Publications by authors named "Billy Down"

Article Synopsis
  • Calcaneal osteomyelitis is challenging to treat, often leading to high recurrence rates and below-knee amputations, especially with severe soft-tissue damage; this study evaluates the effectiveness of single-stage orthoplastic surgery for this condition.
  • A retrospective review included 30 patients treated from 2008 to 2022, assessing factors like osteomyelitis recurrence, flap failure, and complications; findings showed 77% had the infection eradicated, but 23% experienced recurrence, primarily in those who received local flaps.
  • The study concluded that while single-stage orthoplastic management can be effective, local flap reconstruction was linked to a higher recurrence risk, and free flaps took significantly longer to perform, without affecting hospital stay
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Objectives: The aim was to assess the prevalence of never events (NEs) specific to urology in the United Kingdom and identify commonly occurring themes.

Methods: Data from the National Health Service (NHS) NEs website were obtained and all NEs from 2012 to 2022 were reviewed. Urology-specific NEs were identified and further analysed in their respective categories.

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(1) Background: Gastric cancer is a significant cause of cancer-related mortality worldwide. Weight loss and malnutrition associated with cancer are linked with increased mortality rates and reduced quality of life. Cancer cachexia, characterised by the loss of skeletal muscle, is associated with approximately 20% of cancer-related deaths and differs from malnutrition in that it cannot be fully reversed by nutritional support alone.

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Oligometastatic oesophagogastric cancer was recently defined by consensus as the presence of no more than two metastases and an 18-week period of oncological stability during chemotherapy. The number of patients who fit this criterion and whether their oncological outcome differs from those with multi-metastatic disease is unknown. We analysed a database of 497 patients from 2017 to 2021 with metastatic oesophageal cancer.

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Background: The treatment of chronic calcaneal osteomyelitis is a challenging and increasing problem because of the high prevalence of diabetes mellitus and operative fixation of heel fractures. In 1931, Gaenslen reported treatment of hematogenous calcaneal osteomyelitis by surgical excision through a midline, sagittal plantar incision. We have refined this approach to allow successful healing and early mobilization in a modern series of complex patients with hematogenous, diabetic, and postsurgical osteomyelitis.

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Background and objective In many hospitals, the availability of operating theatres and access to senior surgical and anaesthetic support diminish during night hours. Therefore, urgent surgery is sometimes postponed until the following morning rather than performed overnight, if it is judged to be safe. In this study, we aimed to determine if a delay in laparoscopic appendicectomy in cases of acute appendicitis of over 12 hours, analogous to an overnight delay, correlated with worse patient outcomes.

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Background: During the first United Kingdom COVID-19 wave, the Royal Colleges of Surgeons initially recommended conservative management with antibiotics instead of surgery for appendicitis. This study compared local outcomes of appendicitis during this period with a pre-COVID-19 cohort.

Methods: An observational study was conducted in a district general hospital.

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Background: Newly qualified UK doctors report feeling unprepared to perform basic practical procedures. The Royal College of Surgeons of England (RCSEng) responded to this concern by developing a national surgical curriculum, however, a national survey of UK medical schools identified that surgical skills teaching is inconsistent throughout the UK.Peer assisted teaching sessions are delivered by senior students to junior peers and have been demonstrated to be effective in a number of settings.

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Coronavirus disease 2019 (COVID-19) is a zoonotic respiratory infection originating from Wuhan, China. Rapidly spreading from Wuhan to all inhabited continents of the world, the World Health Organisation declared COVID-19 a pandemic on March 11, 2019. Infected patients present with fever and cough; radiological features include bilateral infiltrates on chest x-ray and computed tomography scanning.

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IL-1 family members regulate innate immune responses, are produced by gestation-associated tissues, and have a role in healthy and adverse pregnancy outcomes. To better understand their role at the materno-fetal interface we used a human tissue explant model to map lipopolysaccharide (LPS)-stimulated production of IL-1α, IL-1β, IL-18, IL-33, IL-1Ra, IL-18BPa, ST2 and IL-1RAcP by placenta, choriodecidua and amnion. Caspase-dependent processing of IL-1α, IL-1β, IL-18, and IL-33 and the ability of IL-1α, IL-1β, IL-18, and IL-33 to regulate the production of IL-1RA, IL-18BPa, ST2 and IL-1RAcP was also determined.

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