A Rare Case of Bladder Melanosis: A Case Report and Review of the Literature.

Bladder melanosis is a rare and poorly understood condition involving melanin pigmentation within the urothelial mucosa. Cases often present with haematuria, urinary obstructive symptoms, or cystitis. While generally considered benign, its potential association with malignancy warrants regular monitoring, as cases have previously been reported of an association with urothelial carcinoma and melanoma, although it is unclear whether there is a causal relationship.

Pleural effusion in a patient with previous alcohol excess.

https://bit.ly/3Rk5UfO.

Lack of regional pathways impact on surgical delay: Analysis of the Orthopaedic Trauma Hospital Outcomes-Patient Operative Delays (ORTHOPOD) study.

Introduction: Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital systems, particularly with regards to elective services. We demonstrate through a multicentre, multinational study, the impact of this at scale.

The Use of a High Offset Fully Coated Collarless Cementless Stem Does Not Result in Early Failures in Total Hip Arthroplasty.

Introduction: The Corail femoral stem has excellent long-term survivorship in total hip arthroplasty (THA). However, there remains a paucity of information on the specific performance of the high offset collarless stem in relation to subsidence, loosening, offset, and failure rates.

Methods: Retrospective data were collected on all consecutive high offset collarless Corail stems implanted at a single centre in the UK.

ORthopaedic trauma hospital outcomes - Patient operative delays (ORTHOPOD) Study: The management of day-case orthopaedic trauma in the United Kingdom.

Introduction: ORTHOPOD: Day Case Trauma is a multicentre prospective service evaluation of day-case trauma surgery across four countries. It is an epidemiological assessment of injury burden, patient pathways, theatre capacity, time to surgery and cancellation. It is the first evaluation of day-case trauma processes and system performance at nationwide scale.

Unusual Manifestation of Choroidal Metastasis as Late Presentation of Treated Lung Cancer with Floaters.

Metastatic tumors to the choroid are the most common intraocular malignancies. Choroidal metastasis from lung cancer is uncommon. Visual affection or other ocular manifestations as the initial clinical presentation of lung cancer primarily are rare.

Minimum 5-Year Outcomes of a Multicenter, Prospective, Randomized Control Trial Assessing Clinical and Radiological Outcomes of Patient-Specific Instrumentation in Total Knee Arthroplasty.

Background: Patient-specific instrumentation (PSI) was developed to produce more accurate alignment of components and consequently improve clinical outcomes when used in total knee arthroplasty. We compare radiological accuracy and clinical outcomes at a minimum of 5-year follow-up between patients randomized to undergo total knee arthroplasty performed using PSI or traditional cutting block techniques.

Methods: This multicenter, randomized control trial included patients blinded to the technique 1used.

The orthopaedic waiting list crisis : two sides of the story.

Aims: Due to widespread cancellations in elective orthopaedic procedures, the number of patients on waiting list for surgery is rising. We aim to determine and quantify if disparities exist between inpatient and day-case orthopaedic waiting list numbers; we also aim to determine if there is a 'hidden burden' that already exists due to reductions in elective secondary care referrals.

Methods: Retrospective data were collected between 1 April 2020 and 31 December 2020 and compared with the same nine-month period the previous year.

Paediatric orthopaedics in lockdown: A study on the effect of the SARS-Cov-2 pandemic on acute paediatric orthopaedics and trauma.

Aims: To determine the impact of COVID-19 on orthopaediatric admissions and fracture clinics within a regional integrated care system (ICS).

Methods: A retrospective review was performed for all paediatric orthopaedic patients admitted across the region during the recent lockdown period (24 March 2020 to 10 May 2020) and the same period in 2019. Age, sex, mechanism, anatomical region, and treatment modality were compared, as were fracture clinic attendances within the receiving regional major trauma centre (MTC) between the two periods.

Isolated suprascapular nerve palsy following childbirth: A case study and literature review.

We report a case of 30-year-old lady presenting with a suprascapular nerve (SSN) injury in the postpartum period. Two days following normal delivery, the patient experienced progressive weakness in her left shoulder, of spontaneous onset. Initially thought to be a rotator cuff tear, further imaging indicated a lesion in the SSN.

Current management of necrotising otitis externa in the UK: survey of 221 UK otolaryngologists.

Introduction: Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making.

Tips and tricks of ureteroscopy: consensus statement. Part II. Advanced ureteroscopy.

Our "tips and tricks" focuses on all aspects of upper tract endourology and we hope these will be of use to all trainees and consultants who perform ureteroscopy. We report an "expert consensus view" from experienced endourological surgeons, on all aspects of advanced ureteroscopic techniques, with a particular focus on avoiding and getting out of trouble while performing ureteroscopy. In this paper we provide a summary of placing ureteric access sheath, flexible ureteroscopy, intra renal stone fragmentation and retrieval, maintaining visual clarity and biopsy of ureteric and pelvicalyceal tumours.

Tips and tricks of ureteroscopy: consensus statement Part I. Basic ureteroscopy.

Ureteroscopy is fast becoming the first line treatment option for the majority of urinary tract stones. Ureteroscopy training can be performed in a variety of ways including simulation, hands on ureteroscopy courses and supervised operative experience. We report an "expert consensus view" from experienced endourological surgeons, on all aspects of basic ureteroscopic techniques, with a particular focus on avoiding and getting out of trouble while performing ureteroscopy.

Case-finding for coeliac disease in secondary care: a prospective multicentre UK study.

Background: Coeliac disease affects 1% of the population. Despite this high prevalence, the majority of individuals are undetected. Many patients present with subtle symptoms which may also contribute to under diagnosis.

Nickel allergy following European Union regulation in Denmark, Germany, Italy and the U.K.

Background: Nickel allergy is common worldwide. It is associated with hand dermatitis, and sensitization is often induced by nickel-releasing jewellery. The European Union (EU) introduced legislation to control nickel content and release from jewellery and other consumer items through the EU Nickel Directive 1994, which came into force in 2001 and is now part of the REACH regulation.

Intraoperative clouding of a posterior chamber intraocular lens.

The glistening and delayed opacification of intraocular lenses (IOLs) has been reported in literature as a late and permanent change in the acrylic IOL due to temperature change. We report a case in which clouding and opacification of an IOL occurred intraoperatively within a few seconds of implantation into the capsular bag after routine phacoemulsification. This phenomenon occurred due to the sudden change in temperature of a very cold IOL being implanted into the eye at body temperature.

Bilateral macular haemorrhages secondary to hepatitis-associated aplastic anaemia, treated with Nd:YAG laser posterior hyaloidotomy.

Hepatitis-associated aplastic anaemia (HAAA) is an uncommon but distinct variant of aplastic anaemia in which pancytopenia and bone marrow failure appears 2-3 months after an acute attack of hepatitis. Although bilateral vision loss may rarely be the initial presentation of aplastic anaemia, no such report is known in HAAA. Here the authors report such a case presenting with large premacular subhyaloid haemorrhages secondary to severe anaemia and thrombocytopenia.

Late-onset endophthalmitis secondary to exposed glaucoma tube implant in a rare case of paediatric glaucoma.

Glaucoma drainage implants (GDIs) are used to treat paediatric glaucoma resistant to conventional medical and surgical treatment, achieving good intraocular pressure (IOP) control and long-term success. Late endophthalmitis is a rare complication that may develop following GDI surgery. A 17-year-old male presented with acute endophthalmitis 2 years after Ahmed glaucoma valve implantation with pericardial patch graft for management of refractory glaucoma secondary to congenital ectropion uveae.

Surface replacement trapeziometacarpal joint arthroplasty--early results.

This study reviews the results of Surface Replacement Trapeziometacarpal (SR TMC, Avanta, San Diego, CA) total joint arthroplasty. Fifty patients (62 joints) were included in the study. Forty-three patients (54 joints) were seen at final follow up.

Correlation between the pattern of myopic fundal changes and the axis of astigmatism of the eye.

Aims: Myopic fundal changes have been studied in great detail, clinically and pathologically. To our knowledge correlation between these changes and the axis of astigmatism has not been studied before. This study was conducted to assess the correlation, if any, between the pattern of myopic fundal changes and the axis of astigmatism.

Combined antegrade and retrograde endoscopic retroperitoneal bypass of ureteric strictures: a modification of the 'rendezvous' procedure.

Objective: To evaluate our experience of treating complicated iatrogenic ureteric strictures with a combined antegrade and retrograde endoscopic retroperitoneal bypass technique, a modification of the so-called 'rendezvous' procedure.

Patients And Methods: Seven patients presented to our institution between 2004 and 2008 after developing a complicated iatrogenic ureteric stricture, impassable with solitary antegrade or retrograde stenting techniques. In most cases there was a significant loss of ureteric continuity, with some strictures of up to 10-12 cm.

'Nephrostomy-free' percutaneous nephrolithotomy: experience in a UK district general hospital.

Introduction: Percutaneous nephrolithotomy (PCNL) is the first-line treatment for large and complex renal calculi. Accepted UK practice is to insert a nephrostomy tube at the end of the procedure to drain the kidney and reduce potential complications. 'Tubeless' or 'nephrostomy-free' PCNL has been advocated in selected patients as it is thought to reduce length of hospital stay, analgesia requirements and pain experienced.