388 results match your criteria: "Epsom and St. Helier University Hospitals NHS Trust[Affiliation]"

Article Synopsis
  • The audit aimed to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset specifically for elbow arthroplasty surgeries.
  • In a two-phase approach, Phase 1 compared NJR data with NHS England Hospital Episode Statistics (HES), identifying thousands of unmatched and inaccurate records, particularly for radial head arthroplasties (RHAs).
  • Phase 2 involved collaboration among 142 NHS hospitals to correct and update records, resulting in an improved completeness of the NJR dataset from 63% to 93% and accuracy from 94% to 98%.
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  • Pain is a significant issue for individuals with inflammatory arthritis (IA), affecting their overall well-being, and current UK pain management often relies on long-term opioids and gabapentinoids without sufficient evidence for their effectiveness.
  • Surveys indicate that non-drug therapies for pain relief are not being utilized as much as they could be, highlighting a gap in treatment options.
  • The British Society for Rheumatology is creating a new guideline to provide clear, evidence-based recommendations for pain management in IA, aimed at healthcare professionals, patients, and other stakeholders, ensuring comprehensive care for people living with this condition.
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Modified lipoprotein-induced sFlt1 production in human placental trophoblasts is mediated by protein kinase C.

Eur J Pharmacol

January 2025

Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA; Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK. Electronic address:

Background: Preeclampsia is prevalent in women with diabetes, but the mechanism is unclear. We previously found that oxidized, glycated lipoproteins robustly upregulated soluble fms-like tyrosine kinase-1 (sFlt1), a key mediator of preeclampsia. Here, we determined the role of protein kinase C (PKC) and its subtypes in sFlt1 regulation in placental trophoblasts, and whether this mechanism might mediate the effect of modified lipoproteins.

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Aortic valve disease and cancer are significant causes of mortality, especially in older populations. This meta-analysis addresses a critical question in the management of patients with both aortic valve disease and cancer. As these two conditions are major contributors to mortality, determining the best course of treatment can be complex.

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A quality assessment and systematic review of clinical practice guidelines on hormone replacement therapy for menopause using the AGREE II instrument.

Eur J Obstet Gynecol Reprod Biol

December 2024

Mother and Child Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8 Victor Babes Str, Cluj-Napoca 400347, Romania; 2(nd) Obstetrics and Gynaecology Clinical Section, Cluj County Emergency Clinical Hospital, 55-57 21(st) of December 1989 Bld, Cluj-Napoca 400124, Romania.

Clinical Practice Guidelines (CPGs) have an indispensable role in guiding the selection of treatments for menopause. Variations in guidelines can impact treatments and health outcomes. The aim of this study was to assess CPGs on hormone replacement therapy (HRT) for menopause, systematically reviewing their quality and compiling recommendations for HRT usage.

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Type 1 Diabetes in care homes: A practical guide on management.

Diabet Med

November 2024

Epsom and St Helier University Hospitals NHS Trust, and King's College, London, UK.

The primary purpose of the original NAPCHD project was to develop a national Strategic Document of Diabetes Care for Care Homes which has now been completed and well received as a worthwhile, sustainable, and effective guidance for delivering quality diabetes care in the UK. A Working Group of NAPCHD was established to produce a Position Statement on type 1 diabetes in care homes since this area was recommended as a topic to further develop. There are currently limited data on the prevalence and clinical outcomes associated with type 1 diabetes in care homes and management policies have been non-existent in the UK.

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Hyponatremia in labor and the postpartum period is generally underreported. In this study we aimed to identify attributable causes of severe hyponatremia in an obstetric population and define maternal outcomes. This was a retrospective cohort study, in a single center over a period of 10 years.

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Background: Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)-such as worrying about ways things will go wrong in the future or ruminating about past negative events-is a risk factor for the development of anxiety.

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Concurrent Dandy-Walker malformation and persistent fetal vasculature: A case report.

Int J Surg Case Rep

October 2024

Epsom and St Helier University Hospitals NHS Trust, St Helier Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, United Kingdom. Electronic address:

Introduction And Importance: Dandy-Walker malformation (DWM) is a rare cerebellar condition, and persistent fetal vasculature (PFV) is a congenital eye anomaly. This report presents the first known case of DWM with PFV.

Case Presentation: A 31-day-old male infant presented with right eye discharge, lethargy, and breath-holding spells.

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This Good Practice Paper provides recommendations for the use of advanced imaging for earlier diagnosis and morbidity prevention in multiple myeloma. It describes how advanced imaging contributes to optimal healthcare resource utilisation by in newly diagnosed and relapsed myeloma, and provides a perspective on future directions of myeloma imaging, including machine learning assisted reporting.

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IntroductionRespiratory sentinel surveillance systems leveraging computerised medical records (CMR) use phenotyping algorithms to identify cases of interest, such as acute respiratory infection (ARI). The Oxford-Royal College of General Practitioners Research and Surveillance Centre (RSC) is the English primary care-based sentinel surveillance network.AimThis study describes and validates the RSC's new ARI phenotyping algorithm.

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(1) Background: This study aims to establish the knowledge, attitudes and current behaviours towards female fertility preservation (FP) services amongst healthcare professionals (HCPs) in the UK. (2) Methods: An online survey was advertised publicly on the social media platform between 25 February 2021 and 11 March 2021. (3) Results: In total, 415 participants fulfilled the inclusion criteria and completed the survey.

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Septic shock stands for a group of manifestations that will cause a severe hemodynamic and metabolic dysfunction, which leads to a significant increase in the risk of death by a massive response of the immune system to any sort of infection that ends up with refractory hypotension making it responsible for escalating the numbers of hospitalized patients mortality rate, Organisms that are isolated most of the time are , and . The WHO considers sepsis to be a worldwide health concern; the incidence of sepsis and septic shock have been increasing over the years while being considered to be under-reported at the same time. This review is a quick informative recap of the recent studies regarding diagnostic approaches using lactic acid (Lac), procalcitonin (PCT), Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, as well as management recommendations for using vasopressors, fluid resuscitation, corticosteroids and antibiotics that should be considered when dealing with such type of shock.

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TGFβ1 is a powerful regulator of fibrosis; secreted in a latent form, it becomes active after release from the latent complex. During tissue fibrosis, the EDA + isoform of cellular fibronectin is overexpressed. In pulmonary fibrosis it has been proposed that the fibronectin splice variant including an EDA domain (FN EDA+) activates latent TGFβ.

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Introduction: The National Registry of Rare Kidney Diseases (RaDaR) collects data from people living with rare kidney diseases across the UK, and is the world's largest, rare kidney disease registry. We present the clinical demographics and renal function of 25,880 prevalent patients and sought evidence of bias in recruitment to RaDaR.

Methods: RaDaR is linked with the UK Renal Registry (UKRR, with which all UK patients receiving kidney replacement therapy [KRT] are registered).

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Background: Lowering dietary salt intake reduces albuminuria, an early marker of renal damage and a sensitive predictor of adverse cardiovascular outcomes. The mechanisms underlying this effect are uncertain but small changes in serum sodium concentration may be important: this retrospective cohort study investigated the hypothesis that higher serum sodium concentration is a risk factor for albuminuria (defined as a urine albumin:creatinine ratio [UACR], ≥3 mg/mmol).

Methods: Primary care data from the Royal College of General Practitioners Research and Surveillance Centre were used to identify 47,294 individuals with a UACR result available between April 2010 and March 2015, and no known albuminuria prior to this.

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Article Synopsis
  • Management of nonunited or painful ankle arthrodesis poses challenges, prompting a systematic review on the outcomes of converting an ankle fusion to a total ankle replacement (TAR).
  • The review included 7 studies involving 220 patients and found significant improvements in functional and clinical scores after the conversion, along with an acceptable range of motion.
  • Most complications observed were malleolar fractures (12.8%) and arthrofibrosis (5.6%), with an 8% revision rate, indicating that the conversion generally yields satisfactory outcomes but requires further validation through future studies.
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Pain is a relatively common experience among older people, but unrelieved pain has significant functional, cognitive and emotional consequences for this population. A comprehensive and accurate pain assessment is essential for effective pain management. Self-report tools are suitable to assess pain in older people with normal or mildly impaired cognition, while observational tools are suitable for use with those with significant cognitive impairment or communication difficulties.

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Background: Shoulder dystocia is an unpredictable obstetric condition with potential long-term neonatal complications. The risk of neonatal injury might be related to the condition itself as well as to the obstetrics maneuvers used for its release.

Objectives: To examine the available evidence to assess current management and possible improvement of outcomes.

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Hallux interphalangeal joint (IPJ) flexion contracture is an uncommon deformity with various underlying causes, including trauma, neurological disorders, and connective tissue pathologies. We present a unique case of a 10-year-old female patient with neurofibromatosis type 1 (NF1) and a history of fibula transposition surgery, resulting in a hallux IPJ flexion contracture. We believe that the loss of the proximal fibular attachment of the extensor hallucis longus (EHL) following fibula harvesting resulted in EHL weakness and unopposed flexor hallucis longus (FHL) pull that eventually led to the contracture.

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Background: The risk of hospital insulin prescription errors in the UK has remained unchanged despite the adoption of several national initiatives. This audit was conducted to evaluate whether the prescription errors were related to the information source used.

Aims: To determine what sources of information are used at the time of hospital admission of patients with diabetes to obtain details of their insulin regimen and how different sources relate to prescription errors.

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This Good Practice Paper provides recommendations for the diagnosis and initial management of transplant-eligible high-risk myeloma patients. It describes recent updates to the genetic diagnostics of high-risk myeloma and provides recommendations for treatment on the basis of recent prospective clinical trial evidence.

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Article Synopsis
  • Eosinophilic esophagitis (EoE) is a chronic condition affecting the esophagus, characterized by inflammation and eosinophil infiltration, necessitating updates to existing guidelines due to new medical knowledge.
  • A group of pediatric gastroenterologists reviewed recent studies to create 52 statements and 44 recommendations related to EoE, focusing on diagnostics, treatment options, and diet changes from 2014 to 2022.
  • The updated guidelines highlight the emergence of biologics for treatment, the potential role of steroids for esophageal strictures, and the importance of addressing quality of life and transitioning patients to adult care.
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Purpose: The absence of postoperative circulating tumor DNA (ctDNA) identifies patients with resected colorectal cancer (CRC) with low recurrence risk for adjuvant chemotherapy (ACT) de-escalation. Our study presents the largest resected CRC cohort to date with tissue-free minimal residual disease (MRD) detection.

Experimental Design: TRACC (tracking mutations in cell-free tumor DNA to predict relapse in early colorectal cancer) included patients with stage I to III resectable CRC.

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