216 results match your criteria: "Milton Keynes University Hospital NHS Foundation Trust[Affiliation]"

We report the case of a 72-year-old woman who was admitted following a fall and sustained a right neck of femur fracture. Prior to this admission, she was undergoing chemotherapy for lung cancer. Upon this admission, it was noted that she had developed neutropenic sepsis.

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  • - The increase in life expectancy is leading to higher rates of frailty and eye diseases in the elderly, with conditions like cataracts and glaucoma being particularly impactful, resulting in visual impairment that affects daily living and mental health.
  • - Visual impairment due to eye diseases is closely linked to cognitive decline, creating a vicious cycle where reduced sensory input worsens cognitive health, leading to issues like depression and social isolation.
  • - The review emphasizes the need for early intervention and interdisciplinary care to manage eye diseases and their cognitive implications in the elderly, highlighting the critical role of ophthalmologists in these efforts.
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Long-Term outcomes after stress echocardiography in real world practice: five-year follow-up of the UK Evarest study.

Eur Heart J Cardiovasc Imaging

November 2024

Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.

Aims: Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result to inform on likely longer-term outcomes when applied in real world practice across a healthcare system has not been previously reported.

Methods And Results: 5503 patients recruited across 32 UK NHS hospitals between 2018 and 2022, participating in the EVAREST/BSE-NSTEP prospective cohort study, with data on medical outcomes up to 2023 available from NHS England were included in analysis.

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Perioperative risk scores: prediction, pitfalls, and progress.

Curr Opin Anaesthesiol

February 2025

Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford.

Purpose Of Review: Perioperative risk scores aim to risk-stratify patients to guide their evaluation and management. Several scores are established in clinical practice, but often do not generalize well to new data and require ongoing updates to improve their reliability. Recent advances in machine learning have the potential to handle multidimensional data and associated interactions, however their clinical utility has yet to be consistently demonstrated.

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In this paper we discuss the relevance of continuity equation based aortic valve area (AVA) calculation as a robust parameter suitable for accurate grading of aortic stenosis (AS) irrespective of flow conditions. Combining the AVA-based grading and echocardiography-based staging, can provide with the most comprehensive clinical assessment of patients with AS and preserved left ventricular systolic function to streamline management decisions.

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Background: Diabetes mellitus is a complex condition to manage. Patients with a greater understanding and knowledge of their condition might achieve better glycemic control than others. This study aimed to evaluate the impact of clinical pharmacist-led diabetes education on the knowledge and attitude of individuals with type II diabetes mellitus (T2DM).

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This case report describes an 85-year-old patient who presented with painless, unilateral right testicular swelling of 2 months' duration. This raised the possibility of testicular cancer, especially given his recent treatment for bladder cancer, which included adjuvant intravesical bacillus Calmette-Guerin (BCG) therapy. This poses a diagnostic dilemma regarding tuberculosis (TB) of the testis, BCG complications or a true testicular malignancy.

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Cost-effectiveness of a novel AI technology to quantify coronary inflammation and cardiovascular risk in patients undergoing routine Coronary Computed Tomography Angiography.

Eur Heart J Qual Care Clin Outcomes

September 2024

Acute Multidisciplinary Imaging & Interventional Centre, British Heart Foundation (BHF) Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, United Kingdom.

Aims: Coronary Computed Tomography Angiography (CCTA) is a first line investigation for chest pain in patients with suspected obstructive coronary artery disease (CAD). However, many acute cardiac events occur in the absence of obstructive CAD. We assessed the lifetime cost-effectiveness of integrating a novel artificial intelligence-enhanced image analysis algorithm (AI-Risk) that stratifies the risk of cardiac events by quantifying coronary inflammation, combined with the extent of coronary artery plaque and clinical risk factors, by analysing images from routine CCTA.

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Introduction: Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC).

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  • Frailty is a common syndrome in older adults that leads to less physical resilience and makes them more vulnerable to stress, significantly increasing their health risks and mortality, especially when combined with conditions like diabetes and hypertension.
  • The review highlights that managing diabetes and hypertension in frail individuals often requires multiple medications, resulting in polypharmacy, which can cause serious side effects like falls and poor medication adherence.
  • A multidisciplinary approach, involving specialists like geriatricians and pharmacists, is essential for effectively managing these conditions, and there is a pressing need for more research on best practices for treating frail elderly patients.
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  • The study aims to identify predictors of atrial fibrillation after cardiac surgery (AFACS) to develop better prediction models as part of the PARADISE project.
  • It used a two-stage Delphi consensus process involving 15 international experts from various cardiac and nursing fields to generate and refine a list of candidate predictors.
  • The final list includes 72 predictors categorized into demographics, comorbidities, vital signs, intraoperative factors, postoperative investigations, and interventions, highlighting both patient-related and surgical factors.
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Introduction: Adolescent idiopathic scoliosis (AIS) is present in 2%-3% of those under 18 years old and has a significant impact on pain, function and quality of life. Up to 10% of adolescents with AIS progress to spinal fusion surgery, and of those individuals many experience reduced musculoskeletal function and do not return to sports postoperatively. Physiotherapists have a significant role in promoting participation and offering a graded return to sports, exercise and physical activity.

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Background: Patients' satisfaction with their treatment directly impacts the control of their diabetes. Quality of life is crucial for patients with diabetes mellitus to maintain long-term health and minimize complications. The current study aimed to evaluate the impact of diabetes education on quality of life (QoL) and treatment satisfaction of patients with type 2 diabetes mellitus.

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Background: Long-term outcome of contemporary stress echocardiography has not been systematically assessed.

Objective: To evaluate the association between results of stress echocardiography and patients' outcomes with suspected coronary artery disease using randomised controlled trials.

Methods: Multiple electronic databases were searched for studies evaluating long-term outcome (>12 months) of stress echocardiography in patients suspected of coronary artery disease since year 2000.

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Topic: To evaluate the efficacy and safety of anti-VEGF and panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). The outcomes examined are changes in best-corrected visual acuity (BCVA), neovascularization (NV), central macular thickness (CMT), and adverse outcomes.

Clinical Relevance: Diabetic retinopathy is the leading cause of blindness in working-aged adults globally.

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Background: Nursing shortages are an ongoing concern for neonatal units, with many struggling to meet recommended nurse to patient ratios. Workforce data underlines the high proportion of neonatal nurses nearing retirement and a reduced number of nurses joining the profession. In order to recommend strategies to increase recruitment and retention to neonatal nursing, we need to understand the current challenges nurses are facing within the profession.

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  • * After surgery, both patients experienced pulmonary embolism (PE), suggesting a potential link between high calcium levels and an increased risk of blood clotting (hypercoagulation).
  • * The case highlights the need for more research to determine if chronic high calcium levels without fractures can lead to hypercoagulation and whether this risk is heightened in patients with fractures after surgery.
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Takotsubo cardiomyopathy in a patient with Lynch syndrome.

Lancet

July 2024

Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK; Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham, UK. Electronic address:

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Metabolic dysfunction-associated steatotic liver disease is a growing worldwide pandemic. A limited number of studies have investigated the potential effect of Ramadan fasting on metabolic dysfunction-associated steatotic liver disease (MASLD). There is no single medication for the treatment of MASLD.

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Diabetic ketoacidosis (DKA) is a life-threatening condition affecting individuals with diabetes characterised by hyperglycaemia, metabolic acidosis and ketonemia. The incidence and financial burden of DKA is still high. Thiamine deficiency is well documented in patients with DKA and could be associated with cardiac dysfunction in those patients.

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Background: The HEART score, the T-MACS model and the GRACE score support early decision-making for acute chest pain, which could be complemented by CT coronary angiography (CTCA). However, their performance has not been directly compared.

Methods: In this secondary analysis of a multicentre randomised controlled trial of early CTCA in intermediate-risk patients with suspected acute coronary syndrome, C-statistics and performance metrics (using the predefined cut-offs) of clinical decision aids and CTCA, alone and then in combination, for the index hospital diagnosis of acute coronary syndrome and for 30-day coronary revascularisation were assessed in those who underwent CTCA and had complete data.

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Objective: To derive a new maternity early warning score (MEWS) from prospectively collected data on maternity vital signs and to design clinical response pathways with a Delphi consensus exercise.

Design: Centile based score development and Delphi informed escalation pathways.

Setting: Pregnancy Physiology Pattern Prediction (4P) prospective UK cohort study, 1 August 2012 to 28 December 2016.

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