Switchboard Care Co-Ordination (2022)

Type of publication:
Service improvement case study

Author(s):
*Paul Corbett, Care Co-ordination Team (Shropdoc), Sharon Clennell, *Switchboard

Citation:
SaTH Improvement Hub, March 2022

Abstract:
In order to improve the time taken to connect clinical teams from SaTH and the Care Co-ordination teams, a new system called netcall was trialled. This reduced the burden on the SaTH switchboard and released time for directing other calls.

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Discharge Lounge RSH (2022)

Type of publication:
Service improvement case study

Author(s):
*Hannah Adkins, *Elishia Carter, *Liam Allman-Evitts

Citation:
SaTH Improvement Hub, April 2022

Abstract:
In order to facilitate early flow from the front door areas, a permanent discharge lounge and team were implemented which had positive impact on pre-12 discharges at RSH

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Improved efficiency and safety Chest Drain boxes (2022)

Type of publication:
Service improvement case study

Author(s):
*Leanne Barkess, *Shirley Pickstock, *Jackie Jones

Citation:
SaTH Improvement Hub, February 2022

Abstract:
Chest Drain kits are no longer available to order and the medical team spend time locating the equipment needed to perform pleural procedures. The equipment is often not easily accessible, and the team frequently have to leave the ward to gather the required kit. As part of the improvement, a chest drain kit was created using Set-Up Reduction.

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Factors affecting womens' sexual function during the first-year after childbirth in Greece (2022)

Type of publication:Conference abstract

Author(s):Haritopoulou E.; Papatheodorou D.; Nitsa E.; Antonakou A.; *Papoutsis D.

Citation:BJOG: An International Journal of Obstetrics and Gynaecology. Conference: Royal College of Obstetricians and Gynaecologists World Congress, RCOG 2022. London United Kingdom. 129(Supplement 1) (pp 204), 2022. Date of Publication: June 2022.

Abstract:Objective: Sexual dysfunction after childbirth has been related to the number of vaginal births, the mode of delivery, and to the severity of perineal trauma. The present cross-sectional study was designed to identify the factors that affect the quality of sexual function during the first year after delivery in Greek women. <Design(s): We constructed an 81-item questionnaire that was posted online via the social media for the time period of February-April 2021. Women residing in Greece who had delivered more than 4 weeks ago but not more than 12 months ago were considered eligible for the study. Method(s): Data that was collected included patients' demographics, and data regarding their labour and childbirth. Information on their sexual life before, during and after pregnancy was also collected and the Female Sexual Function Index (FSFI) was used to quantify the sexual function of women during the 4 weeks prior to answering the questionnaire (score range:0-36, with a score of 26 or less indicating sexual dysfunction). After data collection was completed statistical analysis was applied. Result(s): In total there were 441 women responding to the questionnaire with a mean age of 32.5+/-4.4 years old. Approximately half of women delivered 6 months ago and 55.2% were first time mothers. The caesarean section rate in the total sample was 47.9%, and only 34.2% had a spontaneous onset vaginal birth. At childbirth, more than 85% of women sustained perineal trauma, of which 39.3% had an episiotomy. During pregnancy 76% of women had sexual intercourse with their partners, with half of them having a frequency of 2-3 times a month. The mean score of the FSFI index in the total sample was 21.8 +/- 10.7. There was a significant correlation of sexual dysfunction postpartum with exclusive breastfeeding, with increasing maternal age, with reduced number of sleeping hours, with the limited support from their family environment, and with the presence of incontinence. Conversely, the increased frequency of sexual intercourse before and during pregnancy was correlated with a higher score of sexual function postpartum. Perineal trauma, a high body mass index, smoking, and the mode of delivery did not seem to affect the sexual function after delivery. Conclusion(s): We have identified factors that seem to modify the sexual function of Greek women postpartum. These factors should be taken in consideration when providing midwifery care to women after birth.

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Exploring pregnant women's experiences of stopping smoking with an incentive scheme with 'enhanced' support: a qualitative study (2023)

Type of publication:Journal article

Author(s):McCormack F.C.; Hopley R.C.; Boath E.H.; Parry S.L.; Roscoe S.M.; Stewart A.; *Birch V.A.

Citation:erspectives in Public Health. 143(5) (pp 285-291), 2023. Date of Publication: September 2023.

Abstract:Aim: This study aims to understand pregnant women's experiences of smoking cessation with an incentive scheme in a deprived UK city. This is important because smoking cessation with pregnant women is one of the most crucial public health initiatives to promote, and is particularly challenging in deprived areas. While financial incentive schemes are controversial, there is a need to better understand pregnant women's experiences. The scheme combined quasi-financial incentives (shopping vouchers) for validated quits (carbon monoxide (CO) validated at < 10 ppm), enhanced support from smoking cessation advisors, the opportunity to identify a 'Significant Other Supporter' and nicotine replacement therapy. Method(s): With the focus on understanding pregnant women's experiences, a qualitative design was adopted. Semi-structured interviews were completed with 12 pregnant women from the scheme, and the three advisors. All interviews were transcribed, and thematic analysis conducted. Result(s): Pregnant women reported various challenges to quitting, including long-established routines, and stress. Participants were aware of stigma around incentives but were all very positive about the scheme. The relationship with advisors was described as fundamental. The women valued their advice and support, while uptake of the 'Significant Other Supporter' appeared low. Participants viewed the CO monitoring as 'an incentive', while the vouchers were framed as a 'bonus'. Advisors perceived the vouchers as helping engage pregnant women and maintain quit status, and women appreciated the vouchers both as financial assistance and recognition of their accomplishments. Conclusion(s): This study highlights the great value women placed on the support, advice and monitoring from specialist advisors. The distinction between vouchers as a welcomed bonus, rather than 'the incentive' to engage, is important. How smoking cessation and schemes to promote this are communicated to pregnant women and health professionals is important, particularly given the stigma and controversy involved.

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Not All That Glows Is Malignant: Actinomycosis as a Rare Mimic of Lung Cancer (2022)

Type of publication:Conference abstract

Author(s):*Ekhelikar S.; Muthusami R.; *Orme R.; *Ahmad N.

Citation:American Journal of Respiratory and Critical Care Medicine. Conference: International Conference of the American Thoracic Society, ATS 2022. San Francisco, CA United States. 205(1) (no pagination), 2022.

Abstract:Introduction: Pulmonary actinomycosis is a rare bacterial infection that can mimic malignant and chronic suppurative lung conditions, and therefore is often misdiagnosed initially as one of the more common differential diagnoses. The challenge lies in diagnosing this condition prior to surgery as it is completely curable with antibiotics. Case description: A 48 year old man, cigarette smoker and previous intravenous drug user, presented with exertional breathlessness, persistent cough and night sweats. There was no fever or weight loss. A Chest Xray (CXR) and Computerised Tomography (CT) scan showed a left upper lobe cavitating lesion leading to differential diagnoses of bronchogenic malignancy and tuberculosis (TB). A Positron Emission Tomography (PET) scan confirmed a fluorodeoxyglucose (FDG) avid left upper lobe cavitating lesion with enlarged FDG avid thoracic lymphadenopathy. Bronchoscopy and Endobronchial Ultrasound (EBUS) were nondiagnostic. He underwent left upper lobectomy with histopathology confirming Pulmonary actinomycosis and was commenced on Amoxicillin treatment. <br/>Discussion(s): Pulmonary actinomycosis is the third most common type of actinomycosis, behind cervicofacial and abdominal, constituting 15% of total cases. It can occur at all ages, but most case series describe a peak incidence in the 4th and 5th decades. Symptoms are non-specific and often mimic those of it's more common differentials as above and so diagnosing this condition early presents a challenge. Basic laboratory tests reflect the non-specific inflammatory nature of the disease. Imaging modalities (CXR, CT, PET) are helpful, but not diagnostic. The gold standard for diagnosis remains histological examination & bacterial culture of lung biopsy specimen. Histopathologic evidence of granulomas containing neutrophils and sulfur granules with Actinomyces colonies are the hallmark of actinomycosis. Recent data suggests it is increasingly possible to avoid unwarranted surgical procedures, by performing bronchoscopic and percutaneous biopsy techniques. These represent the best chance at preventing unnecessary surgery and should be pursued as they can help exclude malignancy. Penicillin remains the drug of choice for Pulmonary actinomycosis and with correct treatment, the prognosis is excellent. However, those with complications may still require surgery. The chief challenge with Pulmonary actinomycosis is identifying it early, because it is rare, and it also mimics diseases like lung cancer and TB often. We were unable to exclude malignancy with pre-surgical diagnostics and so our patient had surgery. However, clinicians should be aware and consider Pulmonary actinomycosis as an important differential when investigating cavitating lung lesions as diagnosing it early could help prevent physical and psychological morbidity, including unwarranted surgery. (Figure Presented).

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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: An international cohort study (2021)

Type of publication:Journal article

Author(s):Ward A.E.; Nepogodiev D.; Ahmed I.; Chaudhry D.; Dhaif F.; Bankhad-Kendall B.; Mahmood A.; Marais L.; Metcalfe A.; Parsons N.; Siaw-Acheampong K.; Dawson B.E.; Evans J.P.; Glasbey J.C.; Gujjuri R.R.; Heritage E.; Jones C.S.; Kamarajah S.K.; Keatley J.M.; Li E.; McKay S.C.; Pellino G.; Tiwari A.; Simoes J.F.F.; Trout I.M.; Venn M.L.; Wilkin R.J.W.; Ademuyiwa A.O.; Agarwal A.; Al Ameer E.; Alderson D.; Arnaud A.P.; Augestad K.M.; BankheadKendall B.; Benson R.A.; Chakrabortee S.; Blanco-Colino R.; Brar A.; Minaya Bravo A.; Breen K.A.; Lima Buarque I.; Caruana E.; Cunha M.F.; Di Saverio S.; Elhadi M.; Farik S.; Fiore M.; Fitzgerald J.E.; Gallo G.; Ghosh D.; Gomes G.M.A.; Hutchinson P.; Isik A.; Lawani I.; Lederhuber H.; Leventoglu S.; Loffler M.W.; Mazingi D.; Mohan H.; Moore R.; Moszkowicz D.; Ng-Kamstra J.S.; Metallidis S.; Moug S.; Niquen M.; Ntirenganya F.; Outani O.; Pata F.; Pinkney T.D.; Pockney P.; Radenkovic D.; Ramos-De La Medina A.; Roberts K.; Santos I.; Schache A.; Schnitzbauer A.; Shaw R.; Shu S.; Soreide K.; Spinelli A.; Sundar S.; Tabiri S.; Townend P.; Tsoulfas G.; Van Ramshorst G.; Wright N.; Mak J.K.C.; Kulkarni R.; Sharma N.; Nankivell P.; Tirotta F.; Parente A.; Breik O.; Kisiel A.; Cato L.D.; Saeed S.; Bhangu A.; Griffiths E.; Pathanki A.M.; Ford S.; Desai A.; Almond M.; Kamal M.; Chebaro A.; Lecolle K.; Truant S.; El Amrani M.; Zerbib P.; Pruvot F.R.; Mathieu D.; Surmei E.; Mattei L.; Dudek J.; Singhal T.; El-Hasani S.; Nehra D.; Walters A.; Cuschieri J.; Davidson G.H.; Ho M.; Wade R.G.; Johnstone J.; Bourke G.; Brunelli A.; Elkadi H.; Otify M.; Pompili C.; Burke J.R.; Bagouri E.; Chowdhury M.; Abual-Rub Z.; Kaufmann A.; Munot S.; Lo T.; Young A.; Kowal M.; Wall J.; PeckhamCooper A.; Winter S.C.; Belcher E.; Stavroulias D.; Di Chiara F.; Wallwork K.; Qureishi A.; Lami M.; Sravanam S.; Shah K.; Chidambaram S.; Smillie R.; Shaw A.V.; Bandyopadhyay S.; Cernei C.; Bretherton C.; Jeyaretna D.; Ganau M.; Piper R.J.; Duck E.; Brown S.; Jelley C.; Tucker S.C.; Bond-Smith G.; Griffin X.L.; Tebala G.D.; Neal N.; Vatish M.; Noton T.M.; Ghattaura H.; Maher M.; Fu H.; Risk O.B.F.; Soleymani Majd H.; Sinha S.; Aggarwal A.; Kharkar H.; Lakhoo K.; Verberne C.; Mastoridis S.; Senent-Boza A.; Sanchez-Arteaga A.; Benitez-Linero I.; Manresa-Manresa F.; Tallon-Aguilar L.; Melero-Cortes L.; FernandezMarin M.R.; Duran-Munoz-Cruzado V.M.; Ramallo-Solis I.; Beltran-Miranda P.; Pareja-Ciuro F.; Anton-Eguia B.T.; Dawson A.C.; Drane A.; Oliva Mompean F.; GomezRosado J.; Reguera-Rosal J.; Valdes-Hernandez J.; Capitan-Morales L.; Del Toro Lopez M.D.; Tang A.; Beamish A.J.; Price C.; Bosanquet D.; Magowan D.; Solari F.; Williams G.; Nassa H.; Smith L.; Elliott L.; McCabe G.; Holroyd D.; Jamieson N.B.; Mariani N.M.; Nicastro V.; Li Z.; Parkins K.; Spencer N.; Harries R.; Egan R.J.; Motter D.; Jenvey C.; Mahoney R.; Fine N.; Minto T.; Henry A.; Gill C.; Dunne N.; Sarma D.R.; Godbole C.; Carlos W.; Tewari N.; Jeevan D.; Naredla P.; Khajuria A.; Connolly H.; Robertson S.; Sweeney C.; Di Taranto G.; Shanbhag S.; Dickson K.; McEvoy K.; Skillman J.; Sait M.; Al-Omishy H.; Baig M.; Heer B.; Lunevicius R.; Sheel A.R.G.; Sundhu M.; Santini A.J.A.; Fathelbab M.S.A.T.; Hussein K.M.A.; Nunes Q.M.; Jones R.P.; Shahzad K.; Haq I.; Baig M.M.A.S.; Hughes J.L.; Kattakayam A.; Rajput K.; Misra N.; Shah S.B.; Clynch A.L.; Georgopoulou N.; Sharples H.M.; Apampa A.A.; Nzenwa I.C.; Sud A.; Podolsky D.; Coleman N.L.; Callahan M.P.; Dunstan M.; Beak P.; Gerogiannis I.; Ebrahim A.; Alwadiya A.; Goyal A.; Phillips A.; Bhalla A.; Demetriou C.; Grimley E.; Theophilidou E.; Ogden E.; Malcolm F.L.; Davies-Jones G.; Ng J.C.K.; Mirza M.; Hassan M.; Elmaleh N.; Daliya P.; Bateman A.; Chia Z.; A'Court J.; Konarski A.; Faulkner G.; Talwar R.; Patel K.; Askari A.; Jambulingam P.S.; Shaw S.; Maity A.; Hatzantonis C.; Sagar J.; Kudchadkar S.; Cirocchi N.; Chan C.H.; Eberbach H.; Bayer J.; Erdle B.; Sandkamp R.; Kaafarani H.; Breen K.; Bankhead-Kendall B.; Alser O.; Mashbari H.; Velmahos G.; Maurer L.R.; El Moheb M.; Gaitanidis A.; Naar L.; Christensen M.A.; Kapoen C.; Langeveld K.; El Hechi M.; Mokhtari A.; Main B.; MacCabe T.; Newton C.; Blencowe N.S.; Fudulu D.P.; Bhojwani D.; Baquedano M.; Caputo M.; Rapetto F.; Flannery O.; Hassan A.; Edwards J.; Ward A.; Tadross D.; Majkowski L.; Blundell C.; Forlani S.; Nair R.; Guha S.; Brown S.R.; Steele C.; Kelty C.J.; Newman T.; Lee M.; Chetty G.; Lye G.; Balasubramanian S.P.; Sureshkumar Shah N.; Sherif M.; Al-Mukhtar A.; Whitehall E.; Giblin A.; Wells F.; Sharkey A.; Adamec A.; Madan S.; Konsten J.; Van Heinsbergen M.; *Sou A.; *Simpson D.; *Hamilton E.; *Blair J.; Jimeno Fraile J.; Morales-Garcia D.; Carrillo-Rivas M.; Toledo Martinez E.; Pascual A.; Landaluce-Olavarria A.; Gonzalez De Miguel M.; Fernandez Gomez Cruzado L.; Begona E.; Lecumberri D.; Calvo Rey A.; Prada Hervella G.M.; Dos Santos Carregal L.; Rodriguez Fernandez M.I.; Freijeiro M.; El Drubi Vega S.; Van Den Eynde J.; Oosterlinck W.; Van Den Eynde R.; Sermon A.; Boeckxstaens A.; Cordonnier A.; De Coster J.; Jaekers J.; Politis C.; Miserez M.; Galipienso Eri M.; Garcia Montesino J.D.; Dellonder Frigole J.; Noriego Munoz D.; Lizzi V.; Vovola F.; Arminio A.; Cotoia A.; Sarni A.L.; Bekheit M.; Kamera B.S.; Elhusseini M.; Sharma P.; Ahmeidat A.; Gradinariu G.; Cymes W.; Hannah A.; Mignot G.; Shaikh S.; Agilinko J.; Sgro A.; Rashid M.M.; Milne K.; McIntyre J.; Akhtar M.A.; Turnbull A.; Brunt A.; Stewart K.E.; Wilson M.S.J.; Rutherford D.; McGivern K.; Massie E.; Duff S.; Moura F.; Brown B.C.; Asaad P.; Wadham B.; Aneke I.A.; Collis J.; Warburton H.; Fountain D.M.; Laurente R.; Sigamoney K.V.; Dasa M.; George K.; Naqui Z.; Galhoum M.; Lipede C.; Gabr A.; Radhakrishnan A.; Hasan M.T.; Kalenderov R.; Pathmanaban O.; Colombo F.; Chelva R.; Subba K.; Abou-Foul A.K.; Khalefa M.; Hossain F.; Moores T.; Pickering L.; Shah J.; Anthoney J.; Emmerson O.; Bevan K.; Makin-Taylor R.; Ong C.S.; Callan R.; Bloom O.; Vidya R.; Chauhan G.; Kaur J.; Burahee A.; Bleibleh S.; Pigadas N.; Snee D.; Bhasin S.; Crichton A.; Habeebullah A.; Bodla A.S.; Yassin N.; Mondragon M.; Dewan V.; Giuffrida M.C.; Marano A.; Palagi S.; Di Maria Grimaldi S.; Testa V.; Peluso C.; Borghi F.; Simonato A.; Puppo A.; D'Agruma M.; Chiarpenello R.; Pellegrino L.; Maione F.; Cianflocca D.; Pruiti Ciarello V.; Giraudo G.; Gelarda E.; Dalmasso E.; Abrate A.; Daniele A.; Ciriello V.; Rosato F.; Garnero A.; Leotta L.; Chiozza M.; Anania G.; Urbani A.; Koleva Radica M.; Carcoforo P.; Portinari M.; Sibilla M.; Archer J.E.; Odeh A.; Siddaiah N.; Baumber R.; Parry J.; Carmichael H.; Velopulos C.G.; Wright F.L.; Urban S.; McIntyre R.C.; Schroeppel T.J.; Hennessy E.A.; Dunn J.; Zier L.; Parmar C.; McCluney S.; Shah S.; Munoz Vives J.M.; Osorio A.; Gomez Diaz C.J.; Guariglia C.A.; Soto Montesinos C.; Sanchon L.; Xicola Martinez M.; Guardia N.; Collera P.; Diaz Del Gobbo R.; Sanchez Jimenez R.; Farre Font R.; Flores Clotet R.; Brathwaite C.E.M.; Liu H.; Petrone P.; Hakmi H.; Sohail A.H.; Baltazar G.; Heckburn R.; Madhvani K.; Hampton M.; Hormis A.P.; Young R.; Miu V.; Sheridan K.; MacDonald L.; Green S.; Onos L.; Dean B.; Luney C.; Myatt R.; Williams M.A.; McVeigh J.; Alqallaf A.; Ben-Sassi A.; Mellor K.; Joshi P.; Joshi Y.; Crichton R.; Sonksen J.; Aldridge K.; Layton G.R.; Karki B.; Jeong H.; Pankhania S.; Asher S.; Folorunso A.; Mistry S.; Singh B.; Winyard J.; Mangwani J.; Babu B.H.B.; Liyanage A.S.D.; Newman S.; Blake I.; Weerasinghe C.; Ballabio M.; Bisagni P.; Longhi M.; Armao T.; Madonini M.; Gagliano A.; Pizzini P.; Alga A.; Nordberg M.; Sandblom G.; Jallad S.; Lord J.; Anderson C.; El Kafsi J.; Logishetty K.; Saadya A.; Midha R.; Ip M.; Subbiah Ponniah H.; Stockdale T.; Bacarese-Hamilton T.; Foster L.; James A.; Anjarwalla N.; Marujo Henriques D.; Hettige R.; Baban C.; Tenovici A.; Salerno G.; Hardie J.; Page S.; Anazor F.; King S.D.; Luck J.; Kazzaz S.; Patel M.; Shabana A.; Alanbuki A.; Usman O.; Hkruijff S.; De Vries J.P.P.M.; Steinkamp P.J.; Jonker P.K.C.; Van Der Plas W.Y.; Bierman W.; Janssen Y.; Borgstein A.B.J.; Gisbertz S.S.; Van Berge Henegouwen M.I.; Enjuto D.; Perez Gonzalez M.; Diaz Pena P.; Gonzalez J.; Marqueta De Salas M.; Martinez Pascual P.; Rodriguez Gomez L.; Garces Garcia R.; Ramos Bonilla A.; Herrera-Merino N.; Fernandez Bernabe P.; Cagigal Ortega E.P.; Hernandez I.; Garcia De Castro Rubio E.; Cervera I.; Kashora F.; Siddique M.H.; Singh A.; Barmpagianni C.; Basgaran A.; Basha A.; Okechukwu V.; Bartsch A.; Gallagher P.; Maqsood A.; Sahnan K.; Leo C.A.; Lewis S.E.; Ubhi H.K.; Exley R.; Khan U.; Shah P.; Saxena S.; Zafar N.; Abdul-Jabar H.; Mongelli F.; Bernasconi M.; Di Giuseppe M.; Christoforidis D.; La Regina D.; Arigoni M.; Liew I.; Al-Sukaini A.; Mediratta S.; Saxena D.; Boal M.; Dean H.; Higgs S.; Stanger S.; Abdalaziz H.; Constable J.; Ishii H.; Preece R.; Dovell G.; Gopi Reddy R.; Dehal A.; Shah H.B.; Cross G.W.V.; Seyed-Safi P.; Smart Y.W.; Kuc A.; Al-Yaseen M.; Jayasankar B.; Balasubramaniam D.; Abdelsaid K.; Mundkur N.; Gallagher B.; Hine T.; Keeler B.; Soulsby R.E.; Taylor A.; Davies E.; Ryska O.; Raymond T.; Rogers S.; Tong A.; Hawkin P.; Kinnaman G.; Meagher A.; Sharma I.; Holler E.; Dunning J.; Viswanath Y.; Freystaetter K.; Dixon J.; Hadfield J.N.; Hilley A.; Egglestone A.; Smith B.; Arkani S.; Freedman J.; Youssef M.; Sreedharan L.; Baskaran D.; Shaikh I.; Seebah K.; Reid J.; Watts D.; Kouritas V.; Chrastek D.; Maryan G.; Gill D.F.; Khatun F.; Ranjit S.; Parakh J.; Sarodaya V.; Daadipour A.; Khalifa M.; Bosch K.D.; Bashkirova V.; Dvorkin L.S.; Kalidindi V.K.; Choudhry A.; Marx W.; Espino Segura-Illa M.; Sanchez Aniceto G.; Castano-Leon A.M.; Jimenez-Roldan L.; Delgado Fernandez J.; Perez Nunez A.; Lagares A.; Garcia Perez D.; Santas M.; Paredes I.; Esteban Sinovas O.; Moreno-Gomez L.; Rubio E.; Vega V.; Vivas Lopez A.; Labalde Martinez M.; Garcia Villar O.; Pelaez Torres P.M.; Garcia-Borda J.; Ferrero Herrero E.; Gomez P.; Eiriz Fernandez C.; Ojeda-Thies C.; Pardo Garcia J.M.; Wynn Jones H.; Divecha H.; Whelton C.; Board T.; Hardie C.; Powell-Smith E.; Alotaibi M.; Maashi A.; Zowgar A.; Alsakkaf M.; Izquierdo O.; Ventura D.; Castellanos J.; Lara A.; Escobar D.; Arrieta M.; Garcia De Cortazar U.; Villamor Garcia I.; Cioci A.; Ruiz G.; Allen M.; Rakoczy K.; Pavlis W.; Saberi R.; Sobti A.; Khaleel A.; Unnithan A.; Memon K.; Pala Bhaskar R.R.; Maqboul F.; Kamel F.; AlSamaraee A.; Madani R.; Kumar L.; Nisar P.; Agrawal S.; Llaquet Bayo H.; Duchateau N.; De Gheldere C.; Martin J.; Cheng D.; Yang H.; Fayad A.; Wood M.L.; Persad A.; Groot G.; Pham H.; Hakami I.; Boeker C.; Mall J.; Smith H.; Haugstvedt A.F.; Jonsson M.L.; Caja Vivancos P.; Villalabeitia Ateca I.; Prieto Calvo M.; Marin H.; Martin Playa P.; Gainza A.; Aragon Achig E.J.; Rodriguez Fraga A.; Melchor Corcostegui I.; Mallabiabarrena Ormaechea G.; Garcia Gutierrez J.J.; Barbier L.; Pesantez Peralta M.A.; Jimenez Jimenez M.; Municio Martin J.A.; Gomez Suarez J.; Garcia Opere G.; Pascua Gomez L.A.; Onate Aguirre M.; Fernandez-Colorado A.; De La Rosa-Estadella M.; Gasulla-Rodriguez A.; Serrano-Martin M.; Peig-Font A.; Junca-Marti S.; Juarez-Pomes M.; Garrido-Ondono S.; Blasco-Torres L.; Molina-Corbacho M.; Maldonado-Sotoca Y.; Gasset-Teixidor A.; Blasco-Moreu J.; Turrado-Rodriguez V.; Lacy A.M.; De Lacy F.B.; Morales X.; Carreras-Castaner A.; Torner P.; Jornet-Gibert M.; Balaguer-Castro M.; Renau-Cerrillo M.; Camacho-Carrasco P.; Vives-Barquiel M.; Campuzano-Bitterling B.; Gracia I.; Pujol-Muncunill R.; Estaire Gomez M.; Padilla-Valverde D.; Sanchez-Garcia S.; Sanchez-Pelaez D.; Jimenez Higuera E.; Picon Rodriguez R.; Fernandez Camunas A.; Martinez-Pinedo C.; Garcia Santos E.P.; Munoz-Atienza V.; Moreno Perez A.; Lopez De La Manzanara Cano C.A.; Crego-Vita D.; Huecas-Martinez M.; Domenech J.; Rosello Anon A.; Sanguesa M.J.; Bernal-Sprekelsen J.C.; Catala Bauset J.C.; Renovell Ferrer P.; Martinez Perez C.; Gil-Albarova O.; Gilabert Estelles J.; Aghababyan K.; Rivas R.; Rivas F.; Escartin J.; Blas Laina J.L.; Nogues A.; Cros B.; Talal El-Abur I.; Garcia Egea J.; Yanez C.; Kauppila J.H.; Sarjanoja E.; Tzedakis S.; Bouche P.A.; Gaujoux S.; Gossot D.; Seguin-Givelet A.; Fuks D.; Grigoroiu M.; Sanchez Salas R.; Cathelineau X.; MacEk P.; Barbe Y.; Rozet F.; Barret E.; Mombet A.; Cathala N.; Brian E.; Zadegan F.; Conso C.; Baldwin A.J.; West R.; Gammeri E.; Catton A.; Marinos Kouris S.; Pereca J.; Singh J.; Patel P.; Handa S.; Kaushal M.; Kler A.; Reghuram V.; Tezas S.; Oktseloglou V.; Mosley F.; De La Cruz Monroy M.F.I.; Bobak P.; Omar I.; Ahad S.; Langlands F.; Brown V.; Hashem M.; Williams A.; Ridgway A.; Pournaras D.; Britton E.; Lostis E.; Ambler G.K.; Chu H.; Hopkins J.; Manara J.; Chan M.; Doe M.; Moon R.D.C.; Lawday S.; Jichi T.; Singleton W.; Mannion R.; Stewart G.D.; Ramzi J.; Mohan M.; Singh A.A.; Ashcroft J.; Baker O.J.; Coughlin P.; Davies R.J.; Durst A.Z.E.D.; Abood A.; Habeeb A.; Hudson V.E.; Kolias A.; Lamb B.; Luke L.; Mitrasinovic S.; Murphy S.; Ngu A.W.T.; O'Neill J.R.; Waseem S.; Wong K.; Georgiades F.; Hutchinson P.J.; Tan X.S.; Pushpa-Rajah J.; Colquhoun A.; Masterson L.; Abu-Nayla I.; Walker C.; Balakrishnan A.; Rooney S.; Irune E.; Byrne M.H.V.; Durrani A.; Richards T.; Sethuraman Venkatesan A.; Combellack T.; Williams J.; Tahhan G.; Mohammed M.; Kornaszewska M.; Valtzoglou V.; Deglurkar I.; Rahman M.; Von Oppell U.; Mehta D.; Koutentakis M.; Syed Nong Chek S.A.H.; Hill G.; Morris C.; Shinkwin M.; Torkington J.; Cornish J.; Houston R.; Mannan S.; Ayeni F.; Tustin H.; Bordenave M.; Robson A.; Vimalachandran D.; Manu N.; Eardley N.; Krishnan E.; Serevina O.L.; Martin E.; Jones A.; Roy Mahapatra S.; Clifford R.; Matthews W.; Mohankumar K.; Khawaja I.; Palepa A.; Doulias T.; Premakumar Y.; Jauhari Y.; Koshnow Z.; Bowen D.; Uberai A.; Hirri F.; Stubbs B.M.; McDonald C.; Manickavasagam J.; Ragupathy K.; Davison S.; Dalgleish S.; McGrath N.; Kanitkar R.; Payne C.J.; Ramsay L.; Ng C.E.; Collier T.; Khan K.; Evans R.; Brennan C.; Henshall D.E.; Drake T.; Harrison E.M.; Zamvar V.; Tambyraja A.; Skipworth R.J.E.; Linder G.; McGregor R.; Brennan P.; Mayes J.; Ross L.; Smith S.; White T.; Jamjoom A.A.B.; Pasricha R.; Holme T.; Abbott S.; Razik A.; Thrumurthy S.; Steinke J.; Baker M.; Howden D.; Baxter Z.; Osagie L.; Bence M.; Fowler G.E.; Massey L.; Rajaretnam N.; John J.; Goubran A.; Campain N.; McDermott F.D.; McGrath J.S.; Ng M.; Pascoe J.; Phillips J.R.A.; Daniels I.R.; Raptis D.A.; Pollok J.M.; MacHairas N.; Davidson B.; Fusai G.; Soggiu F.; Xyda S.; Hidalgo Salinas C.; Tzerbinis H.; Pissanou T.; Gilliland J.; Chowdhury S.; Varcada M.; Hart C.; Mirnezami R.; Knowles J.; Angamuthu N.; Vijay V.; Shakir T.; Hasan R.; Tansey R.; Ross E.; Loubani M.; Wilkins A.; Cao H.; Capitelli-McMahon H.; Hitchman L.; Ikram H.; Andronic A.; Aboelkassem Ibrahim A.; Totty J.; Tayeh S.; Chase T.; Humphreys L.; Ayorinde J.; Ghanbari A.; Cuming T.; Williams K.; Chung E.; Hagger R.; Karim A.; Hainsworth A.; Flatman M.; Trompeter A.; Hing C.; Brown O.; Tsinaslanidis P.; Benjamin M.W.; Leyte A.; Tan C.; Smelt J.; Vaughan P.; Santhirakumaran G.; Hunt I.; Raza M.; Labib A.; Luo X.; Sudarsanam A.; Rolls A.; Lyons O.; Onida S.; Shalhoub J.; Sugand K.; Park C.; Sarraf K.M.; Erridge S.; Kinross J.; Denning M.; Yalamanchili S.; Abuown A.; Ibrahim M.; Martin G.; Davenport D.; Wheatstone S.; Andreani S.M.; Bath M.F.; Sahni A.; Judkins N.; Rigueros Springford L.; Sohrabi C.; Bacarese-Hamilton J.; Taylor F.G.; Patki P.; Tanabalan C.; Reynolds J.; Alexander M.E.; Smart C.J.; Stylianides N.; Abdalla M.; Newton K.; Bhatia K.; Edmondson R.; Abdeh L.; Jones D.; Zeiton M.; Ismail O.; Naseem H.; Advani R.; Fell A.; Smith A.; Halkias C.; Evans J.; Nikolaou S.; English C.; Kristinsson S.; Oni T.; Ilahi N.; Ballantyne K.; Woodward Z.; Merh R.; Robertson-Smith B.; Mahmoud A.; Ameerally P.; Finch J.G.; Gnanachandran C.; Pop I.; Rogers M.; Yousef Y.; Mohamed I.; Woods R.; Zahid H.; Mundy G.; Aujayeb A.; Townshend D.; McLarty N.; Shenfine A.; Jackson K.; Johnson C.; Dass D.; Ford D.; Khan J.; Thiruchandran G.; Toh S.K.C.; Ahmad Y.; Allana A.; Bellis C.; Babawale O.; Phan Y.C.; Lokman U.; Ismail M.; Koc T.; Witek A.; Duggleby L.; Shamoon S.; Stefan S.; Clancy H.; Singh S.; Mukherjee S.; Ferguson D.; Smith C.; Mansuri A.; Thakrar A.; Wickramarachchi L.; Cuthbert R.; Sivayoganathan S.; Chui K.; Karam E.; Dott C.; Shankar S.; Singh R.; Lane J.; Colvin H.V.; Badran A.; Cadersa A.; Williams S.; Cumpstey A.; Hamady Z.; Aftab R.; Wensley F.; Byrne J.; Morrison-Jones V.; Sekhon G.K.; Shields H.; Shakoor Z.; Yener A.; Talbot T.; Khan A.; Alzetani A.; Cresner R.; Johnson D.; Hughes I.; Hall J.; Rooney J.; Chatterji S.; Zhang Y.; Owen R.; Rudic M.; Hunt J.; Zakai D.; Thomas M.; Aladeojebi A.; Ali M.; Gaunt A.; Barmayehvar B.; Gowda M.; Mansour F.; Jarvis M.; Halliday E.; Lefroy R.; Nanjaiah P.; Ali S.; Kitchen M.; Lin D.J.; Rajgor A.D.; Scurrah R.J.; Kang C.; Watson L.J.; Harris G.; Royle T.; Cunningham Y.; James G.; Steel B.; Luk A.C.O.; Stables G.; Doorgakant A.; Thiruvasagam V.G.; Carter J.; Reid S.; Mohammed R.; Marlow W.; Ferguson H.; Wilkin R.; Konstantinou C.; Yershov D.; Vatish J.; Denning A.; Das R.; Powell S.; Magee C.; Agarwal K.; Mangos E.; Nambirajan T.; Flindall I.; Mahendran V.; Hanson A.; De Marchi J.; Hill A.; Farrell T.; Davis N.F.; Kearney D.; Nelson T.; Picciariello A.; Papagni V.; Altomare D.F.; Granieri S.; Cotsoglou C.; Cabeleira A.; Branco C.; Serralheiro P.; Alves R.; Teles T.; Lazaro A.; Canhoto C.; Simoes J.; Costa M.; Almeida A.C.; Nogueira O.; Oliveira A.; Athayde Nemesio R.; Silva M.; Lopes C.; Amaral M.J.; Valente Da Costa A.; Andrade R.; Guimaraes A.; Guerreiro P.; Ruivo A.; Camacho C.; Duque M.; Santos E.; Breda D.; Oliveira J.M.; De Oliveira Lopez A.L.; Garrido S.; Colino M.; De Barros J.; Correia S.; Rodrigues M.; Cardoso P.; Martins R.; Teixeira J.; Soares A.P.; Morais H.; Pereira R.; Revez T.; Manso M.I.; Domingues J.C.; Henriques P.; Ribeiro R.; Ribeiro V.I.; Cardoso N.; Sousa S.; Martins Dos Santos G.; Miranda P.; Garrido R.; Peralta Ferreira M.; Ascensao J.; Costeira B.; Cunha C.; Rio Rodrigues L.; Sousa Fernandes M.; Azevedo P.; Ribeiro J.; Lourenco I.; Gomes H.; Mendinhos G.; Nobre Pinto A.; Taflin H.; Abdou H.; Richmond M.; Clark J.; O'Meara L.; Hanna N.; Cooper Z.; Salim A.; Hirji S.A.; Brown A.; Chung C.; Hansen L.; Okafor B.U.; Roxo V.; Raut C.P.; Jolissaint J.S.; Mahvi D.A.; Reinke C.; Ross S.; Thompson K.; Manning D.; Perkins R.; Volpe A.; Merola S.; Ssentongo A.; Ssentongo P.; Oh J.S.; Hazelton J.; Maines J.; Gusani N.; Garner M.; Horvath S.; Martin R.C.G.; Bhutiani N.; Choron R.; Peck G.; Soliman F.; Abbas A.; Soliman A.; Kim B.; Jones C.; Dauer M.D.E.; Renza-Stingone E.; Hernandez E.; Gokcen E.; Kropf E.; Sufrin H.; Hirsch H.; Ross H.; Engel J.; Sewards J.; Diaz J.; Poggio J.; Sanserino K.; Rae L.; Philp M.; Metro M.; McNelis P.; Petrov R.; Rehman S.; Pazionis T.; Quintana M.; Jackson H.; Lumenta D.B.; Nischwitz S.P.; Richtig E.; Pau M.; Srekl-Filzmaier P.; Eibinger N.; Michelitsch B.; Fediuk M.; Papinutti A.; Seidel G.; Kahn J.; Cohnert T.U.; Kantor E.; Kahiu J.; Hossain N.; Hosny S.; Sultana A.; Taggarsi M.; Vitone L.; Lambert J.; Vaz O.P.; Sarantitis I.; Shrestha D.; Timbrell S.; Shugaba A.; Jones G.P.; Gardner A.; Tripathi S.S.; Greenhalgh M.S.; Emerson H.; Vejsbjerg K.; Pearce L.; McCormick W.; Fisher A.; Singisetti K.; Aawsaj Y.; Barry C.; Blanco J.; Vanker R.; Ghobrial M.; Jones G.; Kanthasamy S.; Fawi H.; Awadallah M.; Chen F.; Cheung J.; Tingle S.; Abbadessa F.; Sachdeva A.; Rai B.; Chan C.D.; McPherson I.; Booth K.; Mahmoud Ali F.; Pandanaboyana S.; Grainger T.; Nandhra S.; Patience A.; Rogers A.; Roy C.; Williams T.; Dawe N.; McCaffer C.; Riches J.; Bhattacharya S.; Moir J.; Kalson N.S.; Elamin Ahmed H.; Mellor C.; Saleh C.; Koshy R.M.; Hammond J.; Sanderson L.; Wahed S.; Phillips A.W.; Ghosh K.; Rogers L.J.; Labib P.L.; Miller D.; Minto G.; Hope N.; Marchbank A.; Emslie K.; Panahi P.; Ho B.; Perkins C.; Clough E.; Roy H.; Enemosah I.; Campbell R.; Natale J.; Gohil K.; Rela M.; Raza N.; Menakaya C.; Webb J.I.; Antar M.; Modi N.; Sofat R.; Noel J.; Nunn R.; Adegbola S.; Eriberto F.; Sharma V.; Tanna R.; Lodhia S.; Carvalho L.; Osorio C.; Antunes J.; Lourenco S.; Balau P.; Godinho M.; Pereira A.; Keller D.S.; Smart N.J.

Citation:BMJ Open. 11(11) (no pagination), 2021. Article Number: e050830.

Abstract:Objectives: Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting: Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions: Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.

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Reduction in cardiovascular disease morbidity of men and women with familial hypercholesterolaemia (FH) associated with availability of high intensity statins: A cohort study using data from the UK Simon Broome Register linked with secondary care records (2021)

Type of publication:Conference abstract

Author(s):Iyen B.; Qureshi N.; Roderick P.; *Capps N.; Durrington P.N.; McDowell I.F.W.; Cegla J.; Soran H.; Schofield J.; Neil H.A.W.; Kai J.; Weng S.; Humphries S.E.

Citation:Atherosclerosis Plus. Conference: HEART UK 34th Annual Medical & Scientific Virtual Conference. Virtual, Online. 43(Supplement) (pp S5), 2021. Date of Publication: September 2021.

Abstract:Background: Previous studies of the Simon Broome (SB) FH register reported that, compared to the low-intensity statin period (1992-2008), the standardised cardiovascular disease (CVD) mortality ratio in the high-intensity statin period (2009-2015) was 22% lower in men but 115% higher in women. Linkage of the register with Hospital Episodes Statistics (HES) data has now enabled prospective evaluation of CVD morbidity based on inpatient care. Method(s): Standardised Morbidity Ratios (SMbR) compared to age and sex-matched UK primary care patients were calculated [95% confidence intervals] for risk of composite CVD (first HES outcome of CHD, MI, stable or unstable angina, stroke, TIA, PVD, heart failure, PCI and CABG) in men and women under and over the age of 50 years. Result(s): 2,988 (52.5% women) SB register participants had HES records. The SMbR was higher in women than men in both age groups and during both time periods. Compared to 1997-2007, in both men and women aged <50 years the SMbR fell significantly in the 2008-2017 period (8.7[7.3-10.3] vs 17.9[15.7-20.5] and 12.8[10.4-15.7] vs 20.8[17.1-25.4] respectively. By contrast in both sexes in those >50 years in the later time period there was no significant reduction in CVD-admission incidence rates or in SMbR (Men, 6.6[5.3-8.2] vs 5.8[5.0-6.8], Women, 9.2[7.8-10.7] vs 7.5 [6.6-8.5]). Conclusion(s): While the rate of CVD morbidity due to FH has encouragingly fallen significantly over time in both sexes aged <50 years, it has not done so in those >50. This emphasises the importance of early identification and optimal lipid-lowering throughout life for subjects with FH. Funded by the NIHR HTA project 15/134/02 and BHF grants RG3008 and PG008/08.

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The impact of treatment with bile acid sequestrants on quality of life in patients with bile acid diarrhoea (2022)

Type of publication:Journal article

Author(s):Kumar A; Galbraith N; Al-Hassi HO; Jain M; Phipps O; *Butterworth J; Steed H; McLaughlin J; Brookes MJ

Citation:BMC Gastroenterology, 2022 Jul 02; Vol. 22 (1), pp. 325

Abstract:Background: Bile acid diarrhoea (BAD) can be severely debilitating and negatively affect patients' quality of life (QoL). We carried out a multi-centre prospective study exploring QoL outcomes in patients with BAD after treatment with colesevelam. Methods: Patients with or without a positive 23-seleno-25-homotaurocholic acid (SeHCAT) scan were recruited and categorised into four groups: SeHCAT negative control group (CG), idiopathic BAD, post-cholecystectomy (PC) and post-terminal ileal resection for Crohn's disease (CD). Patients with a positive SeHCAT were treated with colesevelam and dosing was titrated to symptomatic response. Patients were reviewed at 4- and 8-weekly intervals and QoL was evaluated by EQ-5D-3L, SF-36, IBDQ-32 at each visit (where relevant). Patients with a negative SeHCAT (CG cohort) completed one set of questionnaires before being discharged from the study. Results: 47 patients (BAD = 24, PC = 12, CD = 11) completed paired QoL questionnaires before and after treatment and 30 CG patients completed a baseline questionnaire. There was a significant improvement in IBDQ-32 mean scores before and after treatment in CD patients [134.6 (95%CI 112.5-156.6) and 158.4 (136.1-180.6), respectively (p = 0.007). Following treatment, BAD patients had significantly improved mean SF-36 scores in the "Role limitation due to physical health" dimension (p = 0.02) and in the overall mental component summary (p = 0.03). Prior to starting treatment, BAD patients had the lowest scores in the 'activity' dimension of the EQ-5D-3L (p = 0.04), which improved significantly after treatment (p = 0.002). Overall, the BAD and CD cohort showed improved mean scores with treatment in all components of the SF-36 and EQ-5D-3L, while the PC cohort showed a general decline in mean scores after treatment. 55% of patients clinically responded to treatment of which 41.7%, 58.3% and 81.8% responded from the BAD, PC and CD groups respectively. Correlations between those deemed as responders with improvements on the SF-36 and EQ-5D dimensions were not statistically significant. Conclusion: Our results demonstrate improved QoL in the BAD and CD cohort with treatment. Further larger studies are recommended specifically investigating the PC cohort and whether patients may improve with newer treatments such as FXR agonists. Trial registration Ethical approval REC Ref: 16/LO/1325.

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Surgical Fixation of Three- and Four-Part Proximal Humeral Fractures Using the Proximal Humeral Interlocking System Plate (2022)

Type of publication:Journal article

Author(s):Saber AY; Said UN; Abdelmonem AH; Elsayed H; Taha M; Hussein W; *Al-Hashimi K; El-Omar O; Elbeshbeshy M

Citation:Cureus, 2022 May 26; Vol. 14 (5), pp. e25348

Abstract:Introduction The management of proximal humeral fractures ranges greatly from conservative management to surgical treatment. For those fractures requiring surgical treatment, internal fixation is the primary method. The aim of internal fixation is to achieve rigid fracture fixation until union occurs, return of shoulder range of motion, and minimise intra-and postoperative complications. The aim of this study was to evaluate the results of the Proximal Humeral Interlocking System Plate (PHILOS) used for the treatment of three-and four-part proximal humeral fractures. Materials and methods This study included 30 patients with a mean age of 54 years (range 20-80 years). Results were checked post-operatively with standard radiographs and clinical evaluation according to the Constant-Murley shoulder score. All patients were followed up for 12 months. Results Union was achieved in all patients with a mean neck/shaft angle of 130° (range 108°-150°). The mean Constant-Murley score at the final follow-up was 82.28 (range 67-96) correlating with good results. No patients developed an intraoperative or postoperative vascular injury, wound complications, or avascular necrosis of the humeral head. Conclusion Our study has shown that the surgical treatment of three- and four-part proximal humeral fractures with the use of the PHILOS plate leads to a good functional outcome. It has also demonstrated the PHILOS plate and is an effective system for fracture stabilisation provided the correct surgical technique is used with awareness of potential hardware complications.

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