799 results match your criteria: "Lancashire Teaching Hospitals NHS Foundation[Affiliation]"

Sustainability and the NHS: video consultations are an opportunity.

BMJ

July 2024

Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK

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Specialist referrals and diagnostic delays in motor neurone disease: Mapping patients' journey through hoops and hurdles in healthcare.

Clin Med (Lond)

July 2024

Department of Neurology, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, United Kingdom; University of Central Lancashire, Preston, PR1 2HE, United Kingdom.

Motor neuron disease (MND) is an uncommon but invariably fatal condition, with a median survival of 24-48 months from symptom onset. Although there is no cure at the moment, early diagnosis is crucial to enable timely access to multidisciplinary care, and enrolment in clinical trials utilising investigational therapies. Unfortunately, diagnostic delays remain common, and the average delay between symptom onset and diagnosis is 12 months.

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Introduction: Cognitive dysfunction is commonplace in Motor Neurone Disease (MND). However, due to the prominent motor symptoms in MND, assessing patients' cognitive function through traditional cognitive assessments, which oftentimes require motoric responses, may become increasingly challenging as the disease progresses. Oculomotor pathways are apparently resistant to pathological degeneration in MND.

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Background: Dislocated IOL exchange conventionally involves manipulation within the anterior chamber which risks secondary injury to anterior chamber structures. We describe and evaluate a 4-haptic IOL rescue technique that avoids entering the anterior chamber and thus minimizes post operative inflammation, astigmatism and recovery time relative to conventional IOL explantation and replacement techniques.

Methods: Retrospective, non-randomized, interventional study of all patients undergoing 4-haptic IOL rescue performed by two independent vitreoretinal surgeons at a single UK centre over two years.

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A woman in her 60s initially presented with rapid-onset left-sided hemiparesis with later development of slurred speech and left-sided facial droop. Despite ruling out common causes, her condition rapidly progressed with the development of bilateral proximal weakness, ophthalmoplegia, ataxia, and pyramidal signs eventually leading to a cardiorespiratory arrest. Extensive investigations, including computerised tomography (CT), magnetic resonance imaging (MRI), and lumbar puncture (LP), were negative for infectious or vascular aetiologies.

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Efficacy and tolerability of Brivaracetam in people with intellectual disability compared to those without intellectual disability.

Epilepsy Behav

September 2024

Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, United Kingdom; CIDER, Peninsula School of Medicine, University of Plymouth, United Kingdom. Electronic address:

Introduction: In England, nearly a quarter of people with intellectual disability (PwID) have epilepsy. Though 70 % of PwID have pharmaco-resistant seizures only 10 % are prescribed anti-seizure medication (ASMs) licenced for pharmaco-resistance. Brivaracetam (BRV) licenced in 2016 has had nine post-marketing studies involving PwID.

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: This study aims to develop and validate the Futile Recanalization Prediction Score (FRPS), a novel tool designed to predict the severity risk of FR and aid in pre- and post-EVT risk assessments. : The FRPS was developed using a rigorous process involving the selection of predictor variables based on clinical relevance and potential impact. Initial equations were derived from previous meta-analyses and refined using various statistical techniques.

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Background: Palliative care provision should be driven by high quality research evidence. However, there are barriers to conducting research. Most research attention focuses on potential patient barriers; staff and organisational issues that affect research involvement are underexplored.

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Reply to P. de Boissieu et al.

J Clin Oncol

August 2024

Alison Birtle, MBBS, MRCP, FRCR, MD, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK, University of Manchester, Manchester, UK, University of Central Lancashire, Preston, UK; Robert Jones, MBChB, PhD, University of Glasgow, Glasgow, UK, Beatson West of Scotland Cancer Centre, Glasgow, UK; and Fay H. Cafferty, PhD , Katie Biscombe, MSc, and Emma Hall, PhD, The Institute of Cancer Research, London, UK.

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Cost-effectiveness of Levodopa-Carbidopa Intestinal Gel in treating people with Advanced Parkinson's disease.

Br J Neurosci Nurs

August 2023

NIHR Applied Research Collaboration North West Coast (ARC NWC), Methodological Innovation, Development, Adaptation and Support (MIDAS) Theme.

Advanced Parkinson's disease affects patients with existing Parkinson's disease by further deteriorating their physical and cognitive functions. In this commentary we critically assess an economic evaluation which compared the cost-effectiveness of levodopa/carbidopa intestinal gel against standard of care in treating patients with Advanced Parkinson's disease. While the economic evaluation indicated that levodopa/carbidopa intestinal gel could be cost-effective within the UK parameters, we highlight important limitations related to its design, modelling and analysis.

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There is a long history of BAME under-representation in medical research. Underrepresentation of minority ethnic groups have been assessed by several studies, showing that black and minority ethnic groups were less likely to participate and engage in medical research when compared to white British groups (in relation to education, occupation, health, belief, and attitudes to medical research).There may be several strategies that improve inclusivity, including translation of participant information, culturally specific recruitment, and adaptations to the invitation process.

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Worldwide, over 2 billion children under the age of 5 experience stunting, wasting, or are underweight. Malnutrition contributes to 45% of all deaths in this age group (approximately 3.1 million deaths) [1].

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Background: Motor neuron disease is a progressive, fatal neurodegenerative disease for which there is no cure. Acceptance and Commitment Therapy (ACT) is a psychological therapy incorporating acceptance, mindfulness, and behaviour change techniques. We aimed to evaluate the effectiveness of ACT plus usual care, compared with usual care alone, for improving quality of life in people with motor neuron disease.

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Background: Total hip replacement (THR)is typically cemented, cementless or hybrid depending on patient factors and surgeon preference. To date no studies have evaluated waste generated with each of these procedures in relation to implant choice, and particularly waste related to consumables. We aimed to quantify the volume; type and ability to recycle this waste and suggest potential strategies for reducing the overall waste related to consumables in THR.

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The term 'diagnostic stewardship' is relatively new, with a recent surge in its use within the literature. Despite its increasing popularity, a precise definition remains elusive. Various attempts have been made to define it, with some viewing it as an integral part of antimicrobial stewardship.

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Temporomandibular disorders include a wide spectrum of extra-articular and intra-articular conditions affecting the temporomandibular joint (TMJ). In salvage cases involving intra-articular end-stage disease, alloplastic temporomandibular joint replacement (TMJR) is a management option which can be utilised to rehabilitate a disabled joint's function and form. Whilst post-TMJR infection is rare, it is one of the most serious complications.

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Background: Both anastomotic leak (AL) and conduit necrosis (CN) after oesophagectomy are associated with high morbidity and mortality. Therefore, the identification of preoperative, modifiable risk factors is desirable. The aim of this study was to generate a risk scoring model for AL and CN after oesophagectomy.

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Introduction: Leptomeningeal melanocytomas are rare tumours originating from neural crest derived melanocytes. They are usually solitary and presentation with multifocal meningeal melanocytoma is very rare and indicative of potentially more aggressive behaviour. This case report and scoping review sought to evaluate the presentation, and key radiological features that can help differentiate multifocal meningeal melanocytoma from other differentials and provide a discussion of the key management and prognostic points once these tumours are diagnosed.

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Aims/hypothesis: The risk of dying within 2 years of presentation with diabetic foot ulceration is over six times the risk of amputation, with CVD the major contributor. Using an observational evaluation of a real-world implementation pilot, we aimed to assess whether for those presenting with diabetic foot ulceration in England, introducing a 12-lead ECG into routine care followed by appropriate clinical action was associated with reduced mortality.

Methods: Between July 2014 and December 2017, ten multidisciplinary diabetic foot services in England participated in a pilot project introducing 12-lead ECGs for new attendees with foot ulceration.

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Article Synopsis
  • Existing gestational weight gain (GWG) charts have varying inclusion/exclusion criteria, affecting their percentile values for weight gain during pregnancy.
  • This study analyzed 31 datasets to determine how including or excluding pregnancies with adverse outcomes, like low birth weight or preterm birth, impacts GWG charts.
  • Results showed minimal differences in GWG trajectories, particularly for those with normal weight, while some slight variations were observed for overweight individuals, but overall, the impact of exclusion was insignificant.
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Article Synopsis
  • Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a serious chronic condition that greatly affects patients' quality of life, causing high levels of fatigue, pain, depression, and anxiety.
  • Although advances in treatment have improved outcomes, there’s limited understanding of the patient experience and a lack of specific tools to measure patient-reported outcomes (PROs).
  • This study aims to develop a disease-specific patient-reported outcome measure (PROM) through qualitative research methods like focus groups and interviews, helping to assess key patient experiences and improve individualized care in clinical practice.
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