernia with obstructive urolithiasis
To the editor, We read with interest the recent radiology page publication by Rathburn et al. highlighting the case of a 64 year old male with prostate cancer who was incidentally found to have left hydronephrosis and renal impairment during staging. Formal computed tomography revealed a 1cm stone in his distal..
| Published: | 01/01/2021 |
| Authors: | Khattak AS, Feyisetan O, Floyd Jr MS, Samsudin A |
Elective major general surgery in a patient who had recovered from COVID‐19: considerations and complications
We describe unanticipated complications and subsequent management of a patient undergoing major elective general surgery following a recent hospital admission with coronavirus disease‐2019 (COVID‐19). A 63‐year‐old man was admitted to hospital with dyspnoea and hypoxia due to COVID‐19. He reported previously being able to walk for over an hour..
| Published: | 27/12/2020 |
| Authors: | Lightburn T, Dixit T, Pedder S, Kalaiselvan R |
Cutaneous squamous cell carcinoma–mms or MMS?
We read with interest the articles by Kiely et al. discussing the challenges of completely excising cutaneous squamous cell carcinomas (cSCC) with standard surgical excision. The incidence of cSCC places a significant burden on skin cancer services, and thus conventional surgical excision remains the pragmatic standard of care. However, incomplete..
| Published: | 23/12/2020 |
| Authors: | Nayar R, Defty C, Tehrani H, Morton J |
Primary Melanoma of the Breast Parenchyma: An Oncoplastic Approach
Summary Primary melanoma of the breast parenchyma (PMPB) is a rare and aggressive disease, with only a few cases reported in the literature. We present the case of a 50-year old woman who underwent mastectomy and immediate breast reconstruction using a free DIEP flap following recurrence after breast conserving surgery...
| Published: | 18/12/2020 |
| Authors: | Snashall E, Kiernan T, Harper-Machin A, Taghizadeh R |
Evaluating the impact of a pharmacist-led prescribing feedback intervention
Background Prescribing errors are prevalent in hospital settings with provision of feedback recommended to support prescribing of doctors. Feedback on prescribing has been described as feasible and valued but limited by doctors, with pharmacists described as credible facilitators of prescribing feedback. Evidence supporting prescribing feedback has been limited to date...
| Published: | 16/12/2020 |
| Authors: | Lloyd M, O'Brien S, Hardy KJ, Furlong NJ |
Management of osteoarthritis of the knee and other joints in rural India
Abstract This is a retrospective review of patients who presented to the senior author's orthopaedic camps in Ranchi, Jharkhand, East India. The aim of this study is identify the obstacles in educating the patients in management of their joint pain and then getting their consent for the appropriate treatment. During..
| Published: | 16/12/2020 |
| Authors: | Naraen A |
Loco-regional recurrence after skin and nipple-sparing mastectomy
Background Immediate autologous tissue breast reconstruction after skin- and nipple-sparing mastectomy, is becoming increasingly popular, while the benefits are evident, the concern is in leaving breast tissue under the skin envelope, which could potentially lead to a higher chance of recurrence. We aim to determine the incidence and study the..
| Published: | 12/12/2020 |
| Authors: | Shah A, Koshy O, Riogi B, Taghizadeh R, Bennett S, Chagla LS |
A panel of urinary proteins predicts active lupus nephritis and response to rituximab treatment
Objectives ∼30% of patients with SLE develop LN. Presence and/or severity of LN are currently assessed by renal biopsy, but biomarkers in serum or urine samples may provide an avenue for non-invasive routine testing. We aimed to validate a urinary protein panel for its ability to predict active renal involvement..
| Published: | 12/12/2020 |
| Authors: | Dawson J, McCaffrey P, Graham D, Williams E, Clewes A, Hornby N |
Groin dissections in skin cancer: Effect of a change in prophylactic antibiotic protocol
Objectives To determine whether groin dissection surgical site infection (SSI) incidence changed with shorter post-operative antibiotic prophylaxis. Background Post-operative prophylaxis changed due to antimicrobial stewardship, from regular oral antibiotics until drain removal, to three intravenous doses. Both groups had a single intravenous dose at induction. Methods A prospective database of..
| Published: | 09/12/2020 |
| Authors: | Dargan D, Beck D, McConville S, Mortimer K, Brackley P |
Minimal Access Tendon Harvesting without a Harvester
Abstract Tendon grafting is a key component of hand reconstructive procedures. Commercially produced tendon harvesters facilitate this grafting process but are not always available. We present an innovative technique that allows tendon harvest to be undertaken using equipment readily available in all hospitals. Only a scalpel blade and a plastic..
| Published: | 09/12/2020 |
| Authors: | Asmar O, Iqbal A |
BCC metastasis: a very rare sequela of a common disease
Basal cell carcinoma (BCC) is the most common skin cancer worldwide, accounting for approximately 80% of non-melanoma skin cancers. BCC metastasis is an extremely rare sequela with an estimated incidence of 0.0028%–0.5% among all BCC diagnoses. We describe a case of an 82-year-old man with a history of multiple previous BCC excisions...
| Published: | 08/12/2020 |
| Authors: | Mohammad M, Schumacher K, Nayar R, Morton J |
Comment on: COVID 19 and the race to publish: an ethical issue
Dear Editor We read Safieddine and Kassir’s letter1 on the ethics of pandemic publication with interest. They commend the role journal editors play in the academic response to the virus by expediently reviewing and disseminating an overwhelming number of submissions. ‘Corona’, from the Latin ‘crown’, was applied to a..
| Published: | 08/12/2020 |
| Authors: | Nolan G |
Short bowel syndrome and the impact on patients and their families: a qualitative study
Background Short bowel syndrome (SBS) is a malabsorptive condition that can result in intestinal failure (SBS‐IF). Many patients with SBS‐IF require home parenteral nutrition (PN) for survival. However, PN has profound effects on patients and their family members. The present study aimed to understand the lived experience of..
| Published: | 01/12/2020 |
| Authors: | Ablett J |
Minimal Access Tendon Harvesting without a Harvester
Abstract Tendon grafting is a key component of hand reconstructive procedures. Commercially produced tendon harvesters facilitate this grafting process but are not always available. We present an innovative technique that allows tendon harvest to be undertaken using equipment readily available in all hospitals. Only a scalpel blade and a plastic..
| Published: | 01/12/2020 |
| Authors: | Asmar O, , Iqbal A |
The perils of diagnosing and managing aortic root prosthetic graft infection
Adan, A; Waldman, S; Noshirwani, A et al. (2020). The perils of diagnosing and managing aortic root prosthetic graft infection. Journal of Cardiac Surgery. 36 (1), 153-155
| Published: | 01/12/2020 |
| Authors: | Waldman S, Noshirwani A |
Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease
Introduction Pilonidal disease (PD) is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, Laser depilation (LD) has been proposed as an adjunct to surgery and shown improved results in previous..
| Published: | 01/12/2020 |
| Authors: | Javed M, Kalaiselvan R, Rajaganeshan R |
Role of clinical judgement in offering adjuvant chemotherapy for Breast Cancer patients
Aim NICE recommends Oncotype Dx for patients with oestrogen receptor‐positive, human epidermal growth factor receptor 2 (HER2)‐negative and lymph node (LN)‐negative patients in the decision for adjuvant chemotherapy. Oncotype Dx predicts cancer recurrence and benefits from chemotherapy based on Recurrence Score (RS >26 significant chemotherapy benefit). We aimed to..
| Published: | 01/12/2020 |
| Authors: | Patnam V, Pushdary KH |
Two‐Stage Flexor tendon repair versus Primary repair
Introduction & Aim In the anatomical extremity, the hand is constantly exposed to the potential risk of injury. If a flexor tendon is injured and recognized as needing surgical intervention, two options are available; Two‐stage Flexor Tendon (TSFT) repair or Primary repair. We evaluated the subjective and functional outcomes of..
| Published: | 01/12/2020 |
| Authors: | Richards B |
Knife to the skin timing in emergency laparotomies (NELA patients): Are we quick enough?
Aim Definitive source control is pivotal in achieving ideal outcomes in patients undergoing emergency laparotomy. NELA suggests that 84% requiring immediate or urgent surgery arrived in theatre in congruous timeframe but does not comment on Knife to skin timings for absolute source control. We aimed to assess time difference of arrival..
| Published: | 01/12/2020 |
| Authors: | Patnam V, Barter R, Kanwar S |
Laser Management of Scars
This book addresses the management of scars using lasers and light. The authors provide a comprehensive overview of the current laser modalities and the science and evidence behind them. They also present various treatments, including those using carbon dioxide lasers, Erbium:YAG lasers, pulsed dye lasers and Q-switched lasers. The..
| Published: | 25/11/2020 |
| Authors: | Shokrollahi K |
Comparison of Scarf-Akin osteotomy with Lapidus-Akin fusion
Background Hallux Valgus associated with medial column instability (disrupted Meary’s line) can be corrected either with Lapidus-Akin or Scarf-Akin procedure. This study compares these two procedures to ascertain if type of surgical procedure performed affects the correction achieved and recurrence rate at 6 months following operative intervention. Materials and Methods..
| Published: | 25/11/2020 |
| Authors: | Thomas T, Khan S, Morgan S, Ballester J |
Introducing video content into Scars, Burns & Healing
Tridente, A. (2020). Introducing video content into Scars, Burns & Healing. Scars, Burn and Healing. 6
| Published: | 24/11/2020 |
| Authors: | Tridente A |
A radon seed identified during skin surgery
A 76‐year‐old man presented to clinic with a 3‐week history of a lesion on his central forehead. The lesion was slowly increasing in size, becoming darker and occasionally bled. A black crusted papule, 3 × 3 mm in size, was visualized on the central forehead. Dermoscopy revealed areas of superficial haemorrhage suggestive..
| Published: | 13/11/2020 |
| Authors: | Lavery MJ, Lorenzelli D, Crema J |
Simultaneous Reconstruction of a Complex Full Thickness Ala and Perialar Defect Involving Multiple Lip and Nasal Subunits
Hassan, D; Morton, J; Defty, C. (2020). Simultaneous Reconstruction of a Complex Full Thickness Ala and Perialar Defect Involving Multiple Lip and Nasal Subunits. Dermatologic Surgery. epub Nov
| Published: | 10/11/2020 |
| Authors: | Hassan D, Morton J, Defty C |
Delayed hypersensitivity to multiple glucocorticoid agents in a patient with cranial giant cell arteritis
Extract DEAR EDITOR, Hypersensitivity reactions to systemic glucocorticoids (GCs) are uncommon and paradoxical, because GCs are used to treat such reactions. The World Allergy Organization divides drug hypersensitivity reactions into immediate (occurring within 1 h of the administered dose) and delayed (appearing after 1 h, although most reactions start after 6 h). Immediate..
| Published: | 09/11/2020 |
| Authors: | Sze JT, Abernethy R |
Rheumatoid arthritis related interstitial lung disease – improving outcomes over 25 years: a large multicentre UK study
Objective This study explores whether the prognosis of interstitial lung disease in rheumatoid arthritis (RA-ILD) has improved over time and assesses the potential influence of drug therapy in a large multicentre UK network. Methods We analysed data from 18 UK centres on patients meeting criteria for both RA and ILD diagnosed..
| Published: | 04/11/2020 |
| Authors: | Dawson J |
Coronavirus (COVID-19) and young people's sexual health
Background COVID-19 has reduced health-seeking behaviour in the UK including in sexual health services (SHS). We sought to describe changes in sexual health attendances among young people (YP) within a semirural service setting (A) and at services based in London and Surrey (B) during the weeks preceding and following lockdown...
| Published: | 02/11/2020 |
| Authors: | Thomson-Glover R, Hamlett H |
DIEP flap reconstruction as salvage option for Poland syndrome breast hypoplasia
Dear Sir, Poland syndrome is a congenital abnormality mostly associated with unilateral hypoplasia of the sternocostal head of pectoralis major, rib cage and upper limb abnormalities. It may include absent or hypoplastic breast can which have a significant psychological impact in female patients who often experience body image disorders. Mild..
| Published: | 01/11/2020 |
| Authors: | Ramadan S, Koshy O |
The effect of the COVID‐19 pandemic on skin cancer surgery in the United Kingdom: a national, multi‐centre, prospective cohort study and survey of Plastic Surgeons
Editor The COVID‐19 pandemic has negatively affected all skin cancer treatment. A national audit of skin cancer excisions by Plastic Surgeons was adapted to establish what effect the pandemic had on the provision and delivery of skin cancer treatment in the United Kingdom. Throughout ‘lockdown’ (March 16th – June 14th 2020) a..
| Published: | 01/11/2020 |
| Authors: | Nolan G, Pritchard-Jones R |
Improving care in ventilated inter‐hospital transfers: a trainee‐led quality improvement project
In Mersey, the location of tertiary centres on distinct sites necessitates frequent emergency inter‐hospital transfers of critically ill patients. Local audits found a median transfer time of 5 h for ventilated patients to our tertiary neurosurgical centre, and the recommended target time of 2 h for ‘door‐to‐balloon’ in primary..
| Published: | 27/10/2020 |
| Authors: | Furniss T |
The use of a non-medicated dressing for superficial-partial thickness burns in children
Background: Cutimed® Sorbact® is a dressing marketed as having antimicrobial properties and easy application without the threat of antibiotic resistance and difficult accessibility. There is little evidence on the clinical outcomes of the use of Cutimed®; Sorbact® in adults and currently no evidence of use of Cutimed® Sorbact® on superficial-partial..
| Published: | 27/10/2020 |
| Authors: | Araia E |
Proceeding with a general anaesthetic in a patient with ongoing symptoms of a hemiplegic migraine
This is the first case in the literature to report a case of hemiplegic migraine aura resolving post‐general anaesthesia. A patient known to have frequent hemiplegic migraines had left‐sided facial droop in the pre‐operative period for elective day‐case surgery. She awoke in recovery with no facial..
| Topic | |
| Published: | 26/10/2020 |
| Authors: | Singh P, Goel R |
Comfort care for burns patients
Zack-Williams, SDL; Gurusinghe, D; Tridente, A; Shokrollahi, K. (2020). Comfort care for burns patients: The gold standard for assessment and delivery of care remains in a burn center. Burns. epub 24 Oct
| Published: | 24/10/2020 |
| Authors: | Zack-Williams SDL, Gurusinghe D, Tridente A, Shokrollahi K |
Electrochemotherapy in the treatment of cutaneous malignancy
Background Electrochemotherapy (ECT) is a treatment for both primary and secondary cutaneous tumours. The international Network for sharing practices on ECT group investigates treatment outcomes after ECT using a common database with defined parameters. Methods Twenty-eight centres across Europe prospectively uploaded data over an 11-year period. Response rates were investigated..
| Published: | 21/10/2020 |
| Authors: | Pritchard-Jones R |
G615(P) Beware! The emerging superbug
Abstract A fit and healthy 8-year old boy presented with a 10-day history of asymptomatic superficial ulcerations initially on the left great toe, and then the left elbow. He was systemically well. The general practitioner had prescribed oral flucloxacillin for infected bite marks but the patient took for 2–3 days as..
| Published: | 14/10/2020 |
| Authors: | Lavery MJ, MacBeth K, Walsh ML |
A Rule of Thumb for Hand Burns
Abstract Hand burns are common and often complex injuries, requiring referral to specialist centers. The patient's thumbprint is a rapid means of accurately assessing hand burn surface area. This study aimed to establish categories and evaluate sites of hand burn surface area in order to facilitate comparison of hand burns...
| Published: | 13/10/2020 |
| Authors: | Adjei B, Dargan D, Shokrollahi K |
Enhancing Reporting of After Action Reviews of Public Health Emergencies
Objective This literature review aimed to identify the range of methods used in after action reviews (AARs) of public health emergencies and to develop appraisal tools to compare methodological reporting and validity standards. Methods A review of biomedical and gray literature identified key approaches from AAR methodological research, real-world AARs,..
| Published: | 13/10/2020 |
| Authors: | Davies R |
Improving foundation year doctors’ confidence with routine suprapubic catheter change
Khattak, AS; Omar, AM; Khattak, AQ; Floyd, MS Jr. (2020). Letter to the editor re: Improving foundation year doctors’ confidence with routine suprapubic catheter change using an easily reproducible simulation model. Journal of Clinical Urology. Pub online 7 Oct.
| Published: | 07/10/2020 |
| Authors: | Khattak AS, Omar A, Khattak AQ, Floyd Jr MS |
Improving foundation year doctors’ confidence with routine suprapubic catheter change
Khattak, AS; Omar, AM; Khattak, AQ; Floyd Jr, MS. (2020). Letter to the editor re: Improving foundation year doctors’ confidence with routine suprapubic catheter change using an easily reproducible simulation model. Journal of Clinical Urology. epub 7 Oct
| Published: | 07/10/2020 |
| Authors: | Khattak AS, Omar A, Khattak AQ, Floyd Jr MS |
The development of a diabetes screening service for the homeless population in St Helens
Aim To screen members of the homeless community in St. Helens for diabetes, and offer advice, support, diabetic eye screening and diabetic foot screening for those with diabetes, following two diabetes-related deaths in this population in 2018. Method(s) The Teardrops Hub staff promoted the drop in service to their service..
| Published: | 07/10/2020 |
| Authors: | Pendlebury H, Bujawansa S, Cardwell J |
Evaluating the views of doctors and nurses on the delivery of a safe insulin tips (SIPS) educational programme
Aim To evaluate the views of doctors and nurses on the delivery and use of a safe insulin tips (SIPS) educational programme. Methods Twelve SIPS were developed covering key areas of safe insulin use by a multi‐professional collaboration of patients and healthcare professionals. Individual SIPs were emailed weekly over 12..
| Published: | 07/10/2020 |
| Authors: | Lloyd M, Michaels S, Cardwell J, Furlong NJ |
Setting up a total contact casting service within a diabetes foot ulcer service
Aims The National Institute for Health and Care Excellence (NICE) recommend total contact casting (TCC) for neuropathic ulceration in the diabetic foot. The St Helens and Knowsley Hospitals Trust, Diabetes Team, determined the feasibility of starting and developing a TCC service within their diabetes foot ulcer service. Method The type..
| Published: | 07/10/2020 |
| Authors: | Pendlebury H, Furlong NJ, Sullivan H |
The impact of local, validated structured education programmes on self-care activities in people with diabetes
Background and Aim Better glycaemic control is exhibited in patients with higher self‐care abilities. The Summary of Diabetes Self‐Care Activities (SDSCA) questionnaire measures diabetes self‐care activities. As part of a local, validated structured education programme, we measure the SDSCA scores before and after completing structured education. Scores..
| Published: | 07/10/2020 |
| Authors: | Furlong NJ, Westall S, Cardwell J, Jackson J, Cairns J, Mitchell L, Bujawansa S, McNulty S, Narayanan RP, Hardy KJ |
The impact of a validated structured education programme diabetes-related distress in patients with type 2 diabetes
Background and Aim Patients with type 2 diabetes experience varying degrees of the emotional burden of diabetes and its treatments. The Problem Areas in Diabetes (PAID) questionnaire can be used to evaluate this domain. As part of a local, validated structured education programme for people with type 2 diabetes, baseline and endpoint..
| Published: | 07/10/2020 |
| Authors: | Cardwell J, Bujawansa S, McNulty S, Furlong NJ, Narayanan RP, Jackson J, Mitchell L, Westall S, Hardy KJ |
The impact of a validated structured education programme on diabetes-related distress in patients with type 1 diabetes
Background and Aim People with type 1 diabetes experience varying degrees of the emotional burden of diabetes and its treatments. The Problem Areas in Diabetes (PAID) questionnaire can be used to evaluate this domain. As part of a local, validated structured education programme for people with type 1 diabetes, baseline and endpoint..
| Published: | 07/10/2020 |
| Authors: | Narayanan RP, Westall S, Sullivan H, Cardwell J, Langan E, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Hardy KJ |
The impact of a validated structured education programme on anxiety and depression in patients with type 2 diabetes
Background There has been a big drive from the UK government and Diabetes UK to provide improved psychological care for patients with diabetes. People with type 2 diabetes experience greater degrees of anxiety and depression than the general population. The Hospital Anxiety and Depression Scale (HADS) questionnaire can evaluate this. As..
| Published: | 07/10/2020 |
| Authors: | Westall S, Jackson J, Mitchell L, Cairns J, Sullivan H, Bujawansa S, McNulty S, Furlong NJ, Narayanan RP, Hardy KJ |
Perceived problem areas in diabetes do not correlate with levels of anxiety and depression
Background and Aim Diabetes‐related distress, anxiety and depression are all highly prevalent in people with diabetes. The Problem Areas In Diabetes (PAID) and Hospital Anxiety and Depression Score (HADS) questionnaires can be used to measure these domains. We evaluated the impact of structured education on each of these. Methods..
| Published: | 07/10/2020 |
| Authors: | Westall S, Narayanan RP, Langan E, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Cardwell J, Hardy KJ |
The impact of a validated structured education programme on anxiety and depression in patients with type 1 diabetes
Background and Aim People with type 1 diabetes experience greater degrees of anxiety and depression than the general population. The Hospital Anxiety and Depression Scale (HADS) questionnaire can evaluate this. As part of a local, validated structured education programme for people with type 1 diabetes, baseline and endpoint measurements of anxiety and..
| Published: | 07/10/2020 |
| Authors: | Sullivan H, Westall S, Jackson J, Cairns J, Cardwell J, Bujawansa S, McNulty S, Furlong NJ, Narayanan RP, Hardy KJ |
The impact of seven-day working by a diabetes specialist nurse (DSN) team within an acute hospital trust
Aim Inpatient Diabetes Specialist Nurse Cover nationally is varied. Post a successful NHS England Transformation funding bid the aim was to provide greater support for ward areas, reduce error rates and increase satisfaction rates through the implementation of seven‐day working and an emergency advice line led by a diabetes..
| Published: | 07/10/2020 |
| Authors: | Michaels S, Bujawansa S, Hardy KJ, Cardwell J, Milne R, Strong AJ, Lee C, Smith R |
Reviewing current type 1 diabetes education provision across Merseyside
Aims NICE guideline NG17 recommend individual care plans agreed with the person with type 1 diabetes (PWT1D), reviewed annually and to include diabetes education provision. Where and how this education should be delivered is up for debate. A group was established in Merseyside to look at education offered to PWT1..
| Published: | 07/10/2020 |
| Authors: | Strong AJ, Cardwell J |
Measuring inpatient diabetes related staff satisfaction using a SurveyMonkey questionnaire
Background We introduced seven‐day working and increased support for inpatients from the diabetes specialist nursing (DSN) Team in 2017. Previous surveys using hand‐delivered or postal questionnaires had resulted in low response rates. This year we used an online survey via SurveyMonkey® to measure inpatient diabetes related staff satisfaction. Aim..
| Published: | 07/10/2020 |
| Authors: | Milne R, Bujawansa S, Hardy KJ, Cardwell J, Michaels S, Smith R, Lee C |
Financial impact of improving diabetes‐related clinical outcomes
Background Our Trust received funding through the NHS Diabetes Transformation Programme to improve inpatient care and foot care. The monies received for inpatient care was used to increase the number of diabetes inpatient nurses by fivefold. We introduced extended weekday coverage (0,800–2,200), weekend cover and an emergency support line. The funding..
| Published: | 07/10/2020 |
| Authors: | Bujawansa S, Furlong NJ, Narayanan RP, Westall S, Cardwell J, Mitchell L, Michaels S, Hardy KJ |
Improved structured education uptake by systematising the offer
Aims In the UK, attendance at diabetes‐structured education is poor. Indeed, even evidence of a formal offer of structured education is sometimes lacking. Our aim was to improve education update by mailing a validated letter offering structured education to every person registered with diabetes in our borough. Methods With..
| Published: | 07/10/2020 |
| Authors: | Mitchell L, Cardwell J, Bujawansa S, Hardy KJ |
Follow‐up screening for diabetes after gestational diabetes (GDM)
Aims NICE guidelines for screening state that all GDM patients should be screened for diabetes at 6–12 weeks postpartum. Previous published data have given a national rate of less than 20%1. We reviewed our screening rate after the interventions of: discussion with the patient at first and last visit, written instructions to..
| Published: | 07/10/2020 |
| Authors: | McNulty SJ, Wilkinson P, Michaels S, Davies H, Sullivan H, Bujawansa S |
Improving glycaemic and cardiovascular risk assessment and management in diabetic foot ulcer patients
Introduction Diabetic foot ulcer increases the risk of cardiovascular disease, nephropathy and mortality. There is over a twofold increase in mortality compared to patients without diabetic foot ulcer, regardless of other risk factors. Aim To improve glycaemic and cardiovascular risk assessment and management on first presentation to the multidisciplinary diabetic..
| Published: | 07/10/2020 |
| Authors: | Roberts H, Kejem H, Furlong NJ |
Comparison of Procedural Outcomes in Transcatheter Aortic Valve Replacement
Background Mechanically expanded valve (MEV) was designed to reduce paravalvular leak and to provide the ability to reposition during transcatheter aortic valve replacement (TAVR). We have assessed recent evidence on procedural outcomes between MEV and the self-expandable valve (SEV). Methods Two independent researchers performed an extensive search on PubMed and..
| Published: | 01/10/2020 |
| Authors: | Akhtar KJ |
Incomplete surgical excision of keratinocyte skin cancers: a systematic review and meta-analysis
Background Keratinocyte or nonmelanoma skin cancer (NMSC) is the commonest malignancy worldwide. The usual treatment is surgical excision. Current guidelines underestimate incomplete excision rates. Objectives We aimed to determine the risk of incomplete excision of NMSCs through a systematic review and meta‐analysis of primary clinical studies. Methods A PRISMA‐..
| Published: | 01/10/2020 |
| Authors: | Nolan G |
Re: Evaluation of erectile function after anastomotic vs substitution urethroplasty for bulbar stricture
Dear Editor, We read with interest the recent paper by Omar et al. [1] regarding the evaluation of erectile function (EF) following bulbar urethroplasty. A prospective non-randomised study of 34 patients with stricture who underwent either anastomotic or substitution urethroplasty is presented with specific emphasis on the effects of the procedure on..
| Published: | 01/10/2020 |
| Authors: | Floyd Jr MS, Omar A |
Outcome of revision surgery for bisphosphonate related subtrochanteric fracture non-union following failed intramedullary nailing
Background Bisphosphonates use is a recognised cause of atypical femur fractures. Intramedullary nailing is the first line of treatment for these fractures, but failure is a common problem due to altered biology, resulting in a non-union and a challenging problem. Purpose There is lack of evidence in the literature on..
| Published: | 26/09/2020 |
| Authors: | Nagy MT, Kwaees TA, Saldanha K |
Is the use of a powered dermatome an aerosol-generating procedure (AGP)? Implications for personal protection against COVID-19 virus
Introduction Many healthcare workers have contracted SARS-CoV-2 during the pandemic, many cases of which have resulted in severe illness and death. No studies have assessed the potential for powered dermatomes to generate aerosol, an essential technique in burns and plastic surgery. The primary aim of the present study was to..
| Published: | 25/09/2020 |
| Authors: | Shokrollahi K, Kyriazidis I, Zak-Williams S, Murgatroyd E, Gurusinghe D |
The association of socioeconomic deprivation and paediatric open tibia fractures
Abstract The primary aim of this study is to test the association of open tibial fractures (OTF), in a paediatric age group, with socioeconomic deprivation. The secondary objectives are to more clearly define the epidemiological characteristics of these high-energy injuries. A consecutive series of patients with OTF presenting to a..
| Published: | 16/09/2020 |
| Authors: | Harrison WD |
P009 The value of random mucosal biopsies in the diagnosis of microscopic colitis
Introduction The incidence of microscopic colitis (MC) has recently increased to that of ulcerative colitis and Crohn's disease but its diagnosis can be difficult. Aim To establish the incidence of MC and the diagnostic value of random mucosal biopsies. Method 100 consecutive patients (35 men and 65 women; median age 58.5 years, ranging from 19..
| Published: | 16/09/2020 |
| Authors: | Brice R |
Corticosteroids reduce mortality and prevent ICU admission in Covid-19 pneumonia
Abstract Can early use of corticosteroids prevent progression of Covid-19 pneumonia to full-blown ARDS, and reduce mortality? Clinical data for use of corticosteroids in severe coronavirus infections are mixed - there is a particular lack of evidence in patients in the pre-critical care stage of illness i.e. before decompensation..
| Published: | 16/09/2020 |
| Authors: | Heaton J, Malhotra P, Stockton P, Rossiter L |
Immature platelet indices alongside procalcitonin for sensitive and specific identification
Abstract Hematological markers that can be rapidly analyzed and regularly monitored during a patient’s stay on ICU, and that can identify bacterial causes of sepsis are being extensively sought. The significance of platelets in early immunological responses provides justification for assessing their usefulness in the identification of bacteremia amongst..
| Published: | 08/09/2020 |
| Authors: | Tridente A |
The role of BAUS Section of Trainees (BSoT) as we negotiate our way through a difficult time in training
The year 2020 has certainly been challenging on a personal and professional level for surgical trainees. Many of us have been redeployed to work in less familiar specialities pushing the boundaries of our professional abilities in order to ensure safe care for all patients during this global pandemic. Educationally, life has..
| Published: | 08/09/2020 |
| Authors: | Tolofari S |
Post‐caesarean section venous thromboembolic prescription: do we need a defined prescriber role?
Venous thromboembolic (VTE) disease remains an important cause of perinatal morbidity and mortality [1]. All patients undergoing a caesarean section (CS) ‘should be considered for thromboprophylaxis with low molecular weight heparin (LMWH) for 10 days after delivery’, as per Royal College of Obstetricians [2]. Anecdotally, within our region, the responsibly of VTE prophylaxis..
| Published: | 01/09/2020 |
| Authors: | Robinson E, Singh P |
Effect of Flash Glucose Monitoring on Glycemic Control, Hypoglycemia, Diabetes-Related Distress, and Resource Utilization
OBJECTIVE The FreeStyle Libre (FSL) flash glucose-monitoring device was made available on the U.K. National Health Service (NHS) drug tariff in 2017. This study aims to explore the U.K. real-world experience of FSL and the impact on glycemic control, hypoglycemia, diabetes-related distress, and hospital admissions. RESEARCH DESIGN AND METHODS..
| Published: | 01/09/2020 |
| Authors: | Furlong NJ |
Simultaneous Augmentation Mammoplasty and Vacuum-Assisted Breast Biopsy for Enhanced Cosmesis and Efficacy
Taghizadeh, R. (2020). Invited Discussion on: Simultaneous Augmentation Mammoplasty and Vacuum-Assisted Breast Biopsy for Enhanced Cosmesis and Efficacy. Aesthetic Plastic Surgery. 44 (0), 2048-2050
| Published: | 01/09/2020 |
| Authors: | Taghizadeh R |
Anthropometric Parameters for Nose Evaluation and Nasal Surgery Planning
Background The esthetic characteristics of face and nose are commonly evaluated before rhinoplasty using a completely subjective method, due to the lack of validated and reliable methods for quantifying facial esthetics and for accurate nose treatment planning. The aim of the study was to review the literature to determine and..
| Published: | 01/09/2020 |
| Authors: | Zace P |
Skin cancer surgery during the COVID-19 pandemic: A national, multicentre, prospective cohort study and survey of plastic surgeons
Abstract Skin cancer is the most common malignancy worldwide. The COVID‐19 pandemic has caused an unprecedented reorganization of healthcare services. This study established what effect the pandemic has had on the provision of skin cancer surgery by plastic surgeons in the U.K., one of the worst affected countries globally...
| Published: | 01/09/2020 |
| Authors: | Nolan G, Pritchard-Jones R |
A regional patch test audit against the 2019 British Association of Dermatologists’ Cutaneous Allergy Service Standards
Abstract The aim of this audit was to assess regional patch testing services in accordance with the British Association of Dermatology's (BAD) Cutaneous Allergy Service Standards, published in July 2019. Audit points incorporated recommendations from a regional audit carried out after the publication of the 2017 BAD contact dermatitis guidelines, in addition..
| Published: | 01/09/2020 |
| Authors: | Pang E |
Beyond corticosteroids for the management of patients with cutaneous immune-related adverse events secondary to immune checkpoint inhibitors
Abstract Immune checkpoint inhibitors (ICIs) restore antitumour immunity and have revolutionized the treatment of several types of malignancy, including melanoma. However, these immunotherapeutic agents are often associated with immune‐related adverse events (irAEs), most commonly in the skin. Guidelines from the European Society for Medical Oncology recommend the use of..
| Published: | 01/09/2020 |
| Authors: | Hindle E |
Surgeon led Urethrography: Procedure, Pitfalls and Pickups: an 18 month review
Introduction: Stricture disease remains an uncommon pathology with an incidence of 0.9%. Urethrography remains an important diagnostic tool in evaluating urethral disease as it provides information regarding stricture length and location. Ideally urethrography should be performed by the operating surgeon. In 2018 a urethral centre was established in Whiston Hospital, Merseyside and..
| Published: | 01/09/2020 |
| Authors: | Floyd Jr MS |
PLASTA National Webinar Series: A developing model for remote surgical education
Dear Sir, We enjoyed the recent publication on the growth of high-quality webinar-based teaching from the Plastic Surgery Trainees Association (PLASTA) and would like to offer some reflections. We agree webinars have many advantages in terms of cost, accessibility, convenience as well as the ability to place experts in niche..
| Published: | 27/08/2020 |
| Authors: | Nolan G |
Development of V-FAST: a vision screening tool for ambulance staff
Background About two-thirds of stroke survivors experience visual problems and most patients who have a stroke limited to the occipital lobe will have visual impairments only. Aim The V-FAST screening tool, which assesses visual symptoms, eye movements, visual field and visual extinction, and a training package to improve diagnostic accuracy..
| Published: | 11/08/2020 |
| Authors: | Bates R |
Acquired reactive perforating collagenosis in association with pregnancy
A 32 year-old woman, at 17 weeks gestation, presented to dermatology with a pruritic erythematous urticarial-like eruption present on the trunk and limbs. A diagnosis of polymorphic eruption of pregnancy (PEP) was made and the patient was referred for ultraviolet B TL01 phototherapy. However at 24 weeks gestation, a separate papular eruption on..
| Published: | 01/08/2020 |
| Authors: | Lavery MJ, Winters S, Lorenzelli D, Low SE, Sharma N, Ngan K |
Reliability and validity of the Wrightington classification of elbow fracture-dislocation
Aims The Wrightington classification system of fracture-dislocations of the elbow divides these injuries into six subtypes depending on the involvement of the coronoid and the radial head. The aim of this study was to assess the reliability and reproducibility of this classification system. Methods This was a blinded study using..
| Published: | 31/07/2020 |
| Authors: |
Common variable immunodeficiency with granulomatous-lymphocytic interstitial lung disease and preceding neurological involvement
Background Common variable immunodeficiency (CVID) is a group of heterogeneous primary immunodeficiencies characterised by a dysregulated and impaired immune response. In addition to an increased susceptibility to infection, it is also associated with noninfectious autoimmune and lymphoproliferative complications. CVID is rarely associated with neurological complications. Pulmonary involvement is more common,..
| Published: | 31/07/2020 |
| Authors: | Stevenson J |
High rates of stillbirth and preterm delivery in women with covid-19 and the efficacy of ECMO in pregnancy
The initial data reported by the UK Obstetric Surveillance System study were of great interest, and the findings have been discussed in our multidisciplinary maternity team. The rates of pregnancy loss, stillbirth, and preterm delivery seem considerably higher than those reported elsewhere. As noted by Magee and colleagues, the stillbirth..
| Published: | 27/07/2020 |
| Authors: | Kingston E |
People with obsessive-compulsive disorder often remain symptomatic following psychological treatment
Background Previous meta-analyses conclude that efficacious psychological treatments for obsessive-compulsive disorder (OCD) exist. However, determining the efficacy of psychological treatments requires multiple forms of assessment. We conducted an individual patient data meta-analysis of randomised controlled trials (RCTs) of manualised psychological therapy for adults with OCD. Methods Four electronic databases were..
| Published: | 25/07/2020 |
| Authors: | Rigby JW |
The effect on the surgeon of surgical complications: Are we doing enough to provide support?
Introduction Surgical complications have been shown to effect surgeons in a wide variety of domains, including psychological consequences and change in practice. A recent systematic review including over 8500 participants concluded that more formal support for surgical wellbeing after complications is required. We aimed to assess the effect of surgical complications..
| Published: | 16/07/2020 |
| Authors: | Clifford R, Kalaiselvan R |
Incidence of genitourinary dysfunction following left‐sided colorectal cancer (CRC) resections
Purpose CRC patients are at an increased risk of developing genitourinary symptoms post‐operatively due to the pelvic dissection. Our primary aim was to evaluate the incidence of genitourinary dysfunction after CRC resections and secondary aim was to look at the documentation about the risk of genitourinary dysfunction in consent..
| Published: | 15/07/2020 |
| Authors: | Javed M, Clark E, MacDonald S, Kalaiselvan R |
Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease:
Introduction Pilonidal disease (PD) is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, Laser depilation (LD) has been proposed as an adjunct to surgery and shown improved results in previous..
| Published: | 15/07/2020 |
| Authors: | Liyanage A, Javed M, Kalaiselvan R, Rajaganeshan R |
Is it time for colorectal surgeons to follow the gynaecologists when removing left sided specimens?
Purpose To analyze different extraction sites for specimen extraction following left sided colorectal resections and risk for developing an IH. Methods Retrospective analysis of 107 patients undergoing laparoscopic left sided colorectal resections. Patients were divided into 3 groups based on extraction sites; midline, transverse (right or left) or pfannenstiel incisions. Data regarding..
| Published: | 15/07/2020 |
| Authors: | Javed M, Thomas E, West C, Chadwick M, Samad A, Rajaganeshan R |
What is the fate of an Ostomy following Emergency Laparotomy?
Purpose To analyse outcomes of patients undergoing emergency laparotomy and stoma formation particularly: stoma reversal, stoma associated complications (SAC) and cost implications. Methods Retrospective analysis of 57 patients identified from NELA database between January 2014 and December 2015. Results Median age was 72 years (IQR: 60–82), M:F = 25:32. The median time duration between admission and..
| Published: | 15/07/2020 |
| Authors: | Javed M, Ting L, Appleton ND, Chadwick M, Rajaganeshan R, Kalaiselvan R |
Overall survival of elderly colorectal cancer (CRC) patients
Purpose Advances in surgical techniques and perioperative care have improved cancer‐related outcomes. This study aims to describe the outcomes of elderly who had curative surgery or symptomatic management for CRC. Methods Retrospective study of consecutive CRC patients between 2014 to 2016 in a DGH, who were 70 years old or above. Demographic..
| Published: | 15/07/2020 |
| Authors: | Javed M, Airey G, Kearsey C, Samad A, Chadwick M, Rajaganeshan R |
Re: Boomerang technique, The Buccal Mucosal Grafting Harvesting Model for Long Urethral Stricture Urethroplasty
Floyd, MS; Omar, AM. (2020). Re: Boomerang technique, The Buccal Mucosal Grafting Harvesting Model for Long Urethral Stricture Urethroplasty: A case series. Urology Journal. 17 (5), 530
| Published: | 08/07/2020 |
| Authors: | Floyd Jr MS, Omar A |
An evaluation of continuous subcutaneous infusions across seven NHS acute hospitals
Background Continuous subcutaneous infusions (CSCIs) are commonly used in the United Kingdom as a way of administering medication to patients requiring symptom control when the oral route is compromised. These infusions are typically administered over 24 h due to currently available safety data. The ability to deliver prescribed medication by CSCI..
| Published: | 07/07/2020 |
| Authors: | Kirk J |
The presentation, diagnosis and management of non-traumatic wrist pain
Objectives The study aims were to assess the burden of non-traumatic wrist pain in terms of numbers of referrals to secondary care and to characterize how patients present, are diagnosed and are managed in secondary care in the UK National Health Service. Methods Ten consecutive patients presenting with non-traumatic wrist..
| Published: | 07/07/2020 |
| Authors: | Lipscombe. S |
Adjuvant therapy with pegylated interferon-alfa2b vs observation in stage II B/C patients
Background Subgroup analyses of two large EORTC adjuvant interferon-alpha2b (IFNα-2b) vs observation randomised trials demonstrated that a treatment benefit was observed only in patients with an ulcerated melanoma without palpable nodes (hazard ratio [HR] for recurrence-free survival [RFS] was 0.69). This was confirmed by a meta-analysis of 15 adjuvant..
| Published: | 01/07/2020 |
| Authors: | Marshall E |
Negative pressure wound therapy versus conventional dressing for open fractures in lower extremity trauma
Aims It has been generally accepted that open fractures require early skeletal stabilization and soft-tissue reconstruction. Traditionally, a standard gauze dressing was applied to open wounds. There has been a recent shift in this paradigm towards negative pressure wound therapy (NPWT). The aim of this study was to compare the..
| Published: | 30/06/2020 |
| Authors: | Khan S |
Invited Discussion on: Fat Necrosis After DIEP Flap Breast Reconstruction: A Review of Perfusion-Related Causes
Taghizadeh, R. (2020). Invited Discussion on: Fat Necrosis After DIEP Flap Breast Reconstruction: A Review of Perfusion-Related Causes. Aesthetic Plastic Surgery. 44 (0), 1462-1465
| Published: | 23/06/2020 |
| Authors: | Taghizadeh R |
Discretionary technology bootlegging tensions in institutional healthcare work
Abstract We explore individuals who take some of their technology use ‘underground’, described as ‘bootlegging’, to enhance healthcare work. We find that healthcare professionals’ informal use of mobile applications in healthcare work sometimes ‘sticks out’ and this produces professional identity tensions: (1) conflict with perceptions of professional behaviour, and (2) defilement of..
| Published: | 08/06/2020 |
| Authors: | Pritchard-Jones R |
Understanding technology mediation and new service provider roles in health care
Purpose Service research holds that as services become more technology dominated, new service provider roles emerge. On a conceptual level, the potential impact of different roles has been discussed with regard to service provider readiness, job performance and overall experience. However, as yet, there is sparse empirical support for these..
| Published: | 08/06/2020 |
| Authors: | Pritchard-Jones R |
Current role of sentinel lymph node biopsy in the management of cutaneous melanoma
Summary Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients for the past 15 years. The high accuracy of this prognostic staging procedure is now recognised in all international guidelines for melanoma. However during this period there have been a number of important changes..
| Published: | 08/06/2020 |
| Authors: | Pritchard-Jones R |
Progesterone to prevent miscarriage in women with early pregnancy bleeding: the PRISM RCT
Background Progesterone is essential for a healthy pregnancy. Several small trials have suggested that progesterone therapy may rescue a pregnancy in women with early pregnancy bleeding, which is a symptom that is strongly associated with miscarriage. Objectives (1) To assess the effects of vaginal micronised progesterone in women with vaginal bleeding..
| Published: | 04/06/2020 |
| Authors: | Rao S |
Low rate of bacterial co-infection in patients with COVID-19
We agree with Michael J Cox and colleagues that clinical management of COVID-19 would be enhanced by further characterisation of bacterial co-infections. A few case reports have described examples of such co-infections. However, national and international6 guidelines recommend empirical antibiotics for all patients who are severely ill with suspected COVID-19,..
| Published: | 03/06/2020 |
| Authors: | Adler H, Ball R, Fisher M, Mortimer K, Vardhan M |
Management of the axilla following neoadjuvant chemotherapy - A change in practice
Introduction Chemotherapy in the neo adjuvant setting has allowed downsizing of breast tumours thus allowing patients to benefit from breast conservation surgery. The effect of neoadjuvant chemotherapy (NAC) has also been observed in the axilla but most units are still treating the axilla with axillary lymph node dissection (ALND). Method(..
| Published: | 01/06/2020 |
| Authors: | Riogi B, Barker D, Harris O, , Chagla LS, Sripadam R |
P067: Assessment of burnout among breast surgeons in the United Kingdom
Background Burnout among physicians has gained significant attention recently because of its rising prevalence, and detrimental impact on quality of care and professional satisfaction. Little is known about burnout among breast surgeons in the United Kingdom (UK). We sought to identify factors that influence overall burnout and professional fulfilment in..
| Published: | 01/06/2020 |
| Authors: | Chagla LS |
P094: Breast school: A holistic approach to optimise recovery following breast surgery
Background The Enhanced Recovery Programme with emphasis on better patient education and preparation encouraged us to introduce a Breast School with a view to increasing Day Cases and improving patient experience and outcomes. This School has been developed by a team of surgeons, anaesthetists, breast care nurses, dieticians, physiotherapists and..
| Published: | 01/06/2020 |
| Authors: | Power G |
The impact of glucocorticoid initiation on the diagnostic accuracy of ultrasound
Background Temporal and axillary artery ultrasound (US) has been recommended by EULAR as the first-line investigation in patients with suspected giant cell arteritis (GCA).1 US is reported as having a 77% sensitivity and 96% specificity for GCA.1 However, these figures have largely been derived from studies carried out in specialist centres where..
| Published: | 01/06/2020 |
| Authors: | Sze JT, Dawson J |
Targeted high concentration botulinum toxin A injections in patients with Raynaud’s phenomenon
Abstract Raynaud’s phenomenon is a vasospastic condition affecting hands and feet which may lead to rest pain, ischemic ulcers and gangrene. Botulinum toxin A has been shown to improve peripheral circulation and relieve vasospastic symptoms. Our aim was to assess our treatment outcomes following Botulinum toxin A injections in..
| Published: | 23/05/2020 |
| Authors: | Nagarajan M, McArthur P |
I’m a new ICU Doc, get me out of here!
Background Junior doctors rotate between hospitals and departments on a frequent basis and need to be able to provide safe and effective care from the first day in their new rotation. Good, timely local induction helps with this, however junior doctors are still required to familiarise themselves with a large..
| Published: | 20/05/2020 |
| Authors: | Cochrane A, Howarth O |
The EIC-ICU (Enhancing Interprofessional Collaboration in the Intensive Care Unit) toolkit
Introduction Effective interprofessional collaboration (IPC) in intensive care units (ICUs) has been associated with better patient outcomes such as reduced mortality rates and length of ICU stay. The level of IPC also predicts the degree to which team members report understanding their patient care goals and how productive they are..
| Published: | 20/05/2020 |
| Authors: | Cochrane A |
Quality Improvement Project to Improve Documentation of Predicted Body Weight
Introduction In patients with acute lung injury or acute respiratory distress syndrome, there is a significantly lower mortality when ventilated with a lower tidal volume (TV) of 6 ml per kg of predicted body weight (PBW) than the traditional TV of 12 ml per kg of PBW.1 In our Intensive Care Unit (..
| Published: | 12/05/2020 |
| Authors: | Tanqueray E, Cochrane A |
Case Report: An Overdose of Melanotan 2 – the Barbie Drug
Background We present a case of accidental Melanotan 2 overdose. Melanotan 2 is an illegal injectable drug consisting of an Alpha Melanocyte Stimulating Hormone analogue used to increase tanning and sexual performance, and known colloquially as the Barbie Drug. Currently the evidence base for management of Melanotan 2 overdose is limited to several..
| Published: | 04/05/2020 |
| Authors: | Gibney E |
The cost-effectiveness of progesterone in preventing miscarriages
Objectives To assess the cost‐effectiveness of progesterone compared with placebo in preventing pregnancy loss in women with early pregnancy vaginal bleeding. Design Economic evaluation alongside a large multi‐centre randomised placebo‐controlled trial. Setting Forty‐eight UK NHS early pregnancy units. Population Four thousand one hundred and fifty‐three..
| Published: | 01/05/2020 |
| Authors: | Rao S |
The landscape of systemic regimens used routinely in the neoadjuvant setting in the UK
Introduction Neoadjuvant systemic therapy (NST) for breast cancer has potential advantages over adjuvant treatments in selected patient groups. Previous studies identified significant variation in NST utilisation across the UK and a lack of data on routine treatment regimens and real-world outcomes. Aims/Objectives The NeST prospective multi-centre cohort study aimed..
| Published: | 01/05/2020 |
| Authors: | Whitehead IJ |
036 Major lower gastro‐intestinal surgery peri‐operative service evaluation project (RESECT)
St Helens and Knowsley Teaching Hospitals NHS Trust is the centre for the largest number of bowel resections within the region, with the aim of becoming a tertiary unit for major lower gastro‐intestinal (GI) surgery. Due to the nature of the operations performed, peri‐operative management and analgesic control..
| Published: | 01/05/2020 |
| Authors: | Herold J, Dixit T |
Surgical outcomes following neoadjuvant chemotherapy
Introduction Potential advantages of neoadjuvant systemic therapy (NST) include downstaging disease to minimise surgery, and in vivo assessment of tumour sensitivity to therapeutic drugs. Considerable variation in NST use remains, however, and it is unclear whether pathological response rates reflect those reported in trials, or whether the downstaging achieved with..
| Published: | 01/05/2020 |
| Authors: | Whitehead IJ |
070 QUENCH: the quality‐improvement project to reduce pre‐operative dehydration times
Pre‐operative fasting aims to minimise the risk of pulmonary aspiration during anaesthesia. Patients often fast for longer than the advised standard times of 6 h for food and 2 h for fluids [1], on a fluctuating emergency list, compromising optimal physiology and patient experience. Peri‐operative quality‐improvement programme (PQIP) data shows..
| Published: | 01/05/2020 |
| Authors: | Jones K |
059 Encouraging standardisation of documentation in anaesthetics using the intensive care framework of central lines
The Faculty of Intensive Care Medicine (ICM) produced a series of World Health Organization (WHO) style checklists, the Local Safety Standards for Invasive Procedures (LocSSIPs), based on a framework from NHS England's Safety Domain to ensure safe practice of invasive procedures and prevent a never event [1, 2]. In Whiston Hospital, the..
| Published: | 01/05/2020 |
| Authors: | Mahambrey T |
The Analysis of Teaching of Medical Schools (AToMS) survey
Background What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based..
| Published: | 01/05/2020 |
| Authors: | Phillips B, Aspinall E |
Exploring UK medical school differences
Background Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction,..
| Published: | 01/05/2020 |
| Authors: | Phillips B, Aspinall E |
An evaluation of emergency department patients referred for urgent lumbar magnetic resonance imaging with suspected cauda equina syndrome
Purpose Failing to correctly diagnose Cauda Equina Syndrome (CES) in the Emergency Department (ED) can have catastrophic consequences for the patient and be costly for the National Health Service (NHS). The ED clinician bears a weight of responsibility in the decision to refer for urgent Magnetic Resonance Imaging (MRI) in..
| Published: | 01/05/2020 |
| Authors: | McCarthy L |
Second primary malignancies in patients receiving treatment with ruxolitinib for myelofibrosis – a regional experience
Patients with myeloproliferative neoplasms (MPN) are at an increased risk of second primary malignancies (SPM) compared with matched‐controls and the general population. The Surveillance, Epidemiology and End Results (SEER) database (US cancer registries) reported that patients with primary myelofibrosis (PMF) had an incidence of SPM of 5·3% after a median..
| Published: | 01/05/2020 |
| Authors: | Nicholson T |
Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer
Abstract Background Non-melanoma skin cancer, which includes basal cell carcinoma and cutaneous squamous cell carcinoma, is the commonest malignancy worldwide. The mainstay of treatment is surgical excision. Despite this being an exceptionally common procedure, it is not known what the accepted standard is for incomplete excision. Multiple single-centre, regional and..
| Published: | 17/04/2020 |
| Authors: | Nolan G |
Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease
Abstract Introduction Pilonidal disease is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, laser depilation has been proposed as an adjunct to surgery and has shown improved results in some..
| Published: | 17/04/2020 |
| Authors: | Liyanage A, Javed M, Defty C, Shaaban H, Kalaiselvan R, Rajaganeshan R |
Electrochemotherapy in the treatment of ulcerated malignant tumors: Results from the inspect registry
Background Electrochemotherapy (ECT) is an effective local treatment for cutaneous tumors and metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in ulcerated versus non-ulcerated cutaneous tumors and metastases. Methods 22..
| Published: | 15/04/2020 |
| Authors: | Liew S |
National utilisation of neoadjuvant systemic therapy and impact on surgical treatment
Introduction Potential advantages of neoadjuvant systemic therapy (NST) include downstaging disease to minimise surgery, and in vivo assessment of tumour sensitivity to therapeutic drugs. Considerable variation in NST use remains, however, and it is unclear whether pathological response rates reflect those reported in trials, or whether downstaging achieved impacts on..
| Published: | 04/04/2020 |
| Authors: | Whitehead IJ |
Management of the axilla following neoadjuvant chemotherapy for breast cancer
Objectives Chemotherapy in the neo adjuvant setting has allowed downsizing of breast tumours thus allowing patients to benefit from breast conservation surgery. The effect of neoadjuvant chemotherapy (NAC) has also been observed in the axilla but most units are still treating the axilla with axillary lymph node dissection (ALND). Materials..
| Published: | 04/04/2020 |
| Authors: | Riogi B, Barker D, Harris O, , Chagla LS |
Avoiding Stroke: A Continuous Monitoring Challenge
Extract Stroke is a leading cause of death and disability worldwide. Risk factors such as advancing age, hypertension, cigarette smoking, atrial fibrillation (AF), diabetes mellitus and prior cardiovascular disease are well established and provide significant opportunities through public health policy to reduce both the disease burden and the socio-economic cost..
| Published: | 04/04/2020 |
| Authors: | Hill AM |
Multiple Lobulated Nodules: Answer
Answer The clinical presentation is consistent with a diagnosis of erythema elevatum diutinum (EED) but with a histological overlap of features characteristic of palisaded neutrophilic granulomatous dermatitis (PNGD). The patient was commenced on dapsone 100mg once daily. After only 4 weeks of treatment, the lesions almost completely resolved. Eustace, K; Carr,..
| Published: | 17/03/2020 |
| Authors: | Eustace K |
Outcomes of Geriatrician Input in Older Patients Undergoing Emergency Laparotomy in a District General Hospital
Abstract With the increasing median age of survival in the UK, there is an increased burden on the provision of medical and surgical care to the population. The 2010 National Confidential Enquiry into Patient Outcome and Death report, “An Age Old Problem,” emphasizes the early involvement of surgical and geriatric consultant..
| Published: | 17/03/2020 |
| Authors: | Mubarik A |
Biologic monotherapy in the biologic naïve patient with rheumatoid arthritis (RA)
Abstract Approximately one-third of patients on biologic therapy for rheumatoid arthritis (RA) receive them as monotherapy. There are few head-to-head randomised control trials comparing biologics as monotherapy. Our aim was to compare the efficacy and persistence of multimodal biologic agents as monotherapy in biologic naïve patients with RA in..
| Published: | 17/03/2020 |
| Authors: | Abernethy R |
Validity of direct magnetic resonance arthrogram in patients with femoroacetabular impingement
Abstract Femoroacetabular Impingement is an established cause of labral tears and chondral delamination. The aim was to test the validity of direct magnetic resonance arthrogram [dMRA] in the diagnosis of the same. We also looked at the short term functional outcome in these patients post hip arthroscopy. The dMRA is..
| Published: | 17/03/2020 |
| Authors: | Mohan R, Gudena R |
Re: A rare case of renal collision tumour of oncocytoma and sarcomatoid renal cell carcinoma
Floyd, MS Jr. (2020). Letter to the Editor re: A rare case of renal collision tumour of oncocytoma and sarcomatoid renal cell carcinoma , Chang et al. Journal of Clinical Urology. 13 (1), 70-71
| Published: | 17/03/2020 |
| Authors: | Floyd Jr MS |
Health workers’ views on audit in maternal and newborn healthcare in LMICs
Objectives To identify and summarise health workers’ views on the use of audit as a method to improve the quality of maternal and newborn healthcare in low‐ and middle‐income countries (LMICs). Methods We conducted a qualitative evidence synthesis. PubMed, CINAHL and Global Health databases were searched using keywords, synonyms..
| Published: | 16/03/2020 |
| Authors: | Kammath V |
Can the Surgical Approach to Total Knee Arthroplasty Influence Early Postoperative Outcomes?
Background Trivector approach to total knee arthroplasty (TKA) is a quadriceps tendon sparing approach, whereas the medial parapatellar (MPP) approach involves making a longitudinal incision in quadriceps tendon. We postulated that quadriceps-sparing approach such as trivector should make postoperative rehabilitation easier and ultimately reduce the length of hospital stay. Objectives..
| Published: | 16/03/2020 |
| Authors: | Reddy G, Islam SUI, Attar FG |
An economic evaluation based on the PRISM Trial
Objectives To assess the cost‐effectiveness of progesterone compared with placebo in preventing pregnancy loss in women with early pregnancy vaginal bleeding. Design Economic evaluation alongside a large multi‐centre randomised placebo‐controlled trial. Setting Forty‐eight UK NHS early pregnancy units. Population Four thousand one hundred and fifty‐three..
| Published: | 16/03/2020 |
| Authors: | Rao S |
Comparison of pharmacy technicians’ and doctors’ medication transcribing errors at hospital discharge
Objectives To compare the transcribing error rates of discharge prescriptions between pharmacy technicians and doctors in an acute hospital setting. Methods Pharmacy technicians were trained in the transcribing of discharge medications from inpatient to discharge medication charts. Prospective prescribing audits were undertaken over 5 days on eight hospital medical wards by..
| Published: | 03/03/2020 |
| Authors: | Lloyd M |
Patient-reported outcomes (PROMs) in stone surgery:
Introduction Patient-reported outcome measures (PROMs) assess the quality of care delivered from a patient’s perspective. There is a paucity of evidence reporting PROMs in the treatment of urolithiasis. In this study, we aimed to assess the impact of urological stone procedures on patients’ morbidity. Methods Data were prospectively collected..
| Published: | 22/01/2020 |
| Authors: | Tolofari S, Starmer B, Agarwal K |
National snapshot audit on the surgical management of LUTS/BPE: what has changed over the past two decades?
Introduction Surgical treatment for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BHP) has experienced changes over the years, with the addition of new treatments. There are limited data on the current national practices when compared with historical data. Method A national audit (audit of surgical management of benign prostatic..
| Published: | 22/01/2020 |
| Authors: | McCabe JE |
Bilateral hamstring origin calcification: rare presentation of Gitelman syndrome
Abstract This case report is the first case to our knowledge of intratendinous or peritendinous calcification reported in Gitelman syndrome (GS) patients. GS represents the clinical manifestations of inactivation of the Slc12a3 genes encoding the thiazide-sensitive sodium chloride cotransporter and the Trpm6-Mg genes encoding the magnesium transporters in..
| Published: | 21/01/2020 |
| Authors: | Mohan R, Dhotare S, Jakaraddi CA |
The role of dry-lab and cadaveric simulation for cystoscopy
Background The aim of this study is to assess validity of the ETXY Multifunctional trainer (ProDelphus, Olinda, Pernambuco, Brazil), a bench-top dry-lab model for simulation of cystoscopy and intravesical injections of Botulinum Toxin A (BTX-A) injections, in terms of educational value, feasibility and acceptability as well as evaluating the use..
| Published: | 21/01/2020 |
| Authors: | McCabe JE |
Identifying patient concerns during consultations in tertiary burns services: development of the Adult Burns Patient Concerns Inventory
Objectives Identifying the issues and concerns that matter most to burns survivors can be challenging. For a number of reasons, but mainly relating to patient empowerment, some of the most pressing concerns patients may have during a clinical encounter may not naturally be the focal point of that encounter. The..
| Published: | 20/01/2020 |
| Authors: | Shokrollahi K |
The NeST (neoadjuvant systemic therapy in breast cancer) study
Introduction Neoadjuvant systemic therapy (NST) has several potential advantages in the treatment of breast cancer. However, there is currently considerable variation in NST use across the UK. The NeST study is a national, prospective, multicentre cohort study that will investigate current patterns of care with respect to NST in the..
| Published: | 20/01/2020 |
| Authors: | Whitehead IJ |
Multiple Lobulated Swellings: Answer
Answer The clinical presentation is consistent with a diagnosis of erythema elevatum diutinum (EED) but with a histological overlap of features characteristic of palisaded neutrophilic granulomatous dermatitis (PNGD) The patient was commenced on dapsone 100mg once daily. After only 4 weeks of treatment, the lesions almost completely resolved. Eustace, K; Carr,..
| Published: | 20/01/2020 |
| Authors: | Eustace K |
Cangrelor
Introduction Acute coronary syndrome (ACS) remains a major cause of mortality and morbidity in people with diabetes. Diabetes is a critical risk factor for the development of ACS and its complications. Guidance on primary coronary intervention (PCI) for ACS from several authorities recommends the use of a P2Y12 inhibitor..
| Published: | 20/01/2020 |
| Authors: | Katira R |
Assessing the quality of information delivered to patients in the pre-operative period
Understanding patient experiences during their anaesthetic journey is essential to assessing quality of care being delivered. At Whiston hospital, as part of maintaining our Anaesthesia Clinical Services Accreditation standards [1], we wanted to evaluate our performance in this domain, particularly in relation to patient understanding and satisfaction following information given to..
| Published: | 01/01/2020 |
| Authors: | Glennon K |
Etomidate in the management of severe Cushing’s disease and MRSA bacteraemia
Abstract We report our experience on managing a case of florid Cushing’s disease with Methicillin-resistant Staphylococcus aureus (MRSA) sepsis using intravenous etomidate in the intensive care unit of a UK district general hospital. Wong, SWP; Yap, Y; Narayanan, RP; Al-Jubouri, M; Grossman, A; Daousi, C; Mahgoub, Y. (2019). Etomidate in..
| Published: | 23/12/2019 |
| Authors: | Wong S, Yap Y, , Al-Jubouri M |
Anti-N-methyl- d -aspartate receptor encephalitis: A case series and review of the literature
Abstract Anti-NMDAR (N-methyl-d-aspartate receptor) encephalitis is a potentially severe form of encephalitis associated with antibodies against NR1 and NR2 subunits of the NMDAR. Anti-NMDAR encephalitis is a treatable cause of encephalitis. An underlying tumor should be actively looked for as this is also considered to be a paraneoplastic syndrome. We..
| Published: | 23/12/2019 |
| Authors: | Abdelaziz M |
Starting a Urethroplasty Service: Initial results from a UK centre
Introduction Stricture disease remains uncommon with an incidence of 0.9%. Most cases are initially managed endoscopically. Urethral reconstruction remains a specialised field and is typically concentrated in specialised centres. In 2018 a urethral centre was established in Whiston Hospital, Merseyside to cater for local demand. Method(s) Sixteen patients who underwent urethral..
| Published: | 23/12/2019 |
| Authors: | Floyd Jr MS |
Posters in imaging & therapy practice
Sharkey, K; Marsh, K. (2019). Posters in imaging & therapy practice . Imaging & Therapy Practice. October (-), 22
| Published: | 23/12/2019 |
| Authors: | Sharkey K, Marsh K |
Radiographer abnormality detection systems: how accurate are we?
Fenning, LA; Melling, R. (2019). Posters in imaging & therapy practice: radiographer abnormality detection systems: how accurate are we? . Imaging & Therapy Practice. Nov (-), 20
| Published: | 23/12/2019 |
| Authors: | Fenning L, Melling R |
Reflection on 30 years as a PDSN
Abstract In her final editorial for the Paediatrics section, Helen Thornton reflects on the advancement of diabetes management over the last 30 years. Thornton, H. (2019). Reflection on 30 years as a PDSN . Journal of Diabetes Nursing. 23 (5), 94
| Published: | 23/12/2019 |
| Authors: | Thornton H |
Low-carbohydrate diets for children and young people with type 1 diabetes
Abstract The use of low-carbohydrate diets in children and young people with type 1 diabetes is receiving increased interest, particularly online; however, it is controversial due to a lack of evidence and concerns about safety. This article provides a detailed review of the current evidence regarding low-carbohydrate diets and the potential..
| Published: | 23/12/2019 |
| Authors: | Brown J |
Re-excision After Breast Conservation Surgery – Our Breast Unit experience
Background The benefit of re-excision surgery for involved margin after BCS among the patient receiving adjuvant radiotherapy is unclear. Omission of re-excision surgery for selected patients with focally involved margin after BCS did not alter DFS and OS. Knowing the biology of cancer may assist to select patients benefiting with..
| Published: | 23/12/2019 |
| Authors: | Pushdary KH, Atherton J, Ray A, Jois RHS |
Breast School: A Holistic Approach to Optimise Recovery Following Breast Surgery
Background The Enhanced Recovery Programme with emphasis on better patient education and preparation encouraged us to introduce a Breast School with a view to increasing day cases and improving patient experience and outcomes. This School has been developed by a team of surgeons, anaesthetists, breast care nurses, dieticians, physiotherapists and..
| Published: | 23/12/2019 |
| Authors: | Power G |
Eccrine hidrocystoma of the external meatus in a hypospadiasis patient
Pina, IM; Omar, AM; Floyd, MS Jr. (2019). Eccrine hidrocystoma of the external meatus in a hypospadiasis patient: a rare finding . Journal of Clinical Urology. epub Aug 20
| Published: | 23/12/2019 |
| Authors: | Pina IM, Omar A, Floyd Jr MS |
Time for a new approach?
Fenning LA. (2019). Time for a new approach? . Imaging & Therapy Practice. Aug (0), 18-24.
| Published: | 23/12/2019 |
| Authors: | Fenning L |
Introducing a quick reference guide for emergency uterotonic and uterine relaxant drug use
Abstract The responsibility of administering drugs for uterine relaxation or contraction during caesarean section often falls to the anaesthetist. This can be particularly challenging for staff who are unfamiliar with these drugs or do not undertake regular obstetrics sessions. In the past, general anaesthesia for caesarean section was far more..
| Published: | 23/12/2019 |
| Authors: | Veal A, Goel V |
PA13 Paediatric 2-week-wait skin cancer audit
Abstract The incidence of skin cancers is rising, and dedicated 2-week wait skin cancer clinics have been set up throughout the U.K. However, skin cancer in paediatric patients is relatively rare, with a reported incidence in the U.S.A. of 1.1 per million in 1 4 year olds, and 10.4 per million..
| Published: | 23/12/2019 |
| Authors: | Hanley T |
P097 Cutaneous toxicity from immune checkpoint inhibitors
Abstract Immune checkpoint inhibitors (ICIs) are immunomodulatory agents used in the treatment of an increasing number of malignancies. They inhibit tumour-induced immunosuppression and reactivate tumour-specific cytotoxic T lymphocytes resulting in control of malignant disease (Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer 2012; 12: 252-64). However, off-target..
| Published: | 23/12/2019 |
| Authors: | Hindle E |
DP18 A rare association between interstitial granulomatous dermatitis and myelofibrosis
Abstract A 61-year-old woman presented with an 18-month history of a widespread eruption, which had started on her face and later spread to involve her neck, chest, upper back and upper limbs. She had been previously been treated for rosacea with metronidazole gel (MetroGel) and 1% hydrocortisone cream without improvement. Her..
| Published: | 23/12/2019 |
| Authors: | Low SE, Ngan K |
Perils of the Pneumatic Tube: How Clean Are Your Pods?
Abstract Pneumatic tube systems (PTS) are useful features in hospitals for efficient transport of items but further scrutiny reveals their potential risks. We investigated the extent of contamination of pods, used within the PTS with specific alert organisms, namely meticillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant enterococci (VRE) and carbapenemase-producing Enterobacterales (..
| Published: | 23/12/2019 |
| Authors: | McMullen P, Lewis P, McGugan O, Mortimer K |
Data from national media reports of ‘Acid attacks’ in England: A new piece in the Jigsaw
Introduction There has been considerable concern in the UK with what seems to have been an increase in so-called ‘Acid Attacks’. The key data sources (Police data, Hospital admissions and Burns unit data) have limitations in capturing the acid attacks comprehensively. Incidents not reported to the police are missed in..
| Published: | 23/12/2019 |
| Authors: | Nagarajan M, Mohamed S, Asmar O, Stubbington Y, George S, Shokrollahi K |
Extraction of Fractured Femoral Stem in Primary Cemented Hip Replacements
Abstract Extracting a fractured stem poses a technical challenge in revision surgery. A number of techniques have been described based on method of fixation (cemented or uncemented); location of the fracture; and composition of the stem alloy. These include the drilling and cortical window techniques. We describe our surgical removal..
| Published: | 23/12/2019 |
| Authors: | Matar HE, |
Metalwork Prominence and Operative Interventions for Treating Olecranon Fractures
Abstract In this systematic review of randomized controlled trials, we aimed to assess the effects of different surgical treatments for olecranon fractures in adults, especially the rate of metalwork prominence. We searched the Cochrane Bone, Joint, and Muscle Trauma Group's Specialized Register (2018), the Cochrane Central Register of Controlled Trials (CENTRAL, 2018,..
| Published: | 23/12/2019 |
| Authors: | Matar HE |
Outcomes of Implant-Arthrodesis as Limb Salvage
Purpose We sought to evaluate our consecutive series of knee-implant arthrodesis patients for failed total knee arthroplasties with medium term clinical and radiographic outcomes. Methods We conducted a retrospective review of a consecutive series of 4 patients (average age, 75 years; range, 69–79) with failed knee arthroplasties and deficient extensor mechanism who underwent..
| Published: | 23/12/2019 |
| Authors: | Matar HE, Stritch P, Emms N |
The “dermal cage”: Inferiorly based dermal flap technique for breast reconstruction after mastectomy
Summary “Direct to implant,” “one-stage,” or “immediate” breast reconstruction procedures have become extremely popular in the last decade. The additional task of covering the lower pole of the prosthetic implant for stability can be achieved by one of two principal methods: either the use of acellular dermal matrix (ADM) or..
| Published: | 23/12/2019 |
| Authors: |
Failure of Cemented Constrained Acetabular Component
Abstract Constrained acetabular components are used as a salvage option for unstable total hip arthroplasties particularly in elderly low demand patients. Their indications include multiple failed revisions with abductor deficiency, neurologic or neuromuscular impairment, recurrent dislocations where the cause of instability cannot be identified despite well-aligned components. Failure of these..
| Published: | 23/12/2019 |
| Authors: | Matar HE, Stritch P, Emms N |
Effectiveness of Negative-Pressure Wound Therapy following Total Hip and Knee Replacements
Abstract In this review, we assess the effects of negative-pressure wound therapy (NPWT) following primary hip and knee replacement surgery with a systematic review of randomized controlled trials (RCTs). We searched the Cochrane Bone, Joint, and Muscle Trauma Group's Specialized Registry on June 12, 2018; the Cochrane Central Register of Controlled Trials (..
| Published: | 23/12/2019 |
| Authors: | Matar HE, Emms N |
Book Review: Special Types of Finger Replantation
McAllister, R; Hassan, D; Shokrollahi, K. (2019). Book Review: Special Types of Finger Replantation . Annals of Plastic Surgery. 83 (5), e1
| Published: | 23/12/2019 |
| Authors: | McAllister R, Hassan D, Shokrollahi K |
Assessment of steroid use as a key performance indicator in inflammatory bowel disease
Background Patients with inflammatory bowel disease (IBD) are at risk of excess corticosteroids. Aims To assess steroid excess in a large IBD cohort and test associations with quality improvement and prescribing. Methods Steroid exposure was recorded for outpatients attending 19 centres and associated factors analysed. Measures taken to avoid excess were..
| Published: | 23/12/2019 |
| Authors: | Bassi A |
Protecting our digital medicine infrastructure
On Friday 12th May at 11:30 a.m., the information technology (IT) helpdesk at our hospital received four calls from people around our organisation, who reported seeing a strange message appear on their screen. The message displayed would become familiar to many thousands of computer users over the ensuing few hours..
| Published: | 23/12/2019 |
| Authors: | Connor M |
Dermatologic Complications With Body Art Tattoos, Piercings and Permanent Make-up
Nagarajan, M; Shokrollahi, K. (2019). Book review: Dermatologic Complications With Body Art Tattoos, Piercings and Permanent Make-up . Annals of Plastic Surgery. 83 (5), e2
| Published: | 23/12/2019 |
| Authors: | Nagarajan M, Shokrollahi K |
Systematic literature review investigating whether methotrexate causes chronic pulmonary fibrosis
Conclusion Conclusion Our systematic literature review found high-quality unbiased evidence that methotrexate does not cause chronic pulmonary fibrosis in humans. In patients with RA, chronic pulmonary fibrosis is due to the underlying disease and not methotrexate. It is important to now address this across all disciplines and reject the hypothesis..
| Published: | 23/12/2019 |
| Authors: | Quah E, Amoasii C, Mudawi T, Dawson J |
Biomechanical considerations for strategies to improve outcomes
Abstract This article is a systematic review of the recent published literature on the biomechanics of volar locking plate fixation of distal radius fractures. PUBMED/MEDLINE and EMBASE databases were searched on 13th Sep 2018. Biomechanical papers on volar locking plate fixation of distal radius fractures since 2010 were included. Papers were..
| Published: | 23/12/2019 |
| Authors: | Ramavath AL, Howard N, Lipscombe. S |
Gynaecomastia: a cosmetic concern or a concerning clinical sign?
Abstract Gynaecomastia is common and often physiological, leading to frequent dismissal as a cosmetic condition. It can however be a symptom of underlying hormone imbalance, which requires further assessment to exclude underlying sinister pathology. We discuss a rare cause of gynaecomastia that demonstrates the importance of a holistic approach to..
| Published: | 20/12/2019 |
| Authors: | Whitehead IJ |
Validity of the International Prostate Symptoms Score
Abstract Postoperative urinary retention necessitating catheterization after major lower limb arthroplasty surgery adds to the patients’ postoperative discomfort and increases the risk of urinary tract infection with potential risk of transient bacteraemia and seeding of infection to prosthetic joints. Preoperative evaluation of patients with lower urinary tract symptoms may help..
| Published: | 20/12/2019 |
| Authors: | Jakaraddi CA |
Ultrasound evidence of bladder outlet obstruction secondary to lichen sclerosus et atrophicus in boys
Background Lichen sclerosus (LS), (balanitis xerotica obliterans), causes pathological phimosis. Many boys present with obstructive symptoms, the cause is usually obvious on examination so ultrasound scans (USS) of the urinary tract are not routinely indicated. We review a series of abnormal USS in boys with LS. Methods Retrospective note review..
| Published: | 20/12/2019 |
| Authors: | Hughes KE |
Re: MR urethrography compared with operative findings
Floyd, MS Jr; Omar AM. (2019). Re: MR urethrography compared with operative findings for the evaluation of urethral strictures . International Urology and Nephrology. 51 (11), 1985-1986
| Published: | 20/12/2019 |
| Authors: | Floyd Jr MS, Omar A |
Identifying Preoperative Factors
Taghizadeh, R. (2019). Identifying Preoperative Factors Associated with the Volume Discrepancy in Patients Undergoing Breast Reconstruction with the Extended Latissimus Dorsi Musculocutaneous Flap Coverage . Aesthetic Plastic Surgery. 43 (6), 1497–1499
| Published: | 20/12/2019 |
| Authors: | Taghizadeh R |
Stroke emergency trolley to improve outcomes in stroke related emergency situations
Introduction High quality care on a HASU requires staff who are skilled in stroke emergencies, a multidisplinary simulation package was introduced on the stroke unit so staff were equipped with the skills to manage stroke emergencies. This identified a development of a stroke specific emergency trolley. Method(s) Members of..
| Published: | 18/12/2019 |
| Authors: | Attwood K |
UGIC P73 Role of peritoneal cytology as part of multi-modal staging in oesophago-gastric cancers: A single centre experience
Background Over 16,000 cases of oesophago-gastric cancer are diagnosed in the UK annually. Multi-modality staging of these cancers include computer tomography, endoscopic ultrasound and positron emission topography. Laparoscopy and peritoneal lavage are recommended as an additional staging modality due to the propensity of these cancers to rapidly metastasise to lymph nodes..
| Published: | 01/11/2019 |
| Authors: | Kaul A |
000363 An international survey on aminoglycoside practices in critically ill patients: The AMINO III study
INTRODUCTION The optimal dosing strategy of aminoglycosides (AG) remains debated in intensive care units (ICUs). OBJECTIVES We investigated the international practices of AG regarding dosing and therapeutic drug monitoring in ICU patients. METHODS A prospective, multicentre, observational, cohort study was conducted in 59 intensive care units (ICUs) across 5 countries. All patients..
| Published: | 19/09/2019 |
| Authors: | Barton G |
P132 Minimally invasive techniques in the management of pilonidal disease
Background Pilonidal sinus disease remains a challenging entity because of the high morbidity of most treatment options and recurrence of symptoms. Minimally invasive methods have been described to minimise the morbidity associated with wound care and reduce time off work. We undertook this systematic review to study the effectiveness of..
| Published: | 11/09/2019 |
| Authors: | Kalaiselvan R |
Microsurgery and Vessel Caliber Mismatch
Introduction The evolution and progress of microsurgery has brought about numerous advances but some challenges still remain. Among these are discrepancies in the vessel size. A significant size discrepancy still equates to technical difficulty and high rate of flow turbulence possibly resulting in subsequent thrombosis. This article reviews the most..
| Published: | 11/09/2019 |
| Authors: | Mohammad M, Adjei B, George S, Alfeky H, Mostafa A, El-Gawad A |
1013 Upper GI Cancer MDT Decision Making
Aim Management of complex oesophago-gastric cancer is difficult and decision making in multidisciplinary team (MDT) meetings may vary between centres across the country. There is currently no absolute standard for management of complex oesophago-gastric cancers. We describe the results of a scenario-based decision making survey sent out to all Upper..
| Published: | 01/09/2019 |
| Authors: | Cheung F, Kalaiselvan R |
0162 Outcomes of surgery following chemoradiotherapy for anal cancer: A 10-year retrospective study
Aim Anal cancer accounts for less than 1% of all cancers but carries considerable morbidity and mortality. We reviewed clinicopathological outcomes for patients undergoing surgery following chemoradiotherapy (CRT) for anal cancer. Method(s) A retrospective review of casenotes from patients undergoing surgery for anal cancer from 2008 -2018 was performed. Patients were..
| Published: | 01/09/2019 |
| Authors: | Liew S |
0070 Comparison of outcomes of transrectal ultrasound guided biopsy (TRUS) and transperineal template guided biopsy
Introduction With the onset of PSA testing, more people are diagnosed with prostate cancer. TRUS guided biopsies has been used as a standard in all prostate re-biopsies. With MRI scans detecting possible prostate cancer foci and the advent of template, the role of TRUS biopsy is questioned for those on..
| Published: | 01/09/2019 |
| Authors: | Ejikeme C, Mistry R |
Co-relation between clinical assessment, CT and intra-operative findings in emergency laparotomy. Is it time to rethink the algorithm?
Aims Although clinical diagnosis has essential value in an emergency setting, CT (computed tomography) has become the central tool of diagnosis to aid the need for emergency laparotomy. Delay in CT can often drastically alter the outcome, especially in patients over the age 60. We aimed to assess if initial clinical..
| Published: | 01/09/2019 |
| Authors: | Patnam V, Altaf K, Holdsworth J, Muttoni E, Rajaganeshan R |
P Th A.13 Video-assisted sinus surgery (VASS): New technique for treatment of surgical site sinus: A case series
Introduction Sinus formation after a procedure is a recognised complication. While most settle without requiring any treatment, many can continue to cause persistent symptoms. These have always been managed by exploration of the sinus tract under general anaesthetic, laying open, excision of the tract or debridement. Results post-surgery may not..
| Published: | 01/09/2019 |
| Authors: | Altaf K, Hajnik J, Patnam V, Rajaganeshan R |
SP 7.2.7- Role of Pre-Operative Chemical Component Separation(Botox) in Abdominal Wall Reconstruction
Aim It is accepted that CCS (Botulinum toxin A, BOTOX) is a useful pre-operative tool to enable successful AWR. UsuallyBOTOXis used in selected complex cases.We propose the routine use of CCS in allmidline defects of more than 5 cm size. To evaluate the outcome of pre-operative US guided injection of..
| Published: | 01/09/2019 |
| Authors: | Singh S, Atherton P, Samad A, Ross S, Benson A, Scott M |
P We F.6- Can satisfactory outcomes be achieved for Abdominal WallReconstruction (AWR) surgery in patients with a Body Mass Index (BMI)above 32kg/m2?
Introduction A high BMI has long been thought to be a negative predictive factor for post-operative outcomes. For AWR surgery, a BMI of 32 is often used as a cut-off. Due to the increasing prevalence of obesity, this is not always possible. Aim This study compared the outcomes of patients undergoing..
| Published: | 01/09/2019 |
| Authors: | Wright C, Singh S, Samad A, West C, Ross S, Scott M |
SP 5.9- Clinical and cost effectiveness of CT scan as first lineinvestigation in diagnosis and treatment of acute abdominal pain – Is it time to change?
Background Abdominal x-ray (AXR) is currently used as a first line radiological investigation in assessing acute abdominal pain, often followed by a CT scan, which may delay diagnosis and treatment.We aimed to assess if AXR was needed at all in assessing these patients and its impact on patient outcomes...
| Published: | 01/09/2019 |
| Authors: | Altaf K, Muttoni E, Holdsworth J, Patnam V, Rajaganeshan R, MacDonald S |
SP 11.5- Adoption of ‘Agile’ project management principles significantly accelerated the development of a multidisciplinary Emergency Laparotomy pathway
Aims Creating patient pathways and protocols that require the input of multiple senior clinicians can be challenging and projects may be delayed, deadlines missed, and ultimately patients may have poorer outcomes. Method(s) 'Agile' is an approach to software development using collaborative self-organizing teams, often in different locations. Trello is..
| Published: | 01/09/2019 |
| Authors: | Kirkham S, Vitovska E, Pantak G, Macadam R, Singh S |
A HaemSTAR-led, UK-wide 'flash-mob' audit of -intravenous immunoglobulin use in immune -thrombocytopenia
Introduction Intravenous immunoglobulin (IVIg) is a common therapy for patients with immune thrombocytopenia (ITP). The initial response rate for IVIg is 80%1 and is typically rapid, with some patients responding in 24 hours, although usually in 2–4 days.2 When IVIg is used alone, the response is relatively short, averaging around 2–4 weeks. Potential side..
| Published: | 13/08/2019 |
| Authors: | Loizou E, Garth L |
Re: Professional protectionism; a barrier to employing a sonographer graduate?
Wolstenhulme, S; Daulby, M. (2019). Re: Professional protectionism; a barrier to employing a sonographer graduate? . Radiography. 25 (3), 274-275
| Published: | 13/08/2019 |
| Authors: | Daulby M |
Suprapubic catheter change, what could go wrong?
Abstract Some patients with neurological bladder dysfunction rely on suprapubic catheters (SPCs) for the management of their urinary symptoms. These catheters are usually changed without incident. However, problems can, and do, arise. We present the case of a 56-year-old woman who had a SPC change which was complicated by the..
| Published: | 13/08/2019 |
| Authors: | Chidozie E |
Re: Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury
Floyd, MS Jr; Khadr, RN. (2019). Re: Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury. Is there an indication? . Internatiobal Brazilian Journal of Urology. 45 (4), 860-1.
| Published: | 13/08/2019 |
| Authors: | Floyd Jr MS |
Boosting morale: “good job, junior”
Barton MA. (2019). Boosting morale: “good job, junior” . BMJ. 365 (24 June), l4344
| Published: | 13/08/2019 |
| Authors: | Barton MA |
EP282 Revising the RCA; Streamlining Root- Cause Analyses for bacteraemias on ITU
Abstract Sepsis is a leading cause of mortality within the Intensive care environment.1 Over the last 3 decades, the recognition of sepsis has greatly improved and blood cultures form an integral part of both diagnosis and management. At the authors’ institution, any detected bacteraemia is examined through a process of Root..
| Published: | 13/08/2019 |
| Authors: | Saunders R, Clark S, Stubbington Y, Tridente A |
EP265 De- Bugging ITU; What to do with a positive blood culture. Journal of the Intensive Care Society
Abstract Positive blood cultures form a cornerstone in the diagnosis and treatment of sepsis. Falsely positive blood cultures due to contamination pose a significant clinical conundrum for the treating clinician. We aimed to develop a tool to aid decision making in the process of distinguishing the postive from the false..
| Published: | 13/08/2019 |
| Authors: | Saunders R, Clark S, Tridente A, Stubbington Y |
EP229 Initial Measurement of Ideal Body Weight in Ventilated Patients to Guide Tidal Volumes
Introduction Lung hyperinflation is a known contributing factor to ventilator-induced lung injury. Tidal volume (Vt) strategies utilising 6 ml/kg targets have shown decreased mortality and fewer days of ventilation when compared to more traditional Vt approaches1,2. Early measurement of Ideal Body Weight (IBW) on admission to critical care is essential..
| Published: | 13/08/2019 |
| Authors: | Edwards M, Tridente A |
Short-term outcomes of endoscopic pilonidal sinus treatment
Kalaiselvan, R; Liyanage, A; Rajaganeshan, R. (2019). Short-term outcomes of endoscopic pilonidal sinus treatment. Annals of the Royal College of Surgeons of England. 5, p1-4. Introduction : Endoscopic treatment for pilonidal disease was initially described by Meinero in 2013. This minimally invasive technique has both technical and aesthetic advantages. The diagnostic application helps..
| Published: | 13/08/2019 |
| Authors: | Kalaiselvan R, Liyanage A, Rajaganeshan R |
RE: Sevens and Reeves ‘Professional protectionism; a barrier to employing a sonographer graduate?’ and Mitchell and Nightingale ‘Sonography culture: Power and protectionism’
Wolstenhulme, S. and Daulby, M.. (2019). RE: Sevens and Reeves ‘Professional protectionism; a barrier to employing a sonographer graduate?’ and Mitchell and Nightingale ‘Sonography culture: Power and protectionism’. Radiography . 25 (3), p.276 Letter to the editor: No abstract available.
| Published: | 09/08/2019 |
| Authors: | Daulby M |
Developing today's trainees to become tomorrow's clinical researchers - an innovative collaboration driving improvements in clinical training and research delivery
Aims: To develop a unique partnership that enables specialty trainees to become regional champions in research, contributing to the ‘delivery of best research for best health’ while gaining essential clinical research skills for their future. Methods: The National Institute for Health Research (NIHR) UK vision is to deliver the ‘best..
| Published: | 09/08/2019 |
| Authors: | Loizou E |
Re: Paratesticular sarcomas: a case series and literature review
Dear Editor, We read with interest the recent paper by Keenan and colleagues ‘Paratesticular sarcomas: a case series and literature review’.1 The authors discuss the histological subtypes of paratesticular sarcomas and discuss the radiological diagnosis. Floyd, MS Jr; Omar AM. (2019). Letter to the editor re: Paratesticular sarcomas: a case series..
| Published: | 27/06/2019 |
| Authors: | Floyd Jr MS, Omar A |
A randomized trial of progesterone in women with bleeding in early pregnancy
Background Bleeding in early pregnancy is strongly associated with pregnancy loss. Progesterone is essential for the maintenance of pregnancy. Several small trials have suggested that progesterone therapy may improve pregnancy outcomes in women who have bleeding in early pregnancy. Methods We conducted a multicenter, randomized, double-blind, placebo-controlled trial to evaluate..
| Published: | 27/06/2019 |
| Authors: | Rao S |
Awareness of surgical expenditure amongst UK trainees and consultants
Introduction Limited knowledge of surgical device and service costs restricts a surgeon's ability to make cost efficient choices and contribute to the efficiency savings required by the NHS to reduce the financial deficit. This study aims to assess how aware surgeons are of surgical equipment and regularly used services. Methods..
| Published: | 27/06/2019 |
| Authors: | Blacker. S |
Understanding randomised controlled trials: a guide for prescribers
Randomised controlled trials are popular studies used to compare two or more groups or treatment interventions. Randomised controlled trials often create evidence to inform clinical practice; therefore, it is important that prescribers are able to interpret the design and findings of these studies, which support formulary and policy decisions, and..
| Published: | 27/06/2019 |
| Authors: | Lloyd M, Williamson J |
Letter to the editor re: Penile paraffinoma: A rare but important presentation. A Gaukroger et al.
Letter - no abstract available. Pina, IM; Hughes, KE, Floyd, MS Jr; Shokrollahi, K; Omar, AM . (2019). Letter to the editor re: Penile paraffinoma: A rare but important presentation. A Gaukroger et al. Journal of clinical urology . 1-2
| Published: | 27/06/2019 |
| Authors: | Floyd Jr MS, Hughes KE, Omar A, Pina IM, Shokrollahi K |
Re: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study.
Comment in: REPLY TO THE AUTHORS: RE: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study. [Int Braz J Urol. 2019] Comment on: The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study. [Int Braz J Urol. 2019] Floyd, MS Jr; Omar, AM; Baird, AD;..
| Published: | 27/06/2019 |
| Authors: | Floyd Jr MS, Omar A |
Vasculitis in Juvenile-Onset Systemic Lupus Erythematosus
Juvenile-onset systemic lupus erythematosus (JSLE) is a rare, heterogeneous multisystem autoimmune disease that can affect any organ, and present with diverse clinical and serological manifestations. Vasculitis can be a feature of JSLE. It more commonly presents as cutaneous vasculitis than visceral vasculitis, which can affect the central nervous system, peripheral..
| Published: | 27/06/2019 |
| Authors: | Lythgoe H |
An anomalous accessory flexor digitorum profundus muscle to the ring finger originating from the flexor pollicis longus tendon
Letter - no abstract available. Adjei, B; George, C; McArthur, P. (2019). An anomalous accessory flexor digitorum profundus muscle to the ring finger originating from the flexor pollicis longus tendon. Journal of hand surgery (European volume) . Published ahead of print
| Published: | 27/06/2019 |
| Authors: | Adjei B, George S, McArthur P |
Autoimmune encephalitis presenting with cognitive decline and hyponatraemia
The article describes the case of a 69-year-old man with a history of increasing confusion, memory loss, unsteadiness and body spasms and was diagnosed with anti leucine-rich glioma inactivated 1 (LGI1) limbic encephalitis with associated faciobrachial dystonic seizures and hyponatraemia Chin, G; Allsup, S; Fratalia, L. (2019). Autoimmune encephalitis presenting with cognitive..
| Published: | 26/06/2019 |
| Authors: | Allsup S, Chin G, Fratalia L |
A unique presentation of destructive shoulder arthropathy in the chronic phase of chronic myeloid leukaemia
We present a previously unreported case of rapidly progressing, destructive shoulder arthropathy as an initial presentation of chronic phase chronic myeloid leukaemia. This patient initially presented to clinic for consideration of an arthroplasty for symptom relief; however, her loss to follow-up yielded a rapid progression of her symptoms. Bone marrow..
| Published: | 26/06/2019 |
| Authors: | Connolly S, Howard J, MacKenzie B, Nicholson T, |
An 11-year analysis of head and neck melanomas following Sentinel lymph node biopsy
Conference Abstract Purpose: A long-term follow-up analysis of head and neck melanoma (HNM) patients undergoing sentinel lymph node biopsy (SLNB), their outcomes, looking specifically at differences between mapping performed the day before, or of surgery. Method(s): A retrospective study of all patients undergoing SLNB for HNM from 25/10/2006 - 27/12/2017, in..
| Published: | 26/06/2019 |
| Authors: | Barnes J, Howes A, Shaaban H, Touil L |
Impact of frailty on critical care and hospital mortality in critically-ill patients with decompensated alcoholic liver disease
Introduction We aimed to assess the effect of frailty as assessed by Clinical Frailty Scale (CFS) and Karnofsky performance score (KPS) on critical care (CC) and hospital mortality in this group at a non-specialist tertiary critical care unit. Methods Patients admitted to critical care were identified from our electronic database..
| Published: | 26/06/2019 |
| Authors: | Tridente A |
Re: Late Presentation of a 9mm Bullet in the Ureteropelvic Junction
Pina, IM; Omar, AH; Floyd, MS Jr. (2019). Re: “Late Presentation of a 9mm Bullet in the Ureteropelvic Junction Causing Acute Renal Failure in a Solitary Functioning Left Kidney” by Jhaveri and D'Angelo (J Endourol Case Rep. 2018;4:173–175) . Journal of Endourology Case Reports. 5 (1), 28-29
| Published: | 26/06/2019 |
| Authors: | Floyd Jr MS, Omar A, Pina IM |
Exploring the impact of a pharmacist‐led feedback intervention on insulin prescribing error frequency
Aims The aim of this research was to explore the impact of pharmacist‐led feedback on insulin prescribing. Methods This study was undertaken in a large UK teaching hospital. Ward pharmacists were trained in the delivery of prescribing feedback. Definitions of insulin prescribing errors were based on the National Diabetes..
| Published: | 26/06/2019 |
| Authors: | Bennett N, Cardwell J, Furlong NJ, Hart A, Lloyd M, Michaels S |
Simulation-based training to support healthcare staff in the management of hypoglycaemia
Aims To evaluate the use of multiprofessional high‐fidelity simulation to educate nurses and healthcare assistants on the management of hypoglycaemia and diabetic ketoacidosis. Methods A simulation‐based training event was developed by a multidisciplinary team. Nurses and healthcare assistants on two hospital wards were invited to participate. Effectiveness of..
| Published: | 26/06/2019 |
| Authors: | Cardwell J, Furlong NJ, Hart A, Lloyd M, Michaels S, Rowson M |
Exploring the impact of a feedback intervention on insulin prescribing behaviour
Aims The aim of this research was to explore the impact of feedback on insulin prescribing behaviour. Method(s) Doctors that had received feedback on their insulin prescribing were invited to participate in the study. Semi-structured interviews were used to explore the potential impact of feedback on their insulin prescribing...
| Published: | 26/06/2019 |
| Authors: | Bennett N, Cardwell J, Furlong NJ, Hart A, Lloyd M, Michaels S |
Autologous breast reconstruction in patients with achondroplasia
Touil, LL; Saggar, AK; Taghizadeh, R. (2019). Autologous breast reconstruction in patients with achondroplasia: Reconstructive and anaesthetic challenges . Journal of plastic, reconstructive & aesthetic surgery: JPRAS. 72 (7), 1219-1243
| Published: | 26/06/2019 |
| Authors: | , Touil L, Taghizadeh R |
Methodological challenges in European ethics approvals for a genetic epidemiology study in critically ill patients
Background During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Methods Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock (GenOSept) project, we asked..
| Published: | 14/05/2019 |
| Authors: | Tridente A |
P3. What have Clinical Librarians ever done for us? A case study with a Regional Burns Service
Introduction In August 2016 a Clinical Librarian service was established for the first time in the Trust. In November 2016 the Clinical Librarian received a request to work with the Regional Burns Service with the purpose of fulfilling two aims: To increase the use of evidence based literature in their everyday practice..
| Published: | 08/05/2019 |
| Authors: | Stubbington Y, Shokrollahi K |
Review: Could this be measles?
Infection with the measles virus causes an unpleasant disease with many potentially serious complications. It is predominantly a childhood illness but can affect any age. Measles is extraordinarily contagious, but immunisation with measles containing vaccine provides comprehensive protection. An international programme of universal immunisation from the mid-1980s has been..
| Published: | 08/04/2019 |
| Authors: | Nee PA, Vardhan M |
Malakoplakia of the parotid gland: a case report and review of localised malakoplakia of the head and neck
INTRODUCTION: Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy. MATERIALS AND METHODS: We report a case of malakoplakia involving the parotid gland and review..
| Published: | 29/03/2019 |
| Authors: | , Nandapalan V, Samian C, Santosh S |
Basal cell carcinoma and electrochemotherapy
Background Basal cell carcinoma(BCC) is one of the most common skin malignancies worldwide. In comparison to current management strategies for BCC, electrochemotherapy (ECT) proved to be a valid alternative in the management of primary and secondary lesions. ECT refers to intratumoural or intravenous injection of bleomycin followed by the..
| Published: | 12/03/2019 |
| Authors: | Liew S |
Electrochemotherapy as an adjunct to the surgical management of metastatic melanoma
Background Electrochemotherapy is a treatment for tumours in the skin, both primary and metastatic. The international Network for sharing practices on Electrochemotherapy (InspECT) group gathers information on treatment outcomes in a common database with defined, outcome parameters in order to improve and guide the use of Electrochemotherapy (ECT). Over a..
| Published: | 12/03/2019 |
| Authors: | Liew S |
Effect of body mass index on depression in a UK cohort of 363 037 obese patients: A longitudinal analysis of transition
With obesity levels increasing, it is important to consider the mental health risks associated with this condition to optimize patient care. Links between depression and obesity have been explored, but few studies focus on the risk profiles of patients across stratified body mass index (BMI) classes above 30 kg/m2 . This..
| Published: | 12/03/2019 |
| Authors: | Muttoni E |
From Socioeconomic Disadvantage to Obesity: The Mediating Role of Psychological Distress and Emotional Eating
OBJECTIVE Lower socioeconomic status is robustly associated with obesity; however, the underpinning psychological mechanisms remain unclear. The current study sought to determine whether the relationship between lower socioeconomic status and obesity is explained by psychological distress and subsequent emotional eating as a coping strategy. It also examined whether psychological resilience..
| Published: | 12/03/2019 |
| Authors: | Christiansen P, Hardman CA, Spinosa J |
Minimally invasive techniques in the management of pilonidal disease
Background Pilonidal sinus disease (PD) is a chronic condition involved in natal cleft. Excision surgery carries equally morbid course of recovery to that of disease itself. Minimally invasive treatments therefore have been developed to minimise morbidity and improve healing rates. This review looks at the literature on effectiveness of endoscopic..
| Published: | 12/03/2019 |
| Authors: | Allen W, Bathla S, Kalaiselvan R, Liyanage A |
Checking expertise in anticipated difficult airway situations
Awake fibreoptic intubation of a patient with an obstructed upper airway is among the more challenging of airway procedures 1. A multidisciplinary approach to safe management is essential 2, with an experienced Ear, Nose and Throat (ENT) surgeon immediately available to perform emergency surgical tracheostomy should awake fibreoptic intubation performed by an..
| Published: | 12/03/2019 |
| Authors: | Angus W, Miller S |
Appendicectomy in older patients with acute appendicitis is not an indication for routine colonoscopy
Dear Editor In the recent article by Mohamed et al., the authors concluded that post-appendicectomy patients aged ≥ 55 years should be offered colonoscopy to exclude coexistent caecal pathology. Considering the small number of positive findings in the study, the results should be more cautiously interpreted, and few potential limitations warrant attention...
| Published: | 22/02/2019 |
| Authors: | Hamedelneel AO |
Porcine vs bovine surfactant therapy for preterm neonates with RDS
Background Bovine surfactants are known to be clinically equivalent but it is unclear if porcine or bovine surfactants at their licensed dose should be preferred to treat respiratory distress syndrome in preterm neonates. Methods We performed a comprehensive review of biochemical and pharmacological features of surfactants to understand the biological..
| Published: | 22/02/2019 |
| Authors: | Tridente A |
Front of neck access: whose responsibility is it?
Background Management of an airway is a vital skill for many specialties. Front of neck access (FONA) is often a feared and unexpected event in a ‘can’t intubate, can’t oxygenate’ (CICO) scenario. Unless a clear plan is formed, further clinical difficulties could arise [1]. The Difficult Airway Society (DAS)..
| Published: | 21/02/2019 |
| Authors: | Jain N, Kainth R, Kennedy T |
The impact of the 21-gene recurrence score (Oncotype DX)
Purpose The 21-gene recurrence score (Oncotype DX) (RS) informs systemic therapy decision making in ER-positive HER2-negative early breast cancer (BC). To date no study has described the more nuanced discussions that take place regarding systemic therapy or the impact of the RS on concordance in such decision making. Here..
| Published: | 20/02/2019 |
| Authors: | Kiernan T |
Potential use of PCSK9 inhibitors as a secondary preventative measure
Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce low-density lipoprotein cholesterol (..
| Published: | 20/02/2019 |
| Authors: | Elamin AFM, Katira R |
P133 An evaluation of nurses’ experiences of short-term physiotherapy teaching
Knowles, L; Buttress, S; Clayson, T. (2019). An evaluation of nurses’ experiences of short-term physiotherapy teaching on a trauma and orthopaedic unit in Ethiopia . Physiotherapy. 105 (Sup 1), e147-148
| Published: | 20/02/2019 |
| Authors: | Knowles L |
P057 Internet educational videos: improving functional recovery following arthroscopic meniscectomy?
Litchfield, F; Buttress; S. (2019). P057 Internet educational videos: improving functional recovery following arthroscopic meniscectomy? . Physiotherapy. 105 (Sup 1), e93-94.
| Published: | 20/02/2019 |
| Authors: | Litchfield F |
An audit of the use of prothrombin complex concentration
Background Prothrombin complex concentrate (PCC) is licensed for emergency reversal of anticoagulation in severe and life-threatening bleeding, intracranial haemorrhage and prior to emergency surgery. It is an expensive resource costing approximately Eur2000 per adult dose. There is evidence of inappropriate use of PCC leading to delays to treatment, inappropriate dosing..
| Published: | 20/02/2019 |
| Authors: | Bonney S, Nee PA, Schofield J |
EPI-28 Neuropathic pain in ALS/MND
Background Although pain worsens quality of life for patients with ALS/MND, it is an under explored aspect of the disease (1). Objectives To investigate in ALS/MND: 1) the prevalence and severity of neuropathic pain (NP) and whether the severity of NP was associated with age, gender or disease duration; 2) whether..
| Published: | 20/02/2019 |
| Authors: | Syrimi ZJ |
Idiopathic intracranial hypertension in the British population with obesity
Purpose Idiopathic intracranial hypertension (IIH) is a syndrome that is characterized by persistently high intracranial pressure and associated with high rates of morbidity and visual loss. Its exact etiology and clinical picture is poorly understood, but it is known to be associated with obesity. The aim of this study was..
| Published: | 20/02/2019 |
| Authors: | Muttoni E |
Salvaging Digital Replantation and Revascularisation
Background Distal digital replantation and revascularisation remains one of the demanding microsurgical procedures due to the difficulty of vascular anastomosis. Venous congestion is the most commonly encountered problem after replantation due to the difficulty of venous anastomosis in traumatic injuries. Heparin, among other drugs, is commonly used to facilitate venous..
| Published: | 20/02/2019 |
| Authors: | McArthur P |
Multiple Lobulated Swellings: Challenge
A 51 year old man presented with a 12-month history of progressive skin nodules. They first appeared on his dorsal hands and elbows and then extended to involve up to his lower limbs. They were occasionally tender and frequently caught in his clothing. He was systemically well with no weight loss...
| Published: | 20/02/2019 |
| Authors: | Eustace K |
Is ferritin estimation and optimisation important in cerebral palsy children
Conclusion We conclude that preoperative haemoglobin estimation alone is not enough in cerebral palsy patients who require single-event multilevel surgery especially those with high Gross Motor Function Classification System (GMFCS) score. This study showed that these patients had low ferritin reserves and many of these patients with low ferritin reserves..
| Published: | 18/02/2019 |
| Authors: | Dhotare S, Mohan R |
Incidence and treatment of malignant tumors of the genitourinary tract
Floyd, MS; Khattak, AQ. (2018). Re: Incidence and treatment of malignant tumors of the genitourinary tract in renal transplant recipients . International Brazilian Journal of Urology. epub 10 October
| Published: | 18/02/2019 |
| Authors: | Floyd Jr MS, Khattak AQ |
The evolving role of the chaperone in medicine-protection and training
The role of the chaperone is integral in clinical examination and with this short communication aim to highlight the evolving role of the chaperone as a “witness” who with the appropriate training and standardised documentation can act as an observer of the behaviour of all parties during the consultation. Touil,..
| Published: | 18/02/2019 |
| Authors: | Gill P, , Sofos S, Touil L |
Exploring the impact of pharmacist-led feedback on prescribing behaviour: A qualitative study
Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To..
| Published: | 16/01/2019 |
| Authors: | Furlong NJ, Hardy KJ, Lloyd M |
Custom-Made Cement-Linked Distal Femoral Replacement
Abstract Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and..
| Published: | 24/12/2018 |
| Authors: | Emms N, Matar HE, Stritch P |
Cancelled operations: a 7 day cohort study of planned adult inpatient surgery
Background Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical..
| Published: | 24/12/2018 |
| Authors: | Adeney C, Behl S, Chadwick M, Coleman T, Dealing S, Ellwood J, Goel V, Kennedy T, Miller T, Reilly R, Syratt T, Welfare E |
Calcific myonecrosis: imaging and radiographic findings
Matar, HE; Stritch, P; Emms, N . (2018).Calcific myonecrosis: imaging and radiographic findings. British journal of hospital medicine . 79 (11), p654
| Published: | 29/11/2018 |
| Authors: | Emms N, Matar HE, Stritch P |
Assessment and Management of Hypotension in the Elderly Patient
Introduction: Elderly patients often present to the emergency department (ED) with nonspecific signs of infection and excessive fluid loss, with limited research into their management. The purpose of this audit was to assess the initial management of hypotensive elderly patients in the ED: observations within 15 min, fluid challenge within 1 h,..
| Published: | 29/11/2018 |
| Authors: | Jacobson MA, Kataria H |
Child abuse in Pakistan: A qualitative study of knowledge, attitudes and practice amongst health professionals
Child abuse is a global problem and pervades all cultures and socio-economic strata. The effects can be profound and life altering for victims. There is substantial literature from high income countries about signs of abuse, but a dearth of data from low and middle income countries like Pakistan. Healthcare professionals (..
| Published: | 29/11/2018 |
| Authors: | Maul KM |
Achondroplasia and deep inferior epigastric artery perforator flap reconstruction
Abstract Achondroplasia is the commonest form of dwarfism, with patients presenting significant anaesthetic challenges. Airway management is problematic due to macrocephaly, midface hypoplasia and narrow nasopharynx. Neck manipulation is dangerous owing to potential pre-existing cervicomedullary stenosis. Other problems may include restrictive lung disease, obstructive sleep apnoea, difficult venous access, hypersalivation..
| Published: | 31/10/2018 |
| Authors: | Jain N |
Implications of deranged activated partial thromboplastin time
Summary Bleeding during and after surgery ranges from trivial to fatal. Bleeding is in part determined by the patient's coagulation status. The UK National Institute for Health and Care Excellence recommends a pre‐operative clotting test for patients with a history of abnormal bleeding. Anaesthetists are familiar with the prothrombin..
| Published: | 31/10/2018 |
| Authors: | Loizou E |
The myth that shames us all
Any aspect of care demands a wise balance between benefits and risks, but problems arise when these are exaggerated, minimised, ignored, or hidden. Although arguments over most drugs have been settled through evidence, the arguments over opioids have persisted despite half a century of evidence. Coyle, S et al. (2018). The..
| Published: | 19/10/2018 |
| Authors: | Coyle S |
Saccular internal carotid artery aneurysm
An 84-year-old woman presented to the emergency department with a 3-day history of progressive binocular diplopia on right-sided horizontal gaze, accompanied with gradual-onset right-sided periorbital headache, vomiting and diarrhoea. Medical history consisted of hypertension and chronic kidney disease, stage 2. Clinical examination demonstrated right-sided VI cranial nerve palsy, normal pupillary light..
| Published: | 19/10/2018 |
| Authors: | Mohsin N |
Role of clinical psychology in UK hospices
Objective The National Institute of Clinical Excellence (NICE) (2004) guidance recommends a tiered approach to psychological care within cancer care. This includes the provision of Clinical Psychologists to support other professionals to deliver high-quality psychological care at levels 1 and 2 and to provide direct input to patients experiencing high levels of distress..
| Published: | 19/10/2018 |
| Authors: | Russell C |
A review of paediatric cervical spinal trauma
Abstract Significant spinal trauma in the paediatric population is uncommon. Cervical spine injuries account for approximately 1.5% of injuries. In paediatric patients a far higher proportion of injuries which affect the spinal column occur in the cervical spine in comparison with adults. The assessment of paediatric spinal injuries and radiographs can..
| Published: | 25/09/2018 |
| Authors: | Brown P |
Book Review: Hand Trauma Illustrated Surgical Guide of Core Procedures
Homer, LE; George, S. (2018). Book Review: Hand Trauma Illustrated Surgical Guide of Core Procedures . Annals of Plastic Surgery. 81 (4), e2
| Published: | 24/09/2018 |
| Authors: | George S, Homer LE |
Decompressive craniectomy in paediatric traumatic brain injury
Introduction Paediatric traumatic brain injury (pTBI) is one of the most frequent neurological presentations encountered in emergency departments worldwide. Every year, more than 200,000 American children suffer pTBIs, many of which lead to long-term damage. Objectives We aim to review the existing evidence on the efficacy of the decompressive craniectomy (DC)..
| Published: | 24/09/2018 |
| Authors: | Muttoni E |
Idiopathic intracranial hypertension in class III obese patients
Objectives Idiopathic intracranial hypertension (IIH) is a syndrome characterised by persistently high intracranial pressure (ICP) in the absence of identifiable ventricular or parenchymal disease. It mainly affects obese patients, with symptoms ranging from persistent headache to complete visual loss. IIH often requires lifelong medical treatment or neurosurgical intervention. Despite its..
| Published: | 24/09/2018 |
| Authors: | Muttoni E |
Is 4 still the floor?
Abstract In her Paediatrics section editorial, Helen Thornton discusses new definitions of hypoglycaemia from the International Hypoglycaemia Study Group and their relevance to clinical care. Thornton H. (2018). Is 4 still the floor? . Journal of Diabetes Nursing. 22 (4), 31
| Published: | 24/09/2018 |
| Authors: | Thornton H |
Facilitating physical activity for young people with type 1 diabetes
Abstract It is recommended that all young people should do at least 60 minutes of physical activity each day. NICE guidance suggests that exercise should be encouraged on a regular basis in young people with diabetes to reduce the risk of developing cardiovascular disease. However, physical activity can pose additional challenges..
| Published: | 24/09/2018 |
| Authors: | Brown J, Thornton H |
Neonatal urticaria: Could it be CAPS?
Abstract A neonatal boy presented with a persistent urticarial rash. Initial investigations showed raised inflammatory markers and evidence of systemic inflammation. A working diagnosis of cryopyrin‐associated periodic syndrome (CAPS) was made, and the patient responded extremely well to Anakinra. Molecular genetic testing revealed a somatic mutation (affecting 12.5% of cells)..
| Published: | 24/09/2018 |
| Authors: | Eustace K |
Assessment and management of infected total knee replacements
Abstract Infection following total knee replacement surgery is a challenging and devastating complication. Clinical assessment including history, examination, radiographs, blood tests and knee aspirations helps to establish the diagnosis. Revision surgery is typically required to eradicate infection and restore function. This has traditionally been performed through two-stage revision surgery, although..
| Published: | 24/09/2018 |
| Authors: | Emms N, Matar HE, Stritch P |
Technical refinements to a validated autologous fat harvesting technique
Abstract Autologous fat transfer is used for a wide variety of reconstructive purposes and in the areas of hand, facial and breast aesthetics, primarily to treat contour and volume deficits and for tissue rejuvenation.1,2 Modifications to the originally described fat harvesting techniques have aimed to achieve a method which is..
| Published: | 24/09/2018 |
| Authors: | Iqbal A, |
Is there preventable mortality in the postoperative period of hip fracture patients?
Objective To identify the risk factors leading to increased risk of mortality in patients with neck of femur fracture treated surgically in a district hospital in UK. Method Retrospective study of records of patients with neck of femur fracture admitted between 1 January 2017 to 31 December 2017 was made. Results 475 patients with neck..
| Published: | 21/09/2018 |
| Authors: | Hamlet L, Naraen A, Roberts C |
Vessel Health and Preservation Framework
Background: Vascular access is an important part of many patient care management plans, but has unwanted risks. A working group led by the Infection Prevention Society (IPS) produced a Vessel Health and Preservation (VHP) Framework. Based on current evidence, a framework was developed for frontline staff to assess and select..
| Published: | 21/09/2018 |
| Authors: | Weston V |
Endourologic strategies for a minimally invasive management
Pina, IM; Floyd Jr, MS; Stubington, SR. (2018). Re: Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion. International Brazilian Journal of Urology. 44 (4), 846-847.
| Published: | 21/09/2018 |
| Authors: | Floyd Jr MS, Pina IM |
Asymptomatic Indurated Plaque in a 16-Year-Old Girl
A 16 year old girl of Chinese origin presented with a 1 year history of an asymptomatic slowly enlarging lesion on the right upper thigh. There was no previous history of skin disease in the patient or any of the family members. She was otherwise well and was under no regular medications...
| Published: | 21/09/2018 |
| Authors: | Aslam A, Xu J |
Novel management of the under diagnosed and difficult to treat arteriosclerotic ulcer of Martorell
Abstract The aim of this case report is to raise awareness and report a novel treatment of an under diagnosed and difficult to treat form of lower limb ulceration, arteriosclerotic ulcer of Martorell. Arteriosclerotic ulcer of Martorell is an intensely painful anterolateral lower leg ulcer with necrosis, that occurs in..
| Published: | 20/09/2018 |
| Authors: | Brackley P |
An outbreak of multidrug-resistant Pseudomonas aeruginosa in a burns service
Background Burns patients are at high risk of nosocomial infection, and Pseudomonas aeruginosa is one of the most common causes of wound and systemic infections resulting in significant morbidity and mortality in burns patients. Aim To describe an outbreak of multidrug-resistant P. aeruginosa (MDR-Pa) at a specialist burns service and..
| Published: | 20/09/2018 |
| Authors: | Mortimer K, Shokrollahi K, Wilkinson D |
Higher failure rate of two-stage revision for infected knee arthroplasties
Purpose To evaluate clinical outcomes of two-stage revision arthroplasty for managing infected knee arthroplasties in significantly compromised patients (host-C). Methods This was a prospective consecutive series of two-stage revisions of infected total knee arthroplasties in host-C-type patients with a minimum 2-year follow-up using objective and patient-reported outcome measures. Thirteen consecutive..
| Published: | 20/09/2018 |
| Authors: | Emms N, Matar HE, Stritch P |
Simple hip dislocations in the elderly
The hip joint is an intrinsically stable joint as a result of the bony and labral anatomy of the acetabulum and femoral head. Hip dislocations are often associated with major trauma. Pure or simple dislocations without associated fractures are rare (Foulk and Mullis, 2010). Elderly patients tend to have hip or..
| Published: | 29/08/2018 |
| Authors: | Attar FG, Matar HE |
Sepsis 3 and the burns patient: do we need Sepsis 3.1?
Sepsis definitions and their relevance to the burns patient Sepsis has been described as ‘one of the oldest and most elusive syndromes in medicine’. Since ancient times, the human mind has been able to conceptualise infection and the possibility of its spread from a localised area to the rest of..
| Published: | 29/08/2018 |
| Authors: | Tridente A |
Could this be whooping cough?
Whooping cough is a notifiable bacterial respiratory infection caused by Bordetella pertussis . It may produce serious disease, especially in immunocompromised individuals and very young children. The number of reported cases increases in the winter months and the incidence peaks every 4–5 years. However, this periodicity is variable and is inconsistent between..
| Published: | 24/08/2018 |
| Authors: | Nee PA, Vaidya A, Vardhan M |
Inferiorly based lotus petal flap & laser therapy in difficult pilonidal sinus management
Aim To assess the efficacy of the lotus petal flap in difficult pilonidal sinus management. Background Pilonidal sinuses may be difficult to treat. Five year recurrence rates range from 18% to 50% Recurrence rates fall with primary closure rather than healing by secondary intention. Techniques such as z-plasty however, distort natal architecture...
| Published: | 24/08/2018 |
| Authors: | Hamnett K, Iqbal A, Nagarajan M |
Malignant proliferating trichilemmal tumour
Proliferating trichilemmal tumours are benign but locally aggressive skin neoplasms arising from hair follicles. Rarely, they can become malignant and must be appropriately managed to prevent recurrence and metastasis. One must have a low threshold for diagnosing this rare neoplasm Singh, P; Usman, A; Motta, L; Khan, I.. (2018).Malignant proliferating..
| Published: | 24/08/2018 |
| Authors: | Khan I, Usman A |
Palliative care in the emergency department
Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient’s needs. Despite suggested models and interventions, this remains challenging in practice. Aim: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending..
| Published: | 15/08/2018 |
| Authors: | Cooper E |
Core obstetric anaesthesia: A comparison of three models of training
Introduction It has been previously documented that over 25% of anaesthetic trainees feel underprepared to enter obstetric on-calls following core obstetric anaesthesia training. The RCoA mandate that core trainees complete the Initial Assessment of Competence in Obstetric Anaesthesia before starting on-call duties. There are different ways to structure training to meet..
| Published: | 15/08/2018 |
| Authors: | Kennedy T |
Blood tests required before labour neuraxial block: A midwife-focused service intervention
Introduction There is no guidance in the UK on what blood tests are required before neuraxial block, or their timing. In labouring women, the decision regarding the safety of spinal and epidural block is left to each individual anaesthetist. This leads to delays in delivery of epidural analgesia and results..
| Published: | 15/08/2018 |
| Authors: | Gerrard C |
Cautionary Tales of Tachypneic Infants in the Bronchiolitis Season
Abstract Although the diagnosis of bronchiolitis is usually straightforward, cardiac, metabolic, musculoskeletal and hematological conditions may present in a similar way and therefore, should not be overlooked. Methods We describe four cases presenting with increased work of breathing that were treated initially as bronchiolitis. However, the progressive clinical course of..
| Published: | 15/08/2018 |
| Authors: | Chilukuri L |
Can internal surgical adhesive facilitate drain-free mastectomy?
Introduction Mastectomy closure without drains has many potential advantages. This study compares a lysine-based high strength adhesive with standard wound drain application. Methods An ethically approved post-market non-inferiority multicentre randomized trial compared standard closure with drains (SWC) vs drain-free closure with adhesive (DFTG) in mastectomy +/-SLNB. Primary outcome was the..
| Published: | 15/08/2018 |
| Authors: | Kiernan T |
Increased recurrence in Scarf osteotomy for mild & moderate hallux valgus with Meary’s line disruption
Background Scarf osteotomy for hallux valgus is a successful procedure. Neverthless recurrence of deformity is reported as 5–8%. First ray instability is a recognised risk factor for recurrence. We investigate whether a radiographic marker such as Meary’s line can be used to predict recurrence. This paper aims to test the..
| Published: | 15/08/2018 |
| Authors: | Bagshaw O, Ballester J, Conway L, Faroug R |
Comparison of pharmacy technicians’ and doctors’ medication transcribing errors at hospital discharge
Objectives To compare the transcribing error rates of discharge prescriptions between pharmacy technicians and doctors in an acute hospital setting. Methods Pharmacy technicians were trained in the transcribing of discharge medications from inpatient to discharge medication charts. Prospective prescribing audits were undertaken over 5 days on eight hospital medical wards by..
| Published: | 14/08/2018 |
| Authors: | Lloyd M |
Mini-delayed reverse flow sural artery flap: Maximising the reach and minimising the hospital stay
Aim Microsurgical free tissue transfer is the gold standard for reconstruction of the lower leg defects. However it can be technically difficult or unavailable, hence local tissues can provide the solution. The distally based sural artery flap with or without delaying is one of the available options. Methods 14 patients with..
| Published: | 14/08/2018 |
| Authors: | Alfeky H |
Improvement in hand trauma service at a regional plastics surgery unit in merseyside (BSSH Guidelines)
Aim The 2007 British Society for Surgery of the Hand (BSSH) guideline contains the timeframe in which all hand trauma needs to be assessed and managed. Whiston Hospital is one of the regional plastic surgery units in the UK. An institutional audit performed in 2015 found the overall compliance with the guideline..
| Published: | 14/08/2018 |
| Authors: | Adjei B, Alfeky H, Bell D, Kelsey C, Nair M |
Single centre outcomes of surgery following chemoradiotherapy for anal cancer
Aim Anal cancer accounts for less than 1% of all cancers but carries considerable morbidity and mortality. We reviewed clinicopathological outcomes for patients undergoing surgery following chemoradiotherapy (CRT) for anal cancer. Methods A retrospective review of casenotes from patients undergoing surgery for anal cancer from 2008-2017 was performed. Patients were identified..
| Published: | 14/08/2018 |
| Authors: | Liew S |
Maximising the outcomes of proximal upper limb replantation
Aim Proximal hand and forearm amputations are devastating injuries, the prediction of the success is always uncertain due to multi factorial risk factors including the mode of injury, level of amputation, presence of contamination and the extent of the damage to the neuro-vascular tree. General patient status and co-morbidities affect..
| Published: | 14/08/2018 |
| Authors: | Alfeky H |
Perforator based V-Y flaps: Versatility in upper lip reconstruction
Aims The upper lip is a unique unit of the face which is formed of three subunits itself. Upper lip cancer is one of the commonest cancers plastic surgeon have to deal with. With the paucity of tissues in this anatomically special area, it is difficult some times to reconstruct..
| Published: | 07/08/2018 |
| Authors: | Alfeky H |
Laparoscopic right hemicolectomy – dissection before ligation
Aims Laparoscopic right hemicolectomy (LRH) is the standard for removal of right-sided colon cancers. Commonly, vessel ligation occurs before mobilisation of the colon or lateral to medial dissection from the caecum. We describe the outcomes of an alternative method: mobilise from transverse colon so that retroperitoneal structures are visible before..
| Published: | 07/08/2018 |
| Authors: | Cheung F, Kalaiselvan R, Samad A, Telfer R |
A Z-plasty training model
Aims The Z-Plasty is often a difficult concept for the trainee to design and execute. Our aim was to simulate a scar that needs either re-orientation or lengthening. Method The authors researched fabrics with different properties (strength, elasticity and anisotropy) along with mechanisms to simulate scar tension. A number of..
| Published: | 07/08/2018 |
| Authors: | Alfeky H, Bell D, Khan I, |
Adjuvant bevacizumab for melanoma patients at high risk of recurrence
Background Bevacizumab is a recombinant humanised monoclonal antibody to vascular endothelial growth factor (VEGF) shown to improve survival in advanced solid cancers. We evaluated the role of adjuvant bevacizumab in melanoma patients at high risk of recurrence. Patients and Methods Patients with resected AJCC stage IIB, IIC and III cutaneous..
| Published: | 24/07/2018 |
| Authors: | Marshall E |
Book Review: Handbook of Otolaryngology
Asmar, O and George, S. (2018). Book Review: Handbook of Otolaryngology. Annals of Plastic Surgery. 81 (2), 140
| Published: | 24/07/2018 |
| Authors: | Asmar O, George S |
Lung cancer stage-shift following a symptom awareness campaign
Background Lung cancer outcomes in the UK are worse than in many other developed nations. Symptom awareness campaigns aim to diagnose patients at an earlier stage to improve cancer outcomes. Methods An early diagnosis campaign for lung cancer commenced in Leeds, UK in 2011 comprising public and primary-care facing components. Rates..
| Published: | 24/07/2018 |
| Authors: | Malhotra P |
Paediatric cystolitholapaxy through the Mitrofanoff/Monti channel
Abstract We read with interest the recent publication by Thomas et al. detailing the first series of 13 cases of paediatric cystolitholapaxy via either the Mitrofanoff or the Monti channel. Specific to this series no complications were reported and holmium laser fragmentation was used in one case only but the time..
| Published: | 24/07/2018 |
| Authors: | Floyd Jr MS, Pina IM |
Long-term persistence with rituximab in patients with rheumatoid arthritis
Objectives To investigate the long term persistence of rituximab (RTX) in a large observational RA cohort, investigate persistence of RTX when used as a first or second line biologic DMARD (bDMARD), to characterize subsequent bDMARD treatment following RTX. Methods Patients with RA starting treatment with RTX (MabThera) between 2008 and 2011 were..
| Published: | 24/07/2018 |
| Authors: | Abernethy R |
Improved analgesia by correction of hypomagnesaemia?
Abstract The role of magnesium as an analgesic in patients is unclear. Hypomagnesaemia is a common electrolyte abnormality, in the chronic state symptoms are insidious and often non-specific. It is often undiagnosed and thus untreated. There is evidence from animal studies that magnesium is involved in pain control including an..
| Published: | 24/07/2018 |
| Authors: | Coyle S |
A multidisciplinary simulation training programme in the hyperacute stroke unit
Background and Aims High-quality care of stroke patients delivered on Hyperacute Stroke Units (HASUs) has been one of the primary contributors to reductions in stroke mortality and institutionalisation. Effective multidisciplinary management of the unwell stroke patient is an essential skill unique to this environment. Simulation training is a well-recognised means..
| Published: | 10/07/2018 |
| Authors: | Attwood K, Hill AM, Rowson M, Seed A |
Contemporary management of ureteral strictures
Abstract Ureteral stricture disease is a luminal narrowing of the ureter leading to functional obstruction of the kidney. Treatment of strictures is mandatory to preserve and protect renal function. In recent times, the surgical management of ureteral strictures has evolved from open repair to include laparoscopic, robotic and interventional techniques...
| Published: | 10/07/2018 |
| Authors: | , Javed S, , McCabe JE, Wong K |
Pain and outcomes of carpal tunnel release
Abstract We conducted a prospective randomized controlled trial to investigate carpal tunnel decompression under local anaesthesia. Carpal tunnel decompression was performed in 37 wrists using local anaesthesia and an arm tourniquet and 36 without tourniquet but with a local anaesthetic mixture containing adrenaline. Patients who underwent carpal tunnel decompression using a tourniquet..
| Published: | 10/07/2018 |
| Authors: | Doorgakant A, Iqbal HJ, Lipscombe. S, , Ramavath AL, Rehmatullah NNT |
Formulating a Patient Concerns Inventory specific to adult burns patients
Background Over the past century, advances in the care of the burned patient have been unprecedented. Mortality has decreased significantly owing to our improved understanding of the pathophysiological response to injury and progress in intensive care, nutrition, surgical techniques and infection control. Subsequently, there has been a paradigm shift from..
| Published: | 10/07/2018 |
| Authors: | Shokrollahi K |
Optic Disc Pit Maculopathy Triggered by Childbirth
Abstract We describe a case of a healthy lady with a known optic disc pit who developed serous maculopathy a few hours after childbirth. We believe this is the first published description of a trigger factor responsible for serous macular detachment in eyes known to have a disc pit. She..
| Published: | 08/06/2018 |
| Authors: | Akram I |
A survey of learning methods
Mohamed, S; Dunne, J; Rawlins, J. (2018). A survey of learning methods used by Plastic Surgery and Anaesthetics trainees in burn care. Burns. 44 (4), 1023.
| Published: | 08/06/2018 |
| Authors: | Mohamed S |
Low cost "commercial off-the-shelf" software in busy pain clinic
Objectives Online based surveys offer unprecedented degree of flexibility to a physician conducting audit of their patients' experiences after clinical intervention. They also enhance patient's experience by offering a convenient process to feedback their progress to their treating physician. The physician's affiliating organisation benefits too by employing a low cost..
| Published: | 08/06/2018 |
| Authors: | Clayton J, Levshankov K |
Transition to adulthood with a bladder augmentation
Pina, IM; Omar, AM; Khadr, RN; Floyd, MS Jr . (2018). Re: Transition to adulthood with a bladder augmentation: histopathologic concerns. International Brazilian Journal of Urology. 44 (epub 3 March)
| Published: | 05/06/2018 |
| Authors: | Floyd Jr MS, Omar A, Pina IM |
Haematology Speciality Trainees Driving NIHR Clinical Research
Abstract In 2016, the NIHR Haematology National Speciality Group founded a pilot programme to develop the clinical research skills of Haematology trainees within Non‐Malignant Haematology (NMH). This unique initiative has since been rolled out successfully throughout CRNs nationwide and equips Haematology trainees with the skills to become future leaders in..
| Published: | 05/06/2018 |
| Authors: | Loizou E, Nicholson T |
Book Review: New Concepts on Abdominoplasty and Further Applications
Alfeky, H; George, S; Shokrollahi, K. (2018). Book Review: New Concepts on Abdominoplasty and Further Applications. Annals of Plastic Surgery. 80 (6), 595
| Published: | 05/06/2018 |
| Authors: | Alfeky H, George S, Shokrollahi K |
Infected total hip replacements
Abstract Infected total hip replacements pose a diagnostic and management challenge. Careful history, clinical examination, blood tests, plain radiographs and hip aspiration are all part of the clinical assessment. International consensus on establishing the diagnosis helps surgeons to formulate management plans. Management strategies include debridement and prosthesis retention, single-stage revision,..
| Published: | 05/06/2018 |
| Authors: | Emms N, Matar HE, Stritch P |
British Thoracic Society quality standards for the investigation and management of pulmonary nodules
Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Methods Development of..
| Published: | 18/05/2018 |
| Authors: | Malhotra P |
Defining the Role of Secondary Intention Healing in Full-Thickness Lid Margin Defects
Extract I should like to thank Drs. Chang, Esmaeli, and Butler for citing my article, “Defining the Role of Secondary Intention Healing in Full-Thickness Lid Margin Defects,” in their recent CME article in Plastic and Reconstructive Surgery. May I respectfully point out, however, that this otherwise most helpful article perpetuates..
| Published: | 18/05/2018 |
| Authors: | Morton J |
Exploring hospital pharmacists’perceptions of their medication communication with prescribers
Abstract Prescribing errors are common and problematic in hospital settings in the UK. Pharmacists have been described as integral in the interception of prescribing errors, with effective medication communication between pharmacists and prescribers important to resolve and optimize prescribing outcomes. However, poor communication between healthcare professionals, including pharmacists and prescribers,..
| Published: | 16/05/2018 |
| Authors: | Furlong NJ, Hardy KJ, Lloyd M |
Calcific myonecrosis: diagnostic dilemma
Abstract Calcific myonecrosis is a rare benign condition affecting mainly the muscles of a single leg compartment. It is thought to follow a history of trauma with a latent period of years. Patients present with a slowly growing mass. Differential diagnosis from a malignant tumour can be made from the..
| Published: | 16/05/2018 |
| Authors: | Connolly S, Emms N, Matar HE, Stritch P |
Does magnesium sulfate have a role in the management of severe traumatic brain injury
Introduction Traumatic brain injury (TBI) is a significant cause of combat morbidity. Currently, the medical management of TBI is limited to supportive critical care. Magnesium sulfate has been studied as a potentially beneficial therapeutic agent. Methods A systematic review and meta-analysis was undertaken, examining the role of magnesium in the..
| Published: | 16/05/2018 |
| Authors: | Blackshaw WJ |
Electrochemotherapy for Breast Cancer—Results From the INSPECT Database
Background Cutaneous recurrence from breast cancer can pose a clinical challenge. It might be the only disease site, or could be part of disseminated disease, and often profoundly affects quality of life. Electrochemotherapy is a palliative treatment using electric pulses to locally permeabilize tumor cells and thereby significantly increase bleomycin..
| Published: | 16/05/2018 |
| Authors: | Liew S |
Admission to our frailty unit reduces length of stay and readmission rate
Background Comprehensive Geriatric Assessment (CGA) improves outcomes for older people admitted to hospital as an emergency. Our Frailty Unit (FU) provides rapid access to CGA for frail older people. We compare outcomes for patients admitted to the FU with patients who have been accepted for the unit but are admitted..
| Published: | 14/05/2018 |
| Authors: | Bussin J, Horner M, Oakdene G |
Book Review: Operative Management of Vascular Anomalies
George, SC; Shokrollahi, K. (2018). Book Review: Operative Management of Vascular Anomalies . Annals of Plastic Surgery. 80 (5), 467
| Published: | 14/05/2018 |
| Authors: | George S, Shokrollahi K |
Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP)
Introduction & Objectives There is conflicting evidence on the role of medical expulsive therapy (MET) in spontaneous stone passage in patients with acute ureteric colic. Randomised trial data has not shown a role for MET use, though these have been underpowered to explore its role in specific patient subgroups. It is..
| Published: | 14/05/2018 |
| Authors: | Mbuvi J |
G418 The clinical spectrum of dorsal stream dysfunction in autism
Aims Bilateral dysfunction of the parieto-occipital cortex, linked to the visual cortex by the dorsal stream, variably produces simultanagnosia (SIM), optic ataxia (OA), and gaze apraxia. This triad, rarely reported in childhood, comprises ‘Balint syndrome’. ‘Dorsal stream dysfunction’ (DSD) describes milder degrees of this disorder. This study aimed to determine..
| Published: | 11/05/2018 |
| Authors: | Assheton D |
Severe perianal dermatitis following surgical correction of Hirschsprung disease
Walsh, M; Boardman, G; MacBeth, K. (2018). Severe perianal dermatitis following surgical correction of Hirschsprung disease successfully managed with topical sucralfate. British Journal of Dermatology. 178 (2)
| Published: | 11/05/2018 |
| Authors: | Boardman G, MacBeth K, Walsh ML |
P576 Impact of improved access to biologic therapies and physician engagement on excess steroid exposure: Results from a UK audit of 3561 patients
Background Steroid-free remission is an important goal of IBD therapy. Improved access to effective therapies and changes in physician awareness of excess steroid exposure might impact this goal. The aim of this study was to evaluate temporal changes in steroid prescribing in UK IBD outpatients in the context of major..
| Published: | 09/04/2018 |
| Authors: | Bassi A |
Magnetic resonance imaging signal artefacts
Abstract We report a case of exuberant artefacts on the magnetic resonance imaging scan of the elbow produced by invisible metal debris secondary to previous surgery. Makki, D; Naikoti, K; Murali, SR. (2018). Magnetic resonance imaging signal artefacts from invisible metal debris following surgery to the elbow. Shoulder & Elbow. 10 (2), 133-135
| Published: | 09/04/2018 |
| Authors: |
Hand burns surface area: A rule of thumb
Introduction Rapid estimation of acute hand burns is important for communication, standardisation of assessment, rehabilitation and research. Use of an individual’s own thumbprint area as a fraction of their total hand surface area was evaluated to assess potential utility in hand burn evaluation. Materials and methods Ten health professionals..
| Published: | 20/03/2018 |
| Authors: | Dargan D, Mandal A, Shokrollahi K |
Prominent Ear Correction: A Comprehensive Review of Fascial Flaps in Otoplasty
A light bulb moment in the late 2000s during a tricky otoplasty operation resulted in me raising the postauricular fascia based distally (anteriorly) rather than proximally as previously described. It was immediately apparent that this versatile tissue could play a greater role in the development of otoplasty than simply covering..
| Published: | 20/03/2018 |
| Authors: |
Checking expertise in anticipated difficult airway situations
Awake fibreoptic intubation of a patient with an obstructed upper airway is among the more challenging of airway procedures. A multidisciplinary approach to safe management is essential, with an experienced Ear, Nose and Throat (ENT) surgeon immediately available to perform emergency surgical tracheostomy should awake fibreoptic intubation performed by an..
| Published: | 20/03/2018 |
| Authors: | Angus W, Miller S |
Analgesic efficacy of bilateral superficial cervical plexus block
Background Thyroid surgery is moderately painful, but is increasingly being considered as a day-case procedure. Bilateral superficial cervical plexus block (BSCPB) provides an adjuvant technique to facilitate this approach, but there is great evidential heterogeneity in randomised controlled trials (RCTs) about its use. Methods A systematic search, critical appraisal, and..
| Published: | 20/03/2018 |
| Authors: | Khirwadkar R |
Percutaneous Suprapubic Cystolitholapaxy
Floyd, MS Jr; Stubington, SR. (2018). Re: Percutaneous Suprapubic Cystolitholapaxy in Adult Patients with Previous Mitrofanoff Repair: Considerations for the Interventional Radiologist. Journal of Vascular and Interventional Radiology. 29 (2), 291
| Published: | 20/03/2018 |
| Authors: | Floyd Jr MS |
Defining the Role of Secondary Intention Healing in Full-Thickness Lid Margin Defects
Morton, JD. (2018). Defining the Role of Secondary Intention Healing in Full-Thickness Lid Margin Defects. Plastic and Reconstructive Surgery. epub 18 Jan
| Published: | 12/02/2018 |
| Authors: | Morton J |
Difficult airway update for ODPs: a quality improvement project
Management of the difficult airway requires familiarity with equipment and algorithms alongside well-rehearsed skills in their implementation. This demands effective collaboration between anaesthetists, ODPs and others, enabling successful execution of techniques in a crisis. NAP4 identified concerns including lack of education and training, inadequacy of skilled staff or equipment and..
| Published: | 12/02/2018 |
| Authors: | Jain N, Rodgers K |
How do junior anaesthetists manage the obese airway?
In 2014, it was estimated that 35% of men and 28% of women would be obese, rising to 47% and 36% respectively by 2025. Methods Based on the Society for Obese & Bariatric Anaesthetist's (SOBA) guidelines, we retrospectively collected data regarding airway management for obese patients undergoing emergency surgery. Results All patients (n = 49) had a BMI > 35. Thirty-seven..
| Published: | 12/02/2018 |
| Authors: | Khirwadkar R, Salvage G, Spilsbury Z |
Surgical trauma induces overgrowth in lower limb gigantism
Summary We describe an unclassified overgrowth syndrome characterised by unregulated growth of dermal fibroblasts in the lower limbs of a 35-year-old woman. A PIK3CA gene mutation resulted in lower limb gigantism. Below the waist, she weighed 117 kg with each leg measuring over 100 cm in circumference. Her total adiposity was 50%..
| Published: | 12/02/2018 |
| Authors: | Graham K |
Current practice in early management of neonatal respiratory distress syndrome
Hendriks, G; Stephenson, R; Yajamanyam, PK. (2017). Current practice in early management of neonatal respiratory distress syndrome: Is it evidence-based? Archives of Disease in Childhood Fetal & Neonatal Edition. epub 23 Dec.
| Published: | 12/02/2018 |
| Authors: | Hendriks G |
A bifid reversed palmaris longus muscle causing median nerve compression in a child
Letter. George, S. and Hassan, Z. (2018). A bifid reversed palmaris longus muscle causing median nerve compression in a child. Journal of hand surgery (European volume). Published online 10th January
| Published: | 01/02/2018 |
| Authors: | George S, Hassan Z |
Is management in school the key to quality improvement?
National Paediatric Diabetes Audit results published in February 2017 for the first time show a significant improvement in diabetes control, with the median HbA1c nationally being 64.5 mmol/mol (8.1%), see Figure 1 (Royal College of Paediatric and Child Health [RCPCH], 2017). This exceeded the trajectory that was seen by our European colleges some..
| Published: | 04/01/2018 |
| Authors: | Thornton H |
Derivation and validation of a prognostic model for postoperative risk stratification of critically ill patients with faecal peritonitis
Background: Prognostic scores and models of illness severity are useful both clinically and for research. The aim of this study was to develop two prognostic models for the prediction of long-term (6 months) and 28-day mortality of postoperative critically ill patients with faecal peritonitis (FP). Methods: Patients admitted to intensive care..
| Published: | 04/01/2018 |
| Authors: | Tridente A |
Critical care pharmacy workforce: UK deployment and characteristics in 2015
Objective: Clinical pharmacists reduce medication errors and optimize the use of medication in critically ill patients, although actual staffing level and deployment of UK pharmacists is unknown. The primary aim was to investigate the UK deployment of the clinical pharmacy workforce in critical care and compare this with published standards...
| Published: | 04/01/2018 |
| Authors: | Barton G |
Video-assisted anal fistula treatment: a high volume unit initial experience
Introduction: Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods: We reviewed a prospectively maintained database relating to consecutive patients undergoing..
| Published: | 04/01/2018 |
| Authors: | Appleton ND, Chadwick M, Cheung F, Kalaiselvan R, Nicholson J, Rajaganeshan R, Rout S, Samad A |
Prevalence of Celiac Disease in 52,721 Youth With Type 1 Diabetes: International Comparison Across Three Continents. Diabetes Care 2017;40:1034–1040
Letter. Craig, M. E.; Prinz, N.; Thornton, H. et al. (2017). Response to Comment on Craig et al. Prevalence of Celiac Disease in 52,721 Youth With Type 1 Diabetes: International Comparison Across Three Continents. Diabetes Care 2017;40:1034–1040 . Diabetes Care . 40 (11), e168-169
| Published: | 04/01/2018 |
| Authors: | Thornton H |
0951: Frailty and functional status as decision factors regarding admission to critical care
INTRODUCTION Pressure on Critical Care (CC) services is significant, with a progressively more complex patient population with increasing comorbidities. Admission may be inappropriate if the patient is unlikely to benefit from it. Guidance published in the past may no longer reflect current practice [1–2]. Clinical frailty is associated with worse outcomes..
| Published: | 03/01/2018 |
| Authors: | Andrews FJ, Feeney J, Tridente A |
eP146: Development of digital video resources for goals of diabetes education: A UK structured education programme
Objective Goals of Diabetes Education is a structured educationprogramme that has been designed to enhance the knowledge, confi-dence and skills of all Children & Young People with Type 1 diabetes and contribute to their physical, social and emotional wellbeing. Introduced in 2016 in the UK this age related competency framework provides a scaffolding..
| Published: | 03/01/2018 |
| Authors: | Thornton H |
0058: Ventilator associated pneumonia: A Cheshire & Mersey critical care network pilot audit
INTRODUCTION Ventilator associated pneumonia (VAP) is an important Intensive Care Unit (ICU) associated infection. VAP is associated with increased mortality, length of stay & cost. ICUs should have standardised systems in place to monitor VAP rates1 . Currently there is no unifying definition of VAP & many of the current definitions in use..
| Published: | 03/01/2018 |
| Authors: |
0063: Development of a clinical criteria for diagnosing and monitoring
INTRODUCTION It is estimated that ventilator-associated pneumonia (VAP) occurs in 10-20% of patients in intensive care1 . Despite advances in prevention strategies, there remains a lack of consensus on standard criteria for clinical diagnosis of VAP. Although surveillance programmes are available, questions remain about their suitability as a clinical diagnostic tool2 ...
| Published: | 03/01/2018 |
| Authors: |
0820: A prognostic model for post-operative risk stratification of critically ill patients with faecal peritonitis
INTRODUCTION Prognostic models of illness severity are useful both clinically and for research purposes. A specific tool for prognostication in critically ill patients with faecal peritonitis is not available. OBJECTIVES We aimed to develop two prognostic models, for the prediction of 6 months and 28 day mortality of post-operative critically ill patients..
| Published: | 03/01/2018 |
| Authors: | Tridente A |
Book Review: Dupuytren Disease and Related Diseases The Cutting Edge
Book review. Gill, P.; Shorollahi, K. (2017). Book Review: Dupuytren Disease and Related Diseases The Cutting Edge . Annals of plastic surgery . 79 (6), p532
| Published: | 03/01/2018 |
| Authors: | Gill P, Shokrollahi K |
Minding the gap: future challenges from acid attacks to mass casualty events
Armed with an increased government mandate for charities to contribute more substantively to gaps in UK healthcare delivery, The Katie Piper Foundation’s overarching ambition to establish tangible rehabilitation for burns and scars outside of the acute hospital setting (and fulfilling as-yet-unrealised criteria of UK burn care standards, which have..
| Published: | 03/01/2018 |
| Authors: | Shokrollahi K |
Impact of operator volume for percutaneous coronary intervention on clinical outcomes: what do the numbers say?
Abstract: The impact of operator and centre volume on clinical outcomes and quality of care has been of considerable debate in recent years in a number of surgical- and procedural-based specialities. A relationship between higher volumes at both the institutional and operator levels and better clinical outcomes would at first..
| Published: | 03/01/2018 |
| Authors: | Rashid M |
655P: Safety of neoadjuvant/adjuvant chemotherapy for gastroesophageal cancers: A single cancer centre experience
Background: Neoadjuvant/adjuvant chemotherapy for gastroesophageal cancers leads to improvement in overall survival and is currently a standard practice. We performed a retrospective study at the Clatterbridge Cancer Centre to examine its safety and identify risk factors. Methods: Patients with gastroesophageal cancers who received cisplatin/5-FU based neoadjuvant and/or..
| Published: | 03/01/2018 |
| Authors: | Cave G |
A multi-centre audit of excess steroid use in 1176 patients with inflammatory bowel disease
BACKGROUND: Corticosteroids are central to inducing remission in inflammatory bowel disease (IBD) but are ineffective maintenance agents. AIM: To benchmark steroid usage in British outpatients and assess factors associated with excess exposure. METHODS: We recorded steroid use in unselected IBD outpatients. Cases meeting criteria for steroid dependency or excess were..
| Published: | 03/01/2018 |
| Authors: | Bassi A |
Letter to the Editor re: Vieira et al. Abdominal wall endometriosis
No abstract. Floyd M.S.and Baird A.D.. (2018). Letter to the Editor re: Vieira et al. Abdominal wall endometriosis. Journal of Clinical Urology . 11 (1), p62-63
| Published: | 03/01/2018 |
| Authors: | Floyd Jr MS |
Video Assisted Peri-anal Abscess Treatment (VPAT+) - Video Vignette
Abstract: We submit a video vignette describing how to perform a video-assistant peri-anal abscess drainage plus insertion of a draining seton. We have been using this technique within the NHS for two years successfully to manage acute perianal abscesses Rajaganeshan, R. and Nicholson, J. A.. (2017). Video Assisted Peri-anal Abscess Treatment (..
| Published: | 02/01/2018 |
| Authors: | Nicholson J, Rajaganeshan R |
A European, Observational Study of Endocrine Therapy Administration in Patients With an Initial Diagnosis of Hormone Receptor-Positive Advanced Breast Cancer
Background: Despite guideline recommendations, reports suggest that a proportion of patients with hormone receptor (HR)-positive locally advanced or metastatic breast cancer (LA/MBC) might not receive endocrine therapy. The aims of this study were to estimate the proportion of postmenopausal patients with an initial (primary) diagnosis of HR-positive LA/..
| Published: | 02/01/2018 |
| Authors: |
Re: Unusual intravesical foreign body
Extract We read with interest the recent case of an unusual intravesical foreign body reported by Bansal et al. (1). A case is presented of an 18 year old female who presented with lower tract symptoms and was found to have a supratrigonal fistula following self insertion of a plastic pen per..
| Published: | 22/12/2017 |
| Authors: | Floyd Jr MS, Omar A, Khattak AQ |
An endophytic squamous cell carcinoma of the distal phalanx masquerading as a bone cyst
Whittam, A; Hassan, Z. (2018). An endophytic squamous cell carcinoma of the distal phalanx masquerading as a bone cyst . Journal of Hand Surgery (European Volume). 43 (2), 210-211
| Published: | 22/12/2017 |
| Authors: | Whittam AM, Hassan Z |
Exploring pharmacist experiences of delivering individualised prescribing error feedback in an acute hospital setting
Highlights • Delivery of prescribing error feedback is valued by hospital pharmacists and considered sustainable • Pharmacists report altered prescribing behaviour and improved prescribing following receipt of feedback • Pharmacists report greater team-work and prescriber communication following delivery of feedback • Delivering prescribing error feedback can improve the self-confidence and self-worth of pharmacists Lloyd,..
| Published: | 20/12/2017 |
| Authors: | Lloyd M, Furlong NJ, Hardy KJ, O'Brien S |
Electrochemotherapy of unresectable cutaneous tumors with reduced dosages of intravenous bleomycin: analysis of 57 patients from the InspECT (International network for sharing practices of ElectroChemoTherapy) registry
Abstract BACKGROUND: Electrochemotherapy (ECT) is currently used to treat unresectable superficial tumors of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing..
| Published: | 20/12/2017 |
| Authors: | Liew S |
43: Management of acute low back pain in the ED: a systematic review
Abstract STUDY OBJECTIVE: There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of..
| Published: | 20/12/2017 |
| Authors: | Ashbrook J |
Postmenopausal craniofacial hyperhidrosis
Summary: Hyperhidrosis is a condition marked by excessive sweating, which can either be localized or generalized. Primary focal hyperhidrosis (PFH) can arise from the palms, plantar feet, axillae and also from the face and scalp. PFH primarily affects a younger population of children and young adults, with the majority presenting..
| Published: | 20/12/2017 |
| Authors: | Eustace K |
110 - Development of postoperative renal dysfunction and anaemia following an elective total knee replacement
The guidelines for the provision of anaesthesia services state that patients undergoing major joint replacement are often elderly, with co-existing medical conditions [1]. Peri-operative acute kidney injury is a leading cause of morbidity and mortality [2]. Methods We conducted retrospective data collection of 194 patients who underwent an elective primary total knee replacement..
| Published: | 19/12/2017 |
| Authors: | Murray D, Fletcher J, Yoxall PF |
35 - Introduction of a learning checklist: a survey of trainees
Methods Following the publication of an educational checklist in the RCoA Bulletin [1], we introduced an adapted checklist in our anaesthetic department as an aid to maximising the learning potential for trainees during operating lists. The checklist was incorporated into the induction packages for new anaesthetic trainees of all grades at..
| Published: | 19/12/2017 |
| Authors: | Kainth R |
Book Review: Deep Sternal Wound Infections
Mandal, A; Shokrollahi, K. (2017). Book Review: Deep Sternal Wound Infections . Annals of Plastic Surgery. 79 (3), 235
| Published: | 15/11/2017 |
| Authors: | Mandal A, Shokrollahi K |
A rare case of suspected perineal nodular induration
Abstract We read with interest the recent paper by Awad et al in which a rare case of perineal nodular induration (PNI) is reported and the surgical technique employed to remove the benign pseudotumour is described. The authors allude to the multiple names for perineal nodular induration (PNI) or biker’..
| Published: | 15/11/2017 |
| Authors: | Floyd Jr MS, Khattak AQ, Omar A |
Case Study: Clinical Governance and review of stroke data
Challenge To minimise delays to hyper-acute stroke unit (HASU) admission for all stroke patients. Solution We developed a system for checking and reviewing data. This governance process aims to help team members understand why there may be delays in getting patients to the stroke unit. Hill, AM. (2017). Clinical Governance and..
| Published: | 13/11/2017 |
| Authors: | Hill AM |
False acute kidney injury alert due to model car fuel ingestion
Summary We report a case of accidental ingestion of model car fuel (Optifuel) resulting in an apparent elevation of serum creatinine of 274 µmol/L (3.1 mg/dL) as measured by the Jaffe (alkaline picrate) reaction, which resulted in an acute kidney injury (AKI) stage 3 alert being reported. Optifuel contains nitromethane, which..
| Published: | 29/09/2017 |
| Authors: | Powell D, Scholes D, Al-Jubouri M, Hassall L |
Autologous fat grafting for scars, healing and pain: a review
Introduction: Current guidelines suggest a multimodal approach to treating scars but there is no gold standard for treatment; however, there is exciting therapeutic potential for the use of autologous fat grafting (AFG). Functional and aesthetic improvements have been reported, including pain relief and scar quality improvement. Aims: To explore the..
| Published: | 26/09/2017 |
| Authors: | Riyat H, Touil L, Shokrollahi K |
Exploring the impact of feedback on prescribing error rates
Background Prescribing errors are prevalent in hospital settings with feedback identified as one potential error reduction strategy. Hospital pharmacists work alongside prescribers at ward level and are credible facilitators of prescribing error feedback. A formalised programme of pharmacist-led prescribing error feedback was designed and implemented Objective To determine the impact..
| Published: | 17/08/2017 |
| Authors: | Lloyd M, O'Brien S, Hardy KJ, Furlong NJ |
FC1.9 Prospective pilot study evaluating the effectiveness of electrochemotherapy
Background Electrochemotherapy (ECT) is currently used to treat cutaneous and subcutaneous tumors of different histotypes. ECT combines cytotoxic drugs and the application of high-intensity electric pulses to increase cell permeability. In 2006, a multicenter European project (ESOPE, European Standard Operating Procedures of Electrochemotherapy) defined the guidelines for ECT application. To date,..
| Published: | 16/08/2017 |
| Authors: | Liew S |
Laparoscopic ventral mesh rectopexy for rectal prolapse using veritas mesh
Introduction Rectal prolapse and obstructive defecation syndrome are life altering conditions, common across the age spectrum. When previously considered unfit for open abdominal surgery, elderly patients have tended to undergo perineal procedures, known to have higher failure rates. The laparoscopic ventral mesh rectopexy (Lap-VMR) allows all patients to benefit from..
| Published: | 16/08/2017 |
| Authors: | Fretwell VL, Brannigan K, Downes C, Rajaganeshan R, Chadwick M |
Microcystic Adnexal Carcinoma
Opinion Statement Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include..
| Published: | 15/08/2017 |
| Authors: | Aslam A |
Preoperative Site Marking: Are We Adhering to Good Surgical Practice?
Objectives Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general..
| Published: | 15/08/2017 |
| Authors: | Bathla S, Chadwick M, Nevins EJ |
Book Review: Flaps and Reconstructive Surgery Second Edition
Whittam, AM; Shokrollahi, K. (2017). Book Review: Flaps and Reconstructive Surgery Second Edition . Annals of Plastic Surgery. 79 (1), 6
| Published: | 15/08/2017 |
| Authors: | Whittam AM, Shokrollahi K |
The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with hand pain: a study protocol for a multi-centre randomised controlled trial (the A-GLOVES trial).
BACKGROUND: Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Usually made of nylon and elastane (i.e. Lycra®), these arthritis gloves apply pressure with the aims of relieving hand pain, stiffness and improving hand function. However,..
| Published: | 19/06/2017 |
| Authors: | Hough Y |
Comparison of Control of Clostridium difficile Infection in Six English Hospitals Using Whole-Genome Sequencing
Background.: Variation in Clostridium difficile infection (CDI) rates between healthcare institutions suggests overall incidence could be reduced if the lowest rates could be achieved more widely. Methods.: We used whole-genome sequencing (WGS) of consecutive C. difficile isolates from 6 English hospitals over 1 year (2013-14) to compare infection control performance. Fecal samples..
| Published: | 19/06/2017 |
| Authors: | Mortimer K |
Bullous pemphigoid and pemphigus vulgaris
Autoimmune bullous diseases are characterised by blistering of the skin or mucous membranes. Blisters form due to the antibodies against structural skin components. The two most common bullous diseases are bullous pemphigoid and pemphigus vulgaris. Most of our epidemiological data comes from European studies. Estimates of the incidence of bullous ..
| Published: | 19/06/2017 |
| Authors: | Aslam A |
Prevalence of Celiac Disease in 52,721 Youth With Type 1 Diabetes
OBJECTIVE Celiac disease (CD) has a recognized association with type 1 diabetes. We examined international differences in CD prevalence and clinical characteristics of youth with coexisting type 1 diabetes and CD versus type 1 diabetes only. RESEARCH DESIGN AND METHODS Data sources were as follows: the Prospective Diabetes Follow-up registry (Germany/Austria); the..
| Published: | 06/06/2017 |
| Authors: | Thornton H |
Heel pressure ulcer prevention
Abstract In the period 2011 to 2015, St Helens and Knowsley Teaching Hospitals NHS Trust evaluated low-friction bootees (LFB) integrated into the care path for patients at-risk of heel pressure ulceration (hPU) in an initiative to reduce hospital acquired hPU related to friction and shear. In 2012, LFB were introduced and hPU reduced..
| Published: | 06/06/2017 |
| Authors: | Gleeson D |
Characteristics and outcome of patients according to the severity of peripheral oedema and breathlessness
Introduction Heart failure is a common reason for hospital admission. Patients presenting with pulmonary and peripheral oedema may be seen as two ends of a spectrum with many patients presenting with a mixed picture. The purpose of the present analysis is to describe patient characteristics according to the severity of..
| Published: | 06/06/2017 |
| Authors: | Mohamed A |
The Katie Piper Foundation
Extract The Katie Piper Foundation was founded by Katie in December 2009, after she survived a brutal attack that led to her spending two months in the Burns Unit at the Chelsea and Westminster Hospital. Shokrollahi, K. (2017). The Katie Piper Foundation: supporting burn survivors in the UK . Wounds UK. 13 (1), 104
| Published: | 06/06/2017 |
| Authors: | Shokrollahi K |
Bacterial agents of the discharging middle ear among children seen at the University of Nigeria Teaching Hospital, Enugu
INTRODUCTION: Discharging middle ear continues to be one of the commonest problems seen in the developing world. There is an ever growing need to carry out studies periodically to determine the common bacterial agents responsible for discharging otitis media and their antibiotic sensitivity especially in set-ups characterized with minimal laboratory..
| Published: | 01/06/2017 |
| Authors: |
Association between age and access to immediate breast reconstruction
Background National guidelines state that patients with breast cancer undergoing mastectomy in England should be offered immediate breast reconstruction (IR), unless precluded by their fitness for surgery or the need for adjuvant therapies. Methods A national study investigated factors that influenced clinicians' decision to offer IR, and collected data on..
| Published: | 24/05/2017 |
| Authors: |
The implementation of the Vessel Health and Preservation framework
Abstract Vascular access is an important component of health care but is not without associated risks, some of which can be life-threatening. The Vessel Health and Preservation (VHP) framework was developed with the intention of providing frontline staff with a resource to assist in assessing and selecting the best vascular..
| Published: | 24/05/2017 |
| Authors: | Weston V |
Surgical Determinants of Patient-Reported Outcomes
Background This national prospective cohort study compared the patient-reported outcomes of breast cancer patients undergoing postmastectomy autologous reconstruction to those who had breast implants, in terms of aesthetic appearance; levels of psychological, physical, and sexual well-being; and overall satisfaction. Methods Of 5063 women who underwent immediate reconstruction (n = 3349) or delayed reconstruction (..
| Published: | 18/05/2017 |
| Authors: |
Phototherapy and photochemotherapy for polymorphic light eruption desensitization
Aslam, A; Fullerton, L; Ibbotson, SH. (2017). Phototherapy and photochemotherapy for polymorphic light eruption desensitization: a five-year case series review from a university teaching hospital . Photodermatology, Photoimmunology & Photomedicine. epub 11 May
| Published: | 18/05/2017 |
| Authors: | Aslam A |
P427 Quality of life and outcomes following video assisted anal fistula treatment
Aim Video assisted anal fistula treatment (VAAFT) is a novel technique. We performed a prospective longitudinal study with the aim of evaluating outcomes and how quality of life was affected with this treatment. Method Patients undergoing VAAFT were entered into a prospective database. A longitudinal study design was employed. Data..
| Published: | 17/05/2017 |
| Authors: | , Rout S, Scott M, Samad A, Chadwick M, Rajaganeshan R |
Book Review: A Practical Guide on Operative Technique and Peri-Operative Management
Defty, C; Shokrollahi, K. (2017). Book Review: A Practical Guide on Operative Technique and Peri-Operative Management . Annals of Plastic Surgery. 78 (5), e4
| Published: | 17/05/2017 |
| Authors: | Defty C, Shokrollahi K |
P.PO.57 Management of placenta praevia
Introduction Placenta praevia is associated with significant fetal and maternal morbidity and mortality. Careful management and compliance with evidence-based local guidelines is imperative to optimise both fetal and maternal outcomes. Methods Women diagnosed with placenta praevia were retrospectively recruited from two neighbouring hospitals in North West England from a 6-month..
| Published: | 17/05/2017 |
| Authors: | McCallin K, D'Costa D, , Harrison S |
Initial UK experience with transversus abdominis muscle release
Introduction Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. Methods The study is a..
| Published: | 16/05/2017 |
| Authors: | , , Scott M |
Straight to CT delivers earlier first definitive treatment
Background The National Optimal Lung Cancer Pathway (NOLCP) recommends performing a CT scan before a patients first appointment in a rapid access suspected lung cancer clinic. A local audit in 2014 at our hospital which receives over 350 two week rule suspected lung cancer referrals per year found that less than 50% of..
| Published: | 16/05/2017 |
| Authors: | Malhotra P, Murphy P, Dawson C, Hunt N, Hendry J |
Specialist community diabetes team
Aim To identify appropriateness and reasons for home visits in people with diabetes referred from a local Clinical Commissioning Group (CCG) to Knowsley Community Diabetes Team. Methods The case records of all patients referred for a home visit from Knowsley CCG (population 161,000) over a 16 month period were examined. Results Seventy..
| Published: | 10/05/2017 |
| Authors: | Wooding A, Garnett I, Timm L |
Effect of academic detailing on insulin prescribing: a before and after study
Abstract Introduction and aims Insulin is a high risk medication with prescribing errors potentially compromising patient care. The aim of the study was to assess the impact of educational outreach on insulin prescribing in a hospital setting. Methods Insulin prescribing was prospectively audited over a four week period. Hospital pharmacists..
| Published: | 28/04/2017 |
| Authors: | Hart A, Lloyd M, Furlong NJ, Hardy KJ |
The 2017 International Joint Working Group recommendations of the Indian College of Cardiology
Abstract There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has..
| Published: | 28/04/2017 |
| Authors: | Kataria H |
Neurocognitive Function of School-aged HIV-infected Children in Enugu, Nigeria
Abstract Background Evidence has shown neurocognitive problems often exist among human immunodeficiency virus (HIV)-infected children. There are limited data for children in Nigeria. Methods This was a cross-sectional study of 100 school-aged perinatally HIV-infected children seen in the paediatric HIV clinic and age/sex-matched controls from the general paediatric clinic...
| Published: | 28/04/2017 |
| Authors: |
Meta-analysis of biomarkers predicting risk of malignant progression in Barrett's oesophagus
Abstract Background Barrett's oesophagus is a precursor to the development of oesophageal adenocarcinoma. This study sought to clarify the role of genetic, chromosomal and proliferation biomarkers that have been the subjects of multiple studies through meta-analysis. Methods MEDLINE, Embase, PubMed and the Cochrane Library were searched for clinical studies assessing..
| Published: | 28/04/2017 |
| Authors: | Altaf K, Hickey L, Kaul A |
An excellent year in Liverpool
Aseri, S. (2016). An excellent year in Liverpool . Transmitter. Autumn, p18.
| Published: | 27/04/2017 |
| Authors: | Aseri S |
Severe co-trimoxazole-induced hypoglycaemia
Summary A 69-year-old man presented to the emergency department with lower respiratory tract infection and febrile neutropaenia. He was recently discharged following a 50-day hospital stay with newly diagnosed microscopic polyangiitis, complicated by pulmonary haemorrhage and severe renal dysfunction requiring renal replacement therapy, plasma exchange and immunosuppression (cyclophosphamide and methylprednisolone)...
| Published: | 26/04/2017 |
| Authors: | Conley TE |
Book Review: Reconstructive Lymph Vascular Surgery
Gurusinghe, D; Shokrollahi, K. (2017). Book Review: Reconstructive Lymph Vascular Surgery . Annals of Plastic Surgery. 78 (4), 364
| Published: | 26/04/2017 |
| Authors: | Gurusinghe D |
Five-year local recurrence for breast cancer: The presentation of our local data
Background Breast cancer is the most common cancer in women, affecting 1 in 8 worldwide. Overall survival has now reached 80% at 5 years, with improved targeted therapy. Although a large amount of data is collected for national audit, in the UK local recurrence rate is largely unknown. Methods Retrospective analysis of prospectively collected..
| Published: | 25/04/2017 |
| Authors: | Clifford R, Antoniadis S, Chagla LS |
Simple reconstructive techniques for conservative breast cancer surgery
Background Patients undergoing breast conservation surgery (BCS) for cancer may benefit with the defect reconstruction using simple techniques to obtain optimal cosmetic & oncological outcome. Aim To determine feasibility simple oncoplastic level 2 reconstruction as a day case. Material and Methods A prospective series of patients eligible for BCS & likely to have..
| Published: | 25/04/2017 |
| Authors: | Jois RHS, |
Specific mutations in KRAS codon 12
Background Activating mutations in KRAS have been suggested as potential predictive and prognostic biomarkers. However, the prognostic impact of specific point mutations remains less clear. This study assessed the prognostic impact of specific KRAS mutations on survival for patients with colorectal cancer. Methods Retrospective review of patients KRAS typed for..
| Published: | 24/04/2017 |
| Authors: | Clifford R |
Risk of lymphoma in patients exposed to antitumour necrosis factor therapy
Abstract Objectives Patients with rheumatoid arthritis (RA) are at increased risk of lymphoma compared with the general population. There are concerns that tumour necrosis factor inhibitors (TNFi) may exacerbate this risk. However, since the excess risk of lymphoma in RA is related to the cumulative burden of inflammation, TNFi may..
| Published: | 24/04/2017 |
| Authors: | Abernethy R |
Relationship between exposure to tumour necrosis factor inhibitor therapy
Abstract Objectives Patients with rheumatoid arthritis (RA) are at increased risk of myocardial infarction (MI) compared with subjects without RA, with the increased risk driven potentially by inflammation. Tumour necrosis factor inhibitors (TNFi) may modulate the risk and severity of MI. We compared the risk and severity of MI in..
| Published: | 24/04/2017 |
| Authors: | Abernethy R |
Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess
Introduction Pilonidal abscess is a common surgical emergency. Conventional treatment with incision and drainage is associated with significant postoperative morbidity. We report our initial experience of using minimally invasive endoscopic technique for the treatment of pilonidal abscesses, referred to as endoscopic pilonidal abscess treatment (EPAT). Materials and Methods A prospective..
| Published: | 14/03/2017 |
| Authors: | Jain Y, Javed M, Singh S, Rout S, , Rajaganeshan R |
Electrochemotherapy in the treatment of metastatic malignant melanoma: A prospective cohort study by InspECT
Background Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors which affect (..
| Published: | 14/03/2017 |
| Authors: | Pritchard-Jones R, Liew S |
Individualised Expert Feedback is Not Essential
Objective To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills—intravenous cannulation, catheterization, and suturing. Background Feedback is a vital component of the learning process, yet great variation persists in its quality,..
| Published: | 14/03/2017 |
| Authors: | Whitehead IJ |
Apert syndrome: A consensus on the management of Apert hands
Introduction Apert Syndrome is a congenital condition characterised by primary craniosynostosis, midfacial malformations and complex symmetrical malformations of the hands and feet. The hands demonstrate one of the most complex collections of congenital upper limb deformities, posing a significant challenge for the paediatric hand surgeon. This study examines the extant..
| Published: | 14/03/2017 |
| Authors: | Mishra A, McArthur P |
Case Report of Lichen Planopilaris Occurring in a Pediatric Patient Receiving a Tumor Necrosis Factor α Inhibitor and a Review of the Literature
Abstract A 12-year-old girl with extended oligoarthritis treated with adalimumab presented with a short history of a progressive cutaneous eruption involving the legs and scalp. Physical examination and histologic results were consistent with lichen planopilaris. The adalimumab was discontinued. She received treatment with topical clobetasol propionate and the majority of..
| Published: | 14/03/2017 |
| Authors: | Walsh ML |
To treat or not to treat? the efficacy of oral paracetamol for delayed closure of the ductus arteriosus; A case report
Background and aims Female infant was born at 29 weeks gestation. At one month of life this baby was self ventilating in air but having frequent profound desaturations requiring stimulation. These did not improve with blood transfusion nor anti reflux therapy. Weight gain was also suboptimal. Echocardiography demonstrated a large haemodynamically..
| Published: | 14/03/2017 |
| Authors: | Brophy H, Bentur H, Abdelaziz M |
DP12 Angioinvasive lympho matoid papulosis: a raresubtype easily mistaken for a high-gradeangioinvasive lymphoma
Abstract A 59-year-old woman presented with painful ulceration on her chin. She described that it began as a nodule that then ulcerated. On examination she had a well-defined area of ulceration measuring 2 x 2 cm with haemorrhagic crust resembling eschar. There was no lymphadenopathy. She was treated with prednisolone and the..
| Published: | 14/03/2017 |
| Authors: | Walsh ML |
PWE-146 Is A Nurse-Led Computerised HCC Surveillance System Effective?
Introduction Hepatocellular carcinoma (HCC) accounts for 90% of liver cancers and has a growing incidence of HCC worldwide. In 2013, liver cancer accounted for 2% of all cancers with an incidence of 5,413 new cases. 90–95% of cases of HCC arise in cirrhosis and non-cirrhotic chronic Hepatitis B.1 Outcomes are poor with a median survival..
| Published: | 14/03/2017 |
| Authors: | Priestley S, Ashton K, Jones J, Fox M |
The incidence of cancer in patients with rheumatoid arthritis
Objective To explore the influence of TNF inhibitor (TNFi) therapy and rituximab (RTX) upon the incidence of cancer in patients with RA and prior malignancy. Methods The study population comprised RA subjects with a prior malignancy reported to the UK national cancer registers, recruited to the British Society for Rheumatology..
| Published: | 14/03/2017 |
| Authors: | Abernethy R |
Protecting vulnerable skin from moisture-associated skin damage
Abstract The skin, the body's largest organ, has several functions. Its barrier role can be undermined if it is in contact with urine, faeces and other sources of excess moisture; overhydration can also increase the likelihood of injury from friction through contact with clothing, incontinence pads or bed linen. If..
| Published: | 14/03/2017 |
| Authors: | Simon D |
Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis
BACKGROUND: Radial artery occlusion (RAO) may occur posttransradial intervention and limits the radial artery as a future access site, thus precluding its use as an arterial conduit. In this study, we investigate the incidence and factors influencing the RAO in the current literature. METHODS AND RESULTS: We searched MEDLINE and..
| Published: | 09/03/2017 |
| Authors: | Rashid M |
Laser significantly improved a debilitating lymphaticovenous malformation: a case report
Abstract Lymphaticovenous malformations are rare congenital anomalies leading to oozing, ulceration and recurrent infections. They are managed by a specialist multi-disciplinary team with compression garments, symptomatic treatments and options such as percutaneous sclerotherapy and debulking procedures. Limited literature exists on the use of laser to seal the lymphatic vesicles. We..
| Published: | 09/03/2017 |
| Authors: | Defty C |
Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT)
Javed, MA. et. al. (2016).Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT). Techniques in Coloproctology . 20 (12), 871-873.
| Published: | 02/03/2017 |
| Authors: | Javed M, Singh S, Fowler H, Jain Y, Scott M, Rajaganeshan R |
Goals of diabetes education: A national UK structured self-management education programme
Objective: Goals of Diabetes Education is a structured education programme that was originally developed in 1996 in Denmark. It was translated and first published in the UK in 2012 to fulfil the requirements of the Paediatric Diabetes Best Practice Tariff. This original structured educational framework has been updated and enhanced following the..
| Published: | 24/02/2017 |
| Authors: | Thornton H |
Effectiveness of a pressure-relieving mattress
Abstract Between the 10 May and 18 July 2016, St Helens and Knowsley Teaching Hospitals NHS Trust conducted a small, non-controlled evaluation set out to assess the performance of the Apex Pro-care Auto pressure-relieving mattress in an acute stroke ward. Seven patients, assessed as being at medium-to-high risk of developing a pressure ulcer (..
| Published: | 23/02/2017 |
| Authors: | Gleeson D |
Relationship between transcutaneous bilirubin
Background Transcutaneous bilirubin (TcB) consists of the skin-deposited bilirubin. Free bilirubin represents the protein-unbound bilirubin (UB) that is able to pass into the tissues. We aimed to describe the relationship UB-TcB and study the passage of UB into the skin. Methods We prospectively enrolled 194 neonates and we measured TcB, UB,..
| Published: | 23/02/2017 |
| Authors: | Tridente A |
Discrepancies between biopsy
Armstrong A; Hart-Pinto, A; Sharma, N; Hassan, Z. (2016). Discrepancies between biopsy and formal excision histology of non-melanoma skin cancer. Journal of plastic, reconstructive and aesthetic surgery (JPRAS). 69 (12), 1714-1716
| Published: | 23/02/2017 |
| Authors: | Hart-Pinto AD, Sharma N, Hassan Z |
Coblation Assisted Procedures
Objectives To assess the clinical effectiveness of coblation assisted upper airway procedures in patients with snoring and sleep apnea. Methods This study was conducted at the ENT Department of St Helens and Knowsley Teaching Hospitals NHS Trust, United Kingdom. Fifty-six consecutive patients who underwent upper airway procedures were included in..
| Published: | 23/02/2017 |
| Authors: | Saleem Y |
Excess steroid use in IBD
Background Corticosteroids are the cornerstone of induction of remission in active IBD but are limited in their ability to maintain remission, and are associated with significant side effects. ECCO defines appropriate steroid use and recommends an exit strategy for steroid dependent patients. Data to support the utility of clinical and..
| Published: | 21/02/2017 |
| Authors: | Bassi A |
A rare cause of mucositis
Trehan, P; Pang, E; Khirwadkar, N; Alsharqi, A; Parslew, R. (2016). A rare cause of mucositis . Clinical and Experimental Dermatology. 41 (8), 951-952
| Published: | 21/02/2017 |
| Authors: | Pang E |
P054: Electrochemotherapy in the treatment
Aims Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors which affect (..
| Published: | 21/02/2017 |
| Authors: | Liew S, Pritchard-Jones R |
The significance of extramural venous invasion
Background and aims Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer. Material and..
| Published: | 21/02/2017 |
| Authors: | Ormsby N, Bermingham HN, |
Implementation of regional anaesthesia service
Background and Aims Regional anaesthesia (RA) allows awake surgery on the upper limb. Avoidance of general anaesthesia (GA) may lead to faster recovery times, reduced costs and improved patient satisfaction. We recently introduced a RA service for day case plastic surgery patients to allow awake surgery. We have performed a..
| Published: | 21/02/2017 |
| Authors: | Mukhtar K |
Age should hold no boundaries for young people
Abstract Diabetes can be diagnosed at any age in childhood. Children and young people (CYP) must be empowered to develop knowledge and self-caring skills with the aim of independence by the time they transfer to young adult services. The percentage of CYP achieving excellent diabetes control has increased from 15.8% in 2012/13..
| Published: | 21/02/2017 |
| Authors: | Thornton H, Seagrave V |
Child abuse in Pakistan
Abstract Aims: Child abuse is a global problem and pervades all cultures and socio-economic strata. The effects of abuse can be profound and life altering for both victims and the victims’ own children. There is substantial literature from High Income Countries about signs of abuse but a dearth of data..
| Published: | 21/02/2017 |
| Authors: | Maul KM |
Management of pretibial lacerations: How patients' well-being is affected by their management
Background: Pretibial lacerations remain one of the commonest problems in plastic surgery. There is still no evidence of superiority of either a conservative or surgical approach for their management, nor any documentation regarding patients' performance following each approach. Methods: We conducted a retrospective study of all patients treated for pretibial..
| Published: | 17/02/2017 |
| Authors: | , Kelsey C, Khan I |
Critical care in the Emergency Department: organ donation
Abstract: Organ transplantation is associated with improved outcomes for some patients with end-stage organ failure; however, the number of patients awaiting a transplant exceeds the available organs. Recently, an extended role has been proposed for EDs in the recognition and management of potential donors. The present review presents an illustrative..
| Published: | 17/02/2017 |
| Authors: | Bonney S, Nee PA, Andrews FJ |
Response to Letter Regarding ‘Pregnancy Following Bariatric Surgery—Medical Complications and Management’
Narayanan, RP; Syed, AA.. (2016).Response to Letter Regarding ‘Pregnancy Following Bariatric Surgery—Medical Complications and Management’. Obesity Surgery. 16 (12), 3008.
| Published: | 17/02/2017 |
| Authors: |
Prediction of malignant progression of Barrett’s oesophagus
Abstract Background Barrett’s Oesophagus (BO) is a precursor for Oesophageal Adenocarcinoma (OAC). Currently, there are no biomarkers in clinical practice that predict the malignant progression in BO. We sought to clarify the effectiveness of common genetic aberrations as potential biomarkers through a systematic review and meta-analyses. Methods MEDLINE, EMBASE..
| Published: | 17/02/2017 |
| Authors: | Altaf K, Hickey L, Kaul A |
VL flaps are not ALT flaps
Extract We read the paper from Kaminsky, Li, Copeland-Halperin, and Miraliakbari (Kaminsky et al, 2015) on the vastus lateralis (VL) free flap for lower extremity Gustilo grade III reconstruction with interest; however, we feel that this paper could be better in mapping the real versatility of the VL flap given the..
| Published: | 17/02/2017 |
| Authors: | El-Gawad A |
Biweekly Viscosupplementation Regimen for Knee Osteoarthritis
Abstract Osteoarthritis is the most common form of arthritis in the Western world, causing disabling symptoms in 10% of people older than 55 years. Hyaluronic acid injections can reduce osteoarthritic pain but require three to five doses administered weekly. This preliminary study aims to assess the efficacy of a more flexible viscosupplementation..
| Published: | 17/02/2017 |
| Authors: | Munir U, Teanby D |
The Laser Test Patch
Extract Laser practitioners, manufacturers and indemnity providers are variably sold on the concept of a laser test patch before full treatment of patients with lasers. But what is the purpose of a test patch, how is a test patch objectively defined, what makes a test patch different from a full..
| Published: | 17/02/2017 |
| Authors: | Shokrollahi K |
Using Stroke Sentinel Audit Data to drive quality improvement
Hill, AM. (1 Feb 2017). Using Stroke Sentinel Audit Data to drive quality improvement. Royal College of Physicians Commentary Magazine
| Published: | 01/02/2017 |
| Authors: | Hill AM |
Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient
INTRODUCTION: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss..
| Published: | 30/01/2017 |
| Authors: | Samsudin A |
Unexpected encounters with ureters
Ureteric injuries are as common as 0.5-3% and are frequently missed.Delayed diagnosis can occur in upto 15% patients and can lead to serious morbidity such as fistula formation, peritonitis, loss of renal function and is a frequent cause of medico legal litigation. The common sites of ureteric injury are at..
| Published: | 23/12/2016 |
| Authors: | Thomas A |
Beyond
The progress in scientific and medical knowledge has been fascinating over the last few decades and has had a noticeable impact on the most recent clinical practice. However, not every patient benefits from this progress in the same way; European and North American data are there to prove how senior..
| Published: | 23/12/2016 |
| Authors: |
Case study: Using SSNAP data to improve stroke services
Extract Being admitted with a suspected stroke can be stressful and bewildering for stroke patients and their families. A simple way to alleviate this and provide high quality stroke care is to try to ensure that patients who have had a suspected stroke are admitted to a specialist ward, and..
| Published: | 29/11/2016 |
| Authors: | Hill AM |
067 Improving access to same-day initial therapy assessment with later working patterns
Introduction Early initial multi-disciplinary therapy assessment following stroke admission is important to establish baseline function, engage patients and families, manage expectations and set realistic rehabilitation and treatment goals. Bray et al established that there are significant variations in assessment time according to time of admission and day of admission. We..
| Published: | 21/11/2016 |
| Authors: | Hill AM |
085 Standardising quoted post-thrombolysis bleeding complication rates using the Heidelberg Bleeding Classification
Introduction Intracerebral haemorrhage is one of the most feared complications of delivering thrombolysis therapy. Variable complication rates are quoted for symptomatic haemorrhage post-thrombolysis, reflecting difficulty establishing whether the extent of haemorrhage, or the original infarction was responsible for the eventual outcome. National datasets such as the Stroke Sentinel National..
| Published: | 21/11/2016 |
| Authors: | Hill AM |
Is the ISAN score valid against stroke datasets with high levels of completeness?
Parallet Session 2A: High Scoring Abstract Introduction In 2015, Smith et al analysed the Stroke Sentinel National Audit Programme dataset to produce a risk assessment tool for predicting 7 and 30 day mortality and the prevalence of stroke associated pneumonia (SAP). In our study we analysed our Trust’s stroke population over the..
| Published: | 21/11/2016 |
| Authors: | Hill AM |
A literature review and summary of capsular contracture: An ongoing challenge to breast surgeons and their patients
Abstract Capsular contracture is a significant difficulty where implants are used in both breast augmentation and breast reconstruction surgery. This report reviews the published literature focusing on factors and techniques that reduce the incidence of this complication, as well as evaluating the available treatment options for patients who have developed..
| Published: | 27/10/2016 |
| Authors: | , |
The development of a stroke unit simulation model to reconfigure an inpatient stroke unit
Summary Our team developed a mathematical simulation of a stroke unit, allowing us to demonstrate the optimal size and configuration for a stroke unit. The model utilised existing known inputs: including the number of strokes, stroke ‘mimics’, TIAs, and optionally the presence of medical outliers on the stroke unit. For..
| Published: | 27/10/2016 |
| Authors: | Hill AM |
Development of a graphical dashboard for real-time analysis of Sentinel Stroke National Audit Programme (SSNAP) data
Summary The Stroke Sentinal National Audit Programme Dataset contains valuable operational data but is limited by its lag time to reporting. We have developed a realtime data dashboard which enables SSNAP data to be used to study the performance of our unit live. Data is entered onto the dashboard by..
| Published: | 27/10/2016 |
| Authors: | Hill AM |
Pregnancy Following Bariatric Surgery—Medical Complications and Management
Abstract Bariatric surgery is most commonly carried out in women of childbearing age. Whilst fertility rates are improved, pregnancy following bariatric surgery poses several challenges. Whilst rates of many adverse maternal and foetal outcomes in obese women are reduced after bariatric surgery, pregnancy is best avoided for 12–24 months to reduce..
| Published: | 27/10/2016 |
| Authors: |
Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital, Enugu
Abstract Background Ear related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children. Objective To determine the prevalence of ear-related problems among children presenting at the Paediatric..
| Published: | 27/10/2016 |
| Authors: |
Retained surgical drain after total knee arthroplasty: An eight-year follow-up
Abstract Case This report describes a patient in whom the intra-articular portion of a suction drain broke during total knee arthroplasty. The broken portion of the drain could not be removed, but the patient experienced no major complications over an eight-year follow-up period. Conclusion The presence of a retained surgical..
| Published: | 27/10/2016 |
| Authors: | Gheorghiu D, Teanby D |
The influence of booking body mass index
Introduction Obesity is a major public health concern with over half of childbearing aged women overweight or obese in the UK. Maternal obesity carries numerous maternal and fetal complications during pregnancy and is a risk factor for anaesthesia related mortality. The incidence of complications such as caesarean section (CS), preeclampsia,..
| Published: | 26/10/2016 |
| Authors: | Anwar A, Yoxall PF |
The UK-PBC risk scores: Derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cholangitis
Abstract The biochemical response to ursodeoxycholic acid (UDCA)—so-called “treatment response”—strongly predicts long-term outcome in primary biliary cholangitis (PBC). Several long-term prognostic models based solely on the treatment response have been developed that are widely used to risk stratify PBC patients and guide their management. However, they do not..
| Published: | 26/10/2016 |
| Authors: | McLindon J |
An audit cycle reviewing the offer of HIV testing
Objectives To determine if the offer of an HIV test at a community sexual health clinic adhered to national guidelines (Offer of HIV testing 97% BASHH). In the first audit cycle (October 2014) the offer of an HIV test (84%) failed to comply with national guidelines. In addition, the uptake of HIV testing..
| Published: | 26/10/2016 |
| Authors: | Botchey SA, |
An audit reviewing Intrauterine contraceptive fitting
Objectives To ensure that contraceptive fitting at a community sexual health clinic meets the auditable standards suggested by the FSRH clinical standards committee. Standards (FSRH clinical standards committee auditable outcomes) (1) The proportion of sexually active women offered sexually transmitted infection screening requesting intrauterine contraception (IUC). [Auditable standard 97%] (2) The proportion of..
| Published: | 10/10/2016 |
| Authors: | , Annuar N, Botchey SA |
The importance of frailty
Introduction Demand for Critical Care (CC) is increasing but admission may be inappropriate if the patient is unlikely to survive. Consequently, published guidance may no longer reflect current practice [1-2]. Clinical frailty evaluation scores have recently been shown to be associated with increased mortality in patients already admitted to CC [3]...
| Published: | 10/10/2016 |
| Authors: | Tridente A |
Gastroschisis: Overview of epidemiology and management trends
Introduction A rise in incidence of gastroschisis has been reported. We investigated the incidence in our unit. Methods In a retrospective series; maternal case notes of all gastroschisis patients diagnosed in utero at a single NHS centre over a 6-year period were reviewed (n = 14). Results Gastroschisis was diagnosed in 14 fetuses,..
| Published: | 07/10/2016 |
| Authors: | Pankaja S |
Communication within an intensive care setting
Introduction The ability to communicate well with patients and their relatives is a fundamental clinical skill in intensive care medicine and central to good medical practice. Communication at the bedside, even when the patient is unconscious or sedated, may often be recalled by critical care survivors and can impact upon..
| Published: | 07/10/2016 |
| Authors: | , Fuller A |
Correctly diagnosing death
Introduction Around 50% of deaths in the UK occur in hospital, giving a total of around 250 000 in 2013 [1]. The responsibility of confirmation and documentation of these deaths rests across all specialties of hospital doctor. The Academy of Medical Royal Colleges (AMRC) released a consensus guideline in 2008 aiming to standardise this process [2]. Guidance..
| Published: | 07/10/2016 |
| Authors: | Webber A, , |
Infusion medication concentrations in UK’s critical care areas
Abstract Following two studies done in 2007 and 2009, a follow-up of the adherence to the suggested guidelines on drug standardisation has been performed with a suggestion for future standards that can be achieved, to complement the recently published Carter report. The Intensive Care Society (ICS) introduced recommendations for infusion concentrations of 16..
| Published: | 06/09/2016 |
| Authors: | Barton G |
Admission to critical care
Introduction Critical Care (CC) services are in increasing demand but published guidance for triaging admissions may no longer reflect current practice [1-2]. Exercise tolerance and clinical frailty assessment may have a role in assessing patients (pts) referred to CC [3]. We aimed to establish the impact of frailty and other factors..
| Published: | 16/08/2016 |
| Authors: | Bolton N, , England L, Feeney J, Tridente A, Wilkinson K |
Platelet function analysis utilising the PFA-100
Introduction Sepsis is known to be associated with impaired platelet function (1). The PFA-100 (Siemens Healthcare, Dade International, Miami, Fla., USA) is a device in which a citrated whole blood sample is aspirated through an aperture coated with agonists inducing platelet activation. Platelet aggregation leads to occlusion of the aperture and..
| Published: | 16/08/2016 |
| Authors: | Bolton N, , Bonney S, Tridente A, Nee PA |
Reduction in tidal volumes for ventilated patients
Introductions Over 60 % of patients admitted to an Intensive Care Unit (ICU) will require Endotracheal Tube (ETT) intubation and mechanical ventilation. The aim was to perform an audit of ventilation regimes in critically ill patients admitted to Whiston Hospital. Its main objectives were to evaluate the current management of ventilated patients..
| Published: | 10/08/2016 |
| Authors: | Fuller A, |
The impact of Karnofsky performance scale
Introductions Karnofsky performance scale (KPS) [1] is being widely to describe patients’ functional status. Correlation between poor functional levels and adverse outcomes has been found. KPS is used in decision making surrounding starting aggressive therapy. We evaluated the impact of KPS on long term renal & patient survival in AKI patients, receiving ..
| Published: | 10/08/2016 |
| Authors: | Tridente A |
Comparison of mortality scores
Introduction Burn injuries are amongst the most severe physical and psychological insults a patient can experience and morbidity is extensive with variable mortality. Studies have repeatedly confirmed factors associated with high mortality, which include increasing age, extent of burn and presence or absence of inhalational injury. Predicting mortality from burns..
| Published: | 10/08/2016 |
| Authors: | Howarth O, Davenport K, , Raftery S |
Outcomes of patients
Introduction Palliative oncology patients are admitted to critical care not uncommonly, outcomes are variable and often difficult to predict. We sought to observe Intensive care unit (ICU) and hospital outcomes of palliative oncology patients, in relation to demographic, disease and organ failure criteria. Methods Retrospective review of the electronic database..
| Published: | 09/08/2016 |
| Authors: | Tridente A |
Emotion sharing: implications for trainee doctor well-being
Farley, S; Manger, J. (2016). Emotion sharing: implications for trainee doctor well-being . Medical Education. 50 (8), 798-800.
| Published: | 25/07/2016 |
| Authors: | Manger J |
Combined infection training
Abstract This commentary discusses the recent pioneering overhaul of training for UK doctors wishing to pursue a career in the infection specialities. Changes include the introduction of new curricula that embrace increased collaboration between the laboratory-based and clinical specialties and a broad-based infection training period, named ‘Combined Infection Training’, which..
| Published: | 25/07/2016 |
| Authors: | Sunny S |
Book Review: Review of Plastic Surgery
Touil, L; Shokrollahi, K. (2016). Book Review: Review of Plastic Surgery . Annals of Plastic Surgery. 77 (2), 140.
| Published: | 25/07/2016 |
| Authors: | Touil L, Shokrollahi K |
Defining the Role of Secondary Intention Healing in Full-Thickness Lid Margin Defects
Abstract More than 30 years have passed since the first case series was published regarding the phenomenon of secondary intention healing in relation to lid margin defects. Despite the fascinating results, the technique has not gained widespread support. This study looks at a series of 34 marginal lower lid defects allowed to..
| Published: | 21/07/2016 |
| Authors: | Morton J |
Use of Video Laryngoscopy forRapid Sequence Induction
Excerpt Video laryngoscopy (VL) is a novel method of achieving endotracheal intubation and there is evidence to show that visualistation of larynx can be improved using VL for rapid sequence induction (RSI). Ahmad, H; Jahan, S; Yusaf, M; Aseri, S. (2016). Use of Video Laryngoscopy for Rapid Sequence Induction . Journal of..
| Published: | 21/07/2016 |
| Authors: | Aseri S |
Early Detection of Epidemic GII-4 Norovirus Strains
Abstract Noroviruses are endemic in the human population, and are recognised as a leading cause of acute gastroenteritis worldwide. Although they are a highly diverse group of viruses, genogroup-II genotype-4 (GII-4) noroviruses are the most frequently identified strains worldwide. The predominance of GII-4 norovirus strains is driven by the periodic..
| Published: | 19/07/2016 |
| Authors: | Trainor E |
Critical care in the emergency department: acute kidney injury
Abstract Acute kidney injury (AKI) is common among emergency department patients admitted to hospital. There is evidence of inadequate management of the condition leading to adverse outcomes. We present an illustrative case of AKI complicating a gastrointestinal disorder in an older adult. We discuss the clinical presentation, assessment and management..
| Published: | 19/07/2016 |
| Authors: | Bailey DJ, Nee PA, , Todd V |
Tolvaptan for Heart Failure
Abstract The vasopressin type 2 receptor antagonist tolvaptan (TLV) is available to treat congestion in patients with heart failure (HF). However, there is paucity of evidence guiding its use, and lack of evidence of its long term efficacy. Our objectives are to perform a systematic review of studies examining tolvaptan's effects..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Diabetic kidney disease in routine clinical care
Aim To examine the impact of service re-design on management and 10-year outcomes in diabetic kidney disease in a real world setting. Methods We established a highly structured, nurse-led diabetic kidney clinic to deliver consistent evidence-based care processes (blood pressure control (BP), glycaemic control (HbA1c), renin-angiotensin-aldosterone (RAAS) blockade, lipid-lowering..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ, O'Brien S |
Absence of Flexor Carpi Radialis
Purpose We present an extremely rare anatomical variation of unilateral flexor carpi radialis (FCR) absence. This rare anatomical variation posed a clinical dilemma to us and we highlight the importance of the surgeon being aware of this anatomical variation of an important structure both as a reconstruction tool and as..
| Published: | 19/07/2016 |
| Authors: | Sofos S |
Reintubation following planned extubation
Introduction Studies indicate reintubation rates following planned extubation to be between 10-20% in the general ICU population. There is evidence that extubation failure and reintubation can worsen outcome, with studies suggesting ICU mortality rates of between 25-50% in these patients. Objectives To establish how our failed extubation rate and subsequent..
| Published: | 19/07/2016 |
| Authors: | Whitmore D, Mahambrey T |
Peri- and post-operative management of the “high-risk” surgical patient
Introduction In 2011, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published a report, “Knowing the Risk,” [1] which reviewed data regarding peri-operative management of the high risk surgical population and subsequently produced recommendations in aim to improve outcomes in this patient population. Of particular focus, recommendations included; clear documentation..
| Published: | 19/07/2016 |
| Authors: | Bridge L, Winslow L |
Obstructive uropathy secondary to bilateral ureteroinguinoscrotal herniation
O, Feyisetan; Floyd, MS Jr, Samsudin, A. (2016). Obstructive uropathy secondary to bilateral ureteroinguinoscrotal herniation . International Brazilian journal of urology. 42 (3), 621-622.
| Published: | 19/07/2016 |
| Authors: | Feyisetan O, Floyd Jr MS, Samsudin A |
Recurrent life-threatening haemoptysis
Abstract A bleeding vertebral artery pseudoaneurysm is a rare cause of haemoptysis. Pseudoaneurysm can arise due to radionecrosis from previous radiotherapy in the base of skull and neck region and may present with haemoptysis many years later. It is important to be aware of this entity in the work-up of..
| Published: | 19/07/2016 |
| Authors: | Hartley JL |
Skin involvement in Dupuytren's disease
Oskrochi, Y; El-Gawad, A. (2016). Re: Wade R, Igali L and Figus A. Skin involvement in Dupuytren's disease The Journal of Hand Surgery (European Volume). 41 (6), 667-668
| Published: | 19/07/2016 |
| Authors: | El-Gawad A |
Tips and tricks of ureteroscopy - Part I
Abstract Ureteroscopy is fast becoming the first line treatment option for the majority of urinary tract stones. Ureteroscopy training can be performed in a variety of ways including simulation, hands on ureteroscopy courses and supervised operative experience. We report an “expert consensus view” from experienced endourological surgeons, on all aspects..
| Published: | 19/07/2016 |
| Authors: | Samsudin A |
An unusual presentation of a vesicouterine fistula
Abstract A 26-year-old female presented with a history of cyclical incontinence following a ventouse assisted delivery. Initial investigations revealed an endometrial deposit in her bladder, which following further investigations revealed a vesicouterine fistula necessitating formal open repair. Floyd, MS; Abbas, G; Connolly, S; Gana, HB; McCabe JE. (2016). An unusual presentation..
| Published: | 19/07/2016 |
| Authors: | Floyd Jr MS, Connolly S, Gana HB, McCabe JE |
A full time regional ortho-plastic unit; initial results
Sargazi, N; El-Gawad, A; Narayan, B; Bell, D; Shanks, L; Nayagam, S; Graham K. (2015). A full time regional ortho-plastic unit; initial results . Journal of plastic, reconstructive & Aesthetic surgery: JPRAS. Published online 31st December
| Published: | 19/07/2016 |
| Authors: | Bell D, Graham K |
The Introduction of Standard Operating Procedures
Abstract United Kingdom (UK) burn units face substantial new obstacles in delivering high quality care because of the advent of full-shift working patterns, cross-specialty cover arrangements, and increased trainee turnover. Junior trainees rely heavily on senior colleagues, who may not be readily accessible. The authors therefore proposed the introduction of..
| Published: | 19/07/2016 |
| Authors: | Lymperopoulos NS, Wilkinson D, Shokrollahi K |
UK service level audit of insulin pump therapy
Aim To conduct an audit of insulin pump therapy in the UK after the issue of guidelines for the use of continuous subcutaneous insulin infusion by NICE in 2008 (Technology Appraisal 151). Methods All centres in the UK, providing pump services to children and young people were invited to participate in an..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ |
The Discrete Scar in Prominent Ear Correction
Introduction Various postauricular incision sites can be used for prominent ear correction depending on technique and surgeon preference. No study has previously looked at the most aesthetic (least visible) location for the postauricular scar. We investigated the visibility of various scar locations on the posterior ear from a third person..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K, Javed M |
Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes
Objective First-degree atrioventricular block is frequently encountered in clinical practice and is generally considered a benign process. However, there is emerging evidence that prolonged PR interval may be associated with adverse outcomes. This study aims to determine if prolonged PR interval is associated with adverse cardiovascular outcomes and mortality. Methods ..
| Published: | 19/07/2016 |
| Authors: | Rashid M |
The prominent antihelix and helix
Background Classic teaching of ear anatomy in the context of otoplasty states that if the antihelical fold is more prominent than the helical fold after surgery then the ear is “overcorrected.” We set out to explore the role of the antihelix in normal ear anatomy, its relevance to aesthetic perceptions..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Ovarian hilar proliferations
Aims To describe four cases of incidentally detected microscopic ovarian hilar Sertoli cell proliferation, a phenomenon that, as far as we are aware, has not been previously reported, and to discuss the differential diagnosis of these lesions. Methods and results The proliferations occurred in women aged 35–62 years, and were composed..
| Published: | 19/07/2016 |
| Authors: | Hasan NU |
Book Review: Practical Skin Surgery
Yao, S. (2016). Book Review: Practical Skin Surgery . Annals of Plastic Surgery. 76 (3), 262.
| Published: | 19/07/2016 |
| Authors: | Yao S |
Book Review: Hair Restoration, An Issue of Facial Plastic Surgery Clinics of North America
Jordan, DJ; Shokrollahi, K. (2016). Book Review: Hair Restoration, An Issue of Facial Plastic Surgery Clinics of North America . Annals of Plastic Surgery. 76 (4), 370
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Validation of a classification system
OBJECTIVE Trials in critical care have previously used unvalidated systems to classify cause of death. We aimed to provide initial validation of a method to classify cause of death in intensive care unit patients. DESIGN, SETTING AND PARTICIPANTS One hundred case scenarios of patients who died in an ICU were..
| Published: | 19/07/2016 |
| Authors: | McCairn AJ, Mahambrey T |
Assessment of diabetes knowledge
Abstract In the UK, approximately 12–25% of all hospital inpatients have diabetes, although most are admitted for other health problems. People with diabetes often have a prolonged hospital stay compared to people without the condition, often as a result of suboptimal inpatient management of their diabetes. During in-depth interviews conducted in..
| Published: | 19/07/2016 |
| Authors: | Cardwell J, Hardy KJ |
P211 Impact of door-to-radiograph time on pneumonia management
Introduction Pneumonia continues to be associated with significant mortality.1 The diagnostic gold standard remains the Chest X-Ray (CXR). Quality indicators such as door-to-antibiotic or door-to-radiograph time are monitored as surrogate outcome measures. Objective To assess the impact of CXR availability at first clinician contact in cases where initial antibiotics were..
| Published: | 19/07/2016 |
| Authors: | Varia R, Ashton A |
Assessing the diagnostic accuracy
Background The British Thoracic Society guidelines (2015) on the investigation and management of pulmonary nodules recommend the use of two risk prediction tools to assess the likelihood of malignancy in solid pulmonary nodules (Brock model following initial CT and the model described by Herder et al. following PET-CT). Management strategies are..
| Published: | 19/07/2016 |
| Authors: | Malhotra P |
P244 The impact of “Seven Day working”
Abstract St Helens and Knowsley NHS trust (STHK) have re designed the acute pathway for medical admissions. Investment in Consultant numbers has allowed the Acute Medical Admissions (MAU) team and the speciality teams to provide robust Consultant input to their areas Monday to Sunday. Speciality Consultants have been released from..
| Published: | 19/07/2016 |
| Authors: | Twite S, Stockton P, Malhotra P |
Long term outcomes in acute kidney injury patients
Introduction and Aims Acute kidney injury (AKI) affects 40% of critically ill patients with UK data reporting 5% needing renal replacement therapy (RRT). Hospital mortality is reported as being up to 60%. We sought to evaluate renal and long term patient survival outcomes in AKI patients receiving RRT on our ICU. Methods..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Obstructive Azoospermia
Extract A 25-year old male presented with primary infertility. He and his partner had been trying to conceive for over 12 months despite normal gynecological investigations. There was no history of chronic respiratory disease, infections, sexual dysfunction, genetic abnormalities, trauma or illicit substance use. Secondary sexual characteristics were normal. Physical examination..
| Published: | 19/07/2016 |
| Authors: | Floyd Jr MS, Connolly S, Gana HB |
Cash direct: Increasing patient choice and access to LARC
Background/introduction Busy lifestyles and women’s continued need and desire for reliable methods of contraception, has led to the development of ‘CaSH Direct’ which offers LARC assessments and procedures at times that are convenient to women but without the need for multiple visits to. Aim(s)/objectives CaSH Direct..
| Published: | 19/07/2016 |
| Authors: | Marshall J, Taylor A |
P118. Improving breast services – It's in the DNA
Introduction All breast referrals must be seen within 2 weeks. The sheer volume of referrals from primary care makes this a challenging target to achieve. It is therefore extremely important that clinics are utilised appropriately and that every effort is taken to minimise non-attendance. Current hospital policy is to re-appoint all..
| Published: | 19/07/2016 |
| Authors: | Chagla LS |
A two nipple technique
Abstract We describe a novel approach to reconstruction of the superiorly placed hypoplastic nipple areola complex (NAC) with the aim of retaining sensation of the nipple and avoiding scars on the upper pole of the breast. We used this novel approach for a 38 year old lady with right sided Poland..
| Published: | 19/07/2016 |
| Authors: | Koshy O, Veliky M |
Acute Urinary Retention in a Female
Extract 56 years old female smoker presented with recurrent urinary tract infections but no hematuria. Pelvic exam revealed an indurated area on the anterior vaginal wall. Magnetic resonance imaging (MRI) revealed a suspicious area around the urethra which was thought to be tumor extension from a bladder cancer. Rigid cystoscopy demonstrated..
| Published: | 19/07/2016 |
| Authors: | , Floyd Jr MS, Khattak AQ |
Unexpected medical undergraduate simulation training (UMUST)
Background Preparing medical students with the skills necessary to deal with emergency situations as junior doctors can be challenging due to the complexities of creating authentic ‘real life’ experiences in artificial environments. The following paper is an evaluation of the UMUST (Unexpected Medical Undergraduate Simulation Training) project; a high-fidelity simulation..
| Published: | 19/07/2016 |
| Authors: | Bennett N |
Tips and tricks of ureteroscopy - Part II
Abstract Our “tips and tricks” focuses on all aspects of upper tract endourology and we hope these will be of use to all trainees and consultants who perform ureteroscopy. We report an “expert consensus view” from experienced endourological surgeons, on all aspects of advanced ureteroscopic techniques, with a particular focus..
| Published: | 19/07/2016 |
| Authors: | Samsudin A |
Youssef’s syndrome
Floyd, MS; Gana, HBY; McCabe, JE. (2016). Letter to the editor re: ‘Youssef’s syndrome: should MRI be the first line investigation?’ . Journal of Clinical Urology. 9 (2), 135-136
| Published: | 19/07/2016 |
| Authors: | Floyd Jr MS, Gana HB, McCabe JE |
Hypofractionated radiotherapy versus conventionally fractionated radiotherapy
Background Patient-reported outcomes (PROs) might detect more toxic effects of radiotherapy than do clinician-reported outcomes. We did a quality of life (QoL) substudy to assess PROs up to 24 months after conventionally fractionated or hypofractionated radiotherapy in the Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer (CHHiP) trial...
| Published: | 19/07/2016 |
| Authors: | Malik Z |
Impact of the introduction of National Institute for Health and Care Excellence (NICE) guideline NG3
Aims NICE updated its guidance on diabetes in pregnancy in February 2015. The changes included recommending cut-off values for diagnosing gestational diabetes (GDM) and lowering the target pre-prandial glucose levels from
| Published: | 19/07/2016 |
| Authors: | Bujawansa S, McNulty S, Wilkinson P, Michaels S, Pankaja S |
Microbiological spectrum of clinically infected foot ulcers
Aims Infection is common in diabetes foot ulcers and early judicious use of antibiotics is important to reduce complications. The choice of initial antibiotic should be based on local microbiological flora. The aim of this study was to determine the microbiological spectrum of clinically infected foot ulcers in patients with..
| Published: | 19/07/2016 |
| Authors: | Ball R |
Vasopressin, steroids and epinephrine
The use of vasopressin and steroids in addition to epinephrine during the resuscitation of patients suffering an in-hospital cardiac arrest is associated with an improved neurological outcome. Rehnberg, J.V.; Nee, P. (2015). Vasopressin, steroids and epinephrine and neurologically favourable survival after in-hospital cardiac arrest . Journal of the Intensive Care Society. 16 (1), 77..
| Published: | 19/07/2016 |
| Authors: | Nee PA |
Pharmacokinetic considerations and dosing strategies of antibiotics
Abstract The treatment of sepsis remains a significant challenge and is the cause of high mortality and morbidity. The pathophysiological alterations that are associated with sepsis can complicate drug dosing. Critical care patients often have capillary leak, increased cardiac output and altered protein levels which can have profound effects on..
| Published: | 19/07/2016 |
| Authors: | Barton G |
Evaluating an alternating mattress on an elderly rehabilitation ward
Abstract Pressure ulcer prevention is a primary requirement for the NHS. Robust nursing procedures and the provision of pressure-relieving equipment is vital in meeting this requirement. However, the Department of Health also regards making considerable financial savings as a fundamental requirement. There is a firm clinical consensus among national and..
| Published: | 19/07/2016 |
| Authors: | Gleeson D |
International genome-wide meta-analysis
Abstract Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We..
| Published: | 19/07/2016 |
| Authors: | McLindon J |
Flap or graft: The best of both in nasal ala reconstruction
Summary The area of the nose immediately medial to the nasofacial groove is a common site for relatively small but penetrating basal cell carcinomas (BCCs). Although larger lesions may necessitate formal subunit reconstruction, smaller lesions pose a considerable dilemma. Full-thickness skin grafts (FTSGs) often result in an unsightly contour defect...
| Published: | 19/07/2016 |
| Authors: | Morton J |
The UK plastic surgery sentinel lymph node biopsy service
Abstract It has been well established that the incidence of melanoma in the UK continues to rise, and that earlier detection leads to overall improved survival. Amongst several prognostic features, primary tumour thickness and regional lymph node status are accepted as the most important.1 Since it was first introduced in 1990..
| Published: | 19/07/2016 |
| Authors: | Brackley P, Yao S |
Low-resolution CT attenuation correction images
Objective To review new incidental findings detected on low-resolution CT attenuation correction (CTAC) images acquired during single-photon emission CT-CT myocardial perfusion imaging as an extension to our initial study. Methods CTAC images acquired as part of myocardial perfusion imaging performed using single-photon emission CT at four UK nuclear medicine centres..
| Published: | 19/07/2016 |
| Authors: | Howes A |
Urinary proteomic profiling in severe obesity
Introduction Obstructive sleep apnoea (OSA) is common in obesity and is associated with cardiovascular and metabolic complications. Continuous positive airway pressure (CPAP) in OSA may lead to physiological changes reflected in the urinary proteome. The aim of this study was to characterise the urinary proteome in severely obese adult subjects..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Comparison of the reconstruction trochanteric antigrade nail (TAN)
Abstract Reverse oblique intertrochanteric fractures have unique mechanical characteristics and are often treated with intramedullary implants. We compared the outcomes of the reconstruction trochanteric antegrade nail (TAN) with the proximal femoral nail antirotation (PFNA). Between July 2008 and February 2014, we reviewed all patients with reverse oblique intertrochanteric fractures treated at our..
| Published: | 19/07/2016 |
| Authors: | Matar HE, Lipscombe. S, Gudena R |
Primary cutaneous myxoid spindle cell squamous cell carcinoma
Summary A 72-year-old woman presented to the plastic surgery outpatient department with a nodular lesion to her shin. This nodule had increased in size, but was slow growing. The patient had a history of sun-damaged skin. On visual examination, the lesion was thought to be a naevus or basal cell..
| Published: | 19/07/2016 |
| Authors: | Khan I |
Preparedness and training in staff responding to a burns disaster
Abstract Effective disaster response is preceded by effective disaster planning, and insufficient staff training has been identified as a problem in the preparation of hospitals for major incidents. Despite this, little is known about the exact levels of training doctors and nurses responding to a disaster receive. The authors conducted..
| Published: | 19/07/2016 |
| Authors: | May J |
Improving rehabilitation after critical illness
Purpose Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. Materials..
| Published: | 19/07/2016 |
| Authors: | Jones C, McCairn AJ |
Proximal femur giant solitary plasmacytoma of bone: lessons learnt
Solitary skeletal Plasmacytoma is a malignant plasma cell tumour that accounts for 3–5% of all monoclonal gammopathies. It presents as a single lytic lesion with clonal plasma cells in the vertebrae, ribs or pelvis, with low or no serum or urine M-protein. Bone marrow is not consistent with multiple myeloma, however,..
| Published: | 19/07/2016 |
| Authors: | Matar HE, Gudena R |
Managing acute severe ulcerative colitis in the hosptialised setting
Abstract Ulcerative colitis affects approximately 146 000 people in the UK and is the most common form of inflammatory bowel disease. The majority of patients will have uncomplicated disease, but around 1 in 10 patients will develop acute severe colitis. Despite modern medical management, colectomy rates of 27% and mortality rates of 1% are still reported...
| Published: | 19/07/2016 |
| Authors: | McClements D |
Pilot study of video assisted anal fistula treatment
Abstract Introduction Video-assisted anal fistula treatment (VAAFT) is a minimally invasive, sphincter-preserving procedure with low morbidity. It was the aim of this prospective study to analyse both the feasibility and preliminary results of video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair for anal fistula. Method The procedure involves..
| Published: | 19/07/2016 |
| Authors: | Ormsby N, Rajaganeshan R |
PTU-233 Transanal haemorrhoidal dearterialization (THD) and targeted mucopexy for haemorrhoids
Introduction This study aims to evaluate the efficacy of transanal haemorrhoidal dearterialization and Mucopexy (THD+Mpx) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid-term outcome. Method Two hundred and fifteen patients affected by Grade II (27, 13%), III (145, 69%) and IV (39, 18%) symptomatic haemorrhoidal disease..
| Published: | 19/07/2016 |
| Authors: | Ormsby N, Singh S, Chadwick M, Scott M, Samad A, Rajaganeshan R |
PTH-306 R1 rectal cancer: an analysis of survival
Introduction Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes of patients with R1 resection of rectal cancer. Method Retrospective study of all patients..
| Published: | 19/07/2016 |
| Authors: | Ormsby N, Chadwick M, Samad A, Scott M, Rajaganeshan R |
PWE-410 Initial UK experience with transversus abdominus muscle release
Introduction Large complicated ventral hernias are an increasingly common problem following laparotomy and particularly laparostomy. Moreover, they are often seen in patients with significant co-morbidities who may have or need to have stomas. Repair with bridging is associated with high recurrence rates and makes surgical risk unattractive. The transversus abdominis..
| Published: | 19/07/2016 |
| Authors: | Scott M |
PWE-336 Outcomes of colorectal cancer resections in patients with multiple co-morbidities and advanced tumours
Introduction Comorbid patients with advanced tumours constitute a rapidly growing segment of patients undergoing colorectal cancer resection, but their outcomes remain understudied and under-reported. Our aims were to analyse outcomes of high risk patients with advanced tumours undergoing curative colorectal resections compared with a similar cohort 2 decades younger. Method Data..
| Published: | 19/07/2016 |
| Authors: | Garry J, Ormsby N, Scott M, Samad A, Rajaganeshan R |
PWE-374 Is ct colonoscopy ready for prime time as first line investigation for high risk patients?
Introduction With CT virtual colonoscopy (CTVC) emerging as a widely available sensitive tool in the investigation of GI pathology, we changed our practice, and are now investigating patients presenting in our “one stop – 2 week rule” gastroenterology clinic with lower GI symptoms with a flexible sigmoidoscopy followed by a CTVC on..
| Published: | 19/07/2016 |
| Authors: | Bennett B, Bassi A |
EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma
Purpose Sentinel lymph node biopsy is an essential staging tool in patients with clinically localized melanoma. The harvesting of a sentinel lymph node entails a sequence of procedures with participation of specialists in nuclear medicine, radiology, surgery and pathology. The aim of this document is to provide guidelines for nuclear..
| Published: | 19/07/2016 |
| Authors: | May J |
Clearing the field: A novel device to assist microsurgeons
Abstract We describe an innovative technique which uses a synergistic approach to maintain a static, clear and dry field and allow the optimal microsurgical repair of neurovascular structures. Jordan, DJ; Jeevan, R; Koshy, O. (2015). Clearing the field: A novel device to assist microsurgeons . Journal of plastic, reconstructive & aesthetic surgery: JPRAS. 68 (12), 1766..
| Published: | 19/07/2016 |
| Authors: | Koshy O |
The implementation of a blood conservation strategy
Introduction Patients admitted to intensive care units (ICUs) are commonly affected by anaemia, which is contributed to by iatrogenic blood loss from diagnostic testing, with potential risks of increasing transfusion requirements and negative effect on outcomes. Recently published guidelines make several recommendations for the management of anaemia and red..
| Published: | 19/07/2016 |
| Authors: | Tridente A, Bonney S, Nee PA |
The FICE course and qualification - experience from the Cheshire and Merseyside group
Introduction The utility of echocardiography for assessing the critically ill patient has long been recognised. The Focused Intensive Care Echocardiography (FICE) training pathway is endorsed by the Intensive Care Society of the UK. Candidates attend a full day course consisting of lectures and practical sessions. Subsequently, every candidate is required..
| Published: | 19/07/2016 |
| Authors: | Bolton N, Rogers G, Booker K, Mohammed A, Mahendran V, Tridente A |
A master stroke or recipe for heartache?
Background Intra-operative fluid management technologies (FMT) have been identified as a high impact intervention by the Department of Health. This is due to savings from reduced complication rates, improved utilisation of critical care resources and reduced length of stay for patients undergoing major procedures when FMT are used. The trust..
| Published: | 19/07/2016 |
| Authors: | Hughes E, Yoxall PF, Waits R |
Effect of CPAP on arterial stiffness
Background Obstructive sleep apnoea (OSA) may independently increase cardiovascular risk in obesity. Although there is evidence that arterial stiffness is altered in OSA, knowledge of these effects with continuous positive airway pressure (CPAP) in severe obesity (body mass index (BMI) ≥ 35 kg/m2) is limited. This study aimed to explore how..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Localization techniques for guided surgical excision of non-palpable breast lesions
Background Breast cancer is the most common form of cancer and the second leading cause of death amongst women in Europe. Amongst five invasive cancers per 1000 women detected in screening, 2.7 were < 15 mm in diameter; and others reported that over one third of excised breast lesions were clinically occult. The challenge..
| Published: | 19/07/2016 |
| Authors: | Jois RHS, |
Efficacy and Safety of a Biweekly Viscosupplementation Regimen
Abstract Osteoarthritis is the most common form of arthritis in the Western world, causing disabling symptoms in 10% of people older than 55 years. Hyaluronic acid injections can reduce osteoarthritic pain but require three to five doses administered weekly. This preliminary study aims to assess the efficacy of a more flexible viscosupplementation..
| Published: | 19/07/2016 |
| Authors: | Munir U, Teanby D |
Postoperative shoulder function
Abstract Reported complications of neck dissection surgery have included decreases in shoulder muscle power and range of motion, drooping shoulder, and shoulder pain. We conducted a cross-sectional study to assess postoperative shoulder function following three different types of neck dissection surgery that were performed at Aga Khan University Hospital and..
| Published: | 19/07/2016 |
| Authors: |
Challenging ipsilateral hip and segmental diaphyseal femur fractures
Description Patients with hip fractures very rarely have hip osteoarthritis (OA), with published data suggesting an inverse relationship between hip fractures and hip OA. In fact, hip OA is found to be protective against intracapsular fractures but increases the risk for extracapsular fractures. This is related, in part, to the..
| Published: | 19/07/2016 |
| Authors: | Matar HE, El-Hosh S, Attar FG |
Book Review: An issue of Clinics in Plastic Surgery
Jordan, D. (2015). Book Review: An issue of Clinics in Plastic Surgery April 2014 . Annals of Plastic Surgery. 74 (5), p519
| Published: | 19/07/2016 |
| Authors: |
Axillary lymph node dissection
Page, F; Nelson, K; et al. (2015). Axillary lymph node dissection: Do you know your boundaries? Journal of Plastic, Reconstructive and Aesthetic Surgery. 68 (4), p597-599
| Published: | 19/07/2016 |
| Authors: | Nelson K |
Discrete Scar in Prominent Ear Correction
Introduction Various postauricular incision sites can be used for prominent ear correction depending on technique and surgeon preference. No study has previously looked at the most aesthetic (least visible) location for the postauricular scar. We investigated the visibility of various scar locations on the posterior ear from a third person..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Bladder reconstruction: The past, present and future (review)
Abstract Ileal conduit urinary diversion is the gold standard treatment for urinary tract reconstruction following cystectomy. This procedure uses gastrointestinal segments for bladder augmentation, a technique that is often associated with significant complications. The substantial progression in the fields of tissue engineering and regenerative medicine over the previous two decades..
| Published: | 19/07/2016 |
| Authors: | Khattak AQ |
Diabetes education through adult learning
Abstract Patient education is acknowledged to be the cornerstone of effective self-management in people with chronic conditions such as diabetes. While the effects of patient education in terms of biophysical endpoints such as HbA1c are well studied, its effects on quality of life (QOL) and other non-biophysical outcomes are..
| Published: | 19/07/2016 |
| Authors: | Cardwell J, Hardy KJ, O'Brien S |
Peripheral T-cell lymphoma
Abstract A 70-year-old Caucasian gentleman presented with a four-month history of a rapidly enlarging skin tumor on his right lower abdomen, episodes of night sweats and generalized pruritus. No other relevant medical or drug history was found. Clinical examination revealed a large 16 by 13 centimeters fungating tumor on his right lower..
| Published: | 19/07/2016 |
| Authors: | Sharma N, Tappin J, Ngan K |
Lichen planus pigmentosus-inversus
Abstract A 50-year-old Caucasian woman presented with a four-month history of asymptomatic, linear hyperpigmentation along the skin creases on the left side of her neck, right axilla and groins. No preceding trigger factor was reported and she had no relevant medical or drug history. Clinical examination revealed multiple, well-demarcated hyperpigmented..
| Published: | 19/07/2016 |
| Authors: | Ngan K, Sharma N |
Management of extensive facial burns
Abstract Perioral facial burns have a high propensity to formation of microstomia and numerous prosthetic devices have been described that can be used postoperatively to address this problem. We introduce a novel device, the Whiston Buccal Prosthesis, which is used intraoperatively and in the early postoperative period and it acts..
| Published: | 19/07/2016 |
| Authors: | , Shokrollahi K, Sofos S, Tehrani H, |
Multiple foreign bodies of long duration in adult vagina
Introduction Foreign bodies of long duration are not unusual in adult vagina. Several published in literature involve children, especially pre-pubertal girls often related to curiosity. Variety of objects have been retrieved ranging from tampons, sex toys, forgotten pessaries, pens, pencil tops, bottles, aerosol caps, fruits, vegetables and packets containing illicit..
| Published: | 19/07/2016 |
| Authors: | Dhannapuneni JS, , Srivastava N |
Haultain's procedure
Introduction Acute uterine inversion is rare but life threatening emergency in the third stage of labour. Prompt recognition and immediate management is the key to saving the patient's life. Traditional management options involve immediate manual replacement with or without hydrostatic pressure. When unsuccessful, surgical correction using Huntington and Haultain's procedures..
| Published: | 19/07/2016 |
| Authors: | Amma JS, Morgan PR, Dhannapuneni JS |
Opsoclonus-myoclonus syndrome
Introduction Opsoclonus-myoclonus syndrome is a rare autoimmune syndrome usually seen in children and very rarely in adults. It typically presents with a triad of opsoclonus, myoclonus and ataxia, and is most often associated with a tumor or after an infection or vaccination. Around half of all adult cases are paraneoplastic..
| Published: | 19/07/2016 |
| Authors: | Forsyth L |
Peri-operative practice in knee arthroscopy
Abstract Knee arthroscopy is one of the commonest elective day case orthopaedic procedures performed worldwide. The incidence of this procedure is 9.9 per 10,000 in England [1]. Day surgery of such a high volume usually has a highly standardized regime of care, however a survey of Swedish and German Orthopaedic surgeons on knee..
| Published: | 19/07/2016 |
| Authors: | Pydisetty R |
Neutrophil to lymphocyte count ratio
Objectives Early identification of patients with blood stream infection (BSI), especially bacteraemia, is important as prompt treatment improves outcome. The initial stages of severe infection may be characterised by increased numbers of neutrophils in the peripheral blood and depression of the lymphocyte count (LC). The neutrophil to LC ratio (NLCR)..
| Published: | 19/07/2016 |
| Authors: | Nee PA, Vardhan M |
Reconstructive outcomes of Mohs surgery compared with convention
Abstract Established in 2012, the Mersey Regional Centre for Mohs Surgery is the first UK Mohs service to be led by a Mohs trained Plastic & Reconstructive surgeon. We evaluate the resection requirements and reconstructive techniques of our patient group and compare their surgical outcome to that which would have been gained..
| Published: | 19/07/2016 |
| Authors: | Wain R, Tehrani H |
A Novel Cadaveric Simulation Program in Urology
Objective To evaluate the urology human cadaver training program developed by the British Association of Urological Surgeons. Design This prospective, observational comparative study recruited urology residents, with different levels of experience, in 2 sessions of a 3-day modular cadaveric operative urology training. Participants performed various procedures on fresh-frozen cadaveric specimens, as..
| Published: | 19/07/2016 |
| Authors: | McCabe JE |
Hemiarthroplasty for Hallux Rigidus
Abstract Hallux rigidus is a progressive osteoarthritic condition affecting the first metatarsophalangeal joint that causes pain and stiffness, with a marked reduction in dorsiflexion. Joint arthrodesis has previously been the standard treatment of hallux rigidus; however, new surgical techniques have evolved and first metatarsophalangeal joint hemiarthroplasty is now a viable..
| Published: | 19/07/2016 |
| Authors: | Gheorghiu D, Ballester J |
Risk of malignancy in pulmonary nodules
Objectives Clinical prediction models assess the likelihood of malignancy in pulmonary nodules detected by computed tomography (CT). This study aimed to validate four such models in a UK population of patients with pulmonary nodules. Three models used clinical and CT characteristics to predict risk (Mayo Clinic, Veterans Association, Brock University)..
| Published: | 19/07/2016 |
| Authors: | Malhotra P |
Treatment of keloid scars
Abstract Keloid scars are pathological scars, which develop as a result of exaggerated dermal tissue proliferation following cutaneous injury and often cause physical, psychological and cosmetic problems. Various theories regarding keloidogenesis exist, however the precise pathophysiological events remain unclear. Many different treatment modalities have been implicated in their management, but..
| Published: | 19/07/2016 |
| Authors: | Tehrani H |
Audit reviewing contraceptive methods
Background Regular review of contraceptive methods in HIV positive women is important to help prevent on-toward drug interaction and un-intended pregnancies. The British HIV Association (BHIVA) recommends all HIV positive women not on therapy be offered all forms of available contraception and those on therapy to avoid certain hormonal combinations...
| Published: | 19/07/2016 |
| Authors: | Rimmer K, Pilkington L, Quayle P |
Early prediction model for delirium
Rationale Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. Purpose To develop and validate a model based on data available at ICU admission to predict delirium development during a patient’s complete ICU stay and..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Risk of solid cancer in patients
Background Patients with rheumatoid arthritis (RA) have an increased risk of certain solid cancers, in particular lung cancer, compared to the general population. Treatment with tumour necrosis factor (TNF) inhibitors (TNFi) may further enhance this risk. Objectives To compare the risk of solid cancer in patients with RA treated with..
| Published: | 19/07/2016 |
| Authors: | Abernethy R |
Serum urate and obstructive sleep apnoea
Abstract Obstructive sleep apnoea (OSA) may increase the risk of hyperuricaemia and predispose to gout. The evidence for the effects of OSA on serum urate in severe obesity is limited. This study investigated whether OSA was associated with serum urate in severe obesity and whether continuous positive airway pressure (CPAP)..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
The Mersey Burns App
Introduction ‘Mersey Burns App’ is a smartphone/tablet application that aids in the assessment of total burn surface area (TBSA) and calculation of fluid resuscitation protocols in burns. This paper presents two studies assessing the speed and accuracy of calculations using Mersey Burns (App) in comparison with a Lund and..
| Published: | 19/07/2016 |
| Authors: | Barnes J, Pritchard-Jones R, McArthur P, Shokrollahi K, |
Investigation and management of pulmonary nodules
SUMMARY OF RECOMMENDATIONS This guideline is based on a comprehensive review of the literature on pulmonary nodules and expert opinion. Although the management pathway for the majority of nodules detected is straightforward it is sometimes more complex and this is helped by the inclusion of detailed and specific recommendations and..
| Published: | 19/07/2016 |
| Authors: | Malhotra P |
Do we practice what we preach
Background & Aims There is a lack of conclusive long-term studies evaluating risk and benefit in the surgical management of patients who show a complete pathological response following radiotherapy in rectal cancer. The trend in practice is becoming increasingly conservative. We questioned whether increased age and/or comorbidity influenced management when..
| Published: | 19/07/2016 |
| Authors: | Ormsby N, Rajaganeshan R |
Third International Intensive Aftercare Conference
ABSTRACT The third international conference on intensive care unit (ICU) diaries and intensive aftercare took place in Norrköping, Sweden, on 28 November 2013. The conference was organized by Carl Bäckman and colleagues, Vrinnevi Hospital and NOFI, and represented by Sissell Storli. More than 100 clinicians from across Europe and the USA..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Melanoma mimic in epidermolysis bullosa simplex
Abstract Epidermolysis bullosa (EB) simplex (EBS) is a mechanobullous disease characterized by blistering, typically of the hands and feet, following friction or minor trauma. A less well-recognized phenomenon in this condition is the sudden development of atypical naevi. We report the case of a 27-year-old hairdresser with a clinical diagnosis..
| Published: | 19/07/2016 |
| Authors: | Sharma N, Ellison J, Walsh ML |
The ADMIN-ICU survey
Objectives There is little evidence and few guidelines to inform the most appropriate dosing and monitoring for antimicrobials in the ICU. We aimed to survey current practices around the world. Methods An online structured questionnaire was developed and sent by e-mail to obtain information on local antimicrobial prescribing practices for..
| Published: | 19/07/2016 |
| Authors: | Barton G |
How should I structure my Post-ICU Clinic?
Ranzani, OT; Jones, C. (2015). How should i structure my Post-ICU Clinic? from early goal rehabilitation to outpatient visits . Minerva Anestesiologica. 81 (8), 832-834
| Published: | 19/07/2016 |
| Authors: | Jones C |
Intra-arterial vasodilators
Objectives The aim of this study is to review the available literature on the efficacy and safety of agents used for prevention of RAS. Background Different vasodilator agents have been used to prevent radial artery spasm (RAS) in patients undergoing transradial cardiac catheterization. Methods We included studies that evaluated any..
| Published: | 19/07/2016 |
| Authors: | Rashid M |
Haematological considerations in urology
Abstract Deep venous thrombosis (DVT) remains a serious and common complication of surgical procedures and is therefore an issue of importance for all urologists. In the UK, pulmonary embolism (PE) following DVT in hospitalised patients causes 32,000 deaths each year. DVT and PE represent the outcome of venous thromboembolism (VTE). The..
| Published: | 19/07/2016 |
| Authors: | Floyd Jr MS, McCabe JE |
Pericyazine for schizophrenia
Background Pericyazine is a 3-cyano-10 (3-4'-hydroxypiperidinopropyl) phenothiazine. It is overall pharmacologically similar with chlorpromazine, though particularly sedating. Dopamine receptor subtype analysis has not been performed for pericyazine, but the drug appears to induce greater noradrenergic than dopaminergic blockade. Compared to chlorpromazine, pericyazine reportedly has more potent antiemetic, antiserotonin, and..
| Published: | 19/07/2016 |
| Authors: | Matar HE |
Antibiotic prophylaxis during dental procedures
Abstract The average age of patients presenting for total joint arthroplasty is decreasing. The number of primary and revision arthroplasty procedures performed in the UK, Europe and USA is increasing annually. As number of procedures performed increases, the life expectancy of our patients and therefore the in vivo duration of..
| Published: | 19/07/2016 |
| Authors: | Pydisetty R |
Penile ulceration
Abstract Penile ulceration is a rare side effect of treatment with nicorandil for the management of angina pectoris. To our knowledge, there have been six reported cases in the literature: Yap et al. reported a case series of three in 20101, Kinney et al. reported two cases in 20102 and Birnie et..
| Published: | 19/07/2016 |
| Authors: | Ellison J, McCabe JE |
Analysis of prolonged jaundice
Background and aims Prolonged neonatal jaundice is a common presentation in newborns and rarely requires intervention; however it is important to rule out sinister causes such as biliary atresia. The outcome of this study was to analyse the demographics of infants presenting with prolonged jaundice, investigations undertaken and results of..
| Published: | 19/07/2016 |
| Authors: | Bentur H |
Plastic and reconstructive Mohs Surgery
Comparisons between Mohs micrographic surgery (MMS) and conventional excision (CE) have been made in the past, in particular relating to tumour recurrence rates; however, there are no comparative studies of reconstructive outcomes between these two methods in the current literature. We compared the reconstructive techniques and histological findings of our..
| Published: | 19/07/2016 |
| Authors: | Wain R, Tehrani H |
Mohs micrographic surgery
Microcystic adnexal carcinoma (MAC) is a locally aggressive tumour with a propensity for perineural and perivascular invasion, resulting in a high recurrence rate even with wide surgical margins (Leibovitch I, Huilgol SC, Selva D et al. Microcystic adnexal carcinoma: treatment with Mohs micrographic surgery. J Am Acad Dermatol 2005; 52: 295-300). We..
| Published: | 19/07/2016 |
| Authors: | Tehrani H |
Communication with patients with tracheostomy
Introduction and Aims Ventilated patients in ITU (intensive treatment unit) tend to be challenging to communicate with, especially patients who are being weaned. These patients usually have tracheostomy in situ and use means such as writing or letter boards to communicate. The situation becomes complex in patient groups that have..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Postoperative Patient-Controlled Analgesia
The latissimus dorsi has been the workhorse flap in breast reconstruction for several decades. The flap has a high reliability but is becoming less frequently used because of the recognized limitations of this flap. These disadvantages include functional impairment such as reduced shoulder mobility and strength. The rate of seroma..
| Published: | 19/07/2016 |
| Authors: | Iqbal A, Shaaban H |
Centralising acute stroke services
Morris and colleagues did not discuss how substantial financial investment in services affected their results. The London stroke strategy was supported by an additional £23m (€28.8m; $37.3m) in funding.2 The cost improvement programme highlighted the need for an extra £13m investment in hyperacute stroke units to provide the imaging and..
| Published: | 19/07/2016 |
| Authors: | Hill AM |
An isolated digital lipoblastoma
Abstract This report presents a girl with a lipoblastoma of a finger presenting as a macrodactyly. Documented inflammation of the digit at birth raises suspicion of neo-adipogenesis, which is recognised in lipomas. This case highlights a rare site for lipoblastomas and explores a potential aetiopathogenesis. Vaiude, P; Husein, B; Hurrell,..
| Published: | 19/07/2016 |
| Authors: | McArthur P |
Intravenous antibiotic administration practices
INTRODUCTION Antibiotics are the curative therapy in the management of sepsis. A point prevalence study in 2007 showed that 51 % of patients on Intensive Care Units worldwide were deemed to have sepsis with 71 % receiving antibiotics. Pharmacokinetic/pharmacodynamic (pk/pd) data suggest that some parameters such as volume of distribution and renal clearance..
| Published: | 19/07/2016 |
| Authors: | Barton G |
Early prediction of delirium
INTRODUCTION Delirium incidence in Intensive Care Unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. We developed and validated an early ICU delirium prediction model. OBJECTIVE To develop and validate a model based on data available at ICU admission to predict..
| Published: | 19/07/2016 |
| Authors: | Jones C |
The admin-ICU survey
INTRODUCTION Antibiotic choice and dosing is one of the cornerstones of infection management in intensive care. Recent research demonstrates variability in antimicrobial pharmacokinetics in the critically ill. There is little evidence to which is the most appropriate dosing, administration and monitoring strategy. OBJECTIVES To determine current practices in antimicrobial dosing,..
| Published: | 19/07/2016 |
| Authors: | Barton G |
Lung protective ventilation
INTRODUCTION In 2013 Futier et al. published work showing that a lung protective ventilation strategy with low tidal volumes for patients undergoing elective major abdominal surgery was associated with improved clinical outcome and reduced healthcare utilisation. It is established within intensive care that protective ventilation strategies are best practice, however until..
| Published: | 19/07/2016 |
| Authors: | Angus W, Glennon K, Mahambrey T, Miller T |
Treatment options for management of gout
Lee, WP; Mavinamane, S. (2014). Treatment options for management of gout . GM: Midlife & Beyond. 44 (9), 39-42
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Low-resolution CT attenuation correction images
Objective To review new incidental findings detected on low-resolution CT attenuation correction (CTAC) images acquired during single-photon emission CT (SPECT-CT) myocardial perfusion imaging (MPI) and to determine whether the CTAC images had diagnostic value and warrant reporting. Methods A multicentre study was performed in four UK nuclear medicine departments. CTAC..
| Published: | 19/07/2016 |
| Authors: | Howes A |
Diagnostic accuracy of MRI scanning
Introduction and Objectives To assess the accuracy of pre-biopsy MRI in detecting prostate cancer prior totransperineal template guided sector (TPTS) prostate biopsies. Materials and Methods Patients undergoing TPTS biopsy for diagnostic purposes (previous negative TRUS biopsies with persisting clinical suspicion of prostate cancer) were included in this prospective analysis. Patients..
| Published: | 19/07/2016 |
| Authors: | McCabe JE |
Foleys in a nutshell
Introduction and Objectives Dr. Frederic Eugen Basil Foley, best known to modern urologists as the man whose name attached to the self-retaining balloon catheter, the commonest urethral catheter ever used. Materials and Methods Dr Foley was an American Urologist, from St. Cloud, Minnesota (5th April, 1891 - 24th March, 1966). He studied..
| Published: | 19/07/2016 |
| Authors: | McCabe JE |
Dopamine agonists and monoamine oxidase B inhibitors
Background Whether initial treatment for Parkinson's disease should consist of levodopa, dopamine agonists, or monoamine oxidase type B inhibitors (MAOBI) is uncertain. We aimed to establish which of these three classes of drug, as initial treatment, provides the most effective long-term control of symptoms and best quality of life for..
| Published: | 19/07/2016 |
| Authors: | Abrams J, Ashley S, Steiger M |
Transfusion and haemoglobin changes in primary THR
Joint replacement surgery causes a significant burden on national blood stocks accounting for approximately 10% of hospital transfusions [1]. Allogenic blood transfusions are associated with increased morbidity and mortality [2]. There is a wide variation in transfusion rates in UK trusts, for primary total hip replacement (THR), with a reported national average of 25% [3]...
| Published: | 19/07/2016 |
| Authors: | Raftery S, Yoxall PF |
Labour epidural efficacy
The aim of our audit was to establish the efficacy of our labour epidurals by assessing the height of the block we achieved whist the epidural was in use and the requirements for ‘top up’ boluses. Following the initial audit we introduced a standardised loading dose to prevent disconnection from..
| Published: | 19/07/2016 |
| Authors: | Yoxall PF |
Vertical scar skin pattern
Abstract Immediate breast reconstruction following mastectomy has become increasingly common. Skin-sparing mastectomies (SSM) and risk reducing mastectomies are becoming more commonly performed.1–3 Where radiotherapy is not anticipated, implant-based reconstruction may be performed. One problem associated with implant-based reconstructions has long been lower pole coverage and support. A number of techniques..
| Published: | 19/07/2016 |
| Authors: | Iqbal A |
Care of children and young people
Background and aim Deliberate Self-harm (DSH) affects 1 in 15 young people and remains one of top 5 causes of acute hospital admissions in UK. We looked at children attending hospital with DSH to assess their pathways of care and discharge outcomes. We also looked to see if any trends emerged in their..
| Published: | 19/07/2016 |
| Authors: | Aziz M, Bentur H |
Utilising the MTP plantar fat
Touil, LL; Lindsay, KJ; Anderson, K; Bell, D. (2015). Utilising the MTP plantar fat: A novel approach in Syme's amputation . Journal of Plastic, Reconstructive and Aesthetic Surgery. 68 (1), 126-129.
| Published: | 19/07/2016 |
| Authors: | Touil L, Bell D |
Radical cystectomy and pelvic lymphadenectomy
Abstract The ileal conduit for urinary diversion after radical cystectomy is a well-described procedure. Furthermore, parastomal hernias, prolapse, stenosis, and retraction of the stoma have been reported as some of the more common complications of this procedure. The subsequent repair of parastomal hernias with a biological mesh and the potential..
| Published: | 19/07/2016 |
| Authors: | Sofos S |
Positron emission tomography
Introduction Positron Emission Tomography (PET) is an important tool in the evaluation of pulmonary nodules. A number of risk prediction tools attempt to discriminate between benign and malignant nodules. Herder et al previously demonstrated an improvement in performance of the Mayo risk prediction tool when information regarding FDG avidity was..
| Published: | 19/07/2016 |
| Authors: | Malhotra P |
Haemoptysis with a normal chest X ray
Introduction Haemoptysis is a red-flag symptom for lung cancer, but there is no consensus on how to investigate patients with haemoptysis and a normal chest X-ray. We sought to determine the yield of CT and bronchoscopy in this patient population in patients attending two hospitals in Northern England. Methods Patients..
| Published: | 19/07/2016 |
| Authors: | Malhotra P |
Exacerbation of COPD
Abstract A shortcut review was carried out to establish whether a normal partial pressure of carbon dioxide (pCO2) on a venous blood sample could be used to rule out hypercarbia. Eleven studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type,..
| Published: | 19/07/2016 |
| Authors: | Woods M |
Trends in clinical variables and outcome
Introduction Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic assessment of trends in selected variables and outcomes. Methods ..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Phenotypic factors associated with outcome
Introduction Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment that require close collaboration between surgical and intensive care teams [1]. We aimed at establishing whether dynamic assessment of trends in selected variables may be associated with outcomes, and..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Successful implementation of a medical emergency team
Introduction A medical emergency team (MET) was introduced in our institution in January 2012 to provide timely response to the needs of acutely ill inpatients and cardiac arrest calls. The MET assesses the patient and prescribes a management plan for the responsible team to follow; promptly stabilising and transferring patients to..
| Published: | 19/07/2016 |
| Authors: | Elmore J, Mahambrey T, Tridente A, Varia R |
Critically ill patients with faecal peritonitis
Introduction Faecal peritonitis (FP) is a common cause of sepsis and admission to the ICU [1]. We report a review of all patients admitted to our ICU over 5 years with FP. The aim was to define the clinical characteristics, outcomes and risk factors for mortality in ICU patients with FP. Methods..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Long-term renal and survival outcomes
Introduction Acute kidney injury (AKI) affects 40% of critically ill patients, with UK data reporting 5% needing renal replacement therapy (RRT). Hospital mortality is reported as being up to 60%. We sought to evaluate renal and long-term patient survival outcomes in AKI patients receiving RRT on our ICU. Methods Data were collected from..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Re-examining the role of whole body Bone Scan
Introduction Current BAUS guidelines for staging prostate cancer include a radionuclide bone scan and MRI or CT of the pelvis/prostate. MRI has a higher sensitivity for detecting skeletal metastasis than bone scan. The aim of our study was to evaluate the incidence of metastasis to the appendicular skeleton in..
| Published: | 19/07/2016 |
| Authors: | Feyisetan O, McCabe JE |
Does time of transfer from critical care to the general wards affect anxiety? A pragmatic prospective cohort study
Objectives To examine prospectively the impact of transfer time on patient anxiety. Design A pragmatic prospective cohort study. Setting 14 bed adult intensive care unit (ICU) in a National Health Service teaching hospital trust in the United Kingdom. Methods Critically ill patients staying on the ICU for at least 24 hours and..
| Published: | 19/07/2016 |
| Authors: | McCairn AJ, Jones C |
Breast conserving surgery
Abstract The increasing incidence of breast cancer and advances in detection of small, impalpable cancers presents increasing challenges for the modern breast surgeon. Accurate localization and excision with adequate oncological margins to reduce loco-regional recurrence rates whilst minimizing volume deficit and maximizing aesthetics remains the “gold standard.” We review the..
| Published: | 19/07/2016 |
| Authors: |
The Chicken Hand
Yao, SZJ; Iqbal, A; Bell, D. (2014). The Chicken Hand: A training model for hand surgery . Journal of Plastic, Reconstructive and Aesthetic Surgery,. 67 (8), e214-16
| Published: | 19/07/2016 |
| Authors: | Yao S, Iqbal A, Bell D |
SAT0130 Rheumatoid Arthritis Related Interstitial Lung Disease
Background Rheumatoid arthritis (RA) is associated with interstitial lung disease (ILD). This is linked with an increased risk of early death from respiratory failure. There is debate on the relative safety of different disease modifying anti rheumatic drugs (DMARDs) in RA-ILD. Objectives We have examined the effect of a range..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
A Model To Assess The Cost Of Flare In Ulcerative Colitis (UC)
Introduction Disease flare in ulcerative colitis (UC) can result in substantial cost implications to the NHS. While the costs associated with treatment and management of UC are well-documented, estimates of the cost of flare are lacking. A cost analysis was performed to construct a model to estimate the costs associated..
| Published: | 19/07/2016 |
| Authors: | Bassi A |
OP0037 Pulsed Cyclophosphamide in the Treatment
Background There is little evidence base to guide clinicians in the management of patients with rheumatoid arthritis (RA) related interstitial lung disease (ILD). In the subgroup who have rapidly deteriorating respiratory function, pulsed cyclophosphamide has been advocated but no assessment of its efficacy has been published. The British Rheumatoid InterstitiaL..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
OP0254 Association between Steroid Therapy and Survival
Background Clinically relevant interstitial lung disease (ILD) is present in approximately 5% of patients with rheumatoid arthritis (RA). Traditionally, oral steroids have been used to treat this manifestation of RA, but no evidence base exists to support this. Indeed, concern has been raised that such an approach might be associated with..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
BI26 Disseminated cutaneous Mycobacterium chelonae...
We report a rare case of disseminated cutaneous Mycobacterium chelonae and phaeohyphomycosis occurring in an immunocompromised patient, a 67-year-old man who developed a rash while on intravenous teicoplanin for Charcot joint osteomyelitis. The rash became widespread over the course of 2 months despite discontinuation of his antibiotics. On initial examination, he..
| Published: | 19/07/2016 |
| Authors: | Hickey S, Forsyth L |
CD14 The use of alitretinoin for chronic hand eczema
Alitretinoin is specifically licensed for adults with severe chronic hand eczema that has not responded to potent topical steroids. Severe disease is defined by the Physician's Global Assessment (PGA) and a Dermatology Life Quality Index (DLQI) of > 15. Our aim was to assess compliance to NICE guidance (National Institute for Health..
| Published: | 19/07/2016 |
| Authors: | Walsh ML |
CPC06 rare case of cutaneous collagenous vasculopathy
We report the case of a 76-year-old woman who presented with a 2-year history of a slowly extending, asymptomatic rash. It had started off on her anterior knees, extending to her arms and trunk. She reported prominence of her rash over the summer months and felt systemically well. Medically she..
| Published: | 19/07/2016 |
| Authors: | Ellison J |
P04 Trophic ulceration secondary to carpal tunnel syndrome
A 56-year-old man presented with a 3-month history of nontraumatic painful ulceration affecting his left hand. He described numbness and pins and needles affecting his left hand with minimal altered sensation affecting his dominant right hand. He has a past medical history of myocardial infarction and is a nonsmoker with..
| Published: | 19/07/2016 |
| Authors: | Ngan K |
P188 Sudeck's atrophy
Case history A 49-year-old woman with Type 2 diabetes for 17 years, diabetic retinopathy and sensory neuropathy presented with a 2week history of left forefoot, plantar ulcer and cellulitis. Peripheral pulses were palpable; clinically and radiologically there was no osteomyelitis. Wound swab revealed methicillin resistant Staphyloccus aureus (MRSA), Group B Streptococcus and..
| Published: | 19/07/2016 |
| Authors: | Keigan S, Mohsin N |
A64 (P310) Outpatient parenteral antibiotic therapy (OPAT)
Aims To determine the benefits of OPAT in diabetes foot infections. Methods This was a retrospective study of consecutively initiated OPAT in patients with diabetes foot infections. Patients initiated on OPAT in a multidisciplinary diabetes foot clinic and inpatients discharged from a diabetes inpatient ward between April 2011 and May 2013 and..
| Published: | 19/07/2016 |
| Authors: | , Hardy KJ, Keigan S, Lewis A, |
Epiglottic Hypoplasia
ABSTRACT Non-syndromic hypoplasia of the epiglottis presenting without symptoms at middle age is an extremely rare entity. We report a 50 years female who presented with oral ulcers and incidentally was found to have an asymptomatic rudimentary epiglottis and thickened bilateral aryepiglottic folds forming an inverted funnel shaped supraglottis protecting the..
| Published: | 19/07/2016 |
| Authors: | Muddaiah A |
Recovery post ICU
Summary Many ICU patients struggle to recovery following critical illness and may be left with physical, cognitive and psychological problems, which have a negative impact on their quality of life. Gross muscle mass loss and weakness can take some months to recover after the patients’ Intensive Care Unit (ICU) discharge,..
| Published: | 19/07/2016 |
| Authors: | Jones C |
G264 Mentoring for Paediatricians
Aims Mentoring has been shown to be important for personal and professional development of doctors. This study aimed to assess the current awareness of and demand for mentoring amongst paediatricians in the UK. This will enable appropriate development and targeting of resources and support, in addition to assisting paediatricians in..
| Published: | 19/07/2016 |
| Authors: | Garr R |
G417(P) Unexplained multiple rib fractures
Background We describe the unusual case of a three month old girl who developed six posterior rib fractures whilst an inpatient on a paediatric ward with a paroxysmal cough. Causality of rib fractures detected in children include non-accidental injury, bone fragility and trauma. A serious case review investigates the contributory..
| Published: | 19/07/2016 |
| Authors: | Aziz M |
Reduction in self-harming behaviour
Abstract No psychotropic drug is specifically licensed for the management of emotionally unstable borderline personality disorder. Prescribing ‘off-label’ places additional responsibilities on the prescriber and may increase liability if there are adverse effects. This case report describes a patient with borderline personality disorder who was started on zuclopenthixol decanoate with..
| Published: | 19/07/2016 |
| Authors: | Javed S |
Multifocal calcifying fibrous tumor at six sites in one patient
Abstract Calcifying fibrous tumors (CFT) are rare benign tumors. They usually affect children and young adults and the incidence is equal in males and females. The usual clinical presentation is that of a painless mass. A computed tomography scan typically reveals a well-demarcated calcified lesion. CFT usually presents as a..
| Published: | 19/07/2016 |
| Authors: | Kelly S, Pinto M |
Emergency colorectal cancer: Primary care input
Introduction Higher morbidity and mortality is seen in patients with colorectal cancer (CRC) who present as an emergency. A study was performed to assess the pre-admission symptoms experienced by such patients, and time taken to referral. Method A retrospective analysis of all CRC patients presenting as an emergency to a..
| Published: | 19/07/2016 |
| Authors: | Rajaganeshan R, Scott M |
Correlation and diagnostic accuracy of CT in the acute surgical
Aim CT in the acute surgical presentation has significantly increased with technological advancement and availability. Emergency CT is reported by the on call radiologist of varying seniority. We undertook a retrospective study to compare the correlation with the initial senior clinicians' diagnosis and the eventual laparotomy findings. Method Retrospective data..
| Published: | 19/07/2016 |
| Authors: | Rajaganeshan R, Wellens T |
Is clinical examination alone becoming obsolete in modern surgic
Aim Computed Tomography (CT) is the radiological investigation of choice for the majority of acute surgical admissions with abdominal pain. Accuracy has been repeatedly reported at over 95% in studies since 2002. A retrospective analysis was performed to compare a senior clinician's bedside diagnosis with that of emergency CT. Method Retrospective review..
| Published: | 19/07/2016 |
| Authors: | Rajaganeshan R, Wellens T |
Loop colostomy and loop ileostomy complications
Aim The formation of a loop stoma is common practice in emergency and elective surgery, but has a profound effect on patient well-being, particularly if complications arise. In our District General Hospital we investigated and compared morbidity outcomes for patients who had loop stomas formed over a 1-year period. Methods..
| Published: | 19/07/2016 |
| Authors: | Chadwick M |
Rheumatoid arthritis-related interstitial lung disease
Objectives The prevalence of interstitial lung disease (ILD) in RA is ∼5%. Previous work identified increasing age, active articular disease and articular damage as risk factors for RA-associated ILD (RA-ILD). The roles of high-resolution CT (HRCT) and lung function testing in defining the nature and extent of pulmonary involvement have recently..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Pseudoangiomatous stromal hyperplasia
INTRODUCTION Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion that can be mistaken for angiosarcoma or fibroadenoma. This rare condition generally tends to present as a palpable mass in premenopausal women which can be seen on mammogram and ultrasound alike. The pathological findings tend to be of a thickening..
| Published: | 19/07/2016 |
| Authors: | Barker D, |
Squamous cell carcinoma and vitiligo
Ultraviolet radiation predisposes to the development of nonmelanoma skin cancer (NMSC). Melanin safeguards the skin against this. This leads one to conjecture that patients with vitiligo are at a higher risk of developing skin malignancies. However, despite the lack of protective melanin and increased oxidative stress due to epidermal hydrogen..
| Published: | 19/07/2016 |
| Authors: | Hindle E |
Great improvement in acute pancreatitis care
Introduction The British Society of Gastroenterologists (BSG) updated guidelines on the management of acute pancreatitis in2005.This audit aimed to improve acute pancreatitis care in accordance with those guidelines. Methods An initial audit of all 39 patients with acute pancreatitis in October-December 2011 was undertaken. Improvements were made through arranging group teaching..
| Published: | 19/07/2016 |
| Authors: | Maitra D |
Education greatly improves AMT scoring
Introduction The best practice tariff (BPT) for fragility hip fracture applies to patients aged 60 years and over admitted with a fractured neck of femur (NOF). It awards 1335 per case provided several criteria are met including completion of pre and post-operative abbreviated mental test (AMT). Our fractured NOF pathway prompted AMTscoring,..
| Published: | 19/07/2016 |
| Authors: | Gudena R, Allsup S |
ROLL after neo adjuvant treatment
Neo-adjuvant chemo & hormone therapy is very effective in reducing the size of the primary breast cancer: this may result into a substantial response, hence the need to localise a non-palpable lesion. A variety of localisation techniques are used to target surgical removal of these subclinical lesions i.e., Wire marker,..
| Published: | 19/07/2016 |
| Authors: | Jois RHS, Harris O, |
Medical Emergency Team
Abstract In January 2011 a multidisciplinary hospital-wide medical emergency team (MET) was introduced at Whiston Hospital replacing the previous cardiac arrest team. The primary aim of this new rapid-response service was to improve early identification and management of deteriorating patients, with a reduction in unplanned intensive care (ICU) admissions, cardiac arrest..
| Published: | 19/07/2016 |
| Authors: | Elmore J, Mahambrey T |
Obstructive sleep apnea
Abstract Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients with obstructive sleep apnea may still be at risk of adverse health outcomes, even without previous cardiovascular disease. Pulse wave analysis non-invasively measures peripheral pulse waveforms and derives measures of haemodynamic..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Compression gloves in hand osteoarthritis
Background/Purpose Compression gloves are used in Hand Osteoarthritis (HOA) to reduce pain (day and/or night), stiffness and improve hand function. A systematic review identified only two trials (sample sizes n= 2 and 5), with inconclusive results [1]. The commonest compression gloves provided in the UK are Isotoner gloves. The aim was..
| Published: | 19/07/2016 |
| Authors: | Hough Y |
Outpatient anti epileptic drug prescribing errors
Purpose Prescription errors are a common and potentially hazardous problem and may cause patient harm. This review evaluates all new anti-epileptic drug (AED) outpatient prescriptions over one year and reviews the subject literature. Methods A 12-month retrospective review of all outpatient prescriptions of AEDs within a large Children's Hospital. Copies..
| Published: | 19/07/2016 |
| Authors: | Bentur H |
Anaplastic large cell lymphoma
Abstract Systemic anaplastic large cell lymphoma (ALCL) is a distinct disease classification provisionally sub-divided into ALCL, Anaplastic Lymphoma Kinase (ALK)+ and ALCL, ALK− entities. More recently, another category of ALCL has been increasingly reported in the literature and is associated with the presence of breast implants. A comprehensive review of..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Rheumatoid arthritis related interstitial lung disease
Background/Purpose Interstitial Lung Disease (ILD) is the commonest manifestation of lung disease in Rheumatoid Arthritis (RA) and the only complication reported to be increasing in prevalence, accounting for 6% of all RA deaths. High resolution computed tomography (HRCT) confirmed 25% of RA patients had radiological evidence of ILD. This study examines..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Delirium sedation and analgesia
Abstract Analgesia, sedation and delirium management are important parts of intensive care treatment as they are relevant for patients' clinical and functional long-term outcome. Previous surveys showed that despite this fact implementation rates are still low. The primary aim of the prospective, observational multicenter study was to investigate the implementation..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Clinical Prediction Models
Background Management of solitary pulmonary nodules (SPNs) depends critically on the pre-test probability of malignancy. Several quantitative prediction models have been developed using clinical and radiological criteria. Three models include CT criteria (Mayo, Veterans Association, Brock University) with a fourth model (Herder) incorporating FDG avidity on CT-PET scan in addition...
| Published: | 19/07/2016 |
| Authors: | Jones C |
Retracting the ear
Jeevan, R; Lymperopoulos, NS and James, MI. (2014). Retracting the ear: A hands-free approach . Journal of Plastic, Reconstructive and Aesthetic Surgery. 67 (2), e65-66
| Published: | 19/07/2016 |
| Authors: | Lymperopoulos NS |
Using surrogate markers
McNulty, SJ and Williams, P. (2014). Bad medicine: using surrogate markers . BMJ. 348 (Published online 10th March).
| Published: | 19/07/2016 |
| Authors: | McNulty SJ, Williams P |
The Liverpool experience
Objective To assess the clinical outcomes and treatment costs of a regional adult burn service in northwest England. Methods We retrospectively reviewed data on a five year cohort of 1075 patients treated by the Mersey Regional Burn Service between 2006 and 2010 to obtain age-stratified mortality estimates based on the lethal area 50 (LA50)..
| Published: | 19/07/2016 |
| Authors: | Lymperopoulos NS |
Lymphopenia as a predictor of bacteremia
Introduction Bloodstream infection (BSI) is associated with a reduction in circulating lymphocytes. Lymphopenia has been proposed as an early marker of BSI in pyrexial adults in the emergency department (ED) setting [1]. The aim of this study was to compare lymphocyte count with conventional markers in patients presenting to the ED..
| Published: | 19/07/2016 |
| Authors: | Nee PA |
Patients with haematological malignancies
Introduction Critical care (CC) admission has traditionally been viewed as likely to result in a poor outcome for immune-compromised haemato-oncological (HO) patients [1,2]. Recent studies have challenged such views [3,4]. We recently reported results from a cohort of HO patients admitted to CC, showing the pAO2/FiO2 (P/F) ratio to be..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Organisational changes in service provision
Introduction Demand for critical care (CC) resources is constantly increasing in the face of limited availability. Guidance for triage exists but may no longer reflect current practice [1,2]. We previously identified nonmedical and medical factors (comorbidities, physiological derangement and functional status) as predicting likelihood of admission of referred patients to CC [3..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Recalibration of the delirium prediction model
Purpose Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients. Methods A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgent and admission category, infection, coma, sedation, morphine use, urea..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Mohs surgery service
Summary Mohs Micrographic Surgery (MMS) is the current ‘gold-standard’ for excision of a number of cutaneous lesions and provides a valuable addition to a skin cancer service. The Mersey Regional Centre for Mohs Surgery is the first MMS service in the UK to be led by an MMS trained Plastic..
| Published: | 19/07/2016 |
| Authors: | Tehrani H |
Frozen section in skin cancer surgery
Prowse, P; May, J; Morton, J. (2014). Frozen section in skin cancer surgery: Is the technique obsolete? Journal of Plastic, Reconstructive and Aesthetic Surgery. 67 (3), 414-15.
| Published: | 19/07/2016 |
| Authors: | May J, Morton J |
Diverticular perforation
Abstract An 81-year-old woman with stage 4 chronic kidney disease (focal segmental glomerulosclerosis) requiring steroids and immunosuppression with mycophenolate mofetil presented with left iliac fossa (LIF) pain, anorexia and rectal bleeding with mucus. Examination and investigations revealed no pyrexia, LIF tenderness, supraclavicular subcutaneous emphysema or leucocytopenia. An erect chest x-ray (figure 1)..
| Published: | 19/07/2016 |
| Authors: | Chadwick M |
Association between immunosuppressive therapy and relative risk
Background RA is associated with clinically relevant interstitial lung disease (ILD) in around 5% of patients. A variety of immunosuppressive agents have been advocated in patients with RA-ILD, with very little evaluation of their comparative effectiveness. We have examined the influence of a range of immunosuppressives (ISP) on mortality in a..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Association Between Biologic Therapy and Survival
Background RA is associated with clinically relevant interstitial lung disease (ILD) in approximately 5% of patients. Concern has been expressed over the use of biologic therapies in patients with RA-ILD, with several reports of disease progression and death from accelerated respiratory failure. We have examined the association between different biologic therapies..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Obstructive sleep apnoea in obese women
Background Recent studies have highlighted an association between gout and obstructive sleep apnoea (OSA), reflecting shared risk factors with increasing body weight associated with gout and OSA. However, intermittent episodes of hypoxia in OSA may lead to purine breakdown and increase uric acid levels, potentially contributing to hyperuricaemia. This study..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Association between steroid therapy and survival
Background Clinically relevant interstitial lung disease (ILD) is present in approximately 5% of patients with RA. Traditionally, oral steroids have been used to treat this manifestation of RA, but no evidence base exists to support this. Indeed, concern has been raised that such an approach might be associated with increased mortality..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Drug-induced interstitial lung disease
Abstract Drug-induced interstitial lung disease (ILD) is a rare but potentially fatal complication from the disease modifying drugs that we use for rheumatological conditions. Clinical presentation, prevalence and screening for MTX pneumonitis will be focussed upon. Diagnostic criteria for hypersensitivity pneumonitis will be reviewed. The talk will also give an..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Uropathogen profiles and antimicrobial resistance
INTRODUCTION & OBJECTIVES Urinary tract infections are a core aspect of urological practice and occupy a large component of infections treated in primary care. The rise of antimicrobial resistance poses a challenge to clinical practice and raises the morbidity and mortality from urinary tract infections. The volume of urinary tract infections,..
| Published: | 19/07/2016 |
| Authors: | McCabe JE |
Sedation in mechanically ventilated adults
Abstract The use of sedative and analgesic dugs is essential in intensive care. The lowest effective doses should be used for the shortest period of time in order to limit the risk of serious complications. Daily interruption of sedation (DIS) is one strategy that has been shown to reduce overall..
| Published: | 19/07/2016 |
| Authors: | Nee PA |
Intra Urethral Human Papillomavirus Related Warts
Iskander, M; Patrick, N; Mistry, R. (2014). Intra Urethral Human Papillomavirus Related Warts Following Urinary Tract Instrumentation . Urology Journal. 11 (2), 1491.
| Published: | 19/07/2016 |
| Authors: | Mistry R |
Audit of insulin pump therapy
Aims The National Institute for Health and Clinical Excellence (NICE) published guidelines for the use of continuous subcutaneous insulin infusion in 2008 (technology appraisal 151). The first UK-wide insulin pump audit took place in 2012 with the aim of determining adherence to the guidance issued in NICE technology appraisal 151. The results of the..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ |
Basal cell carcinoma
Pinto, R; Mavinamane, S. (2014). Basal cell carcinoma: diagnosis and management. GM: Midlife & Beyond. 44 (5), 33-35
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Low dietary sodium
Abstract In a meta-analysis that investigated the effects of dietary sodium restriction in diabetes nephropathy, although blood pressure fell, there were significant increases in plasma renin and aldosterone levels. In this article, we hypothesise that in diabetic nephropathy, ACE-I or ARB treatment attenuates any rise in RAS hormones that might..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ, O'Brien S |
Ulcerating metastatic inguinal lymphadenopathy
Sadri, A; Touil, L; Liew, SW; Brackley, P; Koshy, O. (2014). Salvage of ulcerating metastatic inguinal lymphadenopathy using the inferior pedicled TRAM flap . Journal of Plastic, Reconstructive & Aesthetic Surgery. 67 (5), E138-9
| Published: | 19/07/2016 |
| Authors: | Touil L, Liew S, Brackley P, Koshy O |
Anterior abdominal wall 'peritoneal recess'
Background Chronic abdominal pain is a well-known cause of prolonged morbidity and patient frustration. Often it is managed symptomatically with high recurrence rate and no definite treatment. Material and Methods We present here a new potential space named as ‘Peritoneal Recess’ inside the abdomen which was found during diagnostic laparoscopy..
| Published: | 19/07/2016 |
| Authors: | Samad A |
Johans as knot pusher
Background The base of appendix can be secured by stapling or with endoloops. The authors have reported the use of Johan forceps as endoloop pushers for laparoscopic appendicectomy. Objectives A feasibility study of safety and cost effectiveness of using Johan forceps as endoloop pushers for laparoscopic appendicectomy. Material and Methods..
| Published: | 19/07/2016 |
| Authors: | Kaul A |
Urinary proteomics
Introduction Obstructive sleep apnoea (OSA) is a common complication of obesity and can have a substantial negative impact on a patient's quality of life and risk of cardiovascular disease. In this study, discovery profiling of urinary peptides was performed by capillary electrophoresis- mass spectrometry (CE-MS) in obese subjects with and..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Epidural bolus requirements
Introduction In our department, we use both continuous infusion and programmed intermittent bolus techniques for labour epidural management. As a service evaluation project, we decided to assess the number of additional boluses which were required with each of these techniques. Methods We retrospectively examined the clinical records of 97 women who..
| Published: | 19/07/2016 |
| Authors: | Yoxall PF |
Anterior abdominal wall 'peritoneal recess'
Background No clear guidelines exist about management of chronic abdominal pain. We present here a new potential space named as ‘Peritoneal Recess’ inside the abdomen which was found during diagnostic laparoscopy performed to look for the cause of recurrent abdominal pain. Material and Methods A middle aged patient presented with..
| Published: | 19/07/2016 |
| Authors: | Samad A |
Acquired haemophilia A
Jacob, A; Mavinamane, S. (2014). Acquired haemophilia A as a cause of recurrent bleeding episodes in the elderly . British Journal of Hospital Medicine. 75 (5), 294-95.
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Adjuvant bevacizumab in patients with melanoma
Background Bevacizumab, a monoclonal antibody that targets VEGF, has shown restricted activity in patients with advanced melanoma. We aimed to assess the role of bevacizumab as adjuvant treatment for patients with resected melanoma at high risk of recurrence. We report results from the preplanned interim analysis. Methods We did a..
| Published: | 19/07/2016 |
| Authors: | Marshall E |
Retinopathy of prematurity
Objectives To report on retinopathy of prematurity (ROP) screening compliance against a national guideline, factors associated with non-compliance and effect on ROP treatment. Design National cohort study using operational NHS data from the National Neonatal Research Database (NNRD) for the period 2009–2011. Setting 161 (94%) neonatal units in England. Population Infants born below 32..
| Published: | 19/07/2016 |
| Authors: | Amegavie L |
Stillbirth
Abstract Stillbirth rates both in the UK and worldwide are extremely high. This reflective case study is centred on my first experience at caring for a bereaved couple who lost their baby boy, stillborn, at 27 weeks gestation. Whilst causes of stillbirth are often multi-factorial and unexplained, this reflection aims to..
| Published: | 19/07/2016 |
| Authors: | Stott S |
Nodal recurrence of cutaneous malignant melanoma
Summary We report the case of an 84-year-old woman who had a nodal recurrence of melanoma 45 years after the primary diagnosis of an extremity cutaneous melanoma. It is believed to be the longest disease-free latency period reported between primary melanoma diagnosis and recurrence to date. Late recurrences of melanoma are..
| Published: | 19/07/2016 |
| Authors: | Liew S |
Boardless skin meshers?
May, J; Sadri, A; James, I; Shokrollahi, K. (2014). Cost savings in plastic surgery: Boardless skin meshers? Burns. 40 (4), 780-81
| Published: | 19/07/2016 |
| Authors: | May J, Shokrollahi K |
The IBD-control questionnaire
Introduction Routine capture of reliable, patient-centred health status measures for IBD has not become part of standard practice. The IBD-Control questionnaire is a short (13 item), generic patient-reported outcome measure which we developed to support routine care.1 Methods To further define performance in varied settings, we undertook: (A) A prospective study..
| Published: | 19/07/2016 |
| Authors: | Collins B, Bassi A |
Nurse led one stop upper GI clinics are safe and allow rapid assessment of patients
Introduction Meeting 2 week referral targets presents a challenge to many hospitals. Commonly patients are seen in clinic prior to investigation with resultant additional delays in time to investigation. Nurse led one stop clinics where patients undergo clinical assessment and endoscopic and/or radiological assessment on the same day have the..
| Published: | 19/07/2016 |
| Authors: | Williams S, Ashall B, Cave G, Bassi A |
Clinic Outcomes For Unselected Patients
Introduction There is a well-established role of specialist nurses in on-going management of chronic diseases in specialist clinics. With the reduction in junior doctor hours, advanced nurse clinicians (ANC) are taking on increasing complex medical roles. We aimed to evaluate the effectiveness of ANC in managing unselected new patients (NP)..
| Published: | 19/07/2016 |
| Authors: | McClements D, McLindon J, Chandy R, Priestley S, Fox M, Theis V, Dobson J, Bassi A |
Use of epidural blood patch
Background Epidural blood patch (EBP) is viewed as the "gold standard" treatment for headaches caused by accidental dural puncture (ADP), although it is not supported by strong evidence [1]. The mechanism of action is also poorly understood. Moreover, the success of EBP in treating headaches due to labour epidural related ADP..
| Published: | 19/07/2016 |
| Authors: | Yoxall PF |
Radical nephrectomy
Abstract A 65-year-old man presented with a rapidly enlarging pre-auricular lump, with pruritis and contact bleeding. The patient was referred to dermatology due to the high index of suspicion for malignancy. Following excision of the lump and histological analysis it was found to be a metastasis from renal cell carcinoma...
| Published: | 19/07/2016 |
| Authors: | Mistry R |
Improve outcomes for upper GI cancer patients
Siddique, K; Holmes, J; Kaul, A. (2013). Lean initiative to develop managed clinical network to improve outcomes for upper GI cancer patients in Saint Helens & Knowsley . European Journal of Cancer,. 49 (Suppl 2), S592
| Published: | 19/07/2016 |
| Authors: | Holmes J, Kaul A |
Breast cancer recurrence after ROLL lumpectomy
Background Very few literatures are available on the long term outcomes after Radioguided Occult Lesion Localisation (ROLL) guided lumpectomy for non palpable invasive breast cancer. We previously published a recurrence of 1.9% with median follow up of 33 months. This is the first observation reporting after a Ten year experience with ROLL...
| Published: | 19/07/2016 |
| Authors: | Jois RHS, Carini S, Harris O, Thind R, Desmond S, Ray A, Chagla LS, Bulgasim N, |
Stainless Steel Suture Technique
Proflavine wool with silk ‘tie-overs’ is used commonly to secure a skin graft. Our new strategy employs a surgical steel wire suture that can be twisted down to secure the graft without the need for multiple ties. Figure 1A shows the graft over the defect, and Figures 1B and 1C..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K, Sofos S |
The Critical Care Management of the Burn Patient
Abstract Between 4 and 22% of burn patients presenting to the emergency department are admitted to critical care. Burn injury is characterised by a hypermetabolic response with physiologic, catabolic and immune effects. Burn care has seen renewed interest in colloid resuscitation, a change in transfusion practice and the development of anti-catabolic therapies...
| Published: | 19/07/2016 |
| Authors: | Mahambrey T, Shokrollahi K |
Effective ventilation during cardiac arrest
INTRODUCTION Despite ALS training, management of the airway during in-hospital cardiac arrests often appears poorly performed by the non-anaesthetist. OBJECTIVES To assess the competency of junior doctors airway skills in the cardiac arrest scenario. METHODS We conducted an assessment of foundation year 1 (FY1) doctors´ management of the airway in a..
| Published: | 19/07/2016 |
| Authors: | Young S, Bolton N, |
Time of transfer from critical care
INTRODUCTION Night time transfer from critical care to the general wards is associated with increased hospital mortality and transfer from critical care areas to the general ward between 22:00 and 07:00 should be avoided whenever possible1. In addition the timing of transferring a patient from the critical care unit to the general..
| Published: | 19/07/2016 |
| Authors: | McCairn AJ, Wood J, Jones C |
CORTRAK device in itu
INTRODUCTION The cortrak enteral access system (EAS) allows real time tracking of a NG tube tip, supposedly abolishing the need for x-ray confirmation of nasogastric tube (NGT) position. With the use of an electromagnetic transmitting stylet inserted within the NG tube and a receiver unit placed over the patient's xiphisternum,..
| Published: | 19/07/2016 |
| Authors: | Sharma N |
Stroke mimics - A case of viral encephalitis
Introduction Stroke causes significant morbidity and mortality. In the UK it accounts for up to 11% of deaths annually, with over 56,000 deaths occurring in England and Wales in 1999. Stroke typically presents with focal neurological deficits including speech disturbance and limb weakness, consistent with vascular territory involved. However, in some cases, this..
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
The masquerade of myasthenia gravis
Objective Myasthenia gravis is an autoimmune condition characterised by fatigable muscle weakness. It may present as a bulbar palsy and can mimic a cerebrovascular event. We report a case of myasthenia gravis presenting in a 69 year old which initially presented as stroke. Case presentation A 69 year old male was admitted..
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Acquired haemophilia A in an elderly patient
Background Acquired haemophilia A is a rare condition that can have potentially life-threatening consequences. We report a case of acquired haemophilia A in an elderly patient who had presented to hospital with recurrent bleeding episodes. Case presentation A 73 year old female nursing home resident with advanced dementia and previous stroke..
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Proton pump inhibitors
Objective Proton pump inhibitor (PPI) prescribing has increased dramatically over recent years and has significant cost implications. It is estimated that up to two-thirds of PPI prescriptions are inappropriate and costs the National Health Service approximately 100 million in unnecessary PPI prescribing. PPIs are associated with serious adverse effects including clostridium..
| Published: | 19/07/2016 |
| Authors: | Mavinamane S |
Primary Squamous Cell Carcinoma of the Nipple
Abstract There has been only one documented case in the English literature with the diagnosis of primary Squamous Cell Carcinoma (SCC) of the nipple; we present a further case of a primary SCC of the nipple, thus raising awareness to the skin or breast specialist of this possible presentation for..
| Published: | 19/07/2016 |
| Authors: | Tehrani H, Lymperopoulos NS, Sofos S, |
Mental and physical disability after sepsis
Sepsis remains a major cause of admissions to Intensive Care Units (ICU) and has a high mortality rates and significant morbidity in survivors. There are physical, cognitive and psychological sequelae from severe sepsis that have a negative effect on the patients’ health related quality of life in the longer term..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Tubal occlusion in new infertility patients
Objective 100% of women with risk factors for tubal occlusion should be offered diagnostic laparoscopy. Background NICE CG 156 (February 2013) recommendation 62 suggests that if any woman has comorbities that would lean towards tubal occlusion, that diagnostic lap should be offered. A paper with regards to cost-effectiveness of tubal patency tests by Verhoeve..
| Published: | 19/07/2016 |
| Authors: | Omar M, Langton J |
Management of acute confusion
Abstract This article discusses the management of acute confusion and aggression in patients with infections of the central nervous system (CNS). The issues discussed are applicable to the management of acute confusion of any cause and the principles of care apply to all confused patients. The article addresses many of..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Genotype-guided dosing of warfarin
BACKGROUND The level of anticoagulation in response to a fixed-dose regimen of warfarin is difficult to predict during the initiation of therapy. We prospectively compared the effect of genotype-guided dosing with that of standard dosing on anticoagulation control in patients starting warfarin therapy. METHODS We conducted a multicenter, randomized, controlled..
| Published: | 19/07/2016 |
| Authors: | Nicholson T |
CURBO2–65 better correlation than CURB65
Introduction For patients admitted to hospital with pneumonia, CURB65 (confusion, Urea>7, Respiratory Rate>30 and Blood Pressure
| Published: | 19/07/2016 |
| Authors: | Disney A, Molugu C, Singer A, Stockton P |
CURBO2–65 superior to CURB-65
Introduction and Objectives Community Acquired Pneumonia (CAP) accounts for a significant proportion of hospital admissions and is a common cause of mortality and morbidity in UK. CURB-65 is recommended by BTS and widely used to stratify patients according to severity and guide initial treatment (1). As oxygen is not part of..
| Published: | 19/07/2016 |
| Authors: | Singer A, Disney A, Lewis A, Molugu C, Stockton P |
Dedicated pneumonia follow up clinic
Background It is routine clinical practice, based on British Thoracic Society recommendations, to arrange a clinical review and chest x-ray approximately 6 weeks following an episode of pneumonia in most patients. However there is a paucity of published evidence to support or refute this practice. Objective To determine the clinical and..
| Published: | 19/07/2016 |
| Authors: | Komrower D, Malhotra P, Shanker V, Stockton P, Twite S |
V-DimERS study
Hypothesis The risk of Venous Thromboembolism (VTE) including Pulmonary Embolism (PE) increases proportionately with the level of d-dimers. Introduction The risk of PE/VTE is low when the values of d-dimers are below the reference range (1) (5000. Each group was analysed by separate individual. Data was collected by selecting only those..
| Published: | 19/07/2016 |
| Authors: | Fisher G, Hirons B, Hughes D, Molugu C, Raftery S |
Managing suspected pulmonary embolism
Background We observed a high number of patients admitted with suspected pulmonary embolism (PE) via our acute medical unit. After positive diagnosis, they remained as inpatients until their International Normalised Ratio (INR) was in range resulting in long lengths of stay - Median (range) 7 (0 to 52) days. Recently, there has been..
| Published: | 19/07/2016 |
| Authors: | Varia R |
'CURE-CAP'
Introduction The annual incidence of Community acquired pneumonia (CAP) is 5–11/1000. Between 22% and 42% require admission to hospital. Wide variation exists in the management of CAP despite guidelines issued by the British Thoracic Society (BTS). Care bundles have been shown to improve outcomes through standardisation of care in other diseases as well..
| Published: | 19/07/2016 |
| Authors: | Varia R |
A case of collapse
Abstract We describe the case of a woman who presented with seemingly non-specific symptoms, including collapse, but through examination was eventually revealed to have an unusual, potentially fatal, but treatable neurological condition. We share some thoughts on the process of diagnosis, the difficulty of diagnosing a rare disease and the..
| Published: | 19/07/2016 |
| Authors: | Williams P |
Berlin definition for acute respiratory distress syndrome during
Purpose A new acute respiratory distress syndrome (ARDS) definition has been recently issued: the so-called Berlin definition (BD) has some characteristics that could make it suitable for pediatrics. The European Society for Pediatric Neonatal Intensive Care (ESPNIC) Respiratory Section started a project to evaluate BD validity in early childhood. A..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
DIEP flap breast reconstruction
Background The popularity of the DIEP flap has increased over the last decade. However, there is little information regarding the transfusion rates of this complex procedure. The current study reports the transfusion rates in patients who underwent DIEP flap reconstruction in our unit with an attempt to correlate significant blood..
| Published: | 19/07/2016 |
| Authors: | , Graham K, Koshy O, Lymperopoulos NS, Sofos S |
Fractures of the shaft of humerus
Abstract Humeral shaft fractures account for 1–3% of all fractures. Non-surgical management with functional bracing is arguably the standard of care for most humeral shaft fractures. It results in high union rates and in general the outcome is excellent. Surgical management is indicated in some cases, such as open fractures, polytrauma,..
| Published: | 19/07/2016 |
| Authors: | Kumar V, Rathinam M |
Rheumatoid arthritis-related pulmonary fibrosis
Ennis, H; Dawson, J et al. (2014). HLA-DRB1 associations with rheumatoid arthritis-related pulmonary fibrosis . Scandinavian Journal of Rheumatology. 43 (1), 75-76
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Diffusion of responsibilities
McNulty, SJ and Williams, P. (2014). A call to reduce diffusion of responsibilities . BMJ. 348 (Published online 19th February).
| Published: | 19/07/2016 |
| Authors: | McNulty SJ, Williams P |
An epidemiological survey of the GenOSept cohort
Introduction Faecal peritonitis (FP) is a common cause of sepsis and admission to the intensive care unit (ICU). The Genetics of Sepsis and Septic Shock in Europe (GenOSept) project is investigating the influence of genetic variation on the host response and outcomes in a large cohort of patients with sepsis..
| Published: | 19/07/2016 |
| Authors: | Tridente A |
Serum creatinine and estimated glomerular filtration rate
OBJECTIVE Fasting is not routinely recommended for renal function tests, despite the known effects of cooked meat on creatinine. We therefore studied variation in creatinine and estimate glomerular filtration rate (eGFR) following a standardised cooked meat meal in 80 subjects: healthy volunteers, diabetes patients with chronic kidney disease (CKD) stages 1 & 2, 3A, 3..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ, O'Brien S |
Pathologic Response of Breast Cancer
Background: Neo-adjuvant chemotherapy is being increasingly used for breast cancer. MRI is used for assessing tumour response. Literature on correlation of pathologic response and MRI response is scanty. Aim: Can a pre-operative MRI predict pathologic response of breast cancer to neo-adjuvant chemotherapy? Methods: A consecutive series of patients with invasive..
| Published: | 19/07/2016 |
| Authors: | , Jois RHS, Harris O, Pennick M |
Managing the axilla
Background: Data suggest neoadjuvant chemotherapy (NAC) can downstage the axilla in up to 40% of breast cancers, yet there is no consensus regarding timing and extent of axillary surgery post NAC. Sentinel lymph node biopsy (SLNB) after NAC is also debated. We performed a literature review and suggest an algorithm for..
| Published: | 19/07/2016 |
| Authors: | Pennick M |
Latissimus Dorsi (MSLD) and Latissimus Dorsi (LD) flap breast
Introduction: The Muscle Sparing Latissimus Dorsi (MSLD) flap utilizes only the lateral segment of the muscle containing the descending branch of the thoracodorsal artery with its thoracodorsal artery perforators to supply the skin paddle and fascial components of the flap. The aim of this study was to determine the postoperative..
| Published: | 19/07/2016 |
| Authors: | , Shaaban H, , Iqbal A |
Hyperostosis
Abdelaziz, M; John, CM. (2013). Hyperostosis: an under-recognized complication of prostaglandin infusion . Acta Paediatrica. 102 (5), e192
| Published: | 19/07/2016 |
| Authors: | Abdelaziz M |
Book Review
Sofos, SS and Shokrollahi, K. (2013). Book Review: Laser and IPL Technology in Dermatology and Aesthetic Medicine . Annals of Plastic Surgery. epub 12th June
| Published: | 19/07/2016 |
| Authors: | Sofos S, Shokrollahi K |
Deep Vein Thrombosis
Abstract We describe a rare case of deep vein thrombosis (DVT) in children, highlight the importance of early diagnosis of rare disease with potential complications. In a 5 year old boy presented with persistent leg pain without any obvious cause. Detailed investigation led to diagnosis of DVT. As there are common..
| Published: | 19/07/2016 |
| Authors: | Aabideen K, Ogendele M, Ahmad I, Amegavie L |
Delivery of Parenteral Nutrition
Introduction Recent report by NCEPOD into hospital care of patients receiving parenteral nutrition (PN) suggested that only 19% adult patients had PN care that was considered to represent good practise. An initial audit (retrospective audit over six months) in our hospital suggested lack of quality control at the point of initiation..
| Published: | 19/07/2016 |
| Authors: | Whittingham C, Bassi A |
FRAX analysis
Background Bone health is a significant problem with over 300,000 patients presenting with fragility fractures to hospitals in the UK each year resulting in 20% mortality and 50% disability. FRAX and Q fracture are two fracture risk-assessment tools available to use in the UK. FRAX is an important tool to assess 10-year fracture..
| Published: | 19/07/2016 |
| Authors: | Tayal V, Abernethy R, Clewes A, Dawson J, O'Rourke T |
Lung function tests and high resolution computed tomography
Background Rheumatoid arthritis (RA) is associated with clinically relevant interstitial lung disease (ILD) in approximately 5% of patients. The natural history of the association has been shown to be poor: in a previous study mean survival was 3 years from diagnosis of RA-ILD [1]. The importance of high resolution computed tomography (HRCT) of..
| Published: | 19/07/2016 |
| Authors: | Dawson J |
Assessing the cardiovascular risk burden
Background Rheumatoid arthritis (RA) is associated with the increased risk of cardiovascular (CV) mortality and morbidity. There are recommendations by European League against Rheumatism (EULAR) and National Institute for Health and Clinical Excellence (NICE) to include assessment of cardiovascular, osteoporosis, infection and depression risks annually. One of the ways CV..
| Published: | 19/07/2016 |
| Authors: | Patel V, , Abernethy R, Dawson J, Clewes A, Novak J, Cox A, Williams J, O'Rourke T |
Assessing osteoporosis risk
Background Osteoporosis is a major cause of morbidity in patients with RA. It leads to fragility fractures frequently associated with disability, mortality and major financial and social impact. There is no clear guidance regarding when to screen for Osteoporosis in these group of patients who are at high risk compared..
| Published: | 19/07/2016 |
| Authors: | , Patel V, Abernethy R, Dawson J, Clewes A, Novak J, Cox A, Williams J, O'Rourke T |
Setting up the ventilator
Background We aimed to see if patients were being set up on the ventilator appropriately, with a tailored ventilation strategy including evidence based tidal volumes. Methods A quality improvement project of patients receiving mechanical ventilation (MV) on the ICU over a 6 month period. Patients admitted for organ donation and those..
| Published: | 19/07/2016 |
| Authors: | , McBeath K, |
Laparoscopic versus Open Hysterectomy
Background Endometrial carcinoma accounts for 5% of cancers in women in the UK and is the second most common gynaecological cancer. Obesity is associated with a two- to fivefold increase in the risk of endometrial cancer in both pre and postmenopausal women. Overweight and obese patients have an increased risk of..
| Published: | 19/07/2016 |
| Authors: | Tildesley R, Gilliland J, Dearden D, Kundodyiwa T |
Sexual and Reproductive Healthcare
Objective The Faculty of Sexual and Reproductive Healthcare (FSRH) became an established branch of the Royal College of Obstetrics and Gynaecology (RCOG) in 1993. Although this is a relatively new specialty the practise of genito-urinary medicine is not a new concept. Current sexual health practices are rooted in traditions that took..
| Published: | 19/07/2016 |
| Authors: | Purlackee S |
Metastatic Vulval Crohn's Disease
Background Crohn’s disease is a chronic granulomatous, inflammatory disorder and may have intestinal/extra intestinal manifestations. Vulval involvement is an uncommon extra intestinal manifestation of Crohn’s disease. It is not uncommon to encounter diagnostic dilemmas in vulval lesions. We present a case of abnormal vulval lesions due to..
| Published: | 19/07/2016 |
| Authors: | Idama TO, Myagerimath R |
Body Mass Index >40 and Pregnancy
Objective Review current practice in pregnancy management of women with obesity at a DGH. Method Retrospective case-note survey of over 70% of women with a booking BMI > 40. Results The UK prevalence of women with a known BMI ≥ 35 at any point in pregnancy is approximately 38 500 a year. The Health Survey for England..
| Published: | 19/07/2016 |
| Authors: | Suttenwood HSL, Srivastava N, Ramachandran N |
Bleeding in Early Pregnancy
Objectives Bleeding in early pregnancy (BEP) creates a significant workload for the emergency department (ED) as women seek help out of hours when other specialist services are closed. Turnover of doctors and nurses is high, ED staff are anxious not to miss an ectopic pregnancy and women attend seeking an..
| Published: | 19/07/2016 |
| Authors: | Graham S, Rao S, Moorcroft LK |
Chronic Adnexal Torsion
Introduction Acute adnexal torsion diagnosis is challenging because clinical evaluation and imaging studies are often nonspecific. There are an additional population of women who present with mild, nonspecific symptoms or an incidental finding of an adnexal mass. These cases may represent a failed diagnosis of acute torsion, or perhaps the..
| Published: | 19/07/2016 |
| Authors: | Ramachandran N |
Hydrothermal Ablation
Introduction Heavy menstrual bleeding (HMB) has major impact on a woman’s quality of life. Interventions should aim to improve this rather than focusing on menstrual blood loss. Up to 60% of women with HMB undergo hysterectomy within 5 years of referral to a gynaecologist. Several ablative techniques have been developed to..
| Published: | 19/07/2016 |
| Authors: | Myagerimath R, |
Ovarian Hyperstimulation Syndrome
Background Ovarian Hyperstimulation Syndrome (OHSS) is characterised by presence of multiple luteinized cysts within the ovaries leading to ovarian enlargement. It is commonly associated with assisted fertility treatment. Spontaneous OHSS is an extremely rare event in natural conceptions although a few cases have been described in association with multiple or..
| Published: | 19/07/2016 |
| Authors: | , Mackin D, , Tempest N |
Rescue Cerclage in MCDA Twin Pregnancy
Introduction Around one-third of twin pregnancies in the UK are monochorionic. After single fetal death in a monochorionic pregnancy, the risk to the surviving twin is high and management of such pregnancies is complex. We report a case of rescue cerclage in MCDA twin pregnancy with a view to salvage..
| Published: | 19/07/2016 |
| Authors: | Cording V, Idama TO, Myagerimath R |
Glucose Tolerance Test
Introduction Diabetes is a disorder of carbohydrate metabolism requiring immediate lifestyle changes. Over 650 000 women give birth in England and Wales each year with 2–5% of these women being diabetic. Approximately 87.5% of pregnancies complicated by diabetes are due to gestational diabetes mellitus (GDM) that is dependent on various factors. GDM is associated..
| Published: | 19/07/2016 |
| Authors: | Albert S, , Myagerimath R |
Round Ligament Varicosity in Pregnancy
Introduction Round ligament varicosity (RLV) is an important clinical entity that has not been reported extensively. The incidence of RLV is unknown. It may be easily mistaken for inguinal hernias in gravid patients because these conditions have similar presentations. Distinguishing between varicosities and hernias is critical to avoid performing unnecessary..
| Published: | 19/07/2016 |
| Authors: | Idama TO, Myagerimath R |
External Cephalic Version
Background The term breech trial renewed interest in the procedure of external cephalic version (ECV). It is now recommended that ‘ECV should be discussed and offered to all women with uncomplicated breech presentation at term’. Objective To assess the outcome of ECV in our clinical setting. Methods This was a..
| Published: | 19/07/2016 |
| Authors: | Idama TO |
GLP-1 Treatment
Abstract Glucagon-like peptide 1 (GLP-1) agonist treatment in type 2 diabetes typically improves glycaemic control and results in weight loss. The National Institute for Health and Clinical Excellence (NICE) continuation criteria are that at six months patients must have achieved at least a 3% reduction in weight and an 11mmol/mol (1%) reduction in..
| Published: | 19/07/2016 |
| Authors: | Keigan S, Wessels L, O'Brien S, Hardy KJ |
3-Dimensional Model
Abstract The European Working Time Directive and streamlined training has led to reduced training time. Surgery, as an experience-dependent craft specialty is affected more than other medical specialties. Trainees want to maximize all training opportunities in the clinical setting, and having predeveloped basic skills acquired on a simulated model can..
| Published: | 19/07/2016 |
| Authors: | Graham K, Hassan Z |
Nonmelanoma Skin Tumors
Abstract Introduction: The formation of cutaneous carcinoma has been shown to rely on neovascularization, with angiogenesis being implicated in the invasive process of skin malignancy and metastasis. To date, studies of angiogenesis have generally been limited to in vitro, animal (often murine), or postexcision histopathologic models. Methods: To demonstrate the..
| Published: | 19/07/2016 |
| Authors: | McArthur P, Tehrani H |
Mental and Physical disability
Abstract Sepsis remains a major cause of admissions to Intensive Care Units (ICU) and has a high mortality rates and significant morbidity in survivors. There are physical, cognitive and psychological sequelae from severe sepsis that have a negative effect on the patients' health related quality of life in the longer..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Post-ICU burden for patients and relatives
Jones, C. (2013). What's new on the post-ICU burden for patients and relatives? . Intensive Care Medicine. 39 (10), 1832-35.
| Published: | 19/07/2016 |
| Authors: | Jones C |
Stage 1B Cutaneous Melanoma
Question: Sentinel Lymph Node Biopsy (SLNB) has been advocated as part of the diagnostic and prognostic process in the 2010 updated guidelines for management of cutaneous melanoma. However, there remains some discrepancy in practice across the UK regarding offering SLNB in patients with 1B melanoma (ulceration or mitotic rate ≥1/mm2). Methods: ..
| Published: | 19/07/2016 |
| Authors: | Yao S, Brackley P |
Primary Cutaneous Melanoma
Question: Most current international guidelines for the management of primary cutaneous melanoma stage pT2 and above recommend excisional surgery with a minimum of 2 cm radial margins. However recent systematic reviews suggest that wider excision margins offer no better local disease control than narrow ones. The latest Cochrane review recommended a..
| Published: | 19/07/2016 |
| Authors: | Brackley P, |
Folic Acid Supplementation vs Placebo
Abstract Methotrexate (MTX) is the first-line systemic agent in the treatment of chronic plaque psoriasis (CPP). We undertook a prospective, double-blind, randomized controlled trial in CPP patients treated with MTX to examine the effects of daily folic acid supplementation vs. placebo on MTX efficacy, nausea and serum homocysteine levels. Fifty..
| Published: | 19/07/2016 |
| Authors: |
Mechanically Ventilated Adult Patients
Abstract The combined use of daily interruption of sedation and a nursing-implemented sedation protocol targetting light sedation does not reduce duration of mechanical ventilation in adult ICU patients. Keough, J; Nee, P. (2013). Daily interruption of sedation and nursing-implemented sedation protocol in mechanically ventilated adult patients . Journal of the Intensive Care..
| Published: | 19/07/2016 |
| Authors: | , Nee PA |
Pocket Guide to Plastic Surgery
Abstract There are a number of handy pocket guides in plastic surgery that can help residents, trainees, and medical students to gain consolidated and concise information. We have reviewed 5 of the more popular pocket guides in plastic surgery with a view to assist the discerning buyer to choose the pocket..
| Published: | 19/07/2016 |
| Authors: | Hassan Z, Shokrollahi K |
Trends in the use of bilateral mastectomy
Objectives For healthy women at high risk of developing breast cancer, a bilateral mastectomy can reduce future risk. For women who already have unilateral breast cancer, removing the contralateral healthy breast is more difficult to justify. We examined trends in the number of women who had a bilateral mastectomy in..
| Published: | 19/07/2016 |
| Authors: |
Patients' Perceptions of Cosmetic Surgery
Nassab, R. (2013). Commentary on: Patients' Perceptions of Cosmetic Surgery at a Time of Globalization, Medical Consumerism, and Mass Media Culture: A French Experience . Aesthetic Surgery Journal. 33 (6), 886-7
| Published: | 19/07/2016 |
| Authors: |
Delayed Discharge
Aim: To assess both the rate and the reasons for delayed discharge in Day case inguinal hernia and groin repair in a busy consultant-led day-case unit over an 18 month period. Method: Retrospective analysis of the records of 235 patients who underwent inguinal hernia/groin repair over an 18-month period took place...
| Published: | 19/07/2016 |
| Authors: | Scott M |
Becoming an orthopaedic surgeon
Aim: National training numbers (NTN) in Trauma and Orthopaedics (T&O) in the UK are highly competitive. In 2011 there were 565 applicants for 115 positions. This study aims to assess the academic achievements of candidates successful in gaining an NTN and how building a successful portfolio affected their work-life balance. Methods: A..
| Published: | 19/07/2016 |
| Authors: | Purlackee S |
Pseudo-herniation of small bowel
Introduction: A new potential space named as ‘Peritoneal Recess' was found during diagnostic laparoscopy performed to look for the cause of recurrent abdominal pain. Case Report: A middle aged patient presented with chronic abdominal pain without any obvious cause. All her investigations including small bowel studies were normal; however a..
| Published: | 19/07/2016 |
| Authors: | , Samad A |
Texas sharp shooter
McNulty, SJ; Williams, P. (2012). If you’re going to Vegas, watch out for the Texas sharp shooter . . .. BMJ. Published online 21st December
| Published: | 19/07/2016 |
| Authors: | Williams P, McNulty SJ |
Rotaglide+ total knee replacement
Purpose Mobile-bearing knee replacements were introduced as an alternative to their fixed-bearing counterparts. Movement of the polyethylene insert relative to the tibial tray has been shown to decrease contact stresses, wear and polyethylene-induced osteolysis. The aim of this study is to compare outcomes between mobile and fixed-bearing surfaces of the..
| Published: | 19/07/2016 |
| Authors: | , |
Otoplasty
Shokrollahi, K. (2013). Otoplasty awake and in the prone position-a new perspective . Annals of Plastic Surgery. 70 (1), 1-3
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Split-Thickness Skin Grafts
INTRODUCTION: Significant controversy surrounds the effectiveness of negative pressure wound therapy although it has been in use for decades. Although many clinicians favor this modality in relation to its practicality, ease of use especially in complex wounds, it has faced the same challenges as other dressings in relation to evidence..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Prescribing Errors in Patients
Objective To evaluate the prevalence, type and severity of prescribing errors observed between grades of prescriber, ward area, admission or discharge and type of medication prescribed. Design Ward-based clinical pharmacists prospectively documented prescribing errors at the point of clinically checking admission or discharge prescriptions. Error categories and severities were assigned..
| Published: | 19/07/2016 |
| Authors: | Lloyd M |
Model of Care
Thornton, H. (2013). Which model of care will deliver the improvements we seek? Journal of Diabetes Nursing. 17 (1), 18-19
| Published: | 19/07/2016 |
| Authors: | Thornton H |
Merkel cell carcinoma
Tehrani, H; Iqbal, A; Hancock, K. (2013). Merkel cell carcinoma of the hallux: A case report . European Journal of Plastic Surgery. 36 (1), 63-64
| Published: | 19/07/2016 |
| Authors: | Tehrani H, Iqbal A, |
Central Venous Sinus Thrombosis
Objectives: To describe the predisposing factors clinical presentation, neuroimaging, management and outcome in a cohort of children with cerebral sinus venous thrombosis (CVST). Methods: Retrospective analysis of case notes of patients up to 17 years of age with a diagnosis of CVST, between January 1997 to December 2009 in a tertiary hospital. Results: ..
| Published: | 19/07/2016 |
| Authors: | Clarke R, Ismail N |
Post Traumatic Stress Disorder
Jones, C. (2013). Post Traumatic Stress Disorder – The critical care effect . Australian Critical Care. 26 (1), p4-5
| Published: | 19/07/2016 |
| Authors: | Jones C |
Brown Bowel Syndrome
Brown bowel syndrome, as described by Stamp and Evans (1987), is a rare disorder of lipofuscin accumulation in intestinal smooth muscle which has been described in association with vitamin E deficiency. Asher, C and Mavinamane, S. (2013). Brown Bowel Syndrome . British Journal of Hospital Medicine. 74 (2), 111
| Published: | 19/07/2016 |
| Authors: | Asher C, Mavinamane S |
Combined Carbon Dioxide Laser
Background: Basal cell carcinomas (BCCs) are often seen by general practitioners, plastic surgeons, and dermatologists in the outpatient setting. Photodynamic therapy (PDT) and CO2 laser when used as monotherapy have been successfully used to treat small BCC, with greatest success in the superficial histological subtype but have limitations compared to..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Robot-assisted Laparoscopic Nissen Fundoplication
Introduction: Gastroesophageal reflux disease (GERD) has been the main health concern in the last few years, both in term of quality of life and symptomatology and also causing longterm health concern like cancer. In our current practice laparoscopic Nissen fundoplication is the most commonly performed operative procedure for reflux disease...
| Published: | 19/07/2016 |
| Authors: | Pushdary KH |
Pseudoherniation of Small Bowel
Abstract A middle-aged patient presented with intermittent chronic abdominal pain without any obvious cause. Computed tomography detected a hernia (presumed to be the cause of the patient's symptoms) without any obvious lump on examination. A laparoscopy was performed to repair the hernia. This revealed a left-sided unilateral 'peritoneal recess' at..
| Published: | 19/07/2016 |
| Authors: | , , Samad A |
Calcium Replacement in Hypocalcaemia
Introduction The aim of the study is to examine the efficacy of calcium replacement in patients with hypocalcaemia in the ICU. Hypocalcaemia affects between 15 and 50% of admissions to the ICU. Methods Adjusted calcium results
| Published: | 19/07/2016 |
| Authors: | Chatha H, |
PREDELIRIC
Introduction Delirium is a serious and frequent disorder in ICU patients. The aim of this study was to internationally validate the existing Prediction of Delirium ICU (PREDELIRIC) model to predict delirium in ICU patients. Methods A prospective multicenter cohort study was performed in eight ICUs in six countries (Table 1). The 10..
| Published: | 19/07/2016 |
| Authors: | Jones C |
National Insulin Pump Audit
Introduction The National Insulin Pump Audit is a joint funded project by Diabetes UK, ABCD and the JDRF. As the Cheshire and Merseyside expert reference group for this audit we present the preliminary results for adult patients. Aims The first national audit of insulin pump therapy in the UK. Methods..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ |
Bilateral Arytenoid Keratosis
KEY POINTS We present a rare case of bilateral arytenoid keratosis and concomitant oral leukoplakia in a 52 year old smoker and drinker with an acute hoarse voiceSmoking and alcohol are well known aetiological risk factors for the development of keratosis Laryngeal keratosis is a premalignant mucosal change Laryngeal keratosis is..
| Published: | 19/07/2016 |
| Authors: | Qureshi EH, Saleem Y |
Inpatients with Diabetes
Aim: UK management of inpatients with diabetes is suboptimal. Previously, we found diabetes knowledge to be lacking amongst ward staff nurses. We hypothesised that final year student nurses should know about diabetes management and our aim was to test diabetes knowledge in such students to determine whether low knowledge amongst..
| Published: | 19/07/2016 |
| Authors: | O'Brien S, , Cardwell J, Hardy KJ |
Diabetes Foot Ulceration
Aims: The presence of foot ulceration is associated with increased morbidity and mortality. This study aimed to determine the factors associated with mortality among patients with foot ulcers attending a multidisciplinary diabetes foot clinic. Methods: All patients reviewed consecutively in a multidisciplinary diabetes foot clinic with new foot ulceration between 1..
| Published: | 19/07/2016 |
| Authors: | Hart-Pinto AD, Beeharry D, Hardy KJ, |
Recurrent Foot Ulceration
Aims: To identify risk factors for recurrent foot ulceration (RFU) among people with diabetes attending a multidisciplinary diabetes foot clinic. Methods: All consecutively reviewed patients in amultidisciplinary diabetes foot clinic with newfoot ulceration over an 18-month period were included in this retrospective, observational study. Patients with Charcot neuroarthropathy were excluded...
| Published: | 19/07/2016 |
| Authors: | Hart-Pinto AD, Beeharry D, Hardy KJ, |
Healthcare Assistants Lack the Knowledge
Aim: Much healthcare for people with diabetes is delivered by healthcare assistants (HCAs). We interviewed inpatients with diabetes following discharge from hospital and they raised concerns about HCAs’ understanding of diabetes.Given the enhanced role of HCAs in recent years it is essential they know how to manage inpatients with..
| Published: | 19/07/2016 |
| Authors: | , Cardwell J, Hardy KJ, O'Brien S |
Inpatient Diabetes Care
Aim: Inpatient diabetes care is a burden on NHS resources. National inpatient audits identify areas of poor management but do not provide insight into underlying causes to fix the problems. Our aim was to explore the experiences of inpatients with diabetes, identify reasons for mismanagement and investigate these further. Methods: ..
| Published: | 19/07/2016 |
| Authors: | O'Brien S, , Cardwell J, Hardy KJ |
Guidelines and Inpatient Diabetes Nurse Specialists
Aim: Diabetes specialist nurses (DSNs) have a vital role in enabling people to self-manage and in supporting non-specialist staff. Our research has identified low diabetes knowledge amongst ward nurses and students, but this may not be problematic if DSNs bridge the gap. Here, we surveyed ward nurses to determine their ..
| Published: | 19/07/2016 |
| Authors: | Cardwell J, , Hardy KJ, O'Brien S |
National Insulin Pump Audit (Paediatric)
Introduction: The National Insulin Pump Audit is a joint funded project by Diabetes UK, ABCD and JDRF. As the Cheshire and Merseyside expert reference group for this audit we present the preliminary results for paediatric (children and young persons, CYP) patients. Aims: This is the first national audit of insulin..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ |
Tragedy of the Commons
McNulty, SJ. (2013). The tragedy of the commons for the NHS? . BMJ. 346 (Published online 16th April).
| Published: | 19/07/2016 |
| Authors: | McNulty SJ |
Laser Doppler Imaging
Abstract This review article discusses the use of laser Doppler imaging as a clinimetric tool to determine burn depth in patients presenting to hospital. Laser Doppler imaging is a very sensitive and specific tool to measure burn depth, easy to use, reliable and acceptable to the patient due to its..
| Published: | 19/07/2016 |
| Authors: | Gill P |
Recurrent lentigo maligna melanoma
Abstract There are various types and combinations of coexisting cutaneous neoplasms which have been documented in the past but are uncommon. In this report we describe a case of basal cell carcinoma (BCC) colonised by recurrent lentigo maligna melanoma. A review of the literature has established the coexistence of lentigo..
| Published: | 19/07/2016 |
| Authors: | Ahmad F, Brackley P, Hassan Z |
Zone I Flexor Tendon Injuries
Eighty-two patients who were treated by suture repair for Zone I flexor tendon injuries over a ten-year period were identified, to determine the incidence of post-operative surgical complications and subsequent re-operations. Eighty-five percent of patients completed 12 weeks follow-up post-surgery. Of these patients almost all had good to excellent outcome in..
| Published: | 19/07/2016 |
| Authors: | Bidwai AS, Feldberg L |
Proactive Improvement Strategy Checklist
Aims: Laparoscopic cholecystectomy has been widely accepted as a day case procedure but many trusts struggle to attain this. Techniques have been described to reduce pain and immediate/early complications from surgical and anaesthetic perspectives. We evaluated our theatre practices, targeting areas of improvement, to create and implement a "Proactive..
| Published: | 19/07/2016 |
| Authors: | Mann K, Graham M, Purlackee S, Ray A, Kaul A, Kuduvalli P |
Immunological Faecal Occult Blood Testing
Introduction Current investigation for patients with colorectal symptoms without overt rectal bleeding is undertaken by colonoscopy or by flexible sigmoidoscopy and barium enema. A large majority of patients do not have colorectal cancer. There exists no instant, objective measure to discriminate patients who are likely to have colorectal cancer and..
| Published: | 19/07/2016 |
| Authors: | Kaul A |
Primary Squamous Cell Carcinoma
Abstract There has been only one documented case in the English literature with the diagnosis of primary Squamous Cell Carcinoma (SCC) of the nipple; we present a further case of a primary SCC of the nipple, thus raising awareness to the skin or breast specialist of this possible presentation for..
| Published: | 19/07/2016 |
| Authors: | , Lymperopoulos NS, Sofos S, Tehrani H, |
The Postauricular Fascia
Abstract In recent times, there has been evolving interest in the fascial structure of the ear, especially in relation to otoplasty techniques. Although the fascial tissues used in these procedures are referred to as "postauricular/retroauricular fascia," the sparse anatomical studies that exist use this terminology to describe what is..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Metastatic Skin Cancers
Abstract In the absence of distant disease simultaneous skin cancer metastasis to neck and axillary lymph nodes necessitates both an axillary and neck en block lymphadenectomy. A combined ipsilateral neck and axillary lymph node dissection should involve an in-continuity dissection through the cervicoaxillary canal for optimal lymphatic and oncological clearance...
| Published: | 19/07/2016 |
| Authors: | , Shaaban H |
Farewell
Jones, C. (2013). Farewell to a beloved grandfather . Intensive Care Medicine. Published online 14th May
| Published: | 19/07/2016 |
| Authors: | Jones C |
Obstructive sleep apnoea
Introduction: Obstructive sleep apnoea (OSA) is associated with obesity, hypertension and cardiovascular disease. Arterial stiffness has been proposed as a marker of cardiovascular disease risk. We determined whether severely obese patients with newly diagnosed OSA without previous cardiovascular disease have increased arterial stiffness compared with BMI-matched controls. Methods: 72 patients(35 females),..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Book Review
Molajo, A and Shokrollahi, K. (2013). Book review: aesthetic breast surgery, concepts, and techniques . Annals of Plastic Surgery. 71 (1), 12
| Published: | 19/07/2016 |
| Authors: | Molajo A, Shokrollahi K |
ROLL failure rates
Background: We have used Radioisotope Occult Lesion Localization (ROLL) of breast lesions at our unit since 2002. Literature reports failure rates of 4 - 10% for Wire Guided Localisation (WGL). Ours is the first reporting of the difficulties with ROLL (UK) and lessons learnt from it. Method: A consecutive series of patients underwent..
| Published: | 19/07/2016 |
| Authors: | , Carini S, Harris O, Thind R, Desmond S, Jois RHS |
Impact of a Ward Pharmacy Technician
The impact of clinical pharmacists in terms of intervening in drug therapy and reducing medication errors to improve patient outcomes has been described. In addition, pharmacy technicians have in part enabled the expansion of clinical pharmacy services by taking a more active role in patient care such as undertaking patients’..
| Published: | 19/07/2016 |
| Authors: | Brancaleone CP, Brough S |
Cosmetic surgery growth
Background: Over the past 10 years, there has been significant fluctuation in the yearly growth rates for cosmetic surgery procedures in both the United States and the United Kingdom. Objectives: The authors compare cosmetic surgical procedure rates in the United Kingdom and United States with the macroeconomic climate of each region..
| Published: | 19/07/2016 |
| Authors: |
Diabetic Medicine
Nair, S; Hardy, KJ; Wilding, JPH. (2012). Reply to Camargo et al. Diabetic Medicine . 29 (8), 1086-87
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Human Bite
Pettitt, DA; Molajo, A; and McArthur, P. (2012). A Human Bite . BMJ . Published online 17th July
| Published: | 19/07/2016 |
| Authors: | McArthur P, Molajo A |
Burn Depth Analysis
Shokrollahi, K. (2012). Photography and the mobile phone camera: A good method for burn depth analysis with implications for remote assessment . Burns. 38 (3), 459
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Purple Urine Bag
Asher, C; Mavinamane, S. (2012). A case of purple urine bag syndrome . European Geriatric Medicine. 3 (3), 179-80
| Published: | 19/07/2016 |
| Authors: | Asher C, Mavinamane S |
Secondary care costs in oesophagogastric cancer
Introduction Published data describing the scale, profile and determinants of healthcare resource use for oesophago-gastric cancer (OGC) are scarce, particularly for the UK. The National Cancer Plan (2000) encouraged greater use of imaging for staging and increased use of oncological therapies but the major modalities of palliation and curative surgery have..
| Published: | 19/07/2016 |
| Authors: | Bassi A |
Salvage Anal Cancer Surgery (SACS)
Introduction: 2004 NICE guidance on anal carcinomas advised treatment by specific multidisciplinary teams (MDTs). The National Peer Review Programme recommended each cancer network have a single anal carcinoma MDT and single salvage surgery centre. We present the results of this service. Methods: A retrospective case note audit was performed of all..
| Published: | 19/07/2016 |
| Authors: | Liew S |
Metformin and alcohol
Overend, L; Hardy, K. (2012). Metformin and alcohol . Practical Diabetes. 29 (6), 229-30
| Published: | 19/07/2016 |
| Authors: | Overend L, Hardy KJ |
Colorectal Cancer Risk
Abstract We performed a meta-analysis of five genome-wide association studies to identify common variants influencing colorectal cancer (CRC) risk comprising 8,682 cases and 9,649 controls. Replication analysis was performed in case-control sets totaling 21,096 cases and 19,555 controls. We identified three new CRC risk loci at 6p21 (rs1321311, near CDKN1A; P = 1.14 × 10−10), 11q13.4 (rs3824999,..
| Published: | 19/07/2016 |
| Authors: | Abbas M, Marshall E |
Medical Innovation
Sofos, S; McArthur, P; Shokrollahi, K et al. (2012). Medical Innovation - A Starting Point for Plastic Surgeons . Annals of Plastic Surgery. Published online 8th August 2012.
| Published: | 19/07/2016 |
| Authors: | McArthur P, Shokrollahi K, Sofos S |
Metal Ion Levels
Abstract Plasma levels of cobalt and chromium ions and Metal Artefact Reduction Sequence (MARS)-MRI scans were performed on patients with 209 consecutive, unilateral, symptomatic metal-on-metal (MoM) hip arthroplasties. There was wide variation in plasma cobalt and chromium levels, and MARS-MRI scans were positive for adverse reaction to metal debris (ARMD)..
| Published: | 19/07/2016 |
| Authors: | Malek S |
White Out
Extract A patient in their mid-40s presented with a history of worsening dyspnoea. The patient had neurofibromatosis type 1 and had previous spinal surgery for kyphoscoliosis. A chest x-ray showed a right sided ‘white out’, thought to be a pleural effusion (figure 1A). CT thorax showed a thoracic scoliosis with..
| Published: | 19/07/2016 |
| Authors: | Tack G, Wide J, Stockton P |
Skin lesion in axilla
Invasive lobular carcinoma (ILC) of breast is known to present with atypical clinical findings in the breast, making it difficult to diagnose. It is also known to have unusual sites of metastases arising de novo or in patients treated for known ILC. Skin lesion in axilla could be a cutaneous..
| Published: | 19/07/2016 |
| Authors: | Sripadam R |
Rituximab
Patel, V; Dawson, J and Patel, P. (2012). Comment on: Non-infectious pulmonary toxicity of rituximab: a systematic review . Rheumatology. Published online 4th September
| Published: | 19/07/2016 |
| Authors: | Dawson J, Patel V |
Delivery Room Resuscitation
Background In 2011, on the basis of clinical research studies, the Resuscitation Council (UK) recommended that term infants should be resuscitated initially in room air, and preterm infants in blended oxygen guided by pulse oximetry. Aims We aimed to examine whether UK hospitals follow the Resuscitation Council 2011 (UK) guidelines and how..
| Published: | 19/07/2016 |
| Authors: | Whitby TM |
Right Inguinoscrotal Swelling
Myxofibrosarcoma of the spermatic cord is a rare condition. We present an unusual case of a 69-year-old gentleman who presented to the emergency department on two occasions with a right inguinoscrotal swelling. We will explore the diagnostic difficulties encountered and subsequent management. We will also highlight the importance of histological..
| Published: | 19/07/2016 |
| Authors: | , , Brougham K, McCabe JE |
Interprofessional Simulation-Based Education (IPSE)
Summary Interprofessional simulation-based education (IPSE) is becoming an increasingly popular educational strategy worldwide within undergraduate healthcare curricular. The purpose of the literature review was to examine qualitative, quantitative and mixed/multi-method research studies featuring undergraduate IPSE. A literature review was conducted using CINAHL, MEDLINE, and PsycINFO databases from January 1999 to..
| Published: | 19/07/2016 |
| Authors: |
TA/T1 Transitional Cell Carcinoma
Omar, A; Amirzqadah, P; Khattak, A; Gana, H; Chisholm, N; Jacob, N. (2012). Ten weeks versus 6 weeks maintenance intravesical instillation of mitomycin-C for prevention of recurrence of TA/T1 transitional cell carcinoma of the bladder: A retrospective study in a single institution. Urology. 80 (3 (Supplement)), pS217-18
| Published: | 19/07/2016 |
| Authors: | Amirzadah P, Chisholm N, Gana HB, Khattak AQ, Omar A, Jacob N |
Barium Aspiration
A 70-year-old lady underwent a barium swallow for investigation of dysphagia and unfortunately aspirated a large quantity of contrast material, which dramatically illuminated the airspaces (Figure 1A). The patient received supportive care, chest physiotherapy and prophylactic antibiotics. Varatharaj, A; Roome, C; Allsup, S. (2012). Barium aspiration . QJM: An International Journal of..
| Published: | 19/07/2016 |
| Authors: | Allsup S, Roome C, Varatharaj A |
CT Scout Topograms
Objective Guidelines for the diagnosis and management of new presentations of urolithiasis recommend performing both X-Ray Kidney-Ureter-Bladder (XR-KUB) and CT Kidney-Ureter- Bladder (CT-KUB). We assessed the sensitivity of the CT scout topogram compared with XR-KUB in the detection of urinary tract calculi. Methods Patients that underwent both XR-KUB and CT-KUB..
| Published: | 19/07/2016 |
| Authors: | Massey G, , McCabe JE, |
Mobile lithotripsy service
Objective The introduction of Extracorporeal Shockwave lithotripsy (ESWL) in the 1980s revolutionised the treatment of urinary stones. ESWL is a popular treatment option due to the low risk of morbidity and the reported good rates of stone clearance. Mobile lithotripters offer an ESWL service for DGH populations at a fraction..
| Published: | 19/07/2016 |
| Authors: | , McCabe JE, , Samsudin A |
Preoperative Fasting Time
Jameel, SA; Kataria, C. (2012). Audit of preoperative fasting time . British Journal of Anaesthesia. 109 (3), 479P-480P
| Published: | 19/07/2016 |
| Authors: | Jameel SA, Kataria C |
Red Cell Utilization
Yoxall, PF; Mayhew, D. (2012). Red cell utilization in revision hip surgery and attempting to reduce utilization using a standardized dose of tranexamic acid and appropriate cell salvage . British Journal of Anaesthesia. 109 (3), 475P-476P
| Published: | 19/07/2016 |
| Authors: | Mayhew D, Yoxall PF |
Huisman, MG; Audisio, RA et al. (2012). The predictive ability of timed “Up & Go” in oncogeriatric surgical patients . European Journal of Surgical Oncology. 38 (9), 769-70
| Published: | 19/07/2016 |
| Authors: |
Safe Surgical Monitoring
Abstract It is often difficult to apply traditional ECG electrodes on patients with extensive burns due to a large operative site, compromise of sterility, the fact that traditional placement would be within the operative site or because stick-on pads cannot stick due to prep solution, bleeding and other factors. We..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K, Sofos S, Tehrani H, |
Blunt Carotid Artery Injury
Objective To highlight a rare cause of Horner's syndrome, and to review the management of blunt carotid artery injury. Method Literature search via PubMed for related articles. Results Horner's syndrome and blunt carotid artery injury are rare phenomena; sexual asphyxia as a cause has not previously been reported. This case..
| Published: | 19/07/2016 |
| Authors: | Galli F, Muddaiah A, Banigo A |
Patients With Tracheostomy
Introduction and aims Ventilated patients in ITU (intensive treatment unit) tend to be challenging to communicate with, especially patients who are being weaned. These patients usually have tracheostomy in situ and use means such as writing or letter boards to communicate. The situation becomes complex in patient groups that have..
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Button-Over-Nail Technique
Abstract The "button over the nail" is the most commonly used technique in order to re-insert the flexor digitorum profundus tendon into the distal phalanx in the management of Zone 1 injuries. Recent evidence in the literature has highlighted an associated morbidity with the technique. In this study, 37 patients were identified..
| Published: | 19/07/2016 |
| Authors: | Bidwai AS, Feldberg L |
Functional Antibody Assay
Background and Aim Recurrent respiratory tract infection (RTI) is a frequent presenting complaint in the general paediatric clinic. Children are often tested to screen for possible underlying immunodeficiency and Cystic Fibrosis. We aim to evaluate the indications for performing functional antibody assay (FAA) and how the results affected our clinical ..
| Published: | 19/07/2016 |
| Authors: | Collier JJ, Ho DKK, Abdelaziz M, John CM |
Renal Replacement Catheter Placement
BACKGROUND. This audit was conducted in response to work conducted by Kam et al¹ analysing tracer uptake from adjacently positioned central venous catheters (CVC) and haemofiltration (HF) lines. They found that if the CVC was positioned less than 2cm distal to the tip of the HF catheter, or proximal to..
| Published: | 19/07/2016 |
| Authors: | Lyons MW, Miller T |
Out of Hours Admission
INTRODUCTION. Recent evidence suggests that patients admitted to hospitals in the UK over the weekend have an increased risk of death when compared to those admitted during the week[1]. Likewise, for intensive care admissions, studies suggest that mortality seems to be worse for patients admitted both out of hours[2] and..
| Published: | 19/07/2016 |
| Authors: | , Harvey E, Downes C, |
Topical Negative Pressure Therapy
Abstract Research into topical negative pressure therapy (TNPT) started in 1989 with Dr Louis Argenta and Prof Michael Morykwas of Wake Forest University School of Medicine in North Carolina, USA. In 1997, Morykwas and Argenta concluded that TNPT both enhanced granulation tissue formation and helped bacterial clearance, through the actions of negative..
| Published: | 19/07/2016 |
| Authors: | , Saedi F, McArthur P |
Surviving the Intensive Care
Abstract Patients recovering from critical illness may suffer from physical, psychological, and cognitive problems that have a negative impact on their health-related quality of life. To ensure that patients return as close as possible to their previous physical and mental health, their rehabilitation needs should be assessed and an appropriate..
| Published: | 19/07/2016 |
| Authors: | Jones C |
Our Man in Havana
Varatharaj, A. (2012). The lesson of Dr Hasselbacher from Our man in Havana . Clinical Medicine, Journal of the Royal College of Physicians. 12 (5), 492
| Published: | 19/07/2016 |
| Authors: | Varatharaj A |
Managing Myocardial Infarction
Embolic myocardial infarction is an uncommon but increasingly recognised complication of infective endocarditis. This complication has a high mortality rate and is deemed a relative contraindication to thrombolytic therapy. The present article describes an episode of acute myocardial infarction associated with infective endocarditis. Systemic thrombolytic therapy was administered, which resulted..
| Published: | 19/07/2016 |
| Authors: | Overend L |
Hodgkin's Disease
Purpose: Published literature from India on HD in children is scant. This comprehensive review of published and grey literature was conducted to understand the current management and outcome of childhood HD in India. Methods: A search of MEDLINE and EMBASE was carried out. The search was limited to studies published..
| Published: | 19/07/2016 |
| Authors: | Aabideen K |
Raynaud’s Phenomenon
Abstract Raynaud’s phenomenon of the nipple is an unusual cause of severe nipple pain. Precipitants for Raynaud’s phenomenon of the nipple are known to be cold temperatures, caffeine, and emotional stress. Nipple pain is quoted as the most common cause of cessation of breastfeeding. It is important that..
| Published: | 19/07/2016 |
| Authors: | McGuiness N, Cording V |
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
Abstract Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are effective for obese patients with type 2 diabetes mellitus (T2DM) because they concomitantly target obesity and dysglycaemia. Considering the high prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with T2DM, we determined the impact of 6 months’ GLP-1 RA therapy on..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ |
Reconstructive Limb Surgery
The British Association of Plastic Reconstructive and Aesthetic Surgeons Reconstructive Limb Surgery Course represents part 5 of the its Advanced Educational Courses. This article reports the highlights and contents of the course. Molajo, A. (2012). Course Review: Reconstructive Limb Surgery . Annals of Plastic Surgery. Published online 13th December
| Published: | 19/07/2016 |
| Authors: | Molajo A |
Pilonidal sinus
Abstract Occupationally acquired inter-digital pilonidal sinuses are seldom seen and typically found on the hands of hair dressers. Sheep shearing has traditionally been believed to be a cause of inter-digital pilonidal sinuses; although in reality it is infrequently so with only two previously reported cases in 1951 and 1966. We present a..
| Published: | 19/07/2016 |
| Authors: | , |
Diabetes Legacy Plan
Thornton, H. (2012). A diabetes legacy plan for children and young people . Journal of Diabetes Nursing. 16 (1), 18
| Published: | 19/07/2016 |
| Authors: | Thornton H |
Management of Hyperglycaemia
Chandrasekara, H; Brough, C; Goenka, N; Somauroo, J and Hardy, K. (2012). Management of hyperglycaemia in people with acute coronary syndromes (NICE Clinical Guideline 130): uncertainty persists . Practical Diabetes. 29 (1), 9-11
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
Critical Care
Abstract Inadequate resuscitation of major haemorrhage is an important cause of avoidable death in severely injured patients. Early recognition of blood loss, control of bleeding and restoration of circulating volume are critical to the management of trauma shock, and transfusion of blood components is a key intervention. Vital signs may..
| Published: | 19/07/2016 |
| Authors: | Bonney S, Mahambrey T, Nee PA |
Re-audit of Multidisciplinary Management
Patients are at risk of hypothermia (core body temperature
| Published: | 19/07/2016 |
| Authors: | Kuduvalli P |
Obesity and in-hospital Cardiac Arrest
Resuscitation of the obese presents numerous challenges. It is known that obesity can affect the airway, ventilation and haemodynamics. At present however, Resuscitation Council (UK) guidelines do not suggest modified Advanced Life Support for the obese patient. A large study based on American Heart Association (AHA) data suggested that obesity..
| Published: | 19/07/2016 |
| Authors: | Shelton C, Williams A, Kuduvalli P |
Impalpable Breast Cancer
Background: The detection of impalpable breast cancer lesions is on the rise due to mass population screening. Radio-guided occult lesion localisation (ROLL) has recently been used in the management of early lesions while sentinel lymph node biopsy (SLNB) has been used to detect occult lymph node metastases. In order to..
| Published: | 19/07/2016 |
| Authors: | Herbert J, , Chagla LS, Desmond S, Galea M, Harris O, Ray A, Thind R, Jois RHS |
Sentinel lymph node biopsy
Background: Sentinel lymph node biopsy (SLNB) is an established method of assessing axillary node status in women with early breast cancer. The primary aim of SLNB is to understand lymph node status with minimal morbidity. Current practice is to offer completion axillary clearance for those women with metastases in sentinel..
| Published: | 19/07/2016 |
| Authors: | Galea M, Jois RHS, Swaminathan V, Chagla LS, Thind R, Harris O, Desmond S, |
Decontamination
Introduction An audit to assess the compliance of decontamination of bedside computer keyboards by medical staff on an ICU. The topic was used for audit as previously identified by the hospital infection control department as the worst-performing area on 'clean trace' scoring, and had been a regular topic of discussion..
| Published: | 19/07/2016 |
| Authors: | Disney A, |
Anaesthesia and orphan disease: Phocomelia - a lesson from the past
Mukhtar K; Jayaseelan S; Allsop E (2012) Anaesthesia and orphan disease: Phocomelia - a lesson from the past . European Journal of Anaesthesiology. Published online 5 April 2012
| Published: | 19/07/2016 |
| Authors: | Allsop E, Jayaseelan S, Mukhtar K |
Visible and non visible haematuria
Introduction & Objectives In the UK investigation of patients presenting with any form of haematuria is now accepted practice and patients are often referred to be seen urgently within 2 weeks, with financial penalties imposed if these targets are not met. We set out to ascertain the proportion of patients presenting with..
| Published: | 19/07/2016 |
| Authors: | McCabe JE |
Facial Nerve Branches
Lymperopoulos, N; Lappas, D; Gisakis, I; Juszczyk, A; Karkanevatos, A and Iqbal, A. (2012). Anatomical variations in facial nerve branches in a mediterranean population - A cadaver study . European Archives of Oto-Rhino-Laryngology. 269 (4), 1385
| Published: | 19/07/2016 |
| Authors: | Iqbal A, Lymperopoulos NS |
Gastrointestinal Stromal Tumours
Dimitrakakis, G; Stamou, D; Sofos, SS; Dimitrakaki, IA. (2012). eComment. Gastrointestinal stromal tumours . Interactive Cardiovascular and Thoracic Surgery. 14 (4), 499
| Published: | 19/07/2016 |
| Authors: | Sofos S |
Breast Reconstruction
Wallace C; Shokrollahi K. (2012). Thoracodorsal or Internal Mammary Recipient Vessels for Microvascular Breast Reconstruction? . Annals of Plastic Surgery. 68 (5), 536
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Mobile Phone Camera
Shokrollahi K. (2012). Photography and the mobile phone camera: A good method for burn depth analysis with implications for remote assessment . Burns. 38 (3), 459
| Published: | 19/07/2016 |
| Authors: | Shokrollahi K |
Twitter for Plastic Surgeons
Saedi F; Nassab RS; Shaaban H. (2012). Twitter for Plastic Surgeons. Plastic & Reconstructive Surgery. 129 (5), 893e-94e
| Published: | 19/07/2016 |
| Authors: | , Saedi F, Shaaban H |
Collagen Scaffolds
Abstract The term tissue engineering is the technology that combines cells, engineering and biological/synthetic material in order to repair, replace or regenerate biological tissues such as bone, muscle, tendons and cartilage. The major human applications of tissue engineering are: skin, bone, cartilage, corneas, blood vessels, left mainstem bronchus and..
| Published: | 19/07/2016 |
| Authors: | , , , |
Chondrogenic
Abstract Chondrogenesis is a vital part of adult life, as cartilage is important not only for articulation of joints but also maintenance functions of the body. Chondrogenesis is a five way process of intricate events controlled by specific genes and cell-cell interactions which has been documented over recent years. This..
| Published: | 19/07/2016 |
| Authors: | Griffin M, , |
Chondrogenesis
Abstract Conditions affecting cartilage through damage or age-related degeneration pose significant challenges to individual patients and their healthcare systems. The disease burden will rise in the future as life expectancy increases. This has resulted in vigorous efforts to develop novel therapies to meet current and future needs. Due to the..
| Published: | 19/07/2016 |
| Authors: | , , , |
Self-referral
Background: Nurse Advice Lines have been a long accepted practice in Rheumatology. At St. Helens Hospital we expanded this to a Therapy Advice Line, and noticed an increasing tendency for self referral by our patients. From working parties on management of Early RA and Stable RA we emphasized our self..
| Published: | 19/07/2016 |
| Authors: | Clayton AM, Griffiths AE, Clewes A, Lynch M, Abernethy R, Dawson J |
Nasopharyngeal Aspirate Cost-analysis Review
Introduction SIGN recommends rapid virological testing for RSV. There was a perception that in the absence of laboratory confirmation, infants were being increasingly investigated and treated to cover for bacterial pneumonia. Method A cost analysis comparing two periods when NPA was routinely done and when it was not done was..
| Published: | 19/07/2016 |
| Authors: | Strong JS, Whitby TM |
Tissue Glue
Teo, I; Lam, W; Bell, D. (2012). Practical tips for using tissue glue . Journal of Wound Care. 21 (5), 234-235
| Published: | 19/07/2016 |
| Authors: | Bell D |
V-Y Flap
Summary This case report demonstrates a modification of the so-called ‘Extended V-Y Flap’ used to simultaneously reconstruct a defect involving the upper lip, floor of nose and alar rim following tumour excision. We hope that this case serves as a reminder of the versatility of the V-Y flap in the..
| Published: | 19/07/2016 |
| Authors: | Morton J, |
Plastic Surgery apps
Molajo, A; Vaiude, P; Benson, A. (2012). ‘iReconstruct’: Clinically relevant plastic surgery apps . Journal of Plastic, Reconstructive & Aesthetic Surgery. 65 (6), 838-39
| Published: | 19/07/2016 |
| Authors: | Benson A, , Molajo A |
Turner Syndrome
Abstract Advances in reproductive medicine using oocyte donation have made it possible for women with Turner syndrome (TS) to achieve successful pregnancies. These pregnancies carry substantial fetal and maternal risks, with hypertensive disorders or pregnancy and fetal growth restriction common, and an increased risk of aortic dissection, sometimes fatal, for..
| Published: | 19/07/2016 |
| Authors: | , Brockbank A |
Neck Swelling
Sinha, IP; Stickland, A; John, CM. (2012). A child with neck swelling . BMJ. 344 (7860), e3171
| Published: | 19/07/2016 |
| Authors: | John CM |
Perinatal Mortality
Ekekwe, GO; Anorlu, R. (2012). Perinatal mortality and associated risk factors at Lagos University Teaching Hospital . BJOG: An International Journal of Obstetrics and Gynaecology. 119 (Suppl s1), 51
| Published: | 19/07/2016 |
| Authors: | Ekekwe GO |
Pregnant woman with thrombophilia
Ekekwe, GO; Tempest, N; Rao S. (2012). Pregnant woman with thrombophilia presenting with massive rectus sheath and pelvic haematoma: A case report . BJOG: An International Journal of Obstetrics and Gynaecology. 119 (Suppl s1), 78
| Published: | 19/07/2016 |
| Authors: | Tempest N, Ekekwe GO, Rao S |
Gitelman's syndrome
Ekekwe, GO; Rao, S. (2012). Gitelman's syndrome in pregnancy: A case report . BJOG: An International Journal of Obstetrics and Gynaecology. 119 (Suppl s1), 28-29
| Published: | 19/07/2016 |
| Authors: | Ekekwe GO, Rao S |
Post Fracture Fixation
In spite of the widespread availability of image intensifier for fracture fixation and storage of images on a radiological computer system, routine check radiography is still a common practice. This is even so in situations with no clear indications such as fall or increasing patients' discomfort. Idowu, OK; Menakaya, CU;..
| Published: | 19/07/2016 |
| Authors: | Idowu OK, |
Intensive Care Diaries
Background Relatives of patients recovering from critical illness are at risk of developing posttraumatic stress disorder. Objectives To test whether providing a diary to intensive care patients and their relatives reduces the level of symptoms related to posttraumatic stress disorder in the relatives. Methods Observational study of close family members..
| Published: | 19/07/2016 |
| Authors: | Griffiths RD, Jones C |
UK Radical Cystectomy Audit
Background: UK Urologists have been able to submit radical cystectomy data to the BAUS complex operations database since 2004. In 2011 the datasets were overhauled and a web based system launched. We present an analysis of this newly submitted data. It is hoped that by collecting this data we can gain a..
| Published: | 19/07/2016 |
| Authors: | Fowler S, , McCabe JE |
Rheumatoid Arthritis
OBJECTIVES: To compare the risk of keratinoctye skin cancer (basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)) in patients treated for rheumatoid arthritis (RA) compared with the general population, and to determine whether anti-tumour necrosis factor (TNF) therapy exacerbates this risk. METHODS: Patients with RA enrolled in the British..
| Published: | 19/07/2016 |
| Authors: | Abernethy R |
Validating Imagine-S
Purpose To validate a virtual reality simulator suitable for training Interventional Radiology (IR) skills. Task Analysis (TA) was employed to create a detailed description of a Liver Biopsy procedure, from which critical procedure steps (CPS) were identified. Engineers and computer scientists used the TA and CPS to build a simulator..
| Published: | 19/07/2016 |
| Authors: | Sinha A |
CS gas
Kain, N; Mishra, A; James, MI. (2010). Exposure to CS gas: Guidance needed on secondary effects of CS gas on staff . BMJ. 340 (7745), 494
| Published: | 19/07/2016 |
| Authors: | Kain N, Mishra A, |
Pleural Drain Insertion
Nazareth, DS; Prakash, A; Blayney, S; Stockton, P. (2010). Pleural drain insertion and management in a UK hospital . American Journal of Respiratory and Critical Care Medicine. 181 (Meeting Abstracts)
| Published: | 19/07/2016 |
| Authors: | Blayney S, Prakash A, Nazareth DS, Stockton P |
Community Acquired Pneumonia
Nazareth, DS; Tack, G; Maher, F; Patrick, S; Stockton, P. (2010). Community acquired pneumonia: Improvements in hospital management in a UK NHS hospital . American Journal of Respiratory and Critical Care Medicine. 181 (Meeting Abstracts), D25
| Published: | 19/07/2016 |
| Authors: | Maher F, Nazareth DS, Patrick S, Stockton P, Tack G |
Cheshire and Merseyside Critical Care
Background The intravenous route is the most common route of drug administration on critical care units. Intravenous drug administration can be particularly hazardous on critical care due to complex drug regimes, multiple concurrent infusions and the unstable nature of patients. In response to 800 incidents, the National Patient Safety Agency (NPSA)..
| Published: | 19/07/2016 |
| Authors: | Barton G |
Inflammatory Osteoarthritis
Abstract We report the case of a 51-year-old woman who presented with an inflammatory flare of osteoarthritis of the small joints of her hands occurring in a temporal relationship with the commencement of Arimidex, prescribed to reduce systemic oestrogen levels to treat breast cancer. Following the cessation of Arimidex and..
| Published: | 19/07/2016 |
| Authors: | Williams S |
Insulin Errors
McNulty, SJ; Lewis, A; Hardy, KJ. (2010). Reducing insulin errors . BMJ. 341 (7782), 1065.
| Published: | 19/07/2016 |
| Authors: | Lewis A, Hardy KJ, McNulty SJ |
Acute ortic Valvular Regurgitation
Abstract A 40-year-old man with Wegener's granulomatosis with renal and ocular involvement was admitted with symptoms of fever, malaise and cough not responding to oral antibiotics. On initial assessment, he had patchy consolidation but was also found to have a new cardiac murmur. He was mildly anaemic. Within 2 days of..
| Published: | 19/07/2016 |
| Authors: | Clewes A |
Homodigital Subcutaneous Flap
Hold, P; Tehrani, H and Feldberg, L. (2010). The homodigital subcutaneous flap for soft tissue coverage of the dorsum of the finger: a case series . Hand. 5 (4), 458-60
| Published: | 19/07/2016 |
| Authors: | Tehrani H, Feldberg L |
Beware SLEAZE tactics
Capewell, S and Capewell, A. (2011). Denialism in public health: Beware SLEAZE tactics . BMJ. 342 (7790), 188
| Published: | 19/07/2016 |
| Authors: | Capewell A |
Missile launch pad
Abstract Vehicle airbags significantly reduce vehicle occupant injuries and fatalities in road accidents. However, a number of injuries are recognised as being directly attributable to airbag deployment. The majority of these are blunt injuries due to the high force of airbag deployment and include ocular injuries, burns, chest trauma and,..
| Published: | 19/07/2016 |
| Authors: | Emecheta IE |
Glucagon-like peptide-1 analogues
A 58 year old woman attends a diabetes clinic with type 2 diabetes of seven years’ duration and no history of macrovascular disease. She is obese (body mass index 37), but says she eats a healthy diet and describes this. Her blood pressure is 134/78 mm Hg, and she has microalbuminuria, but normal renal..
| Published: | 19/07/2016 |
| Authors: | Hardy KJ |
A boy with a painful arm
A healthy 8 year old boy, with no history of surgery or medical conditions, presented to the accident and emergency department with severe pain in his right arm after falling off a four foot wall. He had a painful, tender, and swollen right elbow, which he was hesitant to move. The..
| Published: | 19/07/2016 |
| Authors: | McArthur P |
Skill of interpreting imperfect investigations
Shuster suggests that clinicians should direct their efforts away from encouraging a deeper understanding of statistics towards searching for better investigations that will give a definitive answer, yes or no.1 To strive for a test that is 100% sensitive and specific, with a 100% positive and negative predictive value, though admirable, is..
| Published: | 19/07/2016 |
| Authors: | McNulty SJ, Williams S |
Pump Advanced Carbohydrate Education programme
Abstract Enabling patients to have a say in the design and delivery of local health services is a key priority in the NHS. The St Helens and Knowsley Teaching Hospitals NHS Trust diabetes team aimed to set up a peer support group for people with type 1 diabetes to aid in..
| Published: | 19/07/2016 |
| Authors: | Cardwell J, Furlong NJ, Hardy KJ, Wessels L, O'Brien S |
Accidental staggered paracetamol overdose
Abstract Paracetamol is one of the most commonly used drugs both over the counter and on prescription. Liquid paracetamol is available over the counter all over the world. Most commonly available concentrations are 120 mg/5 ml and 250 mg/5 ml. Many parents and healthcare professionals assume that doses available in different countries..
| Published: | 19/07/2016 |
| Authors: | Sills J, Aabideen K |
Carcinoma with Unknown Primary
Abstract Widespread metastatic disease with no obvious primary on initial investigations is a diagnostic challenge often encountered by radiologists. Carcinoma of unknown primary origin (CUP) forms a heterogeneous group of cancers constituting approximately 3-5% of new cancers and amongst the top 10 causes of cancer-related deaths worldwide. A radiologist is often..
| Published: | 19/07/2016 |
| Authors: | , Marshall E, Thind R |
Secondary Breast Cancers
Background: Occurrence of metastatic disease to breast (secondary breast cancer) in both women and men is rare, constituting 0.5-6% of breast malignancy. In addition to systematic history taking and clinical examination, early diagnosis of secondary breast cancer demands vigilance by radiologists to distinguish subtle disparities between much commoner primary breast..
| Published: | 19/07/2016 |
| Authors: | Kulkarni T, , Jois RHS, Harris O, Thind R |
ROLL Lumpectomy
Background Occult breast lesions are being successfully targeted by means of Radioactive-guided Occult Lesion Localization (ROLL). Several reports demonstrate suitability of ROLL technique to excise non-palpable breast lesions with immediate advantages. Aim Evaluation of long-term outcomes after ROLL guided lumpectomy for early breast cancer. Materials and methods A consecutive series..
| Published: | 19/07/2016 |
| Authors: | , Chagla LS, Desmond S, Harris O, Poonawala S, Thind R, Jois RHS |
Prediction of Non Sentinel Nodal Metastases After Positive Sentinel Lymph Node Biopsy for Early Breast Cancer – Burney Breast Unit Experience
Background: Sentinel lymph node biopsy (SLNB) is an established method of assessing axillary node status in women with early breast cancer. The primary aim of SLNB is to understand lymph node status with minimal morbidity. Current practice is to offer completion axillary clearance for those women with metastases in sentinel..
| Published: | 19/07/2016 |
| Authors: | Galea M, Jois RHS, Swaminathan V, Chagla LS, Thind R, Harris O, Desmond S, |
Using Stroke Sentinel National Audit Data To Deliver Organisational Change - A keynote speech to the NI Stroke Forum
Hill, AM. (2016). Using Stroke Sentinel National Audit Data To Deliver Organisational Change - A keynote speech to the NI Stroke Forum. 5th NIMAST Northern Ireland Stroke Conference. 17 May
| Published: | 17/05/2016 |
| Authors: | Hill AM |
Challenging Hunt on Strokes (Letter)
Hill, AM. (2016). Challenging Hunt on Strokes (Letter). The Times. 17 January.
| Published: | 17/01/2016 |
| Authors: | Hill AM |
060 The development of a stroke unit simulation model to reconfigure an inpatient stroke unit
Summary Our team developed a mathematical simulation of a stroke unit, allowing us to demonstrate the optimal size and configuration for a stroke unit. The model utilised existing known inputs: including the number of strokes, stroke ‘mimics’, TIAs, and optionally the presence of medical outliers on the stroke unit. For..
| Published: | 24/10/2015 |
| Authors: | Hill AM |
Oral Presentation: Development of a graphical dashboard for real-time analysis of Stroke Sentinel National Audit (SSNAP) data
Summary The Stroke Sentinal National Audit Programme Dataset contains valuable operational data but is limited by its lag time to reporting. We have developed a realtime data dashboard which enables SSNAP data to be used to study the performance of our unit live. Data is entered onto the dashboard..
| Published: | 23/10/2015 |
| Authors: | Hill AM |
Centralising acute stroke services: study confounded by financial investment
Extract Morris and colleagues did not discuss how substantial financial investment in services affected their results.1 The London stroke strategy was supported by an additional £23m (€28.8m; $37.3m) in funding.2 The cost improvement programme highlighted the need for an extra £13m investment in hyperacute stroke units to Hill, AM. (2014). Centralising..
| Published: | 23/09/2014 |
| Authors: | Hill AM |
Southport and Ormskirk Hospital Staff - Publications pre April 2024
P064 Incidence and Clinical Outcomes of New-onset Autoimmune Connective Tissue Diseases after COVID-19 Infection- A Systematic Literature Review
Background/Aims Cases of new autoimmune and autoinflammatory conditions have been reported among COVID-19 survivors. A literature review on new-onset autoimmune connective tissue diseases (ACTDs) following infection with COVID-19 is lacking.This systematic literature review aimed to evaluate the potential association between COVID-19 infection and the development of new-onset ACTDs..
| Published: | 24/04/2024 |
| Authors: | Nune A |
Validity of ChatGPT-generated musculoskeletal images
Objective In the evolving landscape of medical research and radiology, effective communication of intricate ideas is imperative, with visualizations playing a crucial role. This study explores the transformative potential of ChatGPT4, a powerful Large Language Model (LLM), in automating the creation of schematics and figures for radiology research papers, specifically..
| Published: | 04/03/2024 |
| Authors: | Iyengar KP |
Intra-articular Lipoma of the Pisotriquetral Joint: A Rare Case Report
Intra-articular lipomas are infrequently reported, with most reported cases occurring in the knee joint. A case of intra-articular lipoma in the small joints of the hand, specifically in the pisotriquetral joint, has been documented for the first time. A 24-year-old male visited the emergency department after a road traffic accident..
| Published: | 23/02/2024 |
| Authors: | Iyengar KP |
Impact of Excessive Noise Generation in Orthopaedic Operating Theatres: A Comprehensive Review
Abstract Excessive noise in the orthopaedic operating theatre (OT) is an underrecognized and often neglected health hazard noticed amongst surgeons, patients and theatre and scrub practitioners. A comprehensive search strategy was conducted using databases, such as PubMed, Scopus and Web of Science, with the search words 'noise', 'NIHL' and 'orthopaedics'..
| Published: | 19/02/2024 |
| Authors: | Iyengar KP |
Clinical characteristics, disease trajectories and management of vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome: a systematic review
Background Cases of new autoimmune and autoinflammatory conditions have been reported among COVID-19 survivors. A literature review on new-onset autoimmune connective tissue diseases (ACTDs) following infection with COVID-19 is lacking.This systematic literature review aimed to evaluate the potential association between COVID-19 infection and the development of new-onset ACTDs in..
| Published: | 21/12/2023 |
| Authors: | Nune A |
COVID-19 Vaccination-Related Delayed Adverse Events among Patients with Systemic Lupus Erythematosus
Background: The safety profile of COVID-19 vaccination is well documented, but hesitancy among people with immune-mediated inflammatory diseases, often immunocompromised, remains high, partially due to a scarcity of data on safety over a longer term. We herein aimed to assess delayed adverse events (DAEs) occurring >7 days after COVID-19 vaccination in..
| Published: | 07/12/2023 |
| Authors: | Nune A |
COVID-19 breakthrough infections in type 1 diabetes mellitus: a cross-sectional study by the COVID-19 Vaccination in Autoimmune Diseases (COVAD) Group
Abstract To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients..
| Published: | 07/12/2023 |
| Authors: | Nune A |
Augmentation of natriuretic peptide (NP) receptor A and B (NPR-A and NPR-B) and cyclic guanosine monophosphate (cGMP) signalling as a therapeutic strategy in heart failure
Introduction Heart failure is a complex, debilitating condition and despite advances in treatment, it remains a significant cause of morbidity and mortality worldwide. Therefore, the need for alternative treatment strategies is essential. In this review, we explore the therapeutic strategies of augmenting natriuretic peptide receptors (NPR-A and NPR-B) and cyclic..
| Published: | 05/12/2023 |
| Authors: | Ajay H |
Immune thrombocytopenic purpura after influenza vaccine administration; a systematic review and meta-analysis
Background The American Society of Haematology defines immune thrombocytopenic purpura (ITP) as a common hematologic disorder characterized by a transient or long-term decrease in platelet counts (
| Published: | 25/11/2023 |
| Authors: | Nune A |
HPB P50 A comparison of layered vs mass closure in development of incisional hernia following Kocher’s incision for open cholecystectomy, a retrospective analysis
Background Incisional hernias are a common complication of abdominal surgery. Open cholecystectomy procedures predispose to development of incisional hernias. Studies have shown rates of incisional hernias in visceral abdominal surgery to be 12.6% at one year and 22.4% at 3 years [1]. Several techniques have been developed to reduce rates of incisional hernia, namely..
| Published: | 18/11/2023 |
| Authors: | Korolchuk M, Azam M, Satchidanand R |
Is there a change in ischiofemoral space in lateral position in comparison to supine
Summary Ischiofemoral impingement (IFI) is caused due to impingement of soft tissues between the ischium and the lesser trochanter of the femur, resulting in pain and discomfort. IFI can be caused due to anatomical abnormality, previous trauma and surgery. The quadratus femoris muscle is usually affected in these cases, which..
| Published: | 08/11/2023 |
| Authors: | Iyengar KP |
Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review
Background Although SARS-CoV-2 vaccines are generally safe, there are growing concerns about their link to a potentially life-threatening multi-system inflammatory syndrome following vaccination (MIS-V). We conducted this systematic review to elucidate the prevalence of MIS, severity, treatment, and outcomes following SARS-CoV-2 vaccination. Methods We searched PubMed, Scopus, ScienceDirect, Google Scholar,..
| Published: | 05/11/2023 |
| Authors: | Nune A |
P-149 Assessment and documentation of spiritual needs of hospice inpatients
Background Spiritual care is a fundamental domain of palliative and end-of-life care. Addressing spiritual care empowers patients to take ownership of what is important to them. All healthcare professionals should feel confident to address patients’ spiritual needs and provide tailored individual care and support. Aims To demonstrate that a concise..
| Published: | 02/11/2023 |
| Authors: | Kopec E, Groves K, Hough J |
P-174 Improving assessments of family caregivers: impact of staff education in a hospice at home service
Background In an ageing population, complex health needs, reduced health and social care resources result in an increased reliance on families to provide care at end-of-life. Family caregivers are reported to have increasing challenges to their own health and wellbeing especially as the patient requires more support. National policies recommend..
| Published: | 01/11/2023 |
| Authors: | Davidson J, Birch H, Hough J, Groves K |
Polymyalgia rheumatica and polymyalgia-like syndromes as adverse events following immunisation with COVID-19 vaccines: a 15 months update
Dear Editor Polymyalgia rheumatica (PMR) has been reported as an adverse event following immunisation (AEFI) with COVID-19 vaccines [1, 2]. In April 2022, we published in Reumatologia a narrative review, stating that reports of PMR following COVID-19 vaccination were rare AEFI. Among these, atypical presentation (so-called “PMR-like sytndromes”) were not uncommon. A shared..
| Published: | 31/10/2023 |
| Authors: | Nune A |
Bilateral Cubonavicular and Synchronous Talocalcaneal Tarsal Coalition with Stress Response—Case Report and Review of Literature
Tarsal coalition occurs in 1% of the population and represents a congenital failure of segmentation in two or more tarsal bones. It most commonly occurs at the talocalcaneal and calcaneonavicular joint. Although commonly asymptomatic, it may present with pain, rigidity, and pes planus. Cubonavicular, multiple synchronous, and bilateral coalitions are rare..
| Published: | 27/10/2023 |
| Authors: | Iyengar KP |
The management of patients with polymyalgia rheumatica: limitations to get it right
Sirs We read with interest the editorial article recently published by Mukhtyar et al. (1). We thank the authors for their considerations and suggestions about “getting it right for polymyalgia rheumatica (PMR)”. The authors suggested integrating pathways to improve the diagnostic accuracy of patients suspected to have PMR to reduce reliance..
| Published: | 27/10/2023 |
| Authors: | Nune A |
Journal metrics of the top-ranked Orthopaedic, Medical, and Surgical journals – A cross-sectional, comparative study
Purpose In academic publishing, research metrics play a crucial role in assessing the scientific impact and performance of the published literature, as well as of the journals in which they are published. Several journal-level metrics (JLM) such as the h-index of the analysed journals, total citations, total documents, citable documents,..
| Published: | 18/10/2023 |
| Authors: | Iyengar KP |
Case for funding of continuous glucose monitoring systems for patients with recurrent hypoglycaemia
Introduction Continuous glucose monitoring (CGM) allows real-time interstitial glucose monitoring, therefore reducing the need for regular fingerprick blood testing.1 CGM also informs users of glucose trend data and alarms, which warns users of high or low blood glucose readings. There is a paucity of evidence on the use of CGM..
| Published: | 18/10/2023 |
| Authors: | Ng SM |
Can We Apply Pomodoro Technique in Academic Publishing?
Iyengar, KP; Et al. (2014). Can We Apply Pomodoro Technique in Academic Publishing?. Apollo Medicine. 21(2), pp.176-177. [Online]. Available at: https://www.doi.org/10.4103/am.am_193_23 [Accessed 11 October 2024].
| Published: | 09/10/2023 |
| Authors: | Iyengar KP |
New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review
Abstract A comprehensive, up-to-date systematic review (SR) of the new-onset rheumatic immune-mediated inflammatory diseases (R-IMIDs) following COVID-19 vaccinations is lacking. Therefore, we investigated the demographics, management, and prognosis of new R-IMIDs in adults following SARS-CoV-2 vaccinations. A systematic literature search of Medline, Embase, Google Scholar, LitCovid, and Cochrane was conducted...
| Published: | 08/10/2023 |
| Authors: | Nune A, Mahmood S, Babajan N |
Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group
Objective Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working...
| Published: | 04/10/2023 |
| Authors: | Smith M |
SLCO5A1 and synaptic assembly genes contribute to impulsivity in juvenile myoclonic epilepsy
Abstract Elevated impulsivity is a key component of attention-deficit hyperactivity disorder (ADHD), bipolar disorder and juvenile myoclonic epilepsy (JME). We performed a genome-wide association, colocalization, polygenic risk score, and pathway analysis of impulsivity in JME (n = 381). Results were followed up with functional characterisation using a drosophila model. We identified genome-wide..
| Published: | 28/09/2023 |
| Authors: | Mariguddi. S, Haslam Z |
Why would immuno- and endocrino-senescence, age-related changes in the gut microbiota, and susceptibility to infection...
Sirs We are intrigued by Coskun Benlidayi’s review article in which the author proposed that immunosenescence/inflammaging, increased risk of infections with aging, endocrinosenescence, and age-related changes in gut microbiota are factors associated with polymyalgia rheumatica (PMR) and aging (1)... Manzo, C.; Nune, A.; Castagna, A. (2023). Why would immuno- and..
| Published: | 27/09/2023 |
| Authors: | Nune A |
Perception of Chat Generative Pre-trained Transformer (Chat-GPT) AI tool amongst MSK clinicians
Background: Chat Generative Pre-trained Transformer (ChatGPT); an open access artificial intelligence (AI) tool has been in the limelight with its ability to respond to prompts, analyse data information using algorithms to augment efficiency in day-to-day activities across a spectrum of human activities including MSK/Orthopaedic science. Purpose of the study:..
| Published: | 23/09/2023 |
| Authors: | Iyengar KP, Yousef MMA, Nune A |
High-fidelity virtual reality simulation training in enhancing competency assessment in orthopaedic training
Surgical competence is the ability to successfully apply academic knowledge, clinical skills and professional behaviour to inpatient care. Along with ensuring patient safety, the ability to communicate effectively, collaborative teamwork and probity, and achieving satisfactory competencies form the fundamental principles of good medical practice. Current strategies to develop surgical competencies..
| Published: | 21/09/2023 |
| Authors: | Iyengar KP |
P1-438 A qualitative study of knowledge, attitudes and perceptions of new diabetes technologies in A&E department
Background In August 2022, the National Institute of Health and Care Excellence recommended that all adults and children with type 1 diabetes (T1DM) should have access to Continuous Glucose monitoring systems (CGM). This guidance will increase the number of T1DM patients who present in the A&E department and the..
| Published: | 19/09/2023 |
| Authors: | Alexopoulou V (S&O), McCaffrey L, McCabe M, Ng SM |
Results from learner’s feedback on the use of free, globally accessible CME-accredited e-learning modules in Paediatric Endocrinology and Diabetes
Introduction: The ESPE e-Learning web portal is a free, globally accessible online tool to enhance learning in Paediatric Endocrinology and Diabetes. Since August 2022, the e-learning content includes 30 accredited hours of ESPE/ISPAD e-learning Continuing Medical Education (CME) courses with ten core modules each in Paediatric Endocrinology, Paediatric Endocrinology in Resource..
| Published: | 19/09/2023 |
| Authors: | Ng. SM |
Silver nanoparticle technology in orthopaedic infections
Abstract The number of bariatric operations is increasing each year. Sleeve gastrectomy is the most popular procedure; however, it often requires revision surgery because of insufficient weight loss, weight regain or gastro-oesophageal reflux disease (GORD). The most popular revisional procedures are Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (..
| Published: | 18/09/2023 |
| Authors: | Iyengar KP |
Intermittently scanned continuous glucose monitoring and hypoglycaemia awareness in drivers with diabetes: Insights from the Association of British Clinical Diabetologists Nationwide audit
Aim: Frequent hypoglycaemia results in disruption to usual hypoglycaemic autonomic responses leading to impaired awareness of hypoglycaemia, which is associated with an increased risk of severe hypoglycaemia requiring third-party assistance (SH). The UK Driving and Vehicle Licensing Agency (DVLA) does not permit car driving if they have either a complete..
| Published: | 17/09/2023 |
| Authors: | Saunders. S |
Letter to the editor: Classification and management of sexual dysfunctions in multiple sclerosis patients: A review of current literature, Campetella et al.
Atayi, AA.; Khadr, RN.; Floyd Jr, MS. et al. (2023). Letter to the editor: Classification and management of sexual dysfunctions in multiple sclerosis patients: A review of current literature, Campetella et al. Urologia. Online ahead of print. [Online]. Available at: https://doi.org/10.1177/03915603231199529 [Accessed 27 February 2024].
| Published: | 13/09/2023 |
| Authors: | Atayi AA, Khadr R, Floyd Jr MS |
Can ChatGPT empower people with dyslexia?
No abstract available. Botchu, B.; Iyengar, KP.; Botchu, R. (2023). Can ChatGPT empower people with dyslexia?. Disability and Rehabilitation : Assistive Technology. Online ahead of print (Sep 12), pp.1-2. [Online]. Available at: https://doi.org/10.1080/17483107.2023.2256805 [Accessed 27 February 2024].
| Published: | 12/09/2023 |
| Authors: | Iyengar KP |
Current role and future applications of image-guided interventional procedures in musculoskeletal oncology - A narrative review
Background Musculoskeletal (MSK) image-guided interventional procedures have been increasingly used in and remain crucial in the diagnosis and treatment of musculoskeletal tumours. Aims In this article, we aim to describe commonly performed interventional procedures in the subspeciality of MSK oncology drawing experience from our tertiary referral centre. Recent advances, emerging..
| Published: | 12/09/2023 |
| Authors: | Iyengar KP |
Type 1 diabetes, COVID-19 vaccines and short-term safety: Subgroup analysis from the global COVAD study
Aims/Introduction Coronavirus disease 2019 (COVID-19) vaccinations have been proven to be generally safe in healthy populations. However, the data on vaccine safety in patients with type 1 diabetes are scarce. This study aimed to evaluate the frequency and severity of short-term (
| Published: | 11/09/2023 |
| Authors: | Nune A |
Correlates of breakthrough COVID-19 in vaccinated patients with systemic sclerosis: survival analysis from a multicentre international patient-reported survey
Abstract This study aimed to assess the incidence, predictors, and outcomes of breakthrough infection (BI) following coronavirus disease (COVID-19) vaccination in patients with systemic sclerosis (SSc), a risk group associated with an immune-suppressed state and high cardiopulmonary disease burden. Cross-sectional data from fully vaccinated respondents with SSc, non-SSc autoimmune rheumatic..
| Published: | 05/09/2023 |
| Authors: | Nune A |
A rare case of an intraneural ganglion cyst of the median nerve
Aim of the study Intraneural ganglion cysts are a relatively uncommon type of ganglion cyst that can affect peripheral nerves. They are particularly rare in the upper limb, and even more so in the median nerve, with the vast majority of them occurring in the peroneal nerves. This paper aims..
| Published: | 01/09/2023 |
| Authors: | Iyengar KP |
275 The Declining Elective Workload of a Consultant Surgeon
Aim The elective workload of a consultant surgeon has changed considerably over time. We aimed to describe these changes and explore possible reasons behind them. Method All elective procedures performed by a single consultant vascular and general surgeon at a district general hospital were identified for the years 2000 and 2019. Cases..
| Published: | 30/08/2023 |
| Authors: | Mason P F |
877 Utility Value of Colonoscopy in the Over 80's
Aim To audit the rationale and efficacy of colonoscopy in the over 80’s over a year period at Southport hospital which caters to a geriatrically skewed population. Currently protocol driven diagnostic pathways often lead to direct triaging of patients to endoscopy preventing assessment of biological age of patient, practicalities of..
| Published: | 30/08/2023 |
| Authors: | Challapalli P, Gokul K, Artioukh D |
1241 A Review: How Is Anatomy Best Taught in Postgraduate Surgical Education
Abstract Introduction Successful surgery relies on complete appreciation of the appropriate anatomy, with inadequate expertise noted as a key cause of surgical errors. Despite this, there are fewer formal sessions dedicated to anatomy tuition, with surgical trainees expected to be taught “at the operating table” (Older, 2004). Aim We investigated how..
| Published: | 30/08/2023 |
| Authors: | Chaudhuri T |
609 Improving Patient Counselling in Patients' With PI-RADS 3 Lesions with the Use of PSA Density, A Retrospective Study in a UK District General Hospital
Introduction NICE and EAU guidelines recommend offering prostate biopsy for patients with PI-RADS 3 lesions in a multiparametric MRI. Employing PSA density (PSAd), to further risk-stratify these patients, is a promising approach to advocate for PSA surveillance over biopsies. Here, we appraise the ability of PSAd to risk-stratify PI-RADs 3 lesions across..
| Published: | 30/08/2023 |
| Authors: | Maniarasu S, Elsayed M, Barker H |
147 Pre-Operative Urine Culture for Endourology Surgeries
Aim Our aim was to reduce post-operative endourology infection rates by screening all patient pre-operatively with urine culture. Our local guidelines recommend single dose Gentamicin for prophylaxis prior to endourology procedures. Pre-operative urine culture can identify patients with positive cultures to be treated prior to surgery and to identify multi-resistant..
| Published: | 30/08/2023 |
| Authors: | Maniarasu S, McNicholas DP, Iordan N |
145 Patient Experience of Bladder Outlet Surgery During Covid-19 in a District General Hospital
Aim During the pandemic, bladder outlet surgeries (TURP,Urolift,Rezum) were delayed. Operations were prioritised (P2
| Published: | 30/08/2023 |
| Authors: | Maniarasu S, McNicholas DP, Mistry R |
899 Administration of Fascia-Iliaca Blocks for Hip Fracture Patients on Admission to the A&E Department at Southport DGH
Aim Fascia-iliaca block (FIB) is regional anaesthetic used in A&E for hip fractures; they’re performed under landmark guidance in Southport A&E. NICE recommend FIBs for hip fractures if PO/IV paracetamol/opiates provide insufficient relief; it’s shown to provide superior analgesia and reduce opiate consumption. RCEM..
| Published: | 30/08/2023 |
| Authors: | Moss M, Sha S, Sangani C, Gledhill P |
COVID-19 vaccine safety during pregnancy and breastfeeding in women with autoimmune diseases: results from the COVAD study
Objectives We investigated coronavirus disease 2019 (COVID-19) vaccine safety in pregnant and breastfeeding women with autoimmune diseases (AID) in the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. Methodology Delayed-onset (>7 days) vaccine-related adverse events (AE), disease flares and AID-related treatment modifications were analysed upon diagnosis of AID vs healthy controls (HC) and..
| Published: | 28/08/2023 |
| Authors: | Nune A |
Citation Trend Analysis of the articles published in the Journal of Orthopaedics®
Journal of Orthopaedics® is the premier Orthopaedic journal from India and contributes towards the improvement of the quality of Orthopaedic health care. It proudly received its first Journal Impact Factor of 1.5 in June 2023. Its Journal Level Metrics and Citation Analysis have shown an impressive growth. Citation Trend analysis provides a..
| Published: | 15/08/2023 |
| Authors: | Iyengar KP |
Validation of the supinator fat pad sign in radial head and neck fractures
Objective: To assess the displacement of the supinator fat pad in radial head and neck fractures and to validate its significance. Material and methods: One hundred two adult patients from the Royal Orthopaedic Hospital, Birmingham, United Kingdom and Sultan Qaboos University Hospital, Muscat, Oman with confirmed radial head and/or..
| Published: | 04/08/2023 |
| Authors: | Iyengar KP |
Is cuffed endotracheal intubation in neonates a safe practice?
Summary Endotracheal intubation and ventilation for respiratory insufficiency is a common procedure in preterm and sick infants. Traditionally, uncuffed endotracheal tubes (ETTs) are used in neonatal units, however the use of cuffed ETTs is on the increase, despite the limited evidence. This literature study reviews the evidence available on the..
| Published: | 19/07/2023 |
| Authors: | Oyedokun K |
Second Issue – From the Desk of the Guest Editors
Patel, S; Iyengar, K; Botchu, R. (2023). Second Issue – From the Desk of the Guest Editors. Journal of Arthroscopy and Joint Surgery. 10(3), p.91. [Online]. Available at: 10.4103/jajs.jajs_50_23 [Accessed 26 February 2024].
| Published: | 19/07/2023 |
| Authors: | Iyengar KP |
A case of anti-neutrophil cytoplasmic antibody-associated vasculitis masquerading as Sjögren syndrome
Abstract Anti-neutrophil cytoplasmic antibody (ANCA) -positive vasculitis is a small-vessel vasculitis that affects multiple body systems. Salivary gland involvement in ANCA-associated vasculitis is rare. When present, it mimics infection or malignancy, which might lead to misdiagnosis. In this report, we describe a 72-year-old man who presented with parotid and submandibular..
| Published: | 10/07/2023 |
| Authors: | Pillay SS, Nune A, Raza H |
Will collaborative publishing with ChatGPT drive academic writing in the future?
Ariyaratne, S.; Iyengar, KP. et al. (2023). Will collaborative publishing with ChatGPT drive academic writing in the future?. British Journal of Surgery. 110(9), pp.1213-1214. [Online]. Available at: https://doi.org/10.1093/bjs/znad198 [Accessed 28 February 2024].
| Published: | 27/06/2023 |
| Authors: | Iyengar KP |
Long-term safety of COVID vaccination in individuals with idiopathic inflammatory myopathies: results from the COVAD study
Limited evidence on long-term COVID-19 vaccine safety in patients with idiopathic inflammatory myopathies (IIMs) continues to contribute to vaccine hesitancy. We studied delayed-onset vaccine adverse events (AEs) in patients with IIMs, other systemic autoimmune and inflammatory disorders (SAIDs), and healthy controls (HCs), using data from the second COVID-19 Vaccination in..
| Published: | 23/06/2023 |
| Authors: | Nune A |
Intraoperative Radiological Imaging: An Update on Modalities in Trauma and Orthopedic Surgery
Abstract Intraoperative radiological imaging plays a key role in the management algorithm of patient care. Different intraoperative modalities have applications in the diagnosis, treatment, and monitoring of patient affected by various medical or surgical conditions. Advances in technology, computer software, and integration of various radiological modalities have extended the applications..
| Published: | 20/06/2023 |
| Authors: | Iyengar KP |
A cross-sectional study of the mental health burden among COVID-19 survivors
Introduction Coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on mental health, including stress, anxiety, and depression. This study aimed to assess the incidence and severity of mental health issues among individuals diagnosed with COVID-19 infection. Methods A semi-structured proforma for socio-demographic and clinical parameters was used to collect..
| Published: | 19/06/2023 |
| Authors: | Nune A |
P35 Improving clinical relationship between palliative care and hepatology services: a DGH experience.
Abstract Introduction: Whilst there is evidence that mortality secondary to liver disease is increasing, there is failure to recognise this.1 Early palliative care involvement should be offered to patients with advanced liver disease (MELD >30, or Child Pugh Class C). Regular palliative care-liver disease MDTs improve care through increased recognition, but..
| Published: | 18/06/2023 |
| Authors: | Avades T, Black R, Shami N |
Will ChatGPT Drive Radiology in the Future?
No abstract available. Botchu, R.; Iyengar, KP. (2023). Will ChatGPT Drive Radiology in the Future?. Indian Journal of Radiology and Imaging. 33(4), pp.436-437. [Online]. Available at: https://doi.org/10.1055/s-0043-1769591 [Accessed 28 February 2024].
| Published: | 16/06/2023 |
| Authors: | Iyengar KP |
Birmingham Royal Orthopaedic Hospital (BROH) Femoral Offset-An Ancillary Measure of Adult Dysplasia of the Hip
Introduction Adult dysplasia of the hip (ADH) is a disorder of abnormal development of the hip joint resulting in a shallow acetabulum and uncovering of the femoral head. Several radiological measurements such as the Tönnis angle (acetabular index), lateral center edge angle of Wiberg, and cross-sectional imaging parameters exist..
| Published: | 16/06/2023 |
| Authors: | Iyengar KP |
High fatigue scores in patients with idiopathic inflammatory myopathies: a multigroup comparative study from the COVAD e-survey
Idiopathic inflammatory myopathies (IIMs) confer a significant risk of disability and poor quality of life, though fatigue, an important contributing factor, remains under-reported in these individuals. We aimed to compare and analyze differences in visual analog scale (VAS) scores (0–10 cm) for fatigue (VAS-F) in patients with IIMs, non-IIM systemic autoimmune..
| Published: | 14/06/2023 |
| Authors: | Nune A |
Iliotibial band friction syndrome after knee cementoplasty: a case report
Iliotibial band pathologies can result in lateral knee pain. These are commonly seen in runners and cyclists. Lateral knee pain following knee arthroplasty can be due to distal iliotibial band enthesopathy or impingement by the femoral component. Cementoplasty is a common procedure performed during treatment of osseous lesions. We describe..
| Published: | 10/06/2023 |
| Authors: | Iyengar KP |
Primary Benign Neoplasms of the Spine
Abstract Benign tumours comprise the majority of primary vertebral tumours, and these are often found incidentally on imaging. Nonetheless, accurate diagnosis of these benign lesions is crucial, in order to avoid misdiagnosis as more ominous malignant lesions or infection. Furthermore, some of these tumours, despite their benign nature, can have..
| Published: | 08/06/2023 |
| Authors: | Iyengar KP |
The role of Grey Scale Inversion Imaging (GSII) as a diagnostic tool of neck of femur fractures: is it more effective?
Introduction Grey Scale Inversion Imaging (GSII), a radiology reading software, has been utilized to improve anatomical and pathological delineation and consequently increase the diagnostic accuracy in a variety of trauma and Orthopaedic conditions. Objective/aim The objective of this study was to assess whether Grey Scale Inversion Imaging (GSII) has..
| Published: | 05/06/2023 |
| Authors: | Iyengar KP |
160 An audit of guideline directed medical therapy initiation for patients admitted to hospital for an acute decompensation of heart failure
Introduction Cardiovascular disease is the most common cause of death worldwide (1). Heart failure is a major contributor to this (2), with mortality rates particularly high in those hospitalised due to an acute decompensation (3). Approximately 1 in 4 patients admitted with worsening heart failure die or are readmitted within 30 days of discharge (4), resulting in..
| Published: | 02/06/2023 |
| Authors: | Chiong J |
Feasibility of mobilisation in ICU: a multi-centre point prevalence study of mobility practices in the UK
Background Early mobilisation in critical care is recommended within clinical guidance; however, mobilisation prevalence across the UK is unknown. The study aimed to determine the proportion of patients mobilised out of bed within 48–72 h, to describe their physiological status, and to compare this to published consensus safety recommendations for out-of-bed..
| Published: | 01/06/2023 |
| Authors: | Oliver A (Collaborator) |
Accessory Tibionavicular Muscle: An Unusual Cause of Medial Ankle Pain
Accessory or anomalous muscles around the ankle are not uncommon and are usually asymptomatic. They are traditionally encountered during imaging undertaken for evaluation of ankle pain. We reported the first case of a new accessory muscle in the anteromedial part of the ankle with associated partial thickness tear in an 18..
| Published: | 01/06/2023 |
| Authors: | Iyengar KP |
AB0522 EVALUATING GLOBAL PATTERNS IN TREATMENT AND PREVALENCE OF COMORBIDITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS
Background Regional disparities in the management of systemic lupus erythematosus (SLE) are frequently described. Governance, funding, logistic barriers, and physician choice may be important determinants though scarce data from underrepresented regions limits our understanding. Objectives To evaluate global patterns in treatment of SLE and identify the prevalence of comorbidities. Methods..
| Published: | 30/05/2023 |
| Authors: | Nune A |
OP0081 Prevalence, characteristics, and predictors of breakthrough Covid-19 infections in patients with rheumatoid arthitis: Data from the Covid-19 vaccination in autoimmune disease (COVAD) study
Background Global data on COVID-19 breakthrough infections (BI) following COVID-19 vaccination among autoimmune rheumatic diseases (AIRDs) and especially rheumatoid arthritis (RA) is scarce. Objectives This study aimed to examine the characteristics of COVID-19 BI among patients with RA and compare them with AIRDs and healthy controls (HCs). Methods A global..
| Published: | 30/05/2023 |
| Authors: | Nune A |
Axial spondylarthritis following COVID-19 infection
Although SARS-CoV-2 syndrome primarily affects the lungs, systemic manifestations have been reported. New rheumatic immune-mediated inflammatory diseases have been reported following SARS-CoV-2 infection. We present a case of a woman in her mid-30s who developed inflammatory back pain due to bilateral sacroiliitis with erosions after contracting SARS-CoV-2 infection. Her..
| Published: | 25/05/2023 |
| Authors: | Gopalarathinam R, Nawimana S, Nune A |
Primary Osseous Malignancies of the Spine.
Ariyaratne, S; Iyengar, KP; Jenko, N; James, S; Mehta, J; Botchu, R. (2023). Primary Osseous Malignancies of the Spine. Diagnostics (Basel, Switzerland). 13(10), p.1801. [Online]. Available at: 10.3390/diagnostics13101801 [Accessed 21 February 2024].
| Published: | 19/05/2023 |
| Authors: | Iyengar KP |
ChatGPT in academic publishing: An ally or an adversary?
Ariyaratne, S.; Iyengar, KP. et al. (2023). ChatGPT in academic publishing: An ally or an adversary?. Scottish medical journal. 68(3), pp.129-30. [Online]. Available at: https://doi.org/10.1177/00369330231174231 [Accessed 27 February 2024].
| Published: | 07/05/2023 |
| Authors: | Iyengar KP |
Piggyback Technique—A Safe Way of Performing Rib Biopsy
Rib biopsy can be challenging. A spectrum of bone biopsy techniques are available to undertake Rib Bone biopsy and yield a histological specimen. In this technical report, we described a new Piggyback technique of performing rib biopsy to decrease the incidence of pneumothorax and consolidate diagnostic accuracy. Botchu, R.; Nischal,..
| Published: | 06/05/2023 |
| Authors: | Iyengar KP |
Chat generative pre-trained transformer (ChatGPT): potential implications for rheumatology practice
Nune, A.; Iyengar, KP. et al. (2023). Chat generative pre-trained transformer (ChatGPT): potential implications for rheumatology practice. Rheumatology International. 43(7), pp.1379-1380. [Online]. Available at: https://doi.org/10.1007/s00296-023-05340-3 [Accessed 27 February 2024]
| Published: | 05/05/2023 |
| Authors: | Nune A, Iyengar KP |
Article-level metrics: A new approach to quantify reach and impact of published research
A spectrum of measuring tools are available to evaluate the impact of published literature and the journals they are published in. Journal Level Metrics (JLM) such as Journal Impact Factor (JIF) or CiteScore assess the reputation of peer-reviewed journals based on citation analysis. Whereas, Article Level Metrics (ALM) quantify the..
| Published: | 04/05/2023 |
| Authors: | Iyengar KP |
Editorial: Guest Editors
Patel, S.; Iyengar, KP.; Botchu, R. (2023). Guest Editors. Journal of Arthroscopy and Joint Surgery. 10(2), p.43. [Online]. Available at: 10.4103/jajs.jajs_30_23 [Accessed 26 February 2024].
| Published: | 04/05/2023 |
| Authors: | Iyengar KP |
The T1 Ratio of Marrow (TROM) as a Novel Tool to Identify Metastatic from Nonmalignant Marrow Lesions of the Spine: A Pilot Study
Objective The purpose of this study was to analyze quantitative values of normal and abnormal marrow on T1-weighted images of spine, to propose a ratio for T1 values of abnormal to normal vertebrae, and to assess whether this ratio could be helpful in predicting presence of neoplastic lesions in..
| Published: | 02/05/2023 |
| Authors: | Iyengar KP |
P207 School based training and education program with psychological and peer support (STEPPS) initiative for children and young people living with type 1 diabetes
Aims/Objectives: The delivery of structured diabetes education can be challenging in children and young people (CYP) with type 1 diabetes. The STEPPS program was initiated to enable a positive learning environment for diabetes education based in school. Methods: Single centre using mixed methods analysis of quantitative and semi structured qualitative..
| Published: | 25/04/2023 |
| Authors: | Day H, Quinn M, McCaffrey L, Kyprios H, Hubbard R, Finnigan L, Pintus D, Bray D, Ng SM |
OA29 Flares following COVID-19 vaccination in patients with idiopathic inflammatory myopathies: combined analysis from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) studies
Background/Aims Flares following COVID-19 vaccination are an emerging concern among patients with rare rheumatic disease like idiopathic inflammatory myositis (IIMs), whereas data and understanding of this is rather limited. We aimed to study the prevalence, characteristics and determinants of IIM flares following COVID-19 vaccination. Methods CoVAD (COVID-19 Vaccination In..
| Published: | 24/04/2023 |
| Authors: | Nune A |
P065 Post COVID-19 Syndrome in patients with autoimmune rheumatic diseases: Results from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study
Background/Aims Post COVID-19 syndrome (PCS) is an emerging cause of morbidity and poor quality of life in COVID-19 survivors. We aimed to assess the prevalence, risk factors, outcomes, and association with disease flares of PCS in patients with autoimmune rheumatic diseases (AIRDs) and non-rheumatic autoimmune diseases (nrAIDs), both vulnerable..
| Published: | 24/04/2023 |
| Authors: | Nune A |
E057 A systematic review of new rheumatic immune-mediated inflammatory diseases (R-IMID) following SARS-CoV-2 vaccinations
Background/Aims There are sporadic reports about the development of new rheumatic immune-mediated inflammatory diseases (R-IMIDs) in adults after receiving SARS-CoV-2 vaccines. This systematic review (SR) aimed to critically review and summarize the clinical profile, patient demographics, treatment, and prognosis of new-onset R-IMIDs following SARS-CoV-2 vaccination. Methods We retrieved English-language..
| Published: | 24/04/2023 |
| Authors: | Nune A, Iyengar KP, Durkowski V |
Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Objectives: Disease flares in the post-coronavirus disease 2019 (COVID-19) vaccination period represent a prominent concern, though risk factors are poorly understood. We studied these flares among patients with idiopathic inflammatory myopathies (IIMs) and other autoimmune rheumatic diseases (AIRDs). Methods: The COVAD-1 and -2 global surveys were circulated in early 2021 and 2022, respectively,..
| Published: | 21/04/2023 |
| Authors: | Nune A |
Percutaneous Closure of Post-infarct Left Ventricular Pseudoaneurysm: A Review of Literature
Left ventricular pseudoaneurysm is a well-known complication of myocardial infarction and open-heart surgery and has recently been described as succeeding transapical transcatheter aortic valve replacement. While surgical intervention is the conventional therapeutic approach, transcatheter closure can be considered in patients at high risk for surgical procedures. In this article, we..
| Published: | 20/04/2023 |
| Authors: | Elsayed M |
A comparison of ChatGPT-generated articles with human-written articles
Objective ChatGPT (Generative Pre-trained Transformer) is an artificial intelligence language tool developed by OpenAI that utilises machine learning algorithms to generate text that closely mimics human language. It has recently taken the internet by storm. There have been several concerns regarding the accuracy of documents it generates. This study compares..
| Published: | 14/04/2023 |
| Authors: | Iyengar KP |
Flares after COVID-19 infection in patients with idiopathic inflammatory myopathies: results from the COVAD study
Extract DEAR EDITOR, Viral infections are known triggers of disease flares in idiopathic inflammatory myopathies (IIMs). Reports of post-COVID-19 exacerbation of IIMs suggest a possible role for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in precipitating IIM disease flares [1]. Recently, analysis of patients with pre-pandemic adult-onset dermatomyositis revealed six highly conserved..
| Published: | 02/04/2023 |
| Authors: | Nune A |
Systemic sclerosis and COVID-19 vaccine safety: short-term insights from the global COVID-19 vaccination in autoimmune disease (COVAD) survey
The safety profile of COVID-19 vaccines is understudied in patients with systemic sclerosis (SSc). We compared short-term adverse events (AEs) 7 days following vaccination in patients with SSc vs other rheumatic (AIRDs), non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs). The COVID-19 Vaccination in autoimmune diseases (COVAD) self-reporting e-survey was circulated..
| Published: | 31/03/2023 |
| Authors: | Nune A |
Hydroxyapatite deposition disease (HADD) of the spring ligament: an unusual cause of medial foot pain
Abstract Foot pain is one of the most common presenting complaints in orthopaedic clinical practice and can be attributed to a multitude of pathologies in the various osseous structures, ligaments, and tendons of the foot. The spring ligament complex (SLC) between the calcaneum and navicular supports the talus and plays..
| Published: | 30/03/2023 |
| Authors: | Iyengar KP |
An Unusual Case of Calcific Periarthritis Causing Carpal Tunnel Syndrome and Its Management with Ultrasound-Guided Barbotage
Abstract Hydroxyapatite crystal deposition disease (HADD) is a common disorder resulting from the deposition of calcium hydroxyapatite crystals in various soft tissues, typically in periarticular distribution, including tendons, tendon sheaths, joint capsules, ligaments, bursae, periarticular soft tissues, and occasionally within the joints. The more commonly known subtypes of HADD are..
| Published: | 25/03/2023 |
| Authors: | Iyengar KP |
Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period—a cross-sequential study based on COVAD surveys
Objective Flares of autoimmune rheumatic diseases (AIRDs) following COVID-19 vaccination are a particular concern in vaccine-hesitant individuals. Therefore, we investigated the incidence, predictors and patterns of flares following vaccination in individuals living with AIRDs, using global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surveys. Methods The COVAD surveys were used to..
| Published: | 24/03/2023 |
| Authors: | Nune A |
A systematic review of the incidence, management and prognosis of new-onset autoimmune connective tissue diseases after COVID-19
Abstract A literature review on new-onset autoimmune connective tissue diseases (ACTDs) following COVID-19 is lacking. We evaluated potential associations between COVID-19 and the development of new-onset ACTDs. The “population” was adults with disease terms for ACTDs, including systemic lupus erythematosus (SLE), Sjogren’s syndrome, systemic sclerosis (SSc), idiopathic inflammatory myositis (..
| Published: | 14/02/2023 |
| Authors: | Nune A |
Vaccine hesitancy decreases in rheumatic diseases, long-term concerns remain in myositis: A comparative analysis of the COVAD surveys
Objective COVID-19 vaccines have a favorable safety profile in patients with autoimmune rheumatic diseases (AIRDs) such as idiopathic inflammatory myopathies (IIMs); however, hesitancy continues to persist among these patients. Therefore, we studied the prevalence, predictors and reasons for hesitancy in patients with IIMs, other AIRDs, non-rheumatic autoimmune diseases (nrAIDs) and..
| Published: | 03/02/2023 |
| Authors: | Nune A |
Paediatric Society and Hyperinsulinism Charity National Surveys on CGM Access for Patients With Recurrent Hypoglycaemia
Context Recurrent hypoglycemia can result in significant neurological impairments in children and continuous glucose monitoring (CGM) technology has been shown to reduce recurrent hypoglycemia in conditions such as type 1 diabetes. In the United Kingdom, CGM devices are currently only recommended by the National Institute of Clinical Excellence (NICE) for patients..
| Published: | 30/01/2023 |
| Authors: | Ng SM |
Letter to the editor re: Surgical outcome of male patients with chronic central nervous system disorders...
Pina, IM.; Khadr, RN.; Floyd Jr, MS. (2023). Letter to the editor re: Surgical outcome of male patients with chronic central nervous system disorders and voiding dysfunction due to bladder outlet obstruction. Chang TL, Chen SF, Kuo HC. Int Urol Nephrol. 2022 Oct;54(10):2511-2519. doi: 10.1007/s11255-022-03285-3. Epub 2022 Jul 11. International..
| Published: | 12/01/2023 |
| Authors: | Pina I, Khadr R, Floyd Jr M |
Imaging in Sports Medicine
Muscular, soft tissue, and bony injuries are common among athletes. Different imaging modalities can be used to assess these patients depending on the type of injury and the expert opinion. Multiple imaging modalities are used to diagnose, investigate, and decide an appropriate medical or surgical treatment. Among the modalities that..
| Published: | 01/01/2023 |
| Authors: | Iyengar KP |
Delays in accessing continuous glucose monitoring for people with type 1 diabetes
May Ng discusses the role of NICE guidance in improving access to continuous glucose monitoring (CGM) and urges local trusts to improve processes and advocate for CGM use in children and young people. Ng, SM. (2022). Delays in accessing continuous glucose monitoring for people with type 1 diabetes. Diabetes Care for Children &..
| Published: | 16/11/2022 |
| Authors: | Ng SM |
Diabetes transition: A time to act
Transition services for young people with diabetes need to ensure that young people remain fully engaged in their diabetes care. Ng, SM; Hulikere, S. (2022). Diabetes transition: A time to act. Diabetes Care for Children & Young People. 11(3), pp.98. [Online]. Available at: https://diabetesonthenet.com/diabetes-care-children-young-people/diabetes-transition/ [Accessed 19 September 2024]
| Published: | 16/11/2022 |
| Authors: | Ng SM |
Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review
Dysphagia (swallowing impairment) is a frequent complication of cervical spinal cord injury (cSCI). Recently published national guidance in the UK on rehabilitation after traumatic injury confirmed that people with cSCI are at risk for dysphagia and require early evaluation while remaining nil by mouth [National Institute for Health and Care..
| Published: | 14/11/2022 |
| Authors: | Morgan S |
Ten-Year Experience of a Global and Freely Accessible e-Learning Website for Pediatric Endocrinology and Diabetes
The European Society for Paediatric Endocrinology (ESPE) interactive website, https://www.espe-elearning.org, was first published online in 2012. We describe the various applications of the content of the e-learning website that has been greatly expanded over the last 10 years. A large module on pediatric diabetes was added with the support..
| Published: | 08/11/2022 |
| Authors: | Ng SM |
COVID-19 vaccination in autoimmune diseases (COVAD) study: vaccine safety and tolerance in rheumatoid arthritis
Objectives The COVID-19 vaccination in autoimmune diseases (COVAD) study aimed to assess short-term COVID-19 vaccination-related adverse events (AEs) in RA patients. Methods An online self-reported questionnaire (March–December 2021) was used to capture data related to COVID-19 vaccination-related AEs in RA, other autoimmune rheumatic diseases (AIRDs) (excluding RA and inflammatory myositis),..
| Published: | 31/10/2022 |
| Authors: | Nune A |
Diabetes 101: A novel method for engaging families with diabetes during the COVID-19 pandemic
Diabetes 101 was created by a virtual multidisciplinary diabetes team and initially operated via Twitter in March 2020 as a response to the first national UK lockdown of the COVID-19 pandemic. Anxieties for parents and carers of children living with diabetes were extremely high. Misinformation and a lack of specific guidance for..
| Published: | 18/05/2022 |
| Authors: | Ng SM |
New NICE guidelines for diabetes: Full access to continuous glucose monitoring for all people with type 1 diabetes
May Ng reviews the latest NICE guidance on continuous glucose monitoring (CGM) and how to implement it, including the decision-making process for choosing a device. Ng, SM. (2022). New NICE guidelines for diabetes: Full access to continuous glucose monitoring for all people with type 1 diabetes. Diabetes Care for Children & Young People. 11(2),..
| Published: | 18/05/2022 |
| Authors: | Ng SM |
Christmas special: A double-blind study to determine the best caterpillar cake in a paediatric ward environment
This prospective, double-blind study sought to determine the best supermarket caterpillar cake and whether the original version, Colin, could be distinguished from its descendants. A total of 42 participants at Southport and Ormskirk NHS Hospital rated the quality of the chocolate, cream filling, sponge quality and general impression of seven caterpillar..
| Published: | 16/12/2021 |
| Authors: | Nesbitt V, Ng SM |
NPDA 2019/20: Health disparities and worsening access to diabetes technology based on ethnicity and deprivation
Analysis of the latest National Paediatric Diabetes Audit suggests widening health inequality in glycaemic outcomes and access to diabetes technology. Ng, SM. (2021). NPDA 2019/20: Health disparities and worsening access to diabetes technology based on ethnicity and deprivation. Diabetes Care for Children & Young People. 10(3), pp.68-69. [Online]. Available at: https://diabetesonthenet.com/..
| Published: | 18/08/2021 |
| Authors: | Ng SM |
Elucidating causes of COVID-19 infection and related deaths after vaccination
Background and Aims Symptomatic or asymptomatic COVID-19 infection has been reported in vaccination. In the current article, we try to elucidate various causes behind COVID-19 infection and mortality following COVID-19 vaccination and suggest possible strategies to counteract this threat. Methods We carried out a comprehensive review of the literature using..
| Published: | 15/07/2021 |
| Authors: | Iyengar KP |
Elucidating reasons of COVID-19 re-infection and its management strategies
Background and Aims Reinfection is gradually being recognised after symptomatic or asymptomatic COVID-19 infection. We try to elucidate various explanations behind COVID-19 reinfection and suggest possible strategies to counteract this threat. Methods We carried out a comprehensive review of the literature using suitable keywords such as ‘COVID-19’, ‘Pandemics’, ‘Reinfection’, ‘Vaccines’..
| Published: | 07/05/2021 |
| Authors: | Iyengar KP |
Acute kidney injury: a risk scoring system for general surgical patients
Abstract This article describes the development of a scoring system for general surgical patients to highlight those at greater risk of developing acute kidney injury (AKI). Following a search of the literature on current practice, a list of common variables was composed. Hospital Episode Statistics (HES) data from two random..
| Published: | 28/11/2019 |
| Authors: | Hamilton M |
Inpatient Falls and Orthopaedic Injuries in Elderly Patients: A Retrospective Cohort Analysis From a Falls Register
Background Hospital inpatient falls have been a major area of concern in the healthcare setting. This poses a multifaceted challenge to healthcare systems, as elderly patients are at increased risk of harm and significant morbidity secondary to inpatient falls. In addition, hospital admission increases the risk of falls in acutely..
| Published: | 01/01/1970 |
| Authors: | AlSumadi M, AlAdwan M, Sangani C, Toh E |
St Helens Primary and Community Staff
Early statin use is associated with improved survival and cardiovascular outcomes in patients with atrial fibrillation and recent ischaemic stroke...
Introduction Statins reduce recurrent stroke and cardiovascular events in patients with non-cardioembolic stroke. The benefits of statins in patients with AF and recent IS remain unclear. We aimed to investigate the benefits of statins in patients with AF and recent IS. Patients and methods This retrospective, cohort study was conducted..
| Published: | 10/09/2024 |
| Authors: | Hill. AM, Irving G, Abdul-Rahim. A |
The Association Between Psoriasis and Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis of Observational Studies
Abstract: Psoriasis is a chronic immune-mediated disease affecting the skin, nails, and/or joints. It is associated with systemic inflammation and may also be linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). The objectives of this study were to determine the overall risk of ASCVD in patients with..
| Published: | 28/06/2024 |
| Authors: | Agomoh C |
Management of Adults With Bacterial Meningitis in the Emergency Department
Introduction The Leicester Royal Infirmary Emergency Department is one of the largest single-site Emergency Departments in the UK. We evaluated the department’s management of bacterial meningitis. The current national guideline recommends that all patients presenting with suspected bacterial meningitis receive antibiotics within one hour. Methods A survey of 100 clinicians (..
| Published: | 20/06/2024 |
| Authors: | Olayinka S |
Thirty-Day Readmissions After Hospitalization for Psoriatic Arthritis
Background Psoriatic arthritis (PsA) is correlated with higher rates of major adverse cardiovascular events and autoimmune disorders than the general population, leading to more frequent hospitalizations. This study assessed the rates and characteristics of index and 30-day readmissions among adults hospitalized for PsA and evaluated the indications and predictors of 30..
| Published: | 16/05/2024 |
| Authors: | Anighoro SO |
Early statin use for secondary prevention in patients with atrial fibrillation and recent ischaemic stroke
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/ Background and aims We investigated the benefits of early statin use for secondary prevention of ischaemic stroke (IS) in patients with AF. Methods We conducted a propensity score matched analysis using data within..
| Published: | 15/05/2024 |
| Authors: | Hill. AM, Irving G, Abdul-Rahim. A |
Left atrial appendage occlusion versus direct oral anticoagulants in the prevention of ischaemic stroke in patients with atrial fibrillation
Poster presentation for the ESOC 2024. Full conference programme available here: https://apps.congrex.com/esoc2024/en-GB/pag/ Background and aims Existing randomised controlled trials assessing the safety and efficacy of left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) were of relatively small sample size, or included patients who could..
| Published: | 15/05/2024 |
| Authors: | Irving G, Hill. AM, Abdul-Rahim. A, Elsheikh. S |
Atrial Fibrillation and Stroke: State-of-the-art and future directions
Introduction Stroke is a major complication of atrial fibrillation (AF). About 25% of ischaemic stroke are cardio-embolic in origin; AF is the most common cause of those.1 Nonvalvular AF carries a 5-fold increased risk of stroke,2 while AF related to mitral stenosis increases the risk of stroke by 20-fold.3 The attributable..
| Published: | 31/10/2023 |
| Authors: | Elsheikh S, Hill AM, Irving G, Abdul-Rahim A |
Ten things I wish I had known about academic primary care
Letter to the editor. Dapre, Elizabeth. (2023). Ten things I wish I had known about academic primary care. British Journal of General Practice. 73(735), p.443. [Online]. Available at: http://dx.doi.org/10.3399/bjgp23X735021 [Accessed 11 October 2024].
| Published: | 28/09/2023 |
| Authors: | Dapre E |
1056-P: Impact of Individualized HbA1c Target Setting on Diabetes-Distress, Self-Efficacy, Well-Being, and HbA1c
Abstract American Diabetes Association guidelines emphasize the importance of individualized HbA1c target setting in glycemic management, but little is known of the impact of target-setting on patient well-being. We randomized 50 adults (type 1 or 2) to receive HbA1c targets 5 mmol/mol (0.5%) above or below current value and evaluated impact on..
| Published: | 13/06/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, Lewis GA, Hardy KJ |
P303 Explicit glycated haemoglobin goals improve subsequent HbA1c levels with no impact on health-related quality of life
Background National guidelines recognise the importance of individualising HbA1c targets. Many people with diabetes agree to have their targets re-evaluated in consultations in response to specific characteristics. Aims We aimed to evaluate the impact of relaxed or stretch HbA1c goals on subsequent HbA1c levels and health-related quality..
| Published: | 25/04/2023 |
| Authors: | McNulty S, Westall S, Narayanan RP, Irving G, Furlong NJ, Bujawansa S, Cardwell J, Hardy KJ |
P302 Glycated haemoglobin targets: The experiences and views of people with diabetes and diabetes healthcare professionals
Background National guidelines highlight the importance of individualising HbA1c targets. Little is known about the experiences of people with diabetes and diabetes healthcare professionals (HCPs) on the use of HbA1c targets. We explored the experiences of adults with diabetes and diabetes HCPs on the use of glycated haemoglobin..
| Published: | 25/04/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty SJ, Bujawansa S, Cardwell J, Hardy KJ |
P300 Setting explicit glycated haemoglobin goals improves diabetes-related distress, self-efficacy and wellbeing
Background High levels of diabetes-related distress and low levels of self-efficacy and wellbeing are associated with poorer outcomes in people with diabetes. Aims We evaluated the impact of relaxed or stretch HbA1c targets on diabetes-related distress, self-efficacy and wellbeing in adults with type 1 or type 2 diabetes. Methods We randomised 50..
| Published: | 25/04/2023 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty S, Bujawansa S, Balafshan T, Cardwell J, Hardy KJ |
Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial
Background The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths..
| Published: | 22/12/2022 |
| Authors: | Irving G |
Psychometric and biomedical outcomes of glycated haemoglobin target-setting in adults with type 1 and type 2 diabetes
Background The disease burden of diabetes can have wide-ranging implications on patients’ psychological well-being and health-related quality of life. Glycated haemoglobin targets are commonly used to guide patient management in diabetes to reduce the future risk of developing diabetes complications, but little is known of the psychological impact of glycated..
| Published: | 27/10/2022 |
| Authors: | Westall S, Narayanan RP, Irving G, Hardy KJ |
General practitioners' perceptions of using virtual primary care during the COVID-19 pandemic
Abstract With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. We explored GPs’ perspectives on the main..
| Published: | 16/05/2022 |
| Authors: | Irving G |
The individualisation of glycaemic targets in response to patient characteristics in type 2 diabetes: a scoping review
Background Evidence and guidelines increasingly support an individualised approach to care for people with type 2 diabetes and individualisation of glycaemic targets in response to patient factors. Methods We undertook a scoping review of the literature for evidence of factors impacting upon glycated haemoglobin target individualisation in adults with type 2 diabetes...
| Published: | 20/04/2022 |
| Authors: | Westall S, Narayanan RP, Irving G, Furlong NJ, McNulty S, Bujawansa S, Hardy KJ |
Association between household air pollution and nasopharyngeal pneumococcal carriage in Malawian infants (MSCAPE)
Background Household air pollution from solid fuels increases the risk of childhood pneumonia. Nasopharyngeal carriage of Streptococcus pneumoniae is a necessary step in the development of pneumococcal pneumonia. We aimed to assess the association between exposure to household air pollution and the prevalence and density of S pneumoniae carriage among..
| Published: | 24/01/2022 |
| Authors: | Dherani M |
Putting Down Roots
St Helens is ahead of the curve when it comes to health and social care integration and it has the momentum to stay there, explains Mark Palethorpe Palethorpe, M. (2021). Putting Down Roots. Municipal Journal. Suppl 8 July (.), 10-11
| Published: | 08/07/2021 |
| Authors: | Palethorpe M |
Evaluation of a 'drop box' doorstep assessment service
Abstract The COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being..
| Published: | 29/03/2021 |
| Authors: | Tinsley A, Whittaker C, Cox SJ |
Evaluation of a ‘drop box’ doorstep assessment service to aid remote assessments for COVID-19 in general practice
Abstract: COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed..
| Published: | 29/03/2021 |
| Authors: | Irving G |
The MRCGP Recorded Consultation Assessment: time to drop 10 minutes as standard?
Extract Why do we continue to examine GP trainees at 10 minutes when the RCGP itself has called for longer GP consultations? The recently announced changes to the MRCGP in response to the COVID-19 pandemic has seen the replacement of the Clinical Skills Assessment (CSA) with the Recorded Consultation Assessment (RCA).1..
| Published: | 28/01/2021 |
| Authors: | Irving G |
P300 The role of FMT in reducing hospital admissions and length of stay
Introduction Clostridium difficile infection (CDI) is the most common healthcare associated infection in the NHS with 12,275 cases reported in England in 2018/19. Recurrent Clostridium Difficile infection (rCDI) is an increasingly common problem; the recurrence rate is approximately 20% after a first episode and 45–60% after a second episode of C difficile infection, with..
| Published: | 21/01/2021 |
| Authors: | Baig D, McClements D |
Evaluating the impact of a pharmacist-led prescribing feedback intervention
Background Prescribing errors are prevalent in hospital settings with provision of feedback recommended to support prescribing of doctors. Feedback on prescribing has been described as feasible and valued but limited by doctors, with pharmacists described as credible facilitators of prescribing feedback. Evidence supporting prescribing feedback has been limited to date...
| Published: | 16/12/2020 |
| Authors: | Lloyd M, O'Brien S, Hardy KJ, Furlong NJ |
John Holden: an appreciation
Dr John Holden was known to many within the RCGP for his work on the quality agenda, GP training, clinical audit, Fellowship by Assessment, Membership by Assessment, past Council membership, Provost of Mersey Faculty, and as a recipient of the President’s Medal. John tragically passed away in a fall..
| Published: | 23/12/2019 |
| Authors: | Cox SJ |
Exploring the impact of pharmacist-led feedback on prescribing behaviour: A qualitative study
Background Prescribing errors occur frequently in hospital settings. Interventions to influence prescribing behaviour are needed with feedback one potential intervention to improve prescribing practice. Doctors have reported a lack of feedback on their prescribing previously whilst the literature exploring the impact of feedback on prescribing behaviour is limited. Objectives To..
| Published: | 16/01/2019 |
| Authors: | O'Brien S |
Exploring hospital pharmacists’perceptions of their medication communication with prescribers
Abstract Prescribing errors are common and problematic in hospital settings in the UK. Pharmacists have been described as integral in the interception of prescribing errors, with effective medication communication between pharmacists and prescribers important to resolve and optimize prescribing outcomes. However, poor communication between healthcare professionals, including pharmacists and prescribers,..
| Published: | 16/05/2018 |
| Authors: | O'Brien S |
Practising humility: how philosophy can inform general practice
Note. Murphy, C. (2017). Practising humility: how philosophy can inform general practice. British journal of general practice . 67 (665), p561
| Published: | 03/01/2018 |
| Authors: | Murphy C |
Exploring pharmacist experiences of delivering individualised prescribing error feedback in an acute hospital setting
Highlights • Delivery of prescribing error feedback is valued by hospital pharmacists and considered sustainable • Pharmacists report altered prescribing behaviour and improved prescribing following receipt of feedback • Pharmacists report greater team-work and prescriber communication following delivery of feedback • Delivering prescribing error feedback can improve the self-confidence and self-worth of pharmacists Lloyd,..
| Published: | 20/12/2017 |
| Authors: | Lloyd M, Furlong NJ, Hardy KJ, O'Brien S |
International variations in primary care physician consultation time
Objective To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. Design and outcome measures This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish,..
| Published: | 10/11/2017 |
| Authors: | Holden JD |
Introducing community integrated nursing teams
Abstract The present day collection of financial and demographic challenges confronted by health and social care mean that integrated services are undoubtedly essential to sustain adequate care. However, the impact of integrated care upon healthcare staff and patients as well as new ways of working will need to be demonstrated,..
| Published: | 15/08/2017 |
| Authors: | O'Brien S |
22 controlled trials in Education for Primary Care 1990–2015 (letter)
Holden, JD. (2017). 22 controlled trials in Education for Primary Care 1990–2015. Education for Primary Care . 11 (May ), 1-2
| Published: | 01/06/2017 |
| Authors: | Holden JD |
Which cuff should I use?
Objective To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. Data sources MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. Eligibility criteria Cross-sectional, randomised and cohort..
| Published: | 03/11/2016 |
| Authors: | Irving G |
Interventions to increase or decrease the length of primary care physicians' consultation
Background Observational studies have shown differences in process and outcome between the consultations of primary care physicians whose average consultation lengths differ. These differences may be due to self selection. This is the first update of the original review. Objectives To assess the effects of interventions to alter the length..
| Published: | 25/08/2016 |
| Authors: | Irving G |
Unusual staphylococcal toxic shock syndrome
Abstract Diagnosis of nonmenstrual staphylococcal toxic shock syndrome (TSS) is often challenging. A female medical colleague had a rare entity, a staphylococcal pharyngitis complicated by TSS. The diagnosis was confirmed by isolation of tst-positive Staphylococcus aureus in throat culture and by identification of a specific Vbeta2 expansion pattern of her..
| Published: | 19/07/2016 |
| Authors: | Fletcher C |
Exploring attitudes and opinions of pharmacists toward delivering prescribing error feedback
Background Prescribing error (PE) rates have been extensively reported in the literature. Various interventions at reducing PEs have been studied with some success, yet PEs continue to be a challenge for the health care system. Prescriber feedback has been proposed as one mechanism to reduce PEs in seminal studies. Pharmacists..
| Published: | 19/07/2016 |
| Authors: | O'Brien S |
Formalized prescribing error feedback from hospital pharmacists
Abstract Doctors have reported a lack of awareness of their prescribing errors with lack of feedback considered a system failure. This article summarizes the views of hospital doctors about receiving formal prescribing error feedback from ward-based pharmacists. Lloyd, M; Watmough, SD; O'Brien, SV; Furlong, N; Hardy, K. (2015). Formalized prescribing error..
| Published: | 19/07/2016 |
| Authors: | O'Brien S |
Role models in primary care education
Abstract Role models are widely acknowledged in medicine, but they have received much less attention than the other two essential elements of effective medical education, planned and organised teaching, and structured experiences. This may be the result of not distinguishing between what students and trainers are taught and what they..
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Music: A better alternative than pain?
Holden, R and Holden, J. (2013). Music: A better alternative than pain? . British Journal of General Practice. 63 (615), 536
| Published: | 19/07/2016 |
| Authors: | Holden JD |
A64 (P310) Outpatient parenteral antibiotic therapy...
Aims To determine the benefits of OPAT in diabetes foot infections. Methods This was a retrospective study of consecutively initiated OPAT in patients with diabetes foot infections. Patients initiated on OPAT in a multidisciplinary diabetes foot clinic and inpatients discharged from a diabetes inpatient ward between April 2011 and May 2013 and..
| Published: | 19/07/2016 |
| Authors: | Hodgkins P, McGrail P, O'Hanlon S |
Don’t Shoot the Messenger
Cox, S; Holden, J. (2013). Don't shoot the messenger: The problem of whistleblowing in general practice . British Journal of General Practice. 63 (611), 291
| Published: | 19/07/2016 |
| Authors: | Cox SJ, Holden JD |
Feeding the Beast
Foulkes et al suggest that the ePortfolio software should be developed to make the process of documenting and reporting the progress of trainees easier and quicker. Holden, J; Cox, S; Breach, M; Hargreaves, S; van Dessel, M; Hyde, S; White, J; Parr, H; Clarke, C;. (2013). Educational Supervision for GP Trainees:..
| Published: | 19/07/2016 |
| Authors: | Breach M, Clarke C, Cox SJ, Hargreaves SA, Holden JD, Hyde S, Parr H, Van Dessel M, White J |
Time Efficiency Principle
Abstract The test and retest opportunity afforded by reviewing a patient over time substantially increases the total gain in certainty when making a diagnosis in low-prevalence settings (the time-efficiency principle). This approach safely and efficiently reduces the number of patients who need to be formally tested in order to make..
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Writing therapy
Mugerwa, S and Holden, JD. (2012). Writing therapy: A new tool for general practice? British Journal of General Practice. 62 (605), 661-63
| Published: | 19/07/2016 |
| Authors: | Holden JD, Mugerwa S |
Revalidation
Abstract The start of revalidation for doctors in the United Kingdom in 2012, based on Good Medical Practice1 and a conclusion by annual appraisal that a doctor is ‘up-to-date and fit to practice’, raises important issues for educational leaders in primary care. These include consideration of the purpose of revalidation; what..
| Published: | 19/07/2016 |
| Authors: | Holden JD, Cox SJ, Hargreaves SA |
Chronic Heart Failure Guidelines
Introduction A number of international guidelines have been developed to support primary care clinicians improve the quality of care for patients with chronic heart failure at the end of life. The objective of this study was to undertake a systematic evaluation of such guidelines in relation to end-of-life care. Methods..
| Published: | 19/07/2016 |
| Authors: | Edwards J, Holden JD |
Cancer Diagnosis in Primary Care
Irving, G and Holden, J. (2013). Measures of promptness of cancer diagnosis in primary care . British Journal of Cancer. 108 (10), 2186
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Sexual Health Services
Background Teenage pregnancy rates in the UK are the highest in Western Europe. Causes of teenage pregnancies are multifaceted with complex interplay of social, lifestyle and wider determinants influencing risk. Improving access to sexual health services through community services is an important factor in attempting to tackle this issue, but..
| Published: | 19/07/2016 |
| Authors: | Forster S, Olsen JR |
Eldercare
Holden, J. (2012). What's the alternative? . Health Service Journal. 27th September, p32-33
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Cancer Prognosis
Background: General practitioners are probably asked regularly about the prognosis for patients with cancer. There is no readily available source of information on the accuracy of their estimates. Objective: To discover studies that have reported general practitioners estimates of prognosis. Methods: A search for studies of estimates of prognosis in..
| Published: | 19/07/2016 |
| Authors: | Holden JD, Wooff E |
15 Minute Consultations
Irving, GJ; Holden, J. (2012). 15 minute consultations as standard benefit patients and GPs . BMJ. 344 (7862), 31-32
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Ideas for appraisal
Holden, J. (2010). Ideas for appraisal . Education for primary care. 21 (5), 324-326
| Published: | 19/07/2016 |
| Authors: | Holden JD |
Alcohol Problems
Objective: To describe the pattern of diagnosis of 368 patients with alcohol problems in one general practice in northwest England. Methods: Records were searched retrospectively, and notes were made prospectively from 1996, of all patients who either admitted to drinking more than 50 units per week (men) or 35 units per week (women), or..
| Published: | 19/07/2016 |
| Authors: | Holden JD, Tatham D, Wooff E |
Significant Events
BACKGROUND Patient safety is a key issue in primary care. Significant event analysis (SEA) is a long established method of improving safety. In 2004, SEA was introduced as part of the Quality and Outcomes Framework (QOF) of the new general medical services (GMS) contract. AIM To review SEAs submitted for the..
| Published: | 19/07/2016 |
| Authors: | Cox SJ, Holden JD |
Poor Performance
BACKGROUND The detection, assessment, and management of primary care poor performance raise difficult issues for all those involved. Guidance has largely focused on managing the most serious cases where patient safety is severely compromised. The management of primary care poor performance has become an increasingly important part of primary care..
| Published: | 19/07/2016 |
| Authors: | Cox SJ, Holden JD |
Exploring attitudes and opinions of pharmacists toward delivering prescribing error feedback
Background Prescribing error (PE) rates have been extensively reported in the literature. Various interventions at reducing PEs have been studied with some success, yet PEs continue to be a challenge for the health care system. Prescriber feedback has been proposed as one mechanism to reduce PEs in seminal studies. Pharmacists..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ, Hardy KJ, Lloyd M, O'Brien S |
Formalized prescribing error feedback from hospital pharmacists
Abstract Doctors have reported a lack of awareness of their prescribing errors with lack of feedback considered a system failure. This article summarizes the views of hospital doctors about receiving formal prescribing error feedback from ward-based pharmacists. Lloyd, M; Watmough, SD; O'Brien, SV; Furlong, N; Hardy, K. (2015). Formalized prescribing error..
| Published: | 19/07/2016 |
| Authors: | Furlong NJ, Hardy KJ, Lloyd M, O'Brien S |
After Achilles
Extract Contrary to the view that ‘using time as a diagnostic tool’ is ‘sloppy and idle’ and that general practice has ‘floundered’ as a result of such unhelpful phrases, we consider that general practice has struggled to provide a robust evidence base to confirm or refute the value of time..
| Published: | 01/05/2016 |
| Authors: | Irving G |
The AGREE Reporting Checklist is useful for assessing the quality of clinical practice guideline development
Extract At least two systematic reviews of national and international clinical practice guidelines have used the AGREE tools (I and II). Both found that no guideline was perfect and highlighted the same key problems—a lack of applicability and stakeholder involvement. These domains relate to … Irving, G. (2016). The AGREE Reporting..
| Published: | 12/04/2016 |
| Authors: | Irving G |
Do you understand how your health system works?
Extract As family doctors we should be thinking about how our healthcare system works and how we can shape it. We share responsibility for the distribution of limited resources not only as healthcare professionals, but also as patients and taxpaying citizens. But how much do we know about how the..
| Published: | 05/11/2015 |
| Authors: | Irving G |
Adjustment and adaptation in patients with chronic heart failure at the end of life
Irving, G 2015, 'Adjustment and adaptation in patients with chronic heart failure at the end of life', PhD thesis, University of Liverpool, Liverpool.
| Published: | 02/09/2015 |
| Authors: | Irving G |
The meaning of suffering in patients with advanced progressive cancer
Background There is a lack of research into suffering and what it means to the individual patient with advanced cancer and its importance in end of life care. Aims To explore the concept of suffering and distress by eliciting what individual patients with advanced cancer perceived as suffering and how..
| Published: | 01/09/2015 |
| Authors: | Irving G |
Pharmacological agents for the prevention of vestibular migraine
Background Vestibular migraine is a common cause of episodic vertigo. Many preventive treatments have been proposed for this condition, including calcium antagonists, beta‐blockers, antidepressants, anticonvulsants, selective 5‐HT1 agonists, serotonin antagonists and non‐steroidal anti‐inflammatory drugs (NSAIDs). Objectives To assess the effects of pharmacological agents for the prevention of..
| Published: | 21/06/2015 |
| Authors: | Irving G |
Colchicine for Pericarditis
Background Pericarditis is the inflammation of the pericardium, the membranous sac surrounding the heart. Recurrent pericarditis is the most common complication of acute pericarditis, causing severe and disabling chest pains. Recurrent pericarditis affects one in three patients with acute pericarditis within the first 18 months. Colchicine has been suggested to be..
| Published: | 28/08/2014 |
| Authors: | Irving G |
Cardiovascular disease and cancer compete for the outcome of death
Extract Life is a game of multiple competing risks, and problems arise when we forget that death is a single, non-repetitive event usually attributable to one cause.1 Doctors often consider issues of competing risks when caring for patients with multimorbid chronic disease. For example, it’s not uncommon for a..
| Published: | 19/08/2014 |
| Authors: | Irving G |
From patient uncertainty to WHO policy in two years
Abstract Clinical encounters in daily practice can provide a fertile ground for identifying uncertainties that require further investigation. Addressing such uncertainties by undertaking a Cochrane review can be a rewarding educational process and result in important contributions to health care policy. This paper describes the experiences of a UK GP..
| Published: | 10/03/2014 |
| Authors: | Irving G |
Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions
Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists...
| Published: | 02/12/2013 |
| Authors: | Irving G |
Chronic heart failure guidelines: Do they adequately address patient need at the end-of-life?
Introduction A number of international guidelines have been developed to support primary care clinicians improve the quality of care for patients with chronic heart failure at the end of life. The objective of this study was to undertake a systematic evaluation of such guidelines in relation to end-of-life care. Methods..
| Published: | 03/10/2013 |
| Authors: | Irving G, Holden JD |
NAPCRG 2012: reflections from across the pond
Extract The 40th annual meeting of the North American Primary Care Research Group (NAPCRG) was held in New Orleans from 1–5 December 2012. As early-career family doctors from the UK we were keen to explore primary care research from around the world. With delegates from North America and Europe to the antipodes..
| Published: | 01/08/2013 |
| Authors: | Irving G |
Measures of promptness of cancer diagnosis in primary care
Extract Sir, In their discussion Lyratzopoulos et al (2003) make the crucial point that they were not able to examine whether prolonged values of either the primary care interval or the number of pre-referral consultations were either justifiable or preventable. We also wish to question the widely held assumption that optimum..
| Published: | 01/05/2013 |
| Authors: | Irving G, Holden JD |
Global health: time for full integration into GP education
Extract Postgraduate medical training no longer sufficiently prepares UK doctors for the challenges of the 21st century. In 2010, an Independent Commission on the Education of Health Professionals, published in The Lancet, described a ‘mismatch between present professional competencies and the requirements of an increasingly interdependent world’.1 Globalisation, fuelled by a..
| Published: | 01/05/2013 |
| Authors: | Irving G |
The John Henry effect
Extract The “Ballad of John Henry” tells of the legendary black American steel pin driver, John Henry, who swung a huge nine pound hammer driving railroad spikes on the Chesapeake and Ohio railway in the 1870s.1 John Henry was renowned for his strength among his fellow workers and could drive..
| Published: | 02/04/2013 |
| Authors: | Irving G |
The time-efficiency principle: time as the key diagnostic strategy in primary care
Abstract The test and retest opportunity afforded by reviewing a patient over time substantially increases the total gain in certainty when making a diagnosis in low-prevalence settings (the time-efficiency principle). This approach safely and efficiently reduces the number of patients who need to be formally tested in order to make..
| Published: | 27/03/2013 |
| Authors: | Irving G, Holden JD |
VdGM: Vasco da Gama Movement
Extract The Vasco da Gama Movement is delighted to announce that it is participating in the organization of the World Preconference, which will be carried out in Prague on 24–25 June 2013, prior to the Wonca World Conference. The event is organized in partnership with the Rajakumar Movement (Asia-Pacific Region), the Waynakay..
| Published: | 01/03/2013 |
| Authors: | Irving G |
Dismantling Lord Moran’s ladder: the primary care expert generalist
Extract It is over 50 years since Lord Moran suggested that GPs were doctors who have fallen off the specialist ladder.2 Then, two-thirds of early career GPs would have preferred to have been specialists.2 Today Lord Moran’s ladder lives on. General practice is still not a first career choice for..
| Published: | 01/01/2013 |
| Authors: | Irving G |
Long-term protective effects of hepatitis A vaccines. A systematic review
Objective Data on duration and long-term protective effects of hepatitis A vaccines (HepA) have not been reviewed using a systematic approach. Our objective is to provide a comprehensive review of evidence on the duration of protection achieved by HepA, which is needed for revising existing vaccine policies. Limitations in data..
| Published: | 17/12/2012 |
| Authors: | Irving G |
Global health in the UK's GP postgraduate curriculum
Extract Jennifer Hall and colleagues (Aug 25, p 728) highlight an apparent lack of global health content in UK postgraduate curricula. The Curriculum Development Committee of the UK's Royal College of General Practitioners (RCGP) is currently exploring whether more explicit language about global health issues should appear in the GP postgraduate curriculum...
| Published: | 10/11/2012 |
| Authors: | Irving G |
Do GPs really provide 47 minutes a year for the patient?
Extract The recently published RCGP report on medical generalism brings into focus the need for GPs to spend more time with patients to deliver high quality generalist care. Historically, the figure of 47 minutes a year for the patient has been widely cited and discussed as a summary statistic for the..
| Published: | 01/08/2012 |
| Authors: | Irving G |
Hepatitis A immunisation in persons not previously exposed to hepatitis A
Background In many parts of the world, hepatitis A infection represents a significant cause of morbidity and socio‐economic loss. Whilst hepatitis A vaccines have the potential to prevent disease, the degree of protection afforded against clinical outcomes and within different populations remains uncertain. There are two types of hepatitis..
| Published: | 11/07/2012 |
| Authors: | Irving G, Holden JD |
15 minute consultations as standard benefit patients and GPs
Extract Spence claims that increasing appointments to 15 minutes would reduce availability, limit access, and jeopardise safety with an unknown effect on the quality of patient care. We have offered 15 minute appointments as standard in our practice for eight years with huge benefits for our patients and us. Irving, G; Holden,..
| Published: | 01/06/2012 |
| Authors: | Irving G |
Calling time on the 10-minute consultation
Extract In their editorial, Silverman and Kinnersley present a strong case for moving on from the 10-minute consultation. In 2011 an electronic ‘consultation length’ survey of all UK GP trainees (ST1–ST4) was undertaken by the RCGP Associates in Training committee. One of the key questions within the electronic survey was, ‘..
| Published: | 01/05/2012 |
| Authors: | Irving G |
A pause for thought: reflections on the 2011 SAPC Annual Conference
Extract The 41st Annual Scientific Meeting of the Society for Academic Primary Care (SAPC) was held in Bristol. A packed and varied programme,1 together with excellent organisation, brought people together to share ‘breaking news’ in primary care teaching and research. However, conferences are about more than dissemination of new work...
| Published: | 31/10/2011 |
| Authors: | Irving G |
Can generalism help revive the primary healthcare vision?
Extract It is more than 30 years since the World Health Organization (WHO) called for a paradigm-shift to a model of primary healthcare: a vision of creating ‘Health for All’ through ‘putting people at the centre of health care’.1 Since then, we have seen significant advances in health and healthcare. People..
| Published: | 03/10/2011 |
| Authors: | Irving G |
Academic General Practice Training in the UK-what is it All about?
Abstract Academic GPs have made significant contributions to the care of many millions of patients through research in primary care populations. They have also been instrumental in the development of community-based undergraduate medical education. Here, we explore what academic GP training involves and why all associates in training should have..
| Published: | 01/09/2010 |
| Authors: | Irving G |
Depression in advanced cancer
Purpose Depression is one of the most common psychiatric diseases seen in patients with advanced cancer. It is not only an independent predictor of poor survival in advanced cancer but also reduces quality of life, reduces compliance with treatment and prolongs hospitalization. Yet all too often depression is under diagnosed..
| Published: | 01/08/2010 |
| Authors: | Irving G |
The educational benefits of a federation of four training practices
No abstract available. Hargreaves, S; Irving, G; Holden, J. (2010). The educational benefits of a federation of four training practices. Education for Primary Care. 21 (2), 114-115
| Published: | 31/03/2010 |
| Authors: | Irving G, Holden JD |
The Prevalence of Depression in People with Cancer
This chapter contains sections titled: Prevalence of Depression in Cancer Patients Depression by Cancer Type Depression in Advanced Cancer and Palliative Care Demoralization Conclusions References Massie, MJ; Lloyd-Williams, M; Irving, G; Miller, K. (2010). The Prevalence of Depression in People with Cancer. In: Kissane, DW; Maj, M; Sartorius, N Depression and..
| Published: | 03/03/2010 |
| Authors: | Irving G |
Knowsley Primary and Community Staff
Dental Public Health in Action: IDEA tool: Establishing a prioritisation matrix for oral health improvement interventions
Abstract Initial impetus for action: Oral health is not equitably distributed. More deprived areas experience appreciably worse oral health outcomes. Oral health improvement programmes in Local Authorities (LA) seek to reduce these inequalities but have diminished in recent years following the COVID-19 pandemic. LAs have also endured funding cuts to..
| Published: | 10/04/2024 |
| Authors: | Cronin M |
GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19
Abstract Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can..
| Published: | 17/05/2023 |
| Authors: | Shuker K, Tridente A |
Tales from the Menopause Clinic: A multidisciplinary approach to patient care in women with a breast cancer diagnosis
Abstract We chose to focus my project on urogenital symptoms, as so many women are affected by the impact of lack of oestrogen on urogenital tissue quality despite available treatment options. There are various non-hormonal treatment options available on prescription to manage vasomotor symptoms. These include SSRIs and SNRIs, gabapentin,..
| Published: | 09/10/2021 |
| Authors: | Rostron S |
Can we prevent hospital admissions for diabetes?
Aim To identify reasons for presentation at the emergency department and identify methods to avoid hospital admission in patients from a single Clinical Commissioning Group (CCG). Methods We examined the case records of all patients with diabetes specific emergency admissions from Knowsley CCG area to Aintree University Hospital over a 12..
| Published: | 10/05/2017 |
| Authors: | Merriman M |
The NHS health check programme in England: a qualitative study
Abstract Despite an extensive evidence-base linking patterns of health with social determinants, recent public health policy has emphasized 'lifestyle diseases' and risk factor modification through behavioural and pharmacological intervention. In England, one manifestation of this has been the launch of the National Health Service Health Check programme. This paper reports..
| Published: | 19/07/2016 |
| Authors: | Cushing J, Panter L |
Primary Care Management of Patients
Aims: Evidence-based management of patients with IGR is essential in reducing the incidence of Type 2 diabetes. The estimated adult prevalence of IGR is 2.3%. Without intervention, the majority of IGR patients are likely to develop Type 2 diabetes within five–10 years. A clinical audit was conducted to identify current practice in the..
| Published: | 19/07/2016 |
| Authors: | Conrad D, McNulty S |
Social Marketing
Abstract Social marketing appears to offer a structured approach to the delivery of public health interventions. It uses the principles of marketing to understand health-related behaviour and tailor appropriate and effective interventions to population subgroups. Whilst commercial marketing capitalises on current demand for a tangible benefit, social marketing relies on..
| Published: | 19/07/2016 |
| Authors: | Morris P |
The Liverpool Lung Project Primary Care Implementation Programm
Background More than 90% of people diagnosed with lung cancer in the UK die within a 5-year period. The poor survival is partly linked with late diagnosis often at an advanced stage when various treatment options are less efficacious. The cornerstone of early diagnosis includes prompt identification of high risk individuals,..
| Published: | 19/07/2016 |
| Authors: | Ashton M, Hughes J, Mimnagh C |
Future lung cancer risk
Background Lung cancer continues to be the leading cause of cancer death worldwide. The disease is predominantly common among elderly patients, thus likely to be preceded or accompanied by multiple comorbid conditions. Whilst many studies have reported association between pulmonary diseases and lung cancer occurrence, the role of other chronic..
| Published: | 19/07/2016 |
| Authors: | Ashton M, Hughes J, Mimnagh C |
Management of functional constipation in childhood
Abstract Functional constipation is a common childhood condition. In the majority of cases the constipation develops as a result of a complex weave of factors including specific triggers, e.g. reduced fluid intake following a viral infection or periods of restricted access to the toilet. The passage of large painful..
| Published: | 19/07/2016 |
| Authors: | Rogers J |
Achilles Tendon
Abstract Fluoroquinolone antibiotics have been widely used for over 25 years. Their key adverse effect is tendinopathy. A 76-year-old woman developed bilateral Achilles tendinopathy on the fourth day of fluoroquinolone use. Her doctor advised her to complete the course; however, she went on to sustain bilateral tendoachilles rupture. The patient undertook..
| Published: | 19/07/2016 |
| Authors: | Lewis T |
Halton Primary and Community Staff
CONCEPT OF NEURODEVELOPMENTAL COMORBIDITIES: DO WE NEED A PARADIGM SHIFT?
Conclusion: Embracing the concept of a wider neurodevelopmental spectrum disorder would encourage practitioners to offer a more wholistic therapeutic approaches to diagnosis and interventions, and help patients and their families avoid the agony of widespread service fragmentation. Other researchers have favoured a wider application of the hierarchical descending order of..
| Published: | 30/07/2024 |
| Authors: | Ogundele M |
Clinical benefits of formal definition of subthreshold diagnosis for neurodevelopmental, emotional, behavioural and intellectual disorders (NDEBID).
Conclusion: Subthreshold symptoms of NDEBID are quite common in the general population. Autistic traits are particularly common among extraordinarily talented people and ADHD traits are common among successful sports and athletics people. Subthreshold NDEBID are not benign and are associated with higher risk of several behavioural and psychopathological disorders including..
| Published: | 30/07/2024 |
| Authors: | Ogundele M |
The influence of socioeconomic deprivation on the pattern of melatonin prescribing practices among CYP with NDD in a NW NHS Trust.
Conclusion: The burden of NDEBID conditions is highest among CYP within the lowest SES. They also account for the largest cost of melatonin prescriptions. The cost-effectiveness of preventative measures such as prenatal, early years and school health, education and social welfare projects, as well as parenting training require further research. ..
| Published: | 30/07/2024 |
| Authors: | Ogundele M |
Much to celebrate
The author discusses topics related to midwifery in Great Britain as of December 2019. Topics covered include the need for choice and access for all women in every area, the establishment of Women's and Children's Services Partnership Boards, and the appointment of England's first Chief Midwifery Officer Professor Jacqueline Dunkley-Bent. Casey-Hardman,..
| Published: | 23/12/2019 |
| Authors: | Casey-Hardman C |
Child population dental preventive programme
Introduction An evaluation was undertaken to measure the dental health of five cohorts of 5-year-old children living in Halton and St Helens, each cohort having had a different length of time they were exposed to a population dental prevention programme before their fifth birthday. Method The dental health of each..
| Published: | 19/07/2016 |
| Authors: | Kearney-Mitchell P, Kellett L, Rice A |
Tackling compression therapy in the community
Abstract The use of compression bandaging in venous leg ulcers has been acknowledged as ‘best practice’ for some time now, but these wounds remain a serious management problem in many patients with pain, excess exudate, limb swelling and poor mobility all affecting their quality of life. Wound care in general,..
| Published: | 19/07/2016 |
| Authors: | Moore K |
Outbreak of Measles
Abstract From 1 January to 30 June 2012, 359 confirmed and 157 probable cases of measles were reported in Merseyside, England. The most affected age groups were children under five years and young adults from 15 years of age. Most cases have been sporadic. There have been few outbreaks in nurseries; however, no outbreaks have been..
| Published: | 19/07/2016 |
| Authors: | Mason R |
Prescription for challenging times
Forde, C. (2012). Efficiency: Prescription for challenging times . Health Service Journal . 122 (6291), 30-31
| Published: | 19/07/2016 |
| Authors: | Forde C |
Health Visiting Support Staff
Abstract Community nursery nurses (CNNs) and health visiting assistants (HVAs) are increasingly working and supporting health visitors (HVs) within clinical settings. The acute shortage of HVs and increased workloads has resulted in routine services normally provided by HVs, such as detection/screening for postnatal depression, no longer being offered. A..
| Published: | 19/07/2016 |
| Authors: | Osborn T |
C Difficile Relapses
Abstract Nurses face several challenges in caring for patients with recurrent episodes of C difficile in the community. This article reports on the development of a clinical pathway to meet the needs of older patients and their families. Wynne, S. (2012). Managing C difficile relapses in the community . Nursing Times . 109 (27), 15-17.
| Published: | 19/07/2016 |
| Authors: | Wynne S |
Chronic low back pain
Abstract Chronic low back pain (CLBP) is a condition that causes individuals considerable distress. It also presents a significant challenge to the health service and is often viewed by clinicians as frustrating to manage. The purpose of the present paper is to explore the experiences of individuals in the immediate..
| Published: | 19/07/2016 |
| Authors: | Miller J, Timson D |
Patient Experiences
Abstract Loco-regional recurrence after radical primary treatment of oral cancer is associated with poor prognosis and major patient and carer distress. The patient's psychosocial response to recurrence is underreported in the literature. This is one of the few papers to address in detail this stage in a patient's cancer journey...
| Published: | 19/07/2016 |
| Authors: | Griffiths MJ |
Dental Health
Introduction Dental access centres (DACs) were introduced in England at the turn of the twenty-first century in response to a growing problem of access to NHS dental services. DACs were expected to offer NHS dental care primarily to those patients that were unwilling or unable to attend 'high street' dental..
| Published: | 19/07/2016 |
| Authors: | Kearney-Mitchell P, Milsom KM, Tickle M |
North West Boroughs Community Health Staff
Always consider a differential and a multidisciplinary approach to the foot
Conference Abstract The Multidisciplinary Diabetes Foot Clinic manages patients primarily with neuropathic or neuroischaemic ulcers or Charcot arthropathy. The following are cases that did not fit the classical picture, requiring involvement in the wider multidisciplinary team to diagnose and treat the underlying condition. A 76-year-old gentleman with persistent bilateral plantar..
| Published: | 18/04/2021 |
| Authors: | Sullivan H, Furlong NJ, Pendlebury H |
The development of a diabetes screening service for the homeless population in St Helens
Aim To screen members of the homeless community in St. Helens for diabetes, and offer advice, support, diabetic eye screening and diabetic foot screening for those with diabetes, following two diabetes-related deaths in this population in 2018. Method(s) The Teardrops Hub staff promoted the drop in service to their service..
| Published: | 07/10/2020 |
| Authors: | Pendlebury H, Bujawansa S, Cardwell J |
Setting up a total contact casting service within a diabetes foot ulcer service
Aims The National Institute for Health and Care Excellence (NICE) recommend total contact casting (TCC) for neuropathic ulceration in the diabetic foot. The St Helens and Knowsley Hospitals Trust, Diabetes Team, determined the feasibility of starting and developing a TCC service within their diabetes foot ulcer service. Method The type..
| Published: | 07/10/2020 |
| Authors: | Pendlebury H, Furlong NJ, Sullivan H |
The impact of a validated structured education programme on diabetes-related distress in patients with type 1 diabetes
Background and Aim People with type 1 diabetes experience varying degrees of the emotional burden of diabetes and its treatments. The Problem Areas in Diabetes (PAID) questionnaire can be used to evaluate this domain. As part of a local, validated structured education programme for people with type 1 diabetes, baseline and endpoint..
| Published: | 07/10/2020 |
| Authors: | Narayanan RP, Westall S, Sullivan H, Cardwell J, Langan E, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Hardy KJ |
Perceived problem areas in diabetes do not correlate with levels of anxiety and depression
Background and Aim Diabetes‐related distress, anxiety and depression are all highly prevalent in people with diabetes. The Problem Areas In Diabetes (PAID) and Hospital Anxiety and Depression Score (HADS) questionnaires can be used to measure these domains. We evaluated the impact of structured education on each of these. Methods..
| Published: | 07/10/2020 |
| Authors: | Westall S, Narayanan RP, Langan E, Gallagher CG, Bujawansa S, McNulty S, Furlong NJ, Cardwell J, Hardy KJ |
The Effectiveness of Digital Health Interventions in the Management of Musculoskeletal Conditions
Background Musculoskeletal conditions are the second greatest contributor to disability worldwide and have significant individual, societal, and economic implications. Due to the growing burden of musculoskeletal disability, an integrated and strategic response is urgently required. Digital health interventions provide high-reach, low-cost, readily accessible, and scalable interventions for large patient populations..
| Published: | 08/06/2020 |
| Authors: | Hewitt S, Sephton R |
Engaging public and patients to develop a website to assist people to remain in or return to work
Purpose Musculoskeletal conditions are the second biggest cause of absenteeism in the UK representing 28.2 million working days lost per annum. Current literature suggests that work issues are generally insufficiently addressed in primary healthcare and there is little evidence that evaluates any existing workplace interventions in this setting. To address this..
| Published: | 01/05/2020 |
| Authors: | Sephton R, Bannon C, Cunneely M, Poole A |
A community‐based, two‐week structured education programme
Aims To determine the effectiveness of a community‐based structured education programme for Type 2 diabetes, measuring Hba1c and weight change over a four month period. ‘Diabetes and You’ is a structured education programme delivered by a specialist nurse and dietitian across Knowsley. Methods Participants were recruited between January and..
| Published: | 26/06/2019 |
| Authors: | Gallagher CG |
G361(P) Local vs. regional pathway and cost-implications
Aims Henoch-Schonlein purpura (HSP) is an IgA mediated commonest systemic vasculitis with risk of long-term renal involvement. The regional pathway (Alder Hey) recommends a sixmonth nurse led follow-up with stratification of children into either Standard Pathway (SP) or Proteinuria Pathway (PP) at one week after presentation with PP cohort at..
| Published: | 16/08/2017 |
| Authors: | Viswanathan RK, Woon E, Basavaraju JA |
A questionnaire to identify patellofemoral pain in the community
Background Community-based studies of patellofemoral pain (PFP) need a questionnaire tool that discriminates between those with and those without the condition. To overcome these issues, we have designed a self-report questionnaire which aims to identify people with PFP in the community. Methods Study designs: comparative study and cross-sectional study. Study..
| Published: | 10/10/2016 |
| Authors: | Sephton R, Hough E, James J |
Patellofemoral pain in the community
Background Community-based studies of patellofemoral pain (PFP) need a questionnaire tool that discriminates between those with and those without the condition. To overcome these issues, we have designed a self-report questionnaire which aims to identify people with PFP in the community. Methods Study designs: comparative study and cross-sectional study. Study..
| Published: | 19/07/2016 |
| Authors: | Sephton R |
Case 5: non-healing traumatic wound colonised with MRSA
Abstract A traumatic wound colonised with MRSA failed to respond to topical antimicrobial dressings. Following the combined use of octenilin Wound Gel and octenilin Wound Irrigation Solution, the MRSA was removed in 4 weeks, the necrotic tissue was debrided and the wound started healing. Simon, D. (2016). Case 5: non-healing traumatic wound colonised..
| Published: | 19/07/2016 |
| Authors: | Simon D |
Case 9: heavily exuding, malodorous, necrotic pressure ulcer
Abstract In this case, the necrotic tissue was so hard it was not possible to categorise the ulcer. Octenilin products were able to debride the necrotic tissue, so that the wound depth could be determined. After 4 weeks, the wound was covered with granulation tissue, improving the patient's quality of life...
| Published: | 19/07/2016 |
| Authors: | Simon D |
Case 10: venous leg ulcer that was significantly impairing quality of life
Abstract This heavily exuding, sloughy ulcer was so painful that the patient had difficulty tolerating any physical contact with it. After treatment, pain levels subsided, so that she was better able to tolerate dressing changes, could sleep in her own bed instead of a chair, and started compression therapy. Simon,..
| Published: | 19/07/2016 |
| Authors: | Simon D |
How to improve the community care of leg ulcer patients
Abstract Venous leg ulcers make up a considerable part of the community nurse’s workload and the gold standard treatment is multilayered compression bandaging applied to cleansed and debrided lower limbs. The author of this piece looks at the background to leg ulcer development; as well as how to assess..
| Published: | 19/07/2016 |
| Authors: | Simon D |
Diagnosing osteomyelitis in diabetes foot ulceration
Aims Although osteomyelitis is a common complication of diabetes foot ulceration (DFU), it presents a diagnostic challenge. The aim of this study was to determine the diagnostic modality used to confirm osteomyelitis in patients with DFU. Methods This was a retrospective observational study of patients with DFU complicated by osteomyelitis...
| Published: | 19/07/2016 |
| Authors: | Pendlebury H |
Gelling fibrous silver dressing
Abstract Choosing the correct dressing is often key to moving a wound along the healing trajectory, with its ability to deal with problems such as pain, excess exudate production and inflammation being crucial to the healing outcome. Infection is also a serious problem in many wounds and this article looks..
| Published: | 19/07/2016 |
| Authors: | Forster E |
Practical Prescribing
Synopsis This book provides prescribing advice for medical and non-medical prescribers caring for adult patients with common musculoskeletal problems. It will be particularly useful for non-medical practitioners, including independent physiotherapy and podiatry prescribers. Reference is made to current prescribing law and accountability, and the principles of safe prescribing are clearly..
| Published: | 19/07/2016 |
| Authors: | Sephton R, Dawson J |
Post-operative Tracheal Extubation Practices
Jameel, S; Kataria, C. (2012). Survey of post-operative tracheal extubation practices at a district general hospital . Anaesthesia. 67 (S2), 51
| Published: | 19/07/2016 |
| Authors: | Jameel SA, Kataria C |
Journals and Conferences
Mabvuure N; Griffin M; Hindocha S. (2012). The value of medical student specific journals and surgical conferences to future surgeons . International Journal of Surgery. 10 (3), 167-68
| Published: | 19/07/2016 |
| Authors: | Griffin M, |
Mohs Surgeons
Tehrani H; Sofos S; McPhail J; Brackley P (2012) A Novel Training Model for Mohs Surgeons . Dermatologic Surgery. Published online 6 Feb 2012
| Published: | 19/07/2016 |
| Authors: | , Brackley P, Sofos S, Tehrani H |