Simultaneous Bilateral Patellar Tendon Rupture: A Systematic Review.

The extensor mechanism of the knee can be damaged due to various modes of injury, which, in most cases, will require urgent surgical intervention for repair. Single patellar tendon ruptures are uncommon, but simultaneous bilateral events are even rarer and have been scarcely reviewed in English literature. Research in this area is mainly confined to case series, with some literature reviews but no evidence of more substantial analysis.

Source imaging of seizure onset predicts surgical outcome in pediatric epilepsy.

Objective: To assess whether ictal electric source imaging (ESI) on low-density scalp EEG can approximate the seizure onset zone (SOZ) location and predict surgical outcome in children with refractory epilepsy undergoing surgery.

Methods: We examined 35 children with refractory epilepsy. We dichotomized surgical outcome into seizure- and non-seizure-free.

Presurgical accuracy of dipole clustering in MRI-negative pediatric patients with epilepsy: Validation against intracranial EEG and resection.

Objective: To assess the utility of interictal magnetic and electric source imaging (MSI and ESI) using dipole clustering in magnetic resonance imaging (MRI)-negative patients with drug resistant epilepsy (DRE).

Methods: We localized spikes in low-density (LD-EEG) and high-density (HD-EEG) electroencephalography as well as magnetoencephalography (MEG) recordings using dipoles from 11 pediatric patients. We computed each dipole's level of clustering and used it to discriminate between clustered and scattered dipoles.

Axillary staging in ductal carcinoma in situ with microinvasion: A meta-analysis.

Introduction: Ductal carcinoma in situ with microinvasion (DCISM); arguably a more aggressive subtype of DCIS, currently has variable recommendations governing its staging and management in the UK. As a result, there is ongoing controversy surrounding the most appropriate management of DCISM, in particular the need of axillary staging.

Method: A search was conducted on the databases MEDLINE and Embase using the keywords: breast, DCISM, microinvasion, "ductal carcinoma in situ with microinvasion", sentinel lymph node biopsy, SLNB, axillary staging was performed.

Instagram: A platform for ultrasound education?

Introduction: Social media has become an integral part of our daily life with 38 million users in the UK alone and the average user being logged-in for 135 minutes daily. Social media is increasingly used to disseminate learning in a variety of fields including medicine.

Objectives: The aim of this study was to assess the proportion of Instagram posts using #ultrasound for educational content and compare this with #radiology.

Ictal and interictal source imaging on intracranial EEG predicts epilepsy surgery outcome in children with focal cortical dysplasia.

Objective: To localize the seizure onset zone (SOZ) and irritative zone (IZ) using electric source imaging (ESI) on intracranial EEG (iEEG) and assess their clinical value in predicting epilepsy surgery outcome in children with focal cortical dysplasia (FCD).

Methods: We analyzed iEEG data from 25 children with FCD-associated medically refractory epilepsy (MRE) who underwent surgery. We performed ESI on ictal onset to localize SOZ (ESI-SOZ) and on interictal discharges to localize IZ (ESI-IZ).

An unusual case of bilateral anterior opercular syndrome from a neuro-rehabilitation perspective.

Bilateral anterior opercular syndrome, also known as Foix-Chavany-Marie syndrome, is relatively rare and is characterized by inability of voluntary activation of facial, lingual, pharyngeal, and masticatory muscles with preserved automatic and reflex movements such as smiling and yawning. The syndrome is caused by bilateral lesions of the anterior opercula and results in severe impairments with speech and swallowing. This article describes a patient with bilateral anterior opercular syndrome secondary to embolic strokes and how neuro-rehabilitation improved symptoms.

STAMP: a continuous improvement approach to improve paediatric prescribing and medication safety.

We describe an ongoing quality improvement project focusing on paediatric prescribing and medication safety for medical, surgical and oncology patients in a district general hospital. The project is called STAMP-Safe Treatment and Administration of Medicine in Paediatrics. The project has been running continuously for 24 months.

Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease.

Background: Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference.

Minimally invasive and targeted therapeutic cell delivery to the skin using microneedle devices.

Background: Translation of cell therapies to the clinic is accompanied by numerous challenges, including controlled and targeted delivery of the cells to their site of action, without compromising cell viability and functionality.

Objectives: To explore the use of hollow microneedle devices (to date only used for the delivery of drugs and vaccines into the skin and for the extraction of biological fluids) to deliver cells into skin in a minimally invasive, user-friendly and targeted fashion.

Methods: Melanocyte, keratinocyte and mixed epidermal cell suspensions were passed through various types of microneedles and subsequently delivered into the skin.

Sarcopenia and frailty in chronic respiratory disease.

Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field.

Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study.

Background: Frailty is an important clinical syndrome that is consistently associated with adverse outcomes in older people. The relevance of frailty to chronic respiratory disease and its management is unknown.

Objectives: To determine the prevalence of frailty among patients with stable COPD and examine whether frailty affects completion and outcomes of pulmonary rehabilitation.

Calculating the hip center of rotation using contralateral pelvic anatomy.

Failure to place an artificial hip in the optimal center of rotation results in poor hip function and costly complications. The aim of this study was to develop robust methodology to estimate hip center of rotation (hCoR) from preoperative computed tomography (CT) scans, using contralateral anatomy, in patients with unilateral diseased hips. Ten patients (five male, five female) with normal pelvic anatomy, and one patient with a unilateral dysplastic acetabulum were recruited from the London Implant Retrieval center image bank.

Gait speed and readmission following hospitalisation for acute exacerbations of COPD: a prospective study.

Background: Hospitalisation for acute exacerbations of COPD is associated with high risk of readmission. However, no tool has been validated to stratify patients at discharge for risk of readmission.

Aim: To evaluate the ability of the 4 m gait speed (4MGS), a surrogate marker of frailty, to predict risk of future readmission in hospitalised patients with an acute exacerbation of COPD (AECOPD).

Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement.

There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service.

Minimum clinically important difference for the COPD Assessment Test: a prospective analysis.

Background: The COPD Assessment Test (CAT) is responsive to change in patients with chronic obstructive pulmonary disease (COPD). However, the minimum clinically important difference (MCID) has not been established. We aimed to identify the MCID for the CAT using anchor-based and distribution-based methods.

Development of a virtual reality training curriculum for phacoemulsification surgery.

Purpose: Training within a proficiency-based virtual reality (VR) curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR training curriculum for phacoemulsification surgery (PS).

Patients And Methods: Ten novice-(n) (performed <10 cataract operations), 10 intermediate-(i) (50-200), and 10 experienced-(e) (>500) surgeons were recruited.

The role of accessory product in patients with a stoma.

Intact skin provides a barrier between the body and its environment, and it follows that damage to the peristomal skin can be a significant problem for the person with a stoma. As many as one-third of colostomy patients and two-thirds of ileostomy and urostomy patients will be affected. Usage and opinions about accessory products in stoma care vary enormously and patients can identify accessory products as being necessary for their physical and psychological wellbeing.

Non-union of an undisplaced radial styloid fracture in a heavy smoker: revisiting the association of smoking and bone healing.

Isolated radial styloid fractures occur relatively infrequently, with non-union of such fractures, especially when undisplaced, being highly unusual. Smoking of tobacco, a common habit which is decreasing in prevalence in the developed world, has been proven to exert many adverse effects on tissue healing including bone union. We present a case of non-union of an undisplaced radial styloid fracture in the dominant hand of a young and healthy heavy smoker, emphasising the negative impact of tobacco smoke and its association with bone repair.