Identifying and Treating Severe Bone Marrow Necrosis and Fat Embolism Syndrome in Pediatric Patients With Sickle Cell Disease: A Case Report.

Fat embolism syndrome after bone marrow necrosis is an extremely rare complication in sickle cell disease associated with significant morbidity and mortality. A high index of suspicion is required for diagnosis. This case report will assist pediatric clinicians and hematologists to recognize this severe complication in patients with sickle cell disease and to promptly initiate treatment.

Clinical manifestations and health outcomes associated with Zika virus infections in adults: A systematic review.

Background: Zika virus (ZIKV) has generated global interest in the last five years mostly due to its resurgence in the Americas between 2015 and 2016. It was previously thought to be a self-limiting infection causing febrile illness in less than one quarter of those infected. However, a rise in birth defects amongst children born to infected pregnant women, as well as increases in neurological manifestations in adults has been demonstrated.

Addressing the needs of older adults receiving alcohol treatment during the COVID-19 pandemic: a qualitative study.

Objectives: The COVID-19 global pandemic resulted in major changes to the provision of alcohol treatment in the UK, these changes coincided with increases in the use of alcohol. This study sought to understand the impact of the pandemic on older adults in alcohol treatment, and to explore how changes in the provision of alcohol treatment were experienced.

Method: Semi-structured interviews were completed with older adults (aged 55+) in alcohol treatment, as well as alcohol practitioners providing support to older adults.

Conversion after laparoscopic cholecystectomy in England.

Background: Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic gallstones. Conversion to open surgery is reported to be necessary in 5-10% of cases. This study aimed to define those factors associated in English hospitals with the need to convert a laparoscopic cholecystectomy to an open procedure.

Loop ileostomy following anterior resection: is it really temporary?

Introduction: A temporary loop ileostomy is often created to minimize the impact of peritoneal sepsis if anastomotic dehiscence occurs following low colorectal anastomosis. Although it has been suggested that a loop ileostomy should be reversed within 12 weeks of formation, this is often not the case. We set out to analyse the use of loop ileostomy following elective anterior resection in England and to identify factors associated with non and delayed reversal.

Use of Hartmann's procedure in England.

Introduction: Hartmann's procedure is widely used in the management of complicated diverticular disease and for colorectal cancer. Very little national data are available about the reasons for performing this procedure and the reversal rate.

Method: Hospital episode statistics data were obtained from The Department of Health and exported to an Access database for analysis.

Treatment of a whole population sample of Alzheimer's disease with donepezil over a 4-year period: lessons learned.

Background: In the UK it is recommended that acetylcholinesterase inhibitors be restricted to patients with moderate Alzheimer's disease, and progress monitored within specialist clinics.

Objective: To describe a cohort of patients with Alzheimer's disease from a whole city population treated with donepezil, and to analyse outcomes over 4 years.

Methods: Historical cohort design: 88 patients recruited 1997-1998, assessed at baseline with 4-year follow-up, using an agreed protocol and validated measures: survival, retention in treatment, cognition, non-cognitive symptoms, weight change, carer stress.

Management of acute gallbladder disease in England.

Background: Recent literature suggests that early laparoscopic cholecystectomy for acute gallbladder disease is safe and efficacious, but few data are available on the management of acute gallbladder disease in England.

Methods: Hospital Episode Statistics data for the years 2003-2005 were obtained from the Department of Health. All patients admitted as an emergency with acute gallbladder disease during the period from April 2003 to March 2004 were included as a cohort.

Oesophagectomy practice and outcomes in England.

Background: The 2001 UK National Health Service guidance on improving outcomes recommended centralization of oesophageal resection. The aim of this study was to analyse national trends in oesophageal resection in England to determine whether centralization has occurred and its impact on outcomes.

Methods: The study used data from Hospital Episode Statistics for 1997-1998 to 2003-2004 and included patients who had resection for oesophageal cancer.

A double-blind, randomized controlled trial of cystometry using saline versus 0.3 M potassium chloride infusion in women with overactive bladder syndrome.

Aim: To evaluate the effect of 0.3 M potassium chloride on cystometric parameters by comparing it with normal saline as a filling solution in women with overactive bladder (OAB).

Patients And Methods: Twenty-three women with significant OAB symptoms underwent consecutive cystometrograms (CMGs) using 0.

Creating a community-based memory clinic for older people.

This article describes the development of a multidisciplinary, nurse-led memory clinic. The clinic has grown out of research activity to become an important component of a community service for older people with dementia and other mental health problems. A detailed analysis of the interaction between the clinic and the community mental health team, as practised in this model of care, is presented for consideration.

Interstitial cystitis versus detrusor overactivity: a comparative, randomized, controlled study of cystometry using saline and 0.3 M potassium chloride.

Purpose: We compared cystometric findings in interstitial cystitis and detrusor overactivity using 0.3 M KCl and 0.9% normal saline.

CARREL: an internet platform for the distribution of human organs for transplantation.

Background: Human organs for transplant from a deceased donor are presently distributed in Spain by means of manual handling and telephone or fax transmission of data. This procedure is conducted organ by organ with the information transmitted sequentially. This process has several inherent drawbacks, the main one being the long length of time to allocate organs on many occasions.

Needs for mental health treatment among general practice attenders.

Background: No study has directly assessed the need for mental health care among those consulting in general practice.

Aims: To make a direct assessment of the needs for mental health care in people with non-psychotic disorders consulting their general practitioner.

Method: In a two-phase study design, consecutive general practice attenders aged 17-65 years were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders.

Understanding General Health Questionnaire (GHQ-28) score and its threshold.

Background: The finding of variation in the optimal threshold of the General Health Questionnaire (GHQ) across different settings has proved difficult to explain. This analysis aimed to examine the optimal threshold of the GHQ, its variability and relationship with prevalence of psychiatric disorder.

Methods: A cross-sectional two-phase epidemiological survey was used in a study of non-psychotic psychiatric disorder of General Practice consulters.

Evaluation of a clinical screening instrument to identify states of thiamine deficiency in inpatients with severe alcohol dependence syndrome.

Aims: To develop a Thiamine Deficiency Questionnaire (TDQ), and to assess its reliability in the identification of Thiamine deficiency, in patients with severe alcohol dependence.

Methods: 58 severely alcohol dependent patients underwent socio-demographic, medical, psychiatric, and alcohol use assessment, including administration of the Thiamine Deficiency Questionnaire (TDQ). The Red Blood Cell Thiamine Pyrophosphate concentration provided the 'gold standard' to test the validity of the instrument.