A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme.

Objectives: The Cycling against Hip Pain programme is a 6-week exercise and education treatment pathway for people with hip osteoarthritis. Preliminary results of the Cycling against Hip Pain programme found significant improvements in clinical and patient-reported outcome measures for patients referred from primary care. This article evaluates the effectiveness of the changes made to the pathway in a quality improvement replication programme.

Systematic Review and Pooled Analysis of the Impact of Renorrhaphy Techniques on Renal Functional Outcome After Partial Nephrectomy.

Despite the important relationship between renorrhaphy and functional outcomes of partial nephrectomy, the urological guidelines do not provide recommendations about the optimal renorrhaphy technique. We carried out the first pooled literature analysis of the impact of suture technique on ultimate renal function after partial nephrectomy. Three studies comparing interrupted versus running suture including data on glomerular filtration rate (GFR) were included, for a total of 124 versus 269 patients.

Recent advances in the molecular landscape of lung neuroendocrine tumors.

Neuroendocrine tumors of the lung (Lung-NETs) make up a heterogenous family of neoplasms showing neuroendocrine differentiation and encompass carcinoids and neuroendocrine carcinomas. On molecular grounds, they considered two completely distinct and separate tumor groups with no overlap of molecular alterations nor common developmental mechanisms. Areas covered: Two perspectives were evaluated based on an extensive review and rethinking of literature: (1) the current classification as an instrument to obtaining clinical and molecular insights into the context of Lung-NETs; and (2) an alternative and innovative interpretation of these tumors, proposing a tripartite separation into early aggressive primary high-grade neuroendocrine tumors (HGNET), differentiating or secondary HGNET, and indolent NET.

Surveillance imaging for sporadic renal angiomyolipoma less than 40 mm: lessons learnt and recommendations from the experience of a large district general hospital.

Introduction Sporadic renal angiomyolipomas, although benign in natural can cause life-threatening spontaneous haemorrhage. Surveillance of smaller lesions is recommended but there is no guidance on the surveillance interval or modality. Our aim was to study our sporadic angiomyolipoma population to determine the growth rate, factors that were associated with a higher growth rate and design a surveillance programme.

A multi-centre audit of excess steroid use in 1176 patients with inflammatory bowel disease.

Background: Corticosteroids are central to inducing remission in inflammatory bowel disease (IBD) but are ineffective maintenance agents.

Aim: To benchmark steroid usage in British outpatients and assess factors associated with excess exposure.

Methods: We recorded steroid use in unselected IBD outpatients.

No Benefit of Complex Fractionated Atrial Electrogram Ablation in Addition to Circumferential Pulmonary Vein Ablation and Linear Ablation: Benefit of Complex Ablation Study.

Background: The optimal ablation strategy for persistent atrial fibrillation (AF) remains unclear.

Methods And Results: This multicentre randomized study compared circumferential pulmonary vein ablation+linear ablation (control arm) versus circumferential pulmonary vein ablation+linear ablation+complex fractionated atrial electrogram (CFAE) ablation (CFAE arm) in patients with persistent AF. Circumferential pulmonary vein ablation was performed followed by roof and mitral isthmus ablation, before CFAE ablation in the CFAE arm.

Internal and external focus of attention during gait re-education: an observational study of physical therapist practice in stroke rehabilitation.

Background: Focus of attention is known to play an important role in motor skill learning, yet little is known about how attention is directed within the context of stroke rehabilitation.

Objective: The aims of this study were: (1) to identify physical therapists' use of internal and external focus of attention during gait rehabilitation for individuals with hemiplegia following stroke and (2) to use the findings to design an experimental study examining the impact of focus of attention on learning poststroke.

Design: The study design involved direct nonparticipation observation of physical therapy treatment sessions.

Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis.

What's known on the subject? and What does the study add? The literature yielded only four studies on the subject; however, no clear outcome can be taken from individual studies. This review adds a meta-analysis of these four studies to make the patient cohort larger and to allow for a greater understanding of the procedure in this select group of patients. • To compare the safety and efficacy of laparoscopic partial nephrectomy (LPN) in obese and non-obese patients.

Safety and efficacy of ureteroscopic lithotripsy for stone disease in obese patients: a systematic review of the literature.

Objective: To look at the role and safety of ureteroscopy for stone management in obese patients.

Methods: We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to June 2011 for results of ureteroscopy and stone treatment in obese patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with morbid obesity.

Low dose diamorphine reduces breathlessness without causing a fall in oxygen saturation in elderly patients with end-stage idiopathic pulmonary fibrosis.

There is very little evidence regarding the safety and efficacy of opioids for the control of dyspnoea in the terminal stages of idiopathic pulmonary fibrosis (IPF). We conducted an open case series study of 11 elderly opioid-naive patients referred for management of severe breathlessness before and after their first injection of 2.5 mg diamorphine subcutaneously.

A point of contact for patients and staff.

The concept of nurses working in an extended role was formally introduced by the UKCC 12 years ago, but the role of the rheumatology practitioner had been evolving sporadically over the previous decade. This had resulted in a variety of job titles, including specialist and rheumatology practitioner, with accompanying different levels of resposibility. The changes to junior doctors' hours have meant that more nurses are taking on extended roles.

Thrombolytic therapy for acute ischaemic stroke.

Recombinant tissue plasminogen activator (rt-PA, also known as alteplase; Actilyse) is the first and only licensed thrombolytic approved for use in acute ischaemic stroke in the UK. This article reviews the evidence for the role of rt-PA in acute stroke management and how it may improve long-term clinical outcome for selected patients as part of a comprehensive stroke service.

Variations of invasive Salmonella infection in elderly people.

Four cases of elderly people with differing forms of invasive salmonella infection are presented. Vulnerability factors and patterns of presentation are discussed.

The use of water-filled gloves to prevent the formation of decubitis ulcers on heels.

Water-filled gloves are used regularly to prevent pressure sore development on patients' heels. The efficacy of such flotation therapy is dependent on achieving the correct therapeutic pressure, but water-filled gloves tend to be applied haphazardly. A small-scale study measured pressure on the heels of three volunteers of varying weights, using three sizes of gloves filled with varying amounts of water.