Background: The digitisation of healthcare records has generated vast amounts of unstructured data, presenting opportunities for improvements in disease diagnosis when clinical coding falls short, such as in the recording of patient symptoms. This study presents an approach using natural language processing to extract clinical concepts from free-text which are used to automatically form diagnostic criteria for lung cancer from unstructured secondary-care data.
Methods: Patients aged 40 and above who underwent a chest x-ray (CXR) between 2016 and 2022 were included.
Introduction: Cases of nitrous oxide (NO)-induced myeloneuropathy are increasing at UK hospitals. At our centre, a dedicated ambulatory care pathway, endorsed nationally, was established to treat and monitor patients with NO-myeloneuropathy in 2021 and refined through three audit cycles. We analysed the outcomes of patients on this pathway to better understand factors associated with non-engagement.
View Article and Find Full Text PDFObjective: A series of novel, substituted tetracyclic benzothiazepines were designed and prepared in an effort to optimize the potency of this chemical class against drug-resistant strains of the malaria parasite.
Methods: Tetracyclic benzothiazepines bearing structural modification at seven distinct positions within the structure were synthesized in Knoevenagel condensation reactions followed by sequential intermolecular thio-Michael and then intramolecular imine formation reactions. Following purification and chemical characterization, the novel compounds were tested for in vitro efficacy against blood-stage P.
Introduction: This paper reports the results of a rolling audit of sonographer-performed non-obstetric ultrasound examinations undertaken between 2010 and 2020 in a large University Teaching Hospital Ultrasound Department in the United Kingdom. We believe that this represents the largest published audit of sonographer non-obstetric ultrasound examination quality.
Methods: Random samples of sonographer ultrasound examinations were regularly and systematically audited by consultant-level ultrasound practitioners through review of soft copy images and reports.
Background: Dietary guidelines for type 2 diabetes mellitus (T2DM) emphasise weight management and individualised total carbohydrate intake. Evidence on the most effective dietary patterns (DPs) for T2DM management is mixed, potentially leading to variations in the advice that dietitians provide. The present study aimed to explore dietitians' practice of DP advice provision to adults with T2DM, as well as understand their views when advising their patients on the DPs deemed effective for glycaemic management or recommended by current guidelines.
View Article and Find Full Text PDFHealth Inf Manag
September 2022
The goal of making your data available is that other people can reuse it. A number of factors can prevent anybody from ever exploiting your data. This article reviews some of these factors and suggests some low effort ways you can increase the chances of your data's being used by others.
View Article and Find Full Text PDFBackground: Health information exchange (HIE) is frequently cited as an important objective of health information technology investment because of its potential to improve quality, reduce cost, and increase patient satisfaction. In this paper we examine the status and practices of HIE in six countries, drawn from a range of higher and lower income regions.
Methods: For each of the countries represented - China, England, India, Scotland, Switzerland, and the United States - we describe the state of current practice of HIE with reference to two scenarios: transfer of care and referral.
The ureteric "rendezvous" procedure is an interventional procedure involving both uro-radiological and cystoscopic techniques to manage complex ureteric stenoses or fistulae. We present a case in which this procedure was utilised, with an unusual intra-procedural finding. Macroscopic visualisation of lipids within the urinary tract is an unusual finding at CT, and rarely seen at cystoscopy.
View Article and Find Full Text PDFIntroduction: Simulation is increasingly used throughout medicine. Within ultrasound, simulators are more established for learning transvaginal and interventional procedures. The use of modern high-fidelity transabdominal simulators is increasing, particularly in centres with large trainee numbers.
View Article and Find Full Text PDFObjectives: The electronic health record (EHR) is underused in the hospital setting. The aim of this service evaluation study was to respond to National Health Service (NHS) Digital's ambition for a paperless NHS by capturing routinely collected cardiac outpatient data in the EHR to populate summary patient reports and provide a resource for audit and research.
Design: A PowerForm template was developed within the Cerner EHR, for real-time entry of routine clinical data by clinicians attending a cardiac outpatient clinic.
Ultrasound scan (USS) is a common and important mode of investigation for emergency surgical admissions. Delay in investigation often leads to delayed diagnosis and treatment, and possible extended length of stay (LOS), which has clinical, cost and service provision implications. We aim to investigate the clinical impact on patient care and the cost-effectiveness of a pilot Surgical Assessment Unit (SAU) USS facility.
View Article and Find Full Text PDFObjectives: To evaluate the accuracy of reduced-dose CT scans reconstructed using a new generation of model-based iterative reconstruction (MBIR) in the imaging of urinary tract stone disease, compared with a standard-dose CT using 30% adaptive statistical iterative reconstruction.
Methods: This single-institution prospective study recruited 125 patients presenting either with acute renal colic or for follow-up of known urinary tract stones. They underwent two immediately consecutive scans, one at standard dose settings and one at the lowest dose (highest noise index) the scanner would allow.
Traditional B-Mode and Doppler sonography have been the stalwart of renal tract imaging for many years, and indeed, are in daily use in most centres as the modality of choice for the initial assessment of renal pathology. However, traditional ultrasound scanning can be limited in its ability to accurately characterise renal pathology, and can be inaccurate at determining benign from malignant lesions. Contrast-enhanced ultrasound conveys many benefits, being safe (especially in patients with renal dysfunction), does not require the use of ionising radiation, is quick and relatively cheap and can help to establish whether a focal renal lesion is sinister.
View Article and Find Full Text PDFBackground: Artemisinin-induced dormancy provides a plausible explanation for recrudescence following artemisinin monotherapy. This phenomenon shares similarities with cell cycle arrest where cyclin dependent kinases (CDKs) and cyclins play an important role.
Methods: Transcription profiles of Plasmodium falciparum CDKs and cyclins before and after dihydroartemisinin (DHA) treatment in three parasite lines, and the effect of CDK inhibitors on parasite recovery from DHA-induced dormancy were investigated.
Introduction: Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations.
Methods: To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel).
Investigation of a series of 2,N-bisarylated 2-ethoxyacetamides resulted in the identification of four inhibitors 5, 20, 24, 29 with single-digit micromolar in vitro efficacy against two drug-resistant Plasmodium falciparum strains. These compounds are analogs of structurally-related 1,3-bisaryl-2-propen-1-ones (chalcones), the latter showing efficacy in vitro but not in a malaria-infected mouse. The 2,N-bisarylated 2-ethoxyacetamides (e.
View Article and Find Full Text PDFObjectives: To compare image quality on computed tomographic (CT) images acquired with filtered back-projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) techniques in CT kidney/ureter/bladder (KUB) examination.
Methods: Eighteen patients underwent standard protocol CT KUB at our institution. The same raw data were reconstructed using FBP, ASIR and MBIR.
Function of a renal allograft relies on the integrity of its vascular anatomy. Renal biochemistry, ultrasound and percutaneous biopsy are used in combination to determine allograft function. Biopsy is not without risk, and in this case study we demonstrate a rare but a potentially life-threatening complication of renal allograft biopsy.
View Article and Find Full Text PDF4'-n-Butoxy-2,4-dimethoxy-chalcone (MBC) has been described as protecting mice from an otherwise lethal infection with Plasmodium yoelii when dosed orally at 50 mg/kg/dose, daily for 5 days. In contrast, we found that oral dosing of MBC at 640 mg/kg/dose, daily for 5 days, failed to extend the survivability of P. berghei-infected mice.
View Article and Find Full Text PDFA series of 1,7-diaminoisoquinolinamines, that are expected to mediate antimalarial activity by the same mechanism employed by the chalcones, were produced. Six 7-benzylamino-1-isoquinolinamines were found to be submicromolar inhibitors in vitro of drug-resistant Plasmodium falciparum, with the best possessing activity comparable to chloroquine. Despite being developed from a lead that is a DHFR inhibitor, these compounds do not mediate their antimalarial effects by inhibition of DHFR.
View Article and Find Full Text PDFNicotiana tabacum is emerging as a crop of choice for production of recombinant protein pharmaceuticals. Although there is significant commercial expertise in tobacco farming, different cultivation practices are likely to be needed when the objective is to optimise protein expression, yield and extraction, rather than the traditional focus on biomass and alkaloid production. Moreover, pharmaceutical transgenic tobacco plants are likely to be grown initially within a controlled environment, the parameters for which have yet to be established.
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