Type of publication:
Journal article
Author(s):
Dowell A.C.; Taylor G.S.; *Cobby E.; Wen K.; During V.; Anderson J.; James N.D.; Devall A.J.; Cheng K.K.; Zeegers M.P.; Bryan R.T.
Citation:
PloS one; 2017; vol. 12 (no. 9)
Abstract:
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
*Papoutsis D.; Haefner H.K.
Citation:
Journal of Clinical and Diagnostic Research; Sep 2017; vol. 11 (no. 9)
Abstract:
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
*Howe, D.
Citation:
Indian Journal of Critical Care Medicine; Oct 2017; vol. 21 (no. 10); p. 710-711
Abstract:
Rocuronium is commonly used in preference to suxamethonium for rapid sequence induction in the Intensive Care Unit (ICU). We describe a patient who suffered significant neck trauma following a suicide attempt. On initial presentation to accident and emergency, he was an easy intubation with a Grade 1 view obtained at laryngoscopy. After surgery to repair his neck laceration, he was extubated and discharged from ICU. He later developed a severe aspiration pneumonia and required reintubation. After induction and paralysis with suxamethonium, the best view at laryngoscopy was a Grade 3 despite the use of different laryngoscopes. As the muscle paralysis wore off the patient began breathing. This produced bubbles in the back of the patient's pharynx which directed the clinician to the laryngeal inlet to allow successful intubation. In this case, the short duration of action of suxamethonium significantly aided intubation due to the return of spontaneous breathing by the patient.
Link to full-text [no password required]
Type of publication:
Conference abstract
Author(s):
*Underwood M. 
; *Chadha R.; *Hudda A.; *Green J.; *Fry M.; *Barker V.
Citation:
Journal of Minimally Invasive Gynecology; 2017; vol. 24 (no. 7)
Abstract:
Study Objective: Identify any histological discrepancy between blind endometrial sampling (ES) reported as inadequate, inactive or benign endometrium and office based hysteroscopy with the MyoSure tissue removal system in women with post-menopausal bleeding (PMB). Design: retrospective review of cases from our PMB clinic. Setting:Women attending the PMB clinic who's ES is reported as benign, inactive or inadequate. MyoSure Lite or Classic devices were used for the removal of these lesions. Patients:Women with PMB having an endometrial polypectomy using the MyoSure tissue removal system. Intervention: The MyoSure Lite & Classic tissue removal systems were used to remove endometrial polyps in women with PMB who's ES was inactive, inadequate or benign. Histological comparison between the ES and MyoSure histology was made. Measurements and Main Results: 616 women underwent hysteroscopic evaluation for abnormal uterine 2017; 399 were post-menopausal of which 186 women (46.6%) had inactive endometrium, 82 women (20.6%) had inadequate, 109 (27.3%) had benign/polyp and 22 (5.5%) had simple hyperplasia or higher grade disease detected on the blind endometrial sampling prior to polypectomy. The MyoSure polypectomy of those women with "Proliferative/benign endometrium" demonstrated that 19.3% had higher grade disease (Simple, complex, complex with atypia or cancer) than the ES, for the "inactive group 10.8% had high grade disease and those with an inadequate ES 13.4% had higher grade disease. (Table presented) Endometrial thickness in the PMB group ranged from 1.5-45 mm with a mean of 10.6 mm. There were no reported complications in all 616 cases. Conclusion: This retrospective review of patients with inadequate, inactive or benign ES has demonstrated the significant benefit to patient of having the polyp removed simply without complication in the office setting using the MyoSure tissue removal system. Between 10.8-19.3% will have higher grade disease detected using the MyoSure device, which would have an impact on their medical management.
Type of publication:
Journal article
Author(s):
Methven S.; Perisanidou L.I.; *Nicholas J. ; Dawnay A.
Citation:
Nephron; Sep 2017; vol. 137 (no. 1); p. 189-234
Abstract:
64.1% of haemodialysis (HD) patients and 60.5% of peritoneal dialysis (PD) patients achieved the Renal Association (RA) audit measure for phosphate (<1.7 mmol/L). . 35.9% of HD and 39.5% of PD patients had a serum phosphate above the RA audit standard (>=1.7 mmol/L). Simultaneous control of all three parameters (calcium, phosphate and parathyroid hormone (PTH)) within current target ranges was achieved by 27.6% of HD and 33.1% of PD patients. 79.3% of HD and 77.8% of PD patients had adjusted calcium in the recommended target range of 2.2-2.5 mmol/L. 57.1% of HD and 61.3% of PD patients had phosphate between 1.1-1.7 mmol/L. 56.8% of HD and 63.6% of PD patients had a serum PTH between 16-72 pmol/L. 18.8% of HD and 13.9% of PD patients had a serum PTH >72 pmol/L. 64.3% of HD and 80.4% of PD patients achieved the audit measure for bicarbonate 18-24 mmol/L for HD patients and 22-30 mmol/L for PD patients).
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
*Crowley L.; MacNeill S.; Caskey F.J.; Methven S.; Nsonwu O.; Davies J.; Fluck R.; Byrne C.
Citation:
Nephron; Sep 2017; vol. 137 (no. 1); p. 251-257
Abstract:
Between January 2015 and December 2015 there were a total of 31 episodes of Methicillin Resistant Staphylococcus aureus (MRSA) bacteraemia in patients receiving dialysis for end stage renal disease. The rate of MRSA episodes per 100 dialysis patient years was 0.13 compared to 0.15 the previous year. Rates of Methicillin Sensitive Staphyloccoccus aureus (MSSA) continued their gradual increase with a rate of 2.35 per 100 patient years compared with 2.26 the year before. This was a result of 560 episodes of bloodstream infection between January and December. Rates of Clostridium difficile infection (CDI) were stable with 245 recorded episodes giving a rate of 1.03 per 100 patient years. Escherichia coli (E.coli) infections occurred at a rate of 1.7 per 100 dialysis patient years, an increase on the previous year's rate of 1.49. As found in previous years, a tunnelled catheter was associated with a higher number of infection episodes than other forms of access in those patients with a staphylococcal bacteraemia.
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
*Lake B.; *Cielecki L. ; *Williams S.; *Worrall C.; *Metelko M.
Citation:
Radiography; Nov 2017; vol. 23 (no. 4)
Abstract:
Introduction Breast cancer is increasingly a disease of the elderly, and combined with the NHS Breast Screening Extension means that more elderly patients are having mammography. Increasing age can make mammography more technically difficult. This is a technical note detailing the results of a local audit which may be of interest due to potential service implications. Method A retrospective audit of the first year of screening extension of The Shropshire Breast Screening Programme. Aims to collect data on patient demographics and describe the technical adaptations developed in Shropshire. Results Breast screening extension has increased by 2.5 times the number of women aged 70-74 screened, and doubled the overall numbers of women over 70 screened. Significantly more older patients are being screened to present technical challenges to a screening programme. Data was obtained from a month of screening showed that 29% of patients over 70 needed extra time for positioning. Reasons included 22% difficulty in obtaining adequate positioning and 15% needed a relative to aid with consent. Discussion In the Shropshire screening programme different technical adaptations have been developed and are key to ensuring adequate images. These include double appointments, two radiographers, thorough assessment, steeper angles, seated examinations, from-below imaging and pre-planning for subsequent screen. Conclusion Significantly more older women are having breast screening due to the increasing incidence of breast cancer and the Breast Screening Programme extension. Increasing age can significantly increase time taken for adequate imaging and present technical challenges. Development of technical adaptations to art of mammography is key to achieve adequate images.
Type of publication:
Conference abstract
Author(s):
*V. Vidyaankar, *A. Chakrabarty, *J. McCloud & *R. Clarke
Citation:
Colorectal Disease; Sep 2017; vol. 19 ; Supplement S2 ; p. 123
Abstract:
Aim: Randomised controlled trials have demonstrated advantages of Trans Anal endoscopic microsurgery (TEMS) for the resection of benign and malignant rectal lesions. We assess the safety and outcome of TEMS at a U.K district general hospital. Method: Between July 2011 to January 2017, 122 patients, 54 men and 68 women, Mean age 72 years, underwent TEMS. Patients with Level 4 polyps, large sessile polyps, polyps with invasive features or unsuitable for colonoscopic removal, were selected. Benign follow up with flexible sigmoidoscopy. Cancer follow up with Colonoscopy, MRI, CT, according to protocol. Results: 95 Benign and 27 Cancer lesions. Mean lesion Diameter 46 mm, mean operative time 60 min. Average hospital stay was 1.5 days. Three patients (2.4%) had bleeding, Four (3.2%) perforations, identified and repaired immediately. One (0.8%) surgical emphysema. Four (3.2%) developed pyrexia, two (1.6%) developed minor stricture. One (0.8%) rectovaginal fistula. No recurrence in benign cases. For Early Rectal cancers R0 resection was achieved in 81% and R1 resection in 19% of cases. One (0.8%) developed local cancer recurrence. No mortality. Conclusion: Our study demonstrates that TEMS can be safely performed at a district general hospital by appropriately trained surgeons, with outcomes comparable with international data.
Link to full-text [no password required]
Type of publication:
Conference abstract
Author(s):
Lee M.; Blackwell S.; Brown S.; Sayers A.; Heywood N.; Fearnhead N.; *Lacy-Colson J.; Cornish J.
Citation:
Colorectal Disease; Sep 2017; vol. 19 ; Supplement S2 ; p. 39
Abstract:
Aim: An integral part of trial design is Patient and Public Involvement (PPI) to incorporate patient views and preferences. The aim of this study is to describe the conduct and findings of early PP for a trial in surgical treatment of rectal prolapse. Method: Participants were invited directly by research collaborators and through social media. Only women were invited due to nature of trial. A modified deliberate engagement process was followed. Patients provided expertise on patient experience of the condition, potential recruitment strategies, and outcome measures. Results: 13 patients attended the PPI meeting. Most were recruited by clinicians. Broad representation of age and demographic origin was achieved. Patients agreed with equipoise, and were willing tobe randomised to posterior or ventral rectopexy. Several qualities of life tools were discussed when selecting appropriate outcomes. With respect to sexual function, older patients preferred FSFI and younger patients preferred PISQ-IR. Final consensus was that PISQ-IR was the best compromise for all. Conclusion: Patients with rectal prolapse are willing to engage in PPI for researchers and discuss intimate details on how treatments have affected their personal lives. The PPI exercise confirmed equipoise and modified the outcome measure of sexual function.
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
*Lumsden, Gordon; *Lucas-Garner, Kerry; *Sutherland, Sarah; *Dodenhoff, Ron
Citation:
Musculoskeletal care; Mar 2018; vol. 16 (no. 1); p. 209-213
Abstract:
AIMSPhysiotherapists are beginning to utilize diagnostic ultrasound imaging in upper limb/shoulder clinics. The aim of the present study was to receive feedback on the views of the patients concerning the usefulness of the information obtained immediately from the scan in the management of their problem.METHODS A questionnaire was offered to all patients attending a physiotherapist-led upper limb/shoulder clinic who underwent ultrasound imaging as part of a shoulder assessment over a 6-month period. A total of 103 patients completed a questionnaire for analysis.RESULTSPatients rated the ultrasound scan to be of benefit in all aspects. Regarding the ability to understand their shoulder problem better and in feeling reassured about their problem, 97% of patients either strongly agreed or agreed that this was the case. Concerning the capability of managing their problem, 89% of patients strongly agreed or agreed that they felt more able to do this. In total, 96% of patients evaluated the ultrasound scan to be of very high/high value to them.CONCLUSION Patients highly rate the information gained from ultrasound imaging in a physiotherapy-led upper limb/shoulder clinic and felt that it assisted them in the understanding, reassurance and management of their problem.
Link to full-text [NHS OpenAthens account required]
Shrewsbury and Telford Hospital NHS Trust has an active Research and Innovation Department.
Find out more by visiting either the R&I Intranet pages (only available on a Trust PC) or the R&I pages on the SaTH website.
Shrewsbury and Telford Hospital NHS Trust has an active Improvement Hub.
Find out more by visiting either the Improvement Hub Intranet pages (only available on a Trust PC) or the Improvement Hub page on the SaTH website.