Localised intestinal Kaposi sarcoma in a patient with non-coeliac seronegative villous atrophy.

Seronegative villous atrophy (SNVA) is a diagnostic challenge for gastroenterologists, which is defined by villous atrophy and negative coeliac serology. Non-coeliac forms of SNVA, such as autoimmune enteropathy, can be life-threatening leading to intractable diarrhoea and severe malabsorption that require systemic immunosuppression. When all known causes have been excluded, it is termed idiopathic villous atrophy (IVA).

Supporting disengaged children and young people living with diabetes to self-care: a qualitative study in a socially disadvantaged and ethnically diverse urban area.

Objective: To explore how to enhance services to support the self-care of children and young people (CYP) clinically considered 'disengaged' by diabetes services.

Design: Qualitative study.

Setting: Two diabetes clinics in an ethnically diverse and socially disadvantaged urban area in the UK.

Definition and validation of a system for classifying the undersized Corail femoral stem in total hip arthroplasty.

Introduction: The uncemented total hip arthroplasty relies on a secure initial fixation of the femoral stem to achieve osseointegration. Undersizing of the femoral implant compromises this. Surgeons routinely review postoperative radiographs to assess appropriate sizing, but existing methods of assessment lack standardisation.

An analysis of the outcomes of cervical cone biopsies performed in a low resource setting.

Following skills transfer to this low resource setting, we carried out a descriptive analysis of the outcomes of all cone biopsies performed for women with cervical intra-epithelial neoplasia 3 (CIN 3). We also compared two methods of cone biopsy. All the women had follow-up smear tests at 6 and 18 months.

Long-term use of a 4% sodium cromoglicate cutaneous emulsion in the treatment of moderate to severe atopic dermatitis in children.

Introduction: Sodium cromoglicate (SCG), a chromone with anti-inflammatory, anti-itch and anti-allergic properties. We report a long-term study of a 4% aqueous solution of SCG in children with moderate to severe atopic dermatitis (AD).

Materials And Methods: Children aged 1 to 12 years with AD were entered into a 12-week randomised clinical trial (RCT), followed by 12 months open treatment with known 4% SCG emulsion (Altocrom®).

The knowledge, practice and opinion of midwives' in the UK on their training in obstetric perineal repair.

Purpose: To investigate the knowledge and practice of perineal repair by midwives' in the UK, as well as their perception of the adequacy of their training.

Methods: An anonymous structured questionnaire survey was conducted. Standard statistical comparative analysis was performed between groups.

Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.

Introduction: There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy.

Methods: A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010.

Rectal pseudodiverticulum.

We present the case of a 77-year-old woman who initially presented 13 years ago to a colorectal clinic with a change in bowel habit and bleeding per rectum over 7 months. These symptoms were attributed to a tubulovillous rectal adenoma which was excised transanally, but recurred five times in 12 years. The most recent endoscopy showed recurrence of the rectal adenoma and a new rectal diverticulum.

Smartphone Applications for the Clinical Oncologist in UK Practice.

A number of medical smartphone applications have been developed to assist clinical oncology specialists. Concerns have arisen that the information provided may not be under sufficient scrutiny. This study aims to analyse the current applications available for clinical oncologists in the UK.

Spontaneous mesenteric hematoma complicating an exacerbation of Crohn's disease: report of a case.

Case Presentation: Spontaneous mesenteric haematoma is a rare condition that occurs due to localized bleeding in the mesenteric vascular tree of a bowel segment in the absence of an identifiable cause. Here we report a case of spontaneous mesenteric haematoma during an inflammatory exacerbation of Crohn's disease. The patient underwent surgical management for small bowel obstruction secondary to Crohn's disease, however the concurrent presence of a spontaneous mesenteric haematoma in the mid-jejunal mesentery was successfully managed conservatively.

Thyroid surgery as a 23-hour stay procedure.

Introduction: The main barriers to short stay thyroidectomy are haemorrhage, bilateral recurrent laryngeal nerve palsy causing respiratory compromise and hypocalcaemia. This study assessed the safety and effectiveness of thyroidectomy as a 23-hour stay procedure.

Methods: All patients undergoing total or completion thyroidectomy were prescribed calcium and vitamin D3 supplements following surgery.

Diagnostic role of coronary calcium scoring in the rapid access chest pain clinic: prospective evaluation of NICE guidance.

Background: Coronary artery calcium (CAC) imaging by unenhanced computed X-ray tomography (CT) is recommended as an initial diagnostic test for patients with stable chest pain symptoms but a low likelihood (10-29%) of underlying obstructive coronary artery disease (CAD) after clinical assessment. The recommendation has not previously been tested prospectively in a rapid access chest pain clinic (RACPC).

Methods: We recruited 300 consecutive patients presenting with stable chest pain to the RACPC of three hospitals.

Patient perspective on the management of atrial fibrillation in five European countries.

Background: Long-term management of chronic conditions, such as atrial fibrillation (AF), require frequent interactions with the healthcare systems. The multinational EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) was conducted to investigate patient satisfaction with AF management in different of five European healthcare systems at a time of changing treatment paradigms for stroke prophylaxis, prior to the advent of newer oral anticoagulants.

Methods: Adults (>18 years) were recruited at random from the total populations of France, Germany, Italy, Spain and the UK using a randomized telephone dialling system.

Improving oral function and cosmesis in a case of Freeman-Sheldon syndrome.

Children born with the rare congenital condition Freeman-Sheldon syndrome (FSS) have a characteristic facial appearance: microstomia, a long philtrum, 'H-shaped' chin abnormality and 'pinched lips' in addition to extra-facial features such as kyphoscoliosis and hand deformities. Such children often have problems with oral continence and difficulties with speech leading to both nutritional and psychosocial concerns. Prompt correction through surgery is therefore important in effectively managing the condition.

The investigation of sudden arrhythmic death syndrome (SADS)-the current approach to family screening and the future role of genomics and stem cell technology.

SADS is defined as sudden death under the age of 40 years old in the absence of structural heart disease. Family screening studies are able to identify a cause in up to 50% of cases-most commonly long QT syndrome (LQTS), Brugada and early repolarization syndrome, and catecholaminergic polymorphic ventricular tachycardia (CPVT) using standard clinical screening investigations including pharmacological challenge testing. These diagnoses may be supported by genetic testing which can aid cascade screening and may help guide management.

Epiploic appendagitis with acute appendicitis.

A 28-year-old woman presented to accident and emergency department with a 1-day history of right-sided abdominal pain. She was afebrile, and haemodynamically stable, and the initial diagnosis was acute appendicitis. A transvaginal ultrasound scan was performed and was suggestive of appendicitis.

A systematic review of factors associated with the deferral of donors failing to meet low haemoglobin thresholds.

Background/objectives: Blood donors attending a donation session may be deemed ineligible to donate blood due to a failure to meet low haemoglobin (Hb) thresholds. Several studies have identified factors associated with a donor falling below these Hb thresholds. A review of these factors will inform future prospective studies and form the basis for predictive models of deferral due to low Hb.

Immunotherapy of malignant disease using chimeric antigen receptor engrafted T cells.

Chimeric antigen receptor- (CAR-) based immunotherapy has been under development for almost 25 years, over which period it has progressed from a new but cumbersome technology to an emerging therapeutic modality for malignant disease. The approach involves the genetic engineering of fusion receptors (CARs) that couple the HLA-independent binding of cell surface target molecules to the delivery of a tailored activating signal to host immune cells. Engineered CARs are delivered most commonly to peripheral blood T cells using a range of vector systems, most commonly integrating viral vectors.