Extraanatomic stents for transplant ureteric stenosis.

Surgical and standard endourology options are limited in transplant patients with severe ureteric stenosis, particularly when access to the transplant renal pelvis is limited. The use of a silicone-polytetrafluoroethelene (PTFE)-bonded extraanatomic urinary tract stent for urinary tract drainage is described in two patients. This technique of ureteric reconstruction in renal transplantation may be considered when standard approaches have failed.

Using the internet to deliver education on drug safety.

Background: Medication administration errors (MAEs) occur in 3-8% of all non-intravenous drug doses given in UK hospitals; higher rates have been reported for intravenous drugs. Educational interventions are often advocated as one way of reducing these rates. However, group education sessions are often not practical.

A theoretical investigation into post-operative, intracavitary beta therapy of high-grade glioblastomas using yttrium-90.

Beta therapy with yttrium-90 (90Y) has recently been introduced as a post-operative intra-cavitary treatment for malignant glioblastoma, a generally radioresistant tumour for which cure rates with conventional radiotherapy are usually very disappointing. This short theoretical study investigates the conditions under which 90Y treatment might be most effective and assesses the likely amounts of activity which must be infused in order to successfully cope with the low radiosensitivities which characterize such tumours. The radiobiological and physical analysis is investigated using the linear quadratic (LQ) model and a range of possible scenarios for the distribution and density of the tumour cells surrounding the surgically formed cavities are considered.

Rapporteur report: Basics and technology and metrology and standards.

The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.

Variation of mesorectal volume with abdominal fat volume in patients with rectal carcinoma: assessment with MRI.

The purpose of this study was to assess the variability in the volume of the mesorectum in patients with rectal carcinoma. A retrospective review was made of pelvic MRI studies in 30 patients (mean age 64 years, range 34-88 years, 18M:12F) with histologically proven rectal carcinomas that were confined to the mesorectum. The outer low signal margin of the mesorectum was traced, over at least 10 consecutive 10 mm contiguous slices, until its disappearance.

Intraepidermal animal-type melanoma.

Animal-type melanoma is a rare variant of melanoma in humans.1 Its name is derived from its histological appearance, which is similar to that described in melanomas occurring in white or gray horses.2 All tumors are dermally located, and characterized by a proliferation of deeply pigmented elongated or rounded cells, showing moderate atypia and a low mitotic rate.

Reducing dialysis associated bacteraemia, and recommendations for surveillance in the United Kingdom: prospective study.

Problem: Bacteraemia in dialysis units accounts for major morbidity, mortality, and antibiotic usage. Risk is much greater when lines rather than fistulas are used for haemodialysis. Surveillance is critical for infection control, but no standardised surveillance scheme exists in the United Kingdom.

Radiology of gestational trophoblastic neoplasia.

Gestational trophoblastic neoplasia (GTN) encompasses a broad spectrum of placental lesions from the pre-malignant hydatidiform mole (complete and partial) through to the malignant invasive mole, choriocarcinoma and rare placental site trophoblastic tumour (PSTT). Ultrasound remains the radiological investigation of choice for initial diagnosis, and it can also predict invasive and recurrent disease. Magnetic resonance imaging is of invaluable use in assessing extra-uterine tumour spread, tumour vascularity, and overall staging.

Changes in vascular flow after transdermal oestradiol therapy for prostate cancer: a mechanism for cardiovascular toxicity and benefit?

Objective: To report the influence of transdermal oestradiol therapy on the vascular dynamics of men with advanced prostate cancer.

Patients And Methods: Twenty patients with newly diagnosed locally advanced or metastatic prostate cancer (10 each) were treated using transdermal oestradiol patches. The vascular flow was assessed 6-monthly before and during a year of therapy using arterial and venous Doppler and duplex ultrasonography, arterial and venous photoplethysmography and opto-electronic plethysmography.

Eating together is important: using a dining room in an acute elderly medical ward increases energy intake.

Aim: To investigate the effect of eating in a supervised dining room, on nutritional intake and weight, for elderly patients on an acute medicine for the elderly ward.

Method: Patients on the intervention ward were encouraged to attend a dining room every lunch time by a trained nursing assistant as part of the rehabilitation process. The patients on the control ward ate only by their bedside.

Changes in appetite related gut hormones in intensive care unit patients: a pilot cohort study.

Introduction: The nutritional status of patients in the intensive care unit (ICU) appears to decline not only during their stay in the ICU but also after discharge from the ICU. Recent evidence suggests that gut released peptides, such as ghrelin and peptide YY (PYY) regulate the initiation and termination of meals and could play a role in the altered eating behaviour of sick patients. The aim of this study was to assess the patterns of ghrelin and PYY levels during the stay of ICU patients in hospital.

Surgical reconstruction of the mitral valve.

From Cutler's first attempt to treat the mitral valve by inserting a tenotomy knife through the left ventricle, to Carpentier's introduction of several repair techniques and a functional classification for assessing mitral valve lesions, the history of mitral valve treatment is exciting. Mitral diseases may be degenerative, ischaemic, infective or rheumatic, with or without superimposed impaired left ventricular function and calcification. Understanding the underlying pathological features is also important in determining whether mitral valve repair is feasible, how the valve should be repaired and the prospect for long-term durability of the repair.

Long-term survival and residual hazard after in-hospital cardiac arrest.

Aim: The purpose of this study was to determine long-term survival after in-hospital cardiac arrests and to explore if and when the excess mortality risk imposed by the index event reaches that of an age and sex matched general population.

Method: A retrospective analysis of data from 1,571 in-hospital cardiac arrests between the calendar years 1997 and 2002 inclusive was performed. Two hundred and fifty-nine people survived until hospital discharge, 220 of which were residents in England and included in the study.

Correlation between clinical diagnosis and arthroscopic findings of the shoulder.

Objective: To assess the accuracy of clinical examination by non-specialist orthopaedic surgeons of patients presenting to a diagnostic and treatment centre (DTC) for arthroscopic shoulder surgery.

Methods: A retrospective review of notes of 130 consecutive shoulder arthroscopies performed at a DTC over a 10 month period. Preoperative clinical diagnosis was compared with operative arthroscopic findings.

Studies of the human oropharyngeal airspaces using magnetic resonance imaging. III. The effects of device resistance with forced maneuver and tidal breathing on upper airway geometry.

The anatomical geometry of the upper airways of five healthy volunteers were studied using three-dimensional inhalation-gated magnetic resonance imaging (MRI) for two dummy inhalation devices of varying airflow resistances (0.049(0.5) and 0.

The incidence of prescribing errors in hospital inpatients: an overview of the research methods.

Many different methods have been used to study the incidence of prescribing errors in hospital inpatients. The objectives of this review were to outline the methods used, highlight their strengths and limitations, and summarise the incidence of prescribing errors reported. Methods used may be retrospective or prospective and based on process or on outcome.

Primary glial tumor of the retina with features of myxopapillary ependymoma.

We report a primary retinal tumor with features of myxopapillary ependymoma. The lesion occurred in a 33-year-old man with a long history of phthisis bulbi and a more recent history of pain to the right eye. Enucleated ocular globe revealed a lesion occupying most of the retinal surface.

Vascular access: a guide to peripheral venous cannulation.

This article provides an overview of the knowledge and skills required for peripheral venous cannulation, including anatomy and physiology, psychology, consent, vein selection, device selection, infection control, insertion technique, device securement, sharps' disposal and the prevention and management of complications. A period of supervision and assessment of competency is required to consolidate this theoretical knowledge.

Weight management in primary care: the Counterweight Project.

Obesity is a serious public health problem in the UK and needs to be tackled both at an environmental and an individual patient level. The Counterweight Project is a structured general practice programme and the first large-scale practice nurse-led intervention aimed at improving the management of obesity in primary care. Preliminary results suggest 40% of patients completing the weight management aspect of the programme achieve and maintain a 5% loss of initial body weight at 12 months.

Transdermal estradiol therapy for prostate cancer reduces thrombophilic activation and protects against thromboembolism.

Purpose: Oral estrogens were an effective treatment for prostate cancer but were abandoned because of an increased risk of cardiovascular toxicity and particularly thromboembolism. We have recently shown that transdermal estradiol produces an effective tumor response and negligible cardiovascular toxicity. Here we report the influence of transdermal estradiol therapy on the coagulation profile of men with advanced prostate cancer.

Hair loss with chemotherapy: at a loss over its management?

Alopecia is a common side effect of chemotherapy treatments for cancer; for some individuals this results in complete hair loss. The extent of this depends on many factors including the type or combination of drugs administered, and their doses. Further, it can in some cases be lessened through use of scalp cooling techniques.