Use of the MMRI-R prognostic tool for older patients discharged to nursing homes from hospital: a prospective cohort study.

Background: the Minimum Dataset Mortality Risk Index-Revised (MMRI-R) is a prognostic score predicting 6-month mortality in US nursing homes. It has not been validated in the UK nor at the hospital-nursing home interface.

Methods: prospective cohort study of consecutive patients discharged from hospital or intermediate care to nursing homes from January 2012 to January 2014.

Access site practice and procedural outcomes in relation to clinical presentation in 439,947 patients undergoing percutaneous coronary intervention in the United kingdom.

Objectives: This study sought to determine the relationships among access site practice, clinical presentation, and procedural outcomes in a large patient population.

Background: Transradial access (TRA) has been associated with improved patient outcomes in selected populations in randomized trials. It is unclear whether these outcomes are achievable in clinical practice.

Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study.

It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS).

Evaluating the efficacy of thoracoscopy and talc poudrage versus pleurodesis using talc slurry (TAPPS trial): protocol of an open-label randomised controlled trial.

Introduction: The management of recurrent malignant pleural effusions (MPE) can be challenging. Various options are available, with the most efficacious and widely used being talc pleurodesis. Talc can either be applied via a chest drain in the form of slurry, or at medical thoracoscopy using poudrage.

Differentiated thyroid cancer and pregnancy.

Thyroid cancer is second most common malignancy diagnosed during pregnancy. Differentiated thyroid cancer (DTC) is more common in reproductive age group due to its association with oestrogen and human chorionic gonadotropin. Evaluation and management of DTC has changed from an aggressive approach, now, to a more conservative approach.

Noise-induced hearing loss in small-scale metal industry in Nepal.

Background: There has been no previous research to demonstrate the risk of noise-induced hearing loss in industry in Nepal. Limited research on occupational noise-induced hearing loss has been conducted within small-scale industry worldwide, despite it being a substantial and growing cause of deafness in the developing world.

Method: The study involved a cross-sectional audiometric assessment, with questionnaire-based examinations of noise and occupational history, and workplace noise level assessment.

Accelerated development of mesenteric and renal artery calcific atherosclerosis following radiotherapy for testicular cancer.

We present a case of a 61-year-old male presenting with post-prandial epigastric pain and marked weight loss. Investigation revealed calcific atherosclerosis of the abdominal aorta, coeliac axis, superior mesenteric (SMA) and renal arteries. He had undergone radiotherapy for testicular teratoma 34 years previously.

An unusual presentation of thoracoacromial artery pseudoaneurysm following shoulder arthroplasty.

Pseudoaneurysms of peripheral arteries are not an uncommon condition presenting to vascular surgeons. Perioperative injury and infection are two of the commonest causes. We describe a case of an 82-year-old lady, who presented 10 years following right shoulder joint replacement, with a sharply marginated erythematous cutaneous eruption over the right shoulder.

Patient characteristics and risk of subsequent contralateral hip fracture after surgical management of first fracture.

Background: Sequential hip fractures are associated with increased morbidity and mortality. Understanding of risk factors is important for secondary prevention. Although hip fractures have a multifactorial aetiology related to falls, it is unknown whether fracture management approach influences the risk of sequential hip fractures.

Arterial access site utilization in cardiogenic shock in the United Kingdom: is radial access feasible?

Background: Cardiogenic shock (CS) remains the leading cause of mortality in patients hospitalized with acute myocardial infarction (AMI). The transradial access site (TRA) has become increasingly adopted as a default access site for percutaneous coronary intervention (PCI); however, even in experienced centers that favor the radial artery as the primary access site during PCI, patients presenting in CS are often treated via the transfemoral access site (TFA); and commentators have suggested that CS remains the final frontier that has given even experienced radial operators pause. We studied the use of TRA in patients presenting in CS in a nonselected high-risk cohort from the British Cardiovascular Intervention database over a 7-year period (2006-2012).

Pleural procedures and patient safety: a national BTS audit of practice.

The BTS pleural procedures audit collected data over a 2-month period in June and July 2011. In contrast with the 2010 audit, which focussed simply on chest drain insertions, data on all pleural aspirations and local anaesthetic thoracoscopy (LAT) was also collected. Ninety hospitals submitted data, covering a patient population of 33 million.

Salpingo-ureteric fistula-A rare complication following laparoscopic surgery for colorectal cancer: A case report and literature review.

Introduction: We report the management and outcome of the case of a 57-year old woman with adenocarcinoma of the rectum. Following neo-adjuvant chemo-radiotherapy and laparoscopic-assisted anterior resection of her tumour she developed a right salpingo-ureteric fistula.

Presentation Of Case: Three weeks following laparoscopic anterior resection of the tumour she presented with urinary frequency and incontinence.

X-linked dyskeratosis congenita presenting in adulthood with photodamaged skin and epiphora.

Dyskeratosis congenita (DC) is a clinically and genetically heterogeneous multisystem bone marrow failure disorder of telomere maintenance, which may present with dermatological features. The main cause of mortality is bone marrow failure, often developing in the second decade of life, although pulmonary disease and malignancies such as squamous cell carcinomas (SCCs) may also prove fatal. We report the case of a 28-year-old man with X-linked DC and confirmed DKC1 gene mutation.

Validation of open inguinal hernia repair simulation model: a randomized controlled educational trial.

Background: A hernia repair open surgical simulation computer software was developed at Imperial College London. A randomized controlled educational trial was conducted to investigate the benefit of the simulation on the development of procedural knowledge.

Methods: Medical students in their clinical years were invited to participate in the trial.

Improving management of severe sepsis and uptake of sepsis resuscitation bundle in an acute setting.

Severe sepsis still remains a major cause of morbidity and mortality, claiming between 36,000 to 64,000 lives annually in the UK, with a mortality rate of 35%.[1,2] The project aims to measure the management of severely septic patients in acute medical unit (AMU) in a district general hospital against best practice guidelines, before and after a set of interventions aiming to optimise patient management and outcomes. All new admissions who met the criteria for sepsis in AMU over a two week period were evaluated.

Effects of tea consumption on renal function in a metropolitan Chinese population: the Guangzhou biobank cohort study.

Objective: Green tea consumption has been associated with many prophylactic health benefits. This study examined for the first time associations between tea consumption and renal function in a Chinese population.

Design And Methods: Cross-sectional baseline data including demographics, and lifestyle and weekly consumption of green, black, and oolong tea were analyzed from 12,428 ambulatory subjects aged 50 to 85 years (67.

Has integrated 18F FDG PET/CT improved staging, reduced early recurrence or increased survival in oesophageal cancer?

Background: Survival in oesophageal cancer remains poor with high post-operative recurrence rates. PET/CT was introduced to the Three-Counties Cancer Network (3CCN) in 2006 to detect 'occult' metastatic disease not seen with conventional staging modalities. This study aims to determine whether the introduction of Integrated fluorodeoxyglucose (18F) Positron Emission Tomography (PET/CT) has changed the management, improved survival or reduced the rate of early post-operative recurrence in patients with operable oesophageal cancer.