The resistance to failure of spring ligament reconstruction.

Introduction: The spring ligament (SL) is increasingly recognised as the major structure that fails in acquired adult flatfoot deformity (AAFD). This is the first study that demonstrates integrity of repair of the SL.

Patients And Methods: Six pairs of fresh frozen cadavers were setup in a standardised fashion with ankle in plantargrade (mean age 59 years, BMI 25).

Central pathology review with two-stage quality assurance for pathological response after neoadjuvant chemotherapy in the ARTemis Trial.

The ARTemis Trial tested standard neoadjuvant chemotherapy±bevacizumab in the treatment of HER2-negative early breast cancer. We compare data from central pathology review with report review and also the reporting behavior of the two central pathologists. Eight hundred women with HER2-negative early invasive breast cancer were recruited.

Trastuzumab-associated cardiac events in the Persephone trial.

Background: We report cardiac events in the Persephone trial which compares 6-12 months of adjuvant trastuzumab in women with confirmed HER2-positive, early-stage breast cancer.

Methods: Clinical cardiac events were defined as any of the following: symptoms and/or signs of congestive heart failure (CHF) and new or altered CHF medication. In addition, left ventricular ejection fraction (LVEF) was measured at baseline and then 3 monthly for 12 months.

New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study.

Background: Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs.

Objective: To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC).

Methods: Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study.

Concise Care Bundles In Acute Medicine.

The Queen Elizabeth Hospital in King's Lynn, Norfolk is a 488 bed hospital providing services to approximately 331,000 people across 750 square miles. In 2012 a need was recognised for documentation (pathways) in a practical format to increase usage of national guidelines and facilitate adherence to best practice (gold standards of care) that could be easily version controlled, auditable and provide support in clinical decision-making by junior doctors. BMJ Action Sets[1] fulfilled the brief with expert knowledge, version control and support, though they were deemed too lengthy and unworkable in fast paced settings like the medical assessment unit; they formed the base creation of concise care bundles (CCB).

Assessing fatigue in inflammatory bowel disease: comparison of three fatigue scales.

Background: Fatigue is commonly reported by patients with inflammatory bowel disease (IBD), both in quiescent and active disease. Few fatigue scales have been tested in IBD.

Aim: To assess three fatigue assessment scales in IBD and to determine correlates of fatigue.

Development and psychometric testing of inflammatory bowel disease fatigue (IBD-F) patient self-assessment scale.

Background And Aims: Fatigue is one of the main symptoms of inflammatory bowel disease (IBD) and is frequently reported by people in both active and quiescent disease. Many different fatigue assessment scales have been used to measure fatigue, but none has been developed or tested in IBD. This study aimed to develop a fatigue scale specific to the needs and experiences of people with IBD.

Healthcare professionals' perceptions of fatigue experienced by people with IBD.

Background And Aims: Fatigue is one of the top complaints of people with inflammatory bowel disease (IBD); however this is often not addressed in clinical consultations. This study aimed to gain an understanding of healthcare practitioners' (HCPs) perception of IBD fatigue as experienced by people with IBD.

Methods: Descriptive phenomenology was conducted with 20 HCPs who work with people with IBD.

Changing transfusion practice in total hip arthroplasty: observational study of the reduction of blood use over 6 years.

Patients undergoing primary total hip arthroplasty (THA) have historically been over-transfused. In a district general hospital setting, the authors observed a significant downward trend in blood transfusion requirements in these patients over 6 years after a change in transfusion policy. The purpose of this study was to retrospectively analyze the change in transfusion practice and present the results of the restrictive transfusion policy.

An alternative method for predicting size of femoral component of Oxford partial knee replacement.

Background: No direct intra-operative measurement to determine the ideal size of the femoral component of Oxford unicompartmental knee replacement (UKR) is currently present. The aim of this study is to assess the accuracy of patients' shoe size as a predictor of femoral component size.

Methods: A retrospective study was conducted to identify the correlation between patients' shoe size (British system) and the femoral component size.

Assessing nurses' ability to classify pressure ulcers correctly.

Reduction of pressure ulcers is a key government target, with particular emphasis on the more serious category 3 and 4 ulcers. An audit using photographs of pressure ulcers identified that nurses could correctly classify pressure ulcers 56% of the time using the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel classification system. An intensive training programme resulted in an increase in accuracy of grading pressure ulcers to 62%.

Enteroviral meningoencephalitis in a patient with non-Hodgkin's lymphoma treated previously with rituximab.

A 75-year-old man, with a long history of recurrent lymphoplasmacytoid lymphoma, presented with diffuse large-cell lymphoma affecting adrenal glands and causing severe hypoadrenalism. The lymphoma responded to rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) chemotherapy. Seven months postcompletion of chemotherapy, he developed signs of gastroenteritis and septicaemia.