464 results match your criteria: "Hull and East Yorkshire Hospitals[Affiliation]"

Interventions to prevent surgical site infection in adults undergoing cardiac surgery.

Cochrane Database Syst Rev

December 2024

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

Article Synopsis
  • * It outlines the objectives of a study aimed at assessing the effectiveness of various interventions before, during, and after surgery to prevent SSIs and evaluate their impact on patient outcomes.
  • * The study includes a comprehensive search for randomized controlled trials (RCTs) related to SSI prevention in adult cardiac surgery and aims to establish a clearer standard of care for managing these infections.
View Article and Find Full Text PDF
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%.
View Article and Find Full Text PDF

Introduction: The ultimate answer to the question whether minimal invasive extracorporeal circulation (MiECC) represents the optimal perfusion technique in contemporary clinical practice remains elusive. The present study is a real-world study that focuses on specific perfusion-related clinical outcomes after cardiac surgery that could potentially be favourably affected by MiECC and thereby influence the future clinical practice.

Methods: The MiECS study is an international, multi-centre, two-arm randomized controlled trial.

View Article and Find Full Text PDF

Mechanisms and management of loss of response to anti-TNF therapy for patients with Crohn's disease: 3-year data from the prospective, multicentre PANTS cohort study.

Lancet Gastroenterol Hepatol

June 2024

Department of Gastroenterology, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK; Exeter IBD and Pharmacogenetics Research Group, University of Exeter, Exeter, UK. Electronic address:

Article Synopsis
  • The study aimed to evaluate the effectiveness of two medications, infliximab and adalimumab, for treating patients with active Crohn's disease over three years and to identify what factors contribute to treatment failure.
  • It involved a large cohort of patients across the UK, tracking their responses to anti-TNF therapy and analyzing reasons for loss of effectiveness.
  • Findings showed that remission rates declined over time for both medications, with around 40% of patients on infliximab and about 35% on adalimumab remaining in remission by the end of Year 1, suggesting ongoing challenges in maintaining treatment effectiveness.
View Article and Find Full Text PDF
Article Synopsis
  • Cardiac surgery causes significant inflammation, and the use of corticosteroids is being examined as a way to reduce this inflammation and prevent complications post-surgery, but their safety and effectiveness remain uncertain.
  • The study aims to compare the effects of corticosteroids versus no treatment in adults undergoing cardiac surgery, focusing on mortality, myocardial and pulmonary complications, among other outcomes like atrial fibrillation and length of hospital stay.
  • The research involved comprehensive searches for randomised controlled trials and analyzed data using standard methods to assess various outcomes, with new studies added since the original 2011 review.
View Article and Find Full Text PDF

Objective: Patients diagnosed with colorectal cancer living in more deprived areas experience worse survival than those in more affluent areas. Those living in more deprived areas face barriers to accessing timely, quality healthcare. These barriers may contribute to socioeconomic inequalities in survival.

View Article and Find Full Text PDF

Aims: The aim of this study was to capture 12-month outcomes from a representative multicentre cohort of patients undergoing total ankle arthroplasty (TAA), describe the pattern of patient-reported outcome measures (PROMs) at 12 months, and identify predictors of these outcome measures.

Methods: Patients listed for a primary TAA at 19 NHS hospitals between February 2016 and October 2017 were eligible. PROMs data were collected preoperatively and at six and 12 months including: Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ (foot and ankle)) and the EuroQol five-dimension five-level questionnaire (EQ-5D-5L).

View Article and Find Full Text PDF

Aim: People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC.

View Article and Find Full Text PDF

Background Context: Several minimally invasive lumbar interbody fusion techniques may be used as a treatment for spondylolisthesis to alleviate back and leg pain, improve function and provide stability to the spine. Surgeons may choose an anterolateral or posterior approach for the surgery however, there remains a lack of real-world evidence from comparative, prospective studies on effectiveness and safety with relatively large, geographically diverse samples and involving multiple surgical approaches.

Purpose: To test the hypothesis that anterolateral and posterior minimally invasive approaches are equally effective in treating patients with spondylolisthesis affecting one or two segments at 3-months follow-up and to report and compare patient reported outcomes and safety profiles between patients at 12-months post-surgery.

View Article and Find Full Text PDF

Objectives: To determine the prevalence of organ impairment in long COVID patients at 6 and 12 months after initial symptoms and to explore links to clinical presentation.

Design: Prospective cohort study.

Participants: Individuals.

View Article and Find Full Text PDF

Context: Prader-Willi syndrome (PWS) is a rare neurobehavioral-metabolic disease caused by the lack of paternally expressed genes in the chromosome 15q11-q13 region, characterized by hypotonia, neurocognitive problems, behavioral difficulties, endocrinopathies, and hyperphagia resulting in severe obesity if not controlled.

Objective: The primary end point was change from baseline in hyperphagia using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT). Other end points included Global Impression Scores, and changes in body composition, behaviors, and hormones.

View Article and Find Full Text PDF

An update on the management of thyroid nodules: rationalising the guidelines.

J Laryngol Otol

September 2023

Department of Otorhinolaryngology Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, UK.

Background: Guidance for the management of thyroid nodules has evolved over time, from initial evaluation based predominantly on clinical grounds to now including the established role of ultrasound and fine needle aspiration cytology in their assessment. There is, however, significant variation in the management of thyroid nodules depending on which national guidelines are followed. In addition, there are certain clinical situations such as pregnancy and paediatric thyroid nodules that have differing evaluation priorities.

View Article and Find Full Text PDF

Objectives: To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort.

Methods: Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S.

View Article and Find Full Text PDF

Background: The diagnosis of symptomatic cancer-associated thrombosis often causes distress and alarm for patients, especially for those unaware of the risk, or the signs and symptoms to look out for. There are few data about cancer patients' experiences of incidentally diagnosed pulmonary embolism (IPE), where lack of warning (recognised signs, symptoms) may cause delayed diagnosis and aggravate distress.

Objectives: To explore cancer patients' experience of the diagnosis of and living with incidental pulmonary embolism treated with anticoagulation.

View Article and Find Full Text PDF

Introduction: Treatment of anemia in dialysis patients has been associated with increased risk of vascular access thrombosis (VAT). Proactive IV irOn Therapy in hemodiALysis Patients (PIVOTAL) was a clinical trial of proactive compared with reactive i.v.

View Article and Find Full Text PDF
Article Synopsis
  • The 2016 MiECTiS position paper encouraged collaboration among cardiac surgeons, anesthesiologists, and perfusionists to establish a common language and framework for minimal invasive perfusion technologies.
  • Recent consensus updates confirm that modular minimal invasive extracorporeal circulation (MiECC) is a safe and effective technique for adult cardiac surgeries, enhancing biocompatibility and ensuring patient safety.
  • The MiECTiS supports MiECC as a multidisciplinary approach that significantly benefits patient care, urging its broader adoption to improve healthcare outcomes.
View Article and Find Full Text PDF

Background: Methods for developing national recommendations vary widely. The successful adoption of new guidance into routine practice is dependent on buy-in from the clinicians delivering day-to-day patient care and must be considerate of existing resource constraints, as well as being aspirational in its scope. This initiative aimed to produce guidelines for the management of head and neck squamous cell carcinoma of unknown primary (HNSCCUP) using a novel methodology to maximise the likelihood of national adoption.

View Article and Find Full Text PDF

Introduction: Knee replacement (KR) is a clinically proven procedure typically offered to patients with severe knee osteoarthritis (OA) to relieve pain and improve quality of life. However, artificial joints fail over time, requiring revision associated with higher mortality and inferior outcomes. With more young people presenting with knee OA and increasing life expectancy, there is an unmet need to postpone time to first KR.

View Article and Find Full Text PDF

A woman in her 70s presented to the hospital being generally unwell 8 days following the first dose of the AstraZeneca COVID-19 vaccination. She was in stage III acute kidney injury (AKI) with hyperkalaemia and metabolic acidosis. Urinalysis showed haematoproteinuria.

View Article and Find Full Text PDF

Background: The impact on clinical outcomes of patient selection using perfusion imaging for endovascular thrombectomy (EVT) in patients with acute ischemic stroke presenting beyond 6 hours from onset remains undetermined in routine clinical practice.

Methods: Patients from a national stroke registry that underwent EVT selected with or without perfusion imaging (noncontrast computed tomography/computed tomography angiography) in the early (<6 hours) and late (6-24 hours) time windows, between October 2015 and March 2020, were compared. The primary outcome was the ordinal shift in the modified Rankin Scale score at hospital discharge.

View Article and Find Full Text PDF

Background: People with kidney failure treated with hemodialysis (HD) are at increased risk of stroke compared with similarly aged people with normal kidney function. One concern is that treatment of renal anemia might increase stroke risk. We studied risk factors for stroke in a prespecified secondary analysis of a randomized, controlled trial of intravenous iron treatment strategies in HD.

View Article and Find Full Text PDF

Objective: To evaluate the results of a single stage composite cleft septorhinoplasty procedure ("The Gujrat Technique") to correct the exaggerated cleft nose deformity after completion of nasal growth in an adult patient cohort.

Methods: Adult patients with a residual unilateral cleft nasal deformity were deemed eligible for the proposed "Gujrat Technique". Over a 10-year period (2007-2017), 96 adult patients underwent this composite cleft septorhinoplasty as a single stage operation.

View Article and Find Full Text PDF