Treatment of periorbital veins with vascular laser: A systematic review and retrospective case series. (2024)

Type of publication:
Systematic Review

Author(s):
Mandavia, Rishi; Ahmed, Muhammad; *Parmar, Dilen; Cariati, Massimiliano; Shahidi, Sepideh; Lapa, Tatiana.

Citation:
Journal of Cosmetic Dermatology. 2024 Apr 24.

Abstract:
INTRODUCTION: Vascular lasers may represent a promising treatment option for periorbital veins. This article aims to: (1) systematically review the literature on the safety and effectiveness of vascular laser treatment for periorbital veins and (2) assess safety and effectiveness through a retrospective case series. METHODS: Systematic review: Articles that assessed the safety and effectiveness of vascular laser treatment for periorbital veins were included and quality assessed using the Downs and Black checklist. CASE SERIES: Patient records were retrospectively reviewed from January 2020 to November 2023 to identify all patients who underwent laser treatment for periorbital veins. Outcomes assessment included percentage improvement, patient overall satisfaction and adverse effects. RESULTS: Systematic review: Three articles were included, discussing treatment of blue, periorbital veins using a 1064 nm Nd:YAG laser. Patient Fitzpatrick skin Types I-IV were treated with high patient satisfaction rates and complete clearance of treated veins. Adverse effects included pain, erythema, mild oedema, urticaria and blister formation. Quality of included studies ranged from 7 to 14 out of 21 points. CASE SERIES: Thirty-four patients with skin Types I-V were included. Blue and red periorbital veins were treated using 1064 and 532 nm wavelengths respectively. Mean percentage improvement was 4.8 (complete resolution) and patients' overall satisfaction was ranked 3 (completely satisfied). Adverse effects included erythema, oedema, and bruising. CONCLUSION: Treatment of red and blue periorbital veins using 532 and 1064 nm vascular lasers appears a safe treatment option. The procedure has a short recovery time, with patients able to resume normal activities within 1 day of treatment.

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Epidemiology of metatarsal fractures in Shropshire 2021-2024 (2024)

Type of publication:
Conference abstract

Author(s):
*Mark Garton, *Jenni Rowlands, *Richard Roach

Citation:
Abstract submitted to Bone Research Conference, 2024

Abstract:
Background: Metatarsal fractures are common and disabling fractures, frequently triggered by low-energy injuries, or less often by repetitive loading. ‘Atypical’ metatarsal fractures have also been reported during prolonged anti-resorptive therapy, but a causal relationship remains speculative. Despite their clinical and economic importance, the epidemiology of metatarsal fractures remains poorly understood. We present a detailed service evaluation of radiologically-confirmed metatarsal fractures identified within Shropshire, over a three-year period. Methods: Radiology reports for all adults (≥18 years) attending hospital or community radiology departments between May 2020 and April 2023, were searched electronically using the terms ‘metatarsal’ AND ‘fracture’. All distinct patient episodes with ≥1 confirmed metatarsal fracture were identified for further analysis, and all duplicates were excluded. Age at fracture, sex, fracture type/distribution and mechanism of injury (where known) was recorded. Age- and sex-specific fracture rates were estimated by decade of life, using contemporaneous demographic data. Results: 1121 (758 female) patient-episodes of metatarsal fracture were identified, comprising 312, 397 and 412 individuals in years 1-3 respectively. Mean (SD) age at fracture was 50.7 (18.9) years, with 961 (85.7%) metatarsal fractures occurring in isolation, most (n= 736) affecting the fifth metatarsal. Smaller numbers fractured two (n=72), three (n=63), or four (n=15) metatarsal bones. Most fractures (59%) affected the metatarsal base, and less often the shaft (26%), neck (12%) and head (3%). Fractures were most often oblique (n=410), transverse (n=359) or comminuted (n=120), and only 70 patients had stress fractures. Estimated trauma levels were low (n=632), moderate (n=109), high (n=43) and unknown (n=246), and inversion and falls-related injuries the most commonly reported mechanism. Estimated annual fracture rates per 100,000, increased from 105 among women aged 18-29 years to 153 aged 50-59 years, with a second peak of 142 aged 80-89 years. For men at the same time points, rates were 102, 40 and 31. Although numerically less frequent, metatarsal neck fractures showed the greatest sex difference, becoming exponentially more common in women with age, compared to a gradual age-related decline in men. Discussion: Metatarsal fractures are common, usually affecting the fifth metatarsal in isolation, and often caused by low energy injuries, as shown by previous authors. Lower incidence during Covid lockdown may be genuine or reflect reduced ascertainment. Our estimates of age- and sex-specific fracture rates suggest pronounced sex differences in metatarsal fracture rates with age, which requires further study and linkage to known risk factors and relevant medication exposure.

To set up simulation sessions to assist with the confidence and competence of physiotherapists for on-call training (2023)

Type of publication:
Service improvement case study

Author(s):
*Eleanor Giddings

Citation:
SaTH Improvement Hub, November 2023

Abstract:
To improve physiotherapy staff self perceived competency and confidence in line with the therapy on-call standards of practice by the end of March 2024.

Link to PDF poster

Rationalise stock on Ward 15/16 PRH (2023)

Type of publication:
Service improvement case study

Author(s):
*Yvonne Herbert *Alison Lynn

Citation:
SaTH Improvement Hub, October 2023

Abstract:
Ensure all stock items are available, easily accessible and appropriate stock levels are agreed by October 2023, complying with IPC and Healthy and Safety regulations, including a reduction of 1% in holding
stock by October 2023.

Link to PDF poster