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

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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)

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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)

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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)

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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)

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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)

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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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Worth the paper it's written on? A cross-sectional study of Medical Certificate of Stillbirth accuracy in the UK (2023)

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Type of publication:Journal article

Author(s):Rimmer MP; Henderson I; *Parry-Smith W; Raglan O; Tamblyn J; Heazell AEP; Higgins LE; UKARCOG NESTT working group authors

Citation:International Journal of Epidemiology, 2023, 52(1) pages 295-308

Abstract:Background: The Medical Certificate of Stillbirth (MCS) records data about a baby's death after 24 weeks of gestation but before birth. Major errors that could alter interpretation of the MCS were widespread in two UK-based regional studies. Methods: A multicentre evaluation was conducted, examining MCS issued 1 January 2018 to 31 December 2018 in 76 UK obstetric units. A systematic case-note review of stillbirths was conducted by Obstetric and Gynaecology trainees, generating individual 'ideal MCSs' and comparing these to the actual MCS issued. Anonymized central data analysis described rates and types of error, agreement and factors associated with major errors. Results: There were 1120 MCSs suitable for assessment, with 126 additional submitted data sets unsuitable for accuracy analysis (total 1246 cases). Gestational age demonstrated 'substantial' agreement [K = 0.73 (95% CI 0.70-0.76)]. Primary cause of death (COD) showed 'fair' agreement [K = 0.26 (95% CI 0.24-0.29)]. Major errors [696/1120; 62.1% (95% CI 59.3-64.9%)] included certificates issued for fetal demise at <24 weeks' gestation [23/696; 3.3% (95% CI 2.2-4.9%)] or neonatal death [2/696; 0.3% (95% CI 0.1-1.1%)] or incorrect primary COD [667/696; 95.8% (95% CI 94.1-97.1%)]. Of 540/1246 [43.3% (95% CI 40.6-46.1%)] 'unexplained' stillbirths, only 119/540 [22.0% (95% CI 18.8-25.7%)] remained unexplained; the majority were redesignated as either fetal growth restriction [FGR: 195/540; 36.1% (95% CI 32.2-40.3%)] or placental insufficiency [184/540; 34.1% (95% CI 30.2-38.2)]. Overall, FGR [306/1246; 24.6% (95% CI 22.3-27.0%)] was the leading primary COD after review, yet only 53/306 [17.3% (95% CI 13.5-22.1%)] FGR cases were originally attributed correctly. Conclusion: This study demonstrates widespread major errors in MCS completion across the UK. MCS should only be completed following structured case-note review, with particular attention on the fetal growth trajectory.

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The need to accurately measure energy intake and expenditure in patients with systemic sclerosis (2022)

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Type of publication:Journal article

Author(s):Hughes M.; *Harrison E.; Herrick A.L.; McLaughlin J.T.; Lal S.

Citation:Journal of Scleroderma and Related Disorders, 7(3):217-223, 2022 Oct.

Abstract:Background: Malnutrition is common in systemic sclerosis and patients are frequently underweight. However, the balance between assessed dietary energy intake versus expenditure has been neglected to date. This study aimed to assess energy (dietary) intakes and expenditures and to compare discrepancies in systemic sclerosis.Method(s): Thirty-six outpatients with systemic sclerosis completed the study. Demographics and clinical data were recorded. Functional questionnaires were completed. Predicted energy requirements were calculated. Over a consecutive 3-day period, patients completed an estimated food diary and wore a specialist energy expenditure monitor (SenseWear Armband). Assessments of intake and expenditure were compared for individual patients, and the impact according to patient demographics, clinical manifestations and disease severity evaluated.Result(s): Energy intake did not correlate with predicted (s = 0.117; p = 0.511) or measured (s = -0.039; p = 0.825) expenditures. Predicted and measured energy expenditures correlated, but actual values differed for individuals (intraclass correlation = 0.62; 95% limits of agreement = -459 to 751 kcal). Respiratory involvement was negatively correlated with number of steps (s = -0.350; p = 0.04) and time spent lying (s = 0.333; p = 0.05). There was a significant correlation between body mass index and predicted versus measured energy discrepancy (s = 0.41; p = 0.02), and this discrepancy was greater with higher body mass indices.Conclusion(s): There was no correlation between intake and either predicted or measured energy expenditure. Predicted and measured energy expenditures were strongly correlated yet differed for the individual patient. In patients with systemic sclerosis, where energy expenditure must be accurately assessed, it should be directly measured.

Appropriately timed COVID-19 PCR testing for hospital inpatients (2021)

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Type of publication:Conference abstract

Author(s):*Raffeeq Z.; *Ahmad N.; *Crawford E.; *Dev D.; *Makan A.; *Srinivasan K.; *Moudgil H.

Citation:European Respiratory Journal 2021; 58: Suppl. 65, PA448

Abstract:Background: Nosocomial spread of Coronavirus has been an issue for hospitals across the UK, with a recent report by Public Health England (PHE) and the London School of Hygiene and Tropical Medicine (LSHTM) stating that the effective reproduction rate of SARS-CoV-2 in hospitals has been projected to have been as high as 14 during the first wave of the pandemic [1]. In order to stifle this spread hospital Infection and Prevention Control (IPC) set out regular guidelines concerning when patients should be tested for COVID-19.
Aims and objectives: We attempted to assess how well our trust followed the IPC guidance for testing patients for COVID-19, specifically with regard to swab timing following admission to hospital.
Methods: We analysed all admissions to the hospital during the week of 1st October 2020 to the 7th October 2020. We looked at how many patients were appropriately swabbed on day 1, and day 5, as was required according to IPC guidance at the time.
Results: We found that of the 266 patients admitted in the said week, 4 patients (1.5%) had a swab greater than 24 hours after admission, and 17 (6.39%) patients did not have a PCR swab at all. 148 patients stayed in hospital 5 days or greater, with 19 patients (17.27%) receiving their second swab correctly on day 5 of admission and 91 patients (82.73%) either not having their swab on the correct day or not having a follow up swab at all.
Conclusion: While testing on entry was generally done in a timely manner, follow-up swabs are not performed according to the guidelines set out by IPC, and therefore not following evidence-based practice.

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Another aspect of COVID pandemic: where has all the Flu gone? (2021)

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Type of publication:Conference abstract

Author(s):*Chapman T.; *Etel E.; *Moudgil H.; *Srinivasan K.; *Crawford E.; *Makan A.; *Ahmad N.

Citation:European Respiratory Journal 2021; 58: Suppl. 65, PA3255

Abstract:Background: United Kingdom is officially in the Flu season since the beginning of October 2020. Flu season in the southern hemisphere particularly in Australia and New Zealand have shown dramatic reduction in cases of Influenza during the COVID pandemic.
Aims: Our objective was to look at the incidence of Flu in our rural district general hospital, which has also been affected by the COVID pandemic.
Method: We carried out a retrospective analysis of all patients in hospital during the 3rd and 4th week of January 2021, who had a Flu swab taken. Our hospital used a kit to detect the presence of Flu A, Flu B, Respiratory Syncytial Virus(RSV) A &B and SARS-CoV2 at the same time. Data analysis was done on MS Excel.
Results: 247 patients in hospital had a swab performed for all 4 viruses. 52% were males(n=129) with a Mean Age(SD)73 (14.7) years.120 tested positive for SARS-CoV2 of which 55%(n=66) were males with a mean age(SD)73 (14.6) years. Zero tested positive for Influenza A/B and RSV A/B.
Conclusion: Our small cohort of hospital patients reflected the trend of flu cases present in the Southern Hemisphere, during peak Flu season. It is possible regular hand washing and masks donning contributed to this. In addition, competitive inhibition of the Flu virus by SARS-CoV2 is likely through its binding of sialic acid receptors on the host's cell surface, commonly used by Influenza viruses to gain entry into cells [2]. More laboratory studies are needed to confirm this.

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