71 results match your criteria: "Royal United Hospitals NHS Foundation Trust[Affiliation]"

A two-person verbal check to confirm tracheal intubation: evaluation of practice changes to prevent unrecognised oesophageal intubation.

Br J Anaesth

December 2024

Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals NHS Foundation Trust, Bath, UK; School of Medicine, University of Bristol, Bristol, UK. Electronic address:

Article Synopsis
  • Despite national efforts to highlight the importance of capnography for confirming tracheal intubation, deaths from unrecognized esophageal intubation persist, prompting the adoption of a two-person verbal check during the intubation process.
  • In a study across two hospitals, one implemented a one-step check and the other a two-step check, collecting feedback from anaesthetists and assistants via anonymous questionnaires throughout the process.
  • The majority of participants felt that the two-person checks enhanced communication and teamwork, with high support for continued use; 82% of intubators and 94% of assistants intended to use this method for future intubations.
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A narrative overview of undergraduate geriatric medicine education worldwide.

Eur Geriatr Med

October 2024

Aging and Movement Research Group, Population Health Sciences, University of Bristol Medical School, Canynge Hall, Bristol, BS8 2PN, UK.

There is a mismatch between the healthcare needs of the ageing population worldwide and the amount of education medical students receive in geriatric medicine. In 2014, Mateos-Nozal et al. published a systematic review of all undergraduate education surveys in geriatric medicine-a decade on, it is timely for an up-to-date overview of the state of undergraduate geriatric medicine education globally.

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Objective: To determine the annual incidence of psoriatic arthritis (PsA) in a United Kingdom primary care population with preexisting psoriasis (PsO) followed prospectively over 2 years after excluding baseline prevalence of existing disease.

Methods: Total Burden of Psoriasis (TUDOR; ISRCTN registry: ISRCTN38877516) was a multicenter, prospective, 2-arm parallel-group cluster randomized controlled trial of the early identification of PsA by annual rheumatological assessment (termed "Enhanced Surveillance") vs standard care in people with PsO identified in primary care. Incidence of PsA is reported at 12 months and 24 months using patients from the Enhanced Surveillance arm, which allows for the exclusion of patients with prevalent PsA at baseline.

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Improving Conversations about Parkinson's Dementia.

Mov Disord Clin Pract

July 2024

Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom.

Background: People with Parkinson's disease (PD) have an increased risk of dementia, yet patients and clinicians frequently avoid talking about it due to associated stigma, and the perception that "nothing can be done about it". However, open conversations about PD dementia may allow people with the condition to access treatment and support, and may increase participation in research aimed at understanding PD dementia.

Objectives: To co-produce information resources for patients and healthcare professionals to improve conversations about PD dementia.

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Article Synopsis
  • The study investigates how pain catastrophising affects physical function in patients with Axial Spondyloarthritis (axSpA), focusing on the roles of fear of movement and competence frustration.
  • Among the 98 participants surveyed, results indicated that fear of movement significantly mediates the link between pain and physical function, as well as between pain catastrophising and physical function.
  • Notably, the study is the first to reveal the unique impact of competence frustration within the fear-avoidance model for individuals with axSpA, highlighting potential areas for improving patient care and quality of life.
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Background: The incidence of cancer diagnosed during pregnancy is increasing. Data relating to investigation and management, as well as maternal and foetal outcomes is lacking in a United Kingdom (UK) population.

Methods: In this retrospective study we report data from 119 patients diagnosed with cancer during pregnancy from 14 cancer centres in the UK across a five-year period (2016-2020).

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A phase 2 trial investigating the efficacy and safety of the mPGES-1 inhibitor vipoglanstat in systemic sclerosis-related Raynaud's.

Rheumatology (Oxford)

January 2024

Centre for Musculoskeletal Research, The University of Manchester, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Objective: Our objective was to test the hypothesis, in a double-blind, placebo-controlled study that vipoglanstat, an inhibitor of microsomal prostaglandin E synthase-1 (mPGES-1) which decreases prostaglandin E2 (PGE2) and increases prostacyclin biosynthesis, improves RP.

Methods: Patients with systemic sclerosis (SSc) and ≥7 RP attacks during the last screening week prior to a baseline visit were randomised to four weeks treatment with vipoglanstat 120 mg or placebo. A daily electronic diary captured RP attacks (duration and pain) and Raynaud's Condition Score, with change in RP attacks/week as primary end point.

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Background: Healthcare system data (HSD) are increasingly used in clinical trials, augmenting or replacing traditional methods of collecting outcome data. This study, PRIMORANT, set out to identify, in the UK context, issues to be considered before the decision to use HSD for outcome data in a clinical trial is finalised, a methodological question prioritised by the clinical trials community.

Methods: The PRIMORANT study had three phases.

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Article Synopsis
  • - Adult-onset idiopathic inflammatory myopathy (IIM) increases cancer risk around its onset, prompting the need for tailored cancer screening strategies.
  • - An international expert group developed 18 recommendations using a modified Delphi method, focusing on risk stratification and cancer screening based on IIM subtype and clinical features.
  • - The guidelines specify 'basic' and 'enhanced' cancer screening panels and suggest timing and frequency for screenings, including additional procedures for high-risk patients, aiming for earlier cancer detection and improved survival rates.
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Lower limb muscle strength and balance in older adults with a distal radius fracture: a systematic review.

BMC Musculoskelet Disord

September 2023

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: Distal radius fractures are common fractures in older adults and associated with increased risk of future functional decline and hip fracture. Whether lower limb muscle strength and balance are impaired in this patient population is uncertain. To help inform rehabilitation requirements, this systematic review aimed to compare lower limb muscle strength and balance between older adults with a distal radius fracture with matched controls, and to synthesise lower limb muscle strength and balance outcomes in older adults with a distal radius fracture.

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Objectives: Assessment of construct validity and reliability of a novel patient-reported outcome (PRO) instrument for assessing the severity and impact of RP in SSc.

Methods: An international multicentre study validation study of the 27-item Assessment of Systemic Sclerosis-Associated Raynaud's Phenomenon (ASRAP) and 10-item short-form (ASRAP-SF) questionnaires. The relationship between ASRAP questionnaires and demographics, clinical phenotype and legacy instruments for assessing SSc-RP severity, disability and pain was assessed.

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We document a case of a transient global amnesia (TGA)-like syndrome following open water swimming. This case was atypical for TGA, in that symptoms were prolonged and ischaemic infarct was considered within the differential. MRI did not demonstrate any changes associated with acute ischaemia although did show a mild degree of small vessel change.

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Background: medical education must adapt to meet the challenges and demands of an ageing population, ensuring that graduates are equipped to look after older patients with complex health and social care needs. Recommended curricula in geriatric medicine in the United Kingdom and Europe offer guidance for optimal undergraduate education in ageing. The UK version, written by the British Geriatrics Society (BGS), requires updating to take account of innovations in the specialty, changing guidance from the General Medical Council (GMC), and the need to support medical schools preparing for the introduction of the national Medical Licensing Assessment (MLA).

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Left ventricular assessment with artificial intelligence increases the diagnostic accuracy of stress echocardiography.

Eur Heart J Open

September 2022

Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.

Aims: To evaluate whether left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), automatically calculated by artificial intelligence (AI), increases the diagnostic performance of stress echocardiography (SE) for coronary artery disease (CAD) detection.

Methods And Results: SEs from 512 participants who underwent a clinically indicated SE (with or without contrast) for the evaluation of CAD from seven hospitals in the UK and US were studied. Visual wall motion scoring (WMS) was performed to identify inducible ischaemia.

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Assessment of the Systemic Sclerosis-Associated Raynaud's Phenomenon Questionnaire: Item Bank and Short-Form Development.

Arthritis Care Res (Hoboken)

August 2023

Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust, Bath, UK, and North Bristol NHS Trust and University of Bristol, Bristol, UK.

Objective: To develop, refine, and score a novel patient-reported outcome instrument to assess the severity and impact of Raynaud's phenomenon (RP) in systemic sclerosis (SSc).

Methods: The Assessment of Systemic Sclerosis-Associated Raynaud's Phenomenon (ASRAP) questionnaire items were developed with patient insight partner support and grounded in the lived patient experience of SSc-RP. ASRAP items underwent formal qualitative assessment and linguistic testing.

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Diet and irritable bowel syndrome: an update from a UK consensus meeting.

BMC Med

September 2022

Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.

There has been a renewed interest in the role of dietary therapies to manage irritable bowel syndrome (IBS), with diet high on the agenda for patients. Currently, interest has focussed on the use of traditional dietary advice (TDA), a gluten-free diet (GFD) and the low FODMAP diet (LFD). A consensus meeting was held to assess the role of these dietary therapies in IBS, in Sheffield, United Kingdom.

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The World Health Organization (WHO) advocates investment in high-quality undergraduate education in geriatric medicine as a means of meeting the future needs of the aging population. However, there is a lack of evidence for the optimal delivery of training in this area. Rigorous pedagogical research is required to determine the most effective way to equip tomorrow's doctors with the skills and knowledge to care for older adults with complex health and social care needs.

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Reply.

Arthritis Care Res (Hoboken)

February 2023

Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust, and University of Bath, Bath, UK.

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The human skin can be affected by a multitude of diseases including inflammatory conditions such as atopic dermatitis and psoriasis. Here, we describe how skin barrier integrity and immunity become dysregulated during these two most common inflammatory skin conditions. We summarise recent advances made in the field of the skin innate immune system and its interaction with adaptive immunity.

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Physical activity (PA) is a primary non-pharmacological treatment option for those living with rheumatoid arthritis (RA) and spondyloarthritis (SpA). The aim of this systematic literature review was to summarize and present an updated synthesis of the factors associated with PA in the RA and SpA populations. A tailored search of PubMed (inc.

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Background: Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification.

Objective: We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams.

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Objective: To explore mortality outcome usage in Cochrane systematic reviews and Core Outcome Sets for research.

Study Design And Setting: Cochrane PICO searches identified Cochrane reviews (published January 2015-March 2021) including mortality outcomes. These outcomes were categorized according to terminology used: all-cause mortality, cause-specific mortality, infant mortality, maternal mortality, survival.

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