532 results match your criteria: "Watford General Hospital.[Affiliation]"

Bridging Distances and Enhancing Care: A Comprehensive Review of Telemedicine in Surgery.

Cureus

December 2024

Colorectal Surgery, Torbay and South Devon NHS Foundation Trust, Torbay, GBR.

Telemedicine in surgical care has undergone rapid advancements in recent years, leveraging technologies such as telerobotics, artificial intelligence (AI) diagnostics, and wearable devices to facilitate remote evaluation and monitoring of patients. These innovations have improved access to care, reduced costs, and enhanced patient satisfaction. However, significant challenges remain, including technical barriers, limited tactile feedback in telesurgery, and inequities arising from digital literacy and infrastructure gaps.

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Background and objective Hand numbness, often associated with carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CuTS), significantly impacts the quality of life. This study aimed to evaluate the effectiveness of combined carpal and cubital tunnel decompression (CCTD) in patients with concurrent mild to moderate cervical spine stenosis when compared to single decompression procedures. Methods We retrospectively reviewed the records of 100 patients who underwent decompression surgery for hand numbness and concurrent cervical spine stenosis, with positive electromyography (EMG) results in some cases, between January 1, 2023, and January 1, 2024.

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Article Synopsis
  • - Recent improvements in image-guided tissue sampling, like CT, US, and MRI-guided biopsies, are enhancing diagnostics in oncology by targeting tissue characteristics effectively.
  • - New methods like fusion imaging and technologies such as molecular breast imaging and shear wave elastography are being explored, but ultrasound remains favored for its cost-effectiveness and ease of use.
  • - Innovations in biopsy techniques, including augmented reality and robotic assistance, are promising, yet further research and overcoming cost and access issues are necessary for broader implementation.
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Retinal arteriovenous malformations (AVMs) are rare congenital, nonhereditary vascular anomalies of the retina. We report the case of a 6-year-old child presenting with recurrent frontal headaches. Funduscopy examination revealed an AVM in the right eye, inferior to the optic nerve head.

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Article Synopsis
  • - The ATTEST-2 trial evaluated if tenecteplase, a newer thrombolytic agent, is at least as effective as the standard alteplase within 4.5 hours of an acute ischaemic stroke by comparing outcomes like the modified Rankin Scale (mRS) at 90 days post-treatment.
  • - Conducted across 39 UK stroke centers, the study randomly assigned 1,777 eligible stroke patients to receive either tenecteplase or alteplase, focusing on their recovery outcomes and safety, including complications such as bleeding.
  • - Results showed that tenecteplase was non-inferior to alteplase regarding the distribution of mRS scores, but it did not
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Article Synopsis
  • * A thorough development process included interviews with families and staff, a two-round Delphi survey, and consensus meetings involving 169 participants from 12 countries, identifying essential outcomes for future trials.
  • * Six key outcomes were agreed upon, which include measures of delirium occurrence, distress, severity, cognition, hospital admissions, and mortality, and the COS was endorsed by major delirium associations for use in upcoming research.
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Introduction: Robotic-assisted surgery (RAS) is one of the most influential surgical advances with widespread clinical and health-economic benefits. West Hertfordshire Teaching Hospital NHS Trust was the first in the UK to simultaneously integrate two CMR Surgical Versius robots. This study aims to investigate clinical outcomes of RAS, explore surgeon learning curves and assess the feasibility of implementation within a district general hospital (DGH).

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Background Laparoscopic sleeve gastrectomy (LSG) has become a widely accepted bariatric procedure for treating morbid obesity and associated comorbidities due to its relatively straightforward technique and positive outcomes in terms of weight loss and metabolic improvement. Objective To investigate the frequency and types of early complications following LSG using four ports. Methods This prospective observational study was conducted at Al Hadi International Hospital, Swabi, Pakistan, from January 2022 to December 2022.

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Background: We describe a case of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in a 16-year-old patient who initially presented with clinical features of septic meningoencephalitis. This case outlines the importance of considering a diagnosis of MOGAD in patients who fail to improve with appropriate antimicrobial therapy or show a positive clinical response to glucocorticoids (often used in treatment of meningococcal meningitis). We emphasise the importance of recognising that an infectious prodrome can precede MOGAD.

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Introduction: Approximately 20 % of femoral fragility fracture patients take anticoagulants, typically warfarin or Direct Oral AntiCoagulant (DOAC). These can impact timing of surgery affecting patient survival. Due to several possible approaches and numerous factors to consider in the preoperative workup of anticoagulated patients, potential for variations in clinical practice exist.

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  • This study examines the link between clinical and imaging features with hormonal subtypes, growth, and surgical treatment of incidental adrenal cortical adenomas (ACAs) in a cohort of patients from 2000 to 2016.
  • Out of 1516 patients, various hormonal subtypes were identified, with factors like age, sex, and tumor size influencing these subtypes, while imaging measures like Hounsfield units (HU) were not significant predictors.
  • The findings indicate younger age, larger tumor size, and increased growth were associated with a higher likelihood of needing adrenalectomy, especially for patients with mild autonomous cortisol secretion (MACS) and nonfunctioning adenomas (NFAs).
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Aim: To evaluate the impact of denosumab on (i) the incidence of type 2 diabetes (T2D), and (ii) long-term health outcomes (microvascular [neuropathy, retinopathy, nephropathy] and macrovascular [cardiovascular disease, cerebrovascular accident] complications, and all-cause mortality) in patients with T2D, before (iii) combining results with prior studies using meta-analysis.

Methods: A retrospective analysis of data in a large global federated database (TriNetX; Cambridge, MA) was conducted from 331 375 patients, without baseline T2D or cancer, prescribed either denosumab (treatment, n = 45 854) or bisphosphonates (control, n = 285 521), across 83 healthcare organizations. Propensity score matching (1:1) of confounders was undertaken that resulted in 45 851 in each cohort.

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Gastrocnemius Release in the Treatment of Achilles Tendinopathy: A Systematic Review.

Indian J Orthop

May 2024

West Hertfordshire Teaching Hospitals NHS Trust, Trauma and Orthopaedic Surgery Department, Watford General Hospital, Vicarage Road, Watford, WD18 0HB UK.

Background: The aim of this study is to evaluate the use of isolated gastrocnemius release in the treatment of Achilles tendinopathy. The primary outcome is the change in patient-reported pain outcomes. Secondary outcomes include the change in patient-reported foot and ankle function, ankle range of motion and strength, patient satisfaction and rate of surgical complications.

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Background: Both anastomotic leak (AL) and conduit necrosis (CN) after oesophagectomy are associated with high morbidity and mortality. Therefore, the identification of preoperative, modifiable risk factors is desirable. The aim of this study was to generate a risk scoring model for AL and CN after oesophagectomy.

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Background: Apical ground-glass opacification (GGO) identified on CT angiography (CTA) performed for suspected acute stroke was developed in 2020 as a coronavirus-disease-2019 (COVID-19) diagnostic and prognostic biomarker in a retrospective study during the first wave of COVID-19.

Objective: To prospectively validate whether GGO on CTA performed for suspected acute stroke is a reliable COVID-19 diagnostic and prognostic biomarker and whether it is reliable for COVID-19 vaccinated patients.

Methods: In this prospective, pragmatic, national, multi-center validation study performed at 13 sites, we captured study data consecutively in patients undergoing CTA for suspected acute stroke from January-March 2021.

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The impact of anticoagulant medications on fragility femur fracture care: The hip and femoral fracture anticoagulation surgical timing evaluation (HASTE) study.

Injury

June 2024

South Tees Hospitals NHS Foundation Trust, Middlesbrough, TS4 3BY, UK; University of Teesside, Middlesbrough, TS1 3BX, UK; University of York, York, YO10 5DD, UK.

Introduction: Due to their hypocoagulable state on presentation, anticoagulated patients with femoral fragility fractures typically experience delays to surgery. There are no large, multicentre studies previously carried out within the United Kingdom (UK) evaluating the impact of anticoagulant use in this patient population. This study aimed to evaluate the current epidemiology and compare the perioperative management of anticoagulated and non-anticoagulated femoral fragility fracture patients.

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Background: Emergency laparotomy is a commonly performed surgical procedure that has higher post-operative morbidity and mortality than elective surgery. Previous research has identified that patients valued postoperative quality of life (QoL) more than the risk of mortality when deciding to undergo emergency surgery. Current pre-operative scoring and risk stratification systems for emergency laparotomy do not account for or provide prediction tools for post-operative QoL.

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Delirium is common in hospitalised patients, and there is currently no specific treatment. Identifying and treating underlying somatic causes of delirium is the first priority once delirium is diagnosed. Several international guidelines provide clinicians with an evidence-based approach to screening, diagnosis and symptomatic treatment.

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Article Synopsis
  • Thiamine di-phosphate plays a crucial role in processes related to glucose metabolism and brain function, which are linked to delirium; the study explored how thiamine deficiency and intravenous supplementation could affect delirium in intensive care patients.
  • The researchers analyzed two datasets: one from a 2017 study of 57 patients and another involving 3,074 patients before and after a thiamine supplementation protocol was introduced.
  • The findings showed no significant link between thiamine levels and delirium incidence, and although there was an increase in thiamine supplementation leading to a slight reduction in delirium, this was not statistically significant, indicating the need for more extensive clinical trials.
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Study Design: Bibliometric analysis.

Objectives: This study aimed to highlight the 200 most influential articles related to traumatic spinal cord and spinal column injuries and provide an insight of past and current global trends in spinal trauma research.

Methods: The Web of Science database was used to identify the top 200 most cited articles on the topic of traumatic spinal cord injury (SCI) and spinal column injuries between using a prespecified algorithm.

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Background: To determine whether there is any difference in graft rerupture rates and clinical outcomes between cases having vancomycin graft presoaking vs. no vancomycin presoaking in anterior cruciate ligament (ACL) reconstruction (ACLR).

Methods: Systematic review and meta-analysis.

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