The UK Foot and Ankle COVID-19 National (FAlCoN) audit.

Aims: The primary objective was to determine the incidence of COVID-19 infection and 30-day mortality in patients undergoing foot and ankle surgery during the global pandemic. Secondary objectives were to determine if there was a change in infection and complication profile with changes introduced in practice.

Methods: This UK-based multicentre retrospective national audit studied foot and ankle patients who underwent surgery between 13 January and 31 July 2020, examining time periods pre-UK national lockdown, during lockdown (23 March to 11 May 2020), and post-lockdown.

Non-sebaceous lymphadenoma of the submandibular gland: diagnostic challenges in the head and neck cancer pathway.

Non-sebaceous lymphadenoma (NSLA) is a rare benign salivary gland tumour with lymphoid and epithelial components and without sebaceous differentiation. The large majority of the reported cases arise within the parotid gland. We present an NSLA arising from the submandibular gland.

Yoga and Cardiovascular Health Trial (YACHT): a UK-based randomised mechanistic study of a yoga intervention plus usual care versus usual care alone following an acute coronary event.

Objective: To determine the effects of yoga practice on subclinical cardiovascular measures, risk factors and neuro-endocrine pathways in patients undergoing cardiac rehabilitation (CR) following acute coronary events.

Design: 3-month, two-arm (yoga +usual care vs usual care alone) parallel randomised mechanistic study.

Setting: One general hospital and two primary care CR centres in London.

Surrendering control, or nothing to lose: Parents' preferences about participation in a randomised trial of childhood strabismus surgery.

Background: Intermittent exotropia is the most common form of divergent strabismus (squint) in children. Evidence regarding its optimum management is limited. A pilot randomised controlled trial has recently been completed (Surgery versus Active Monitoring in Intermittent Exotropia trial) to determine the feasibility of a full randomised controlled trial.

Nicorandil-induced leg ulceration without mucosal involvement.

We report a case of leg ulceration occurring in a patient without mucosal ulcers, in whom nicorandil appeared to be the main aetiological factor. Having failed to heal on compression therapy, the ulcer rapidly improved and healed after the discontinuation of nicorandil. Most cases of nicorandil-induced ulcers reported in the literature develop on mucosal surfaces, including oral, vulval, perianal and peristomal ulcers.

Physiotherapeutic management strategies for the treatment of cystic fibrosis in adults.

Physiotherapy has long been considered a cornerstone of condition management for people with cystic fibrosis (CF). The presentation of CF has changed over time with an increased life expectancy and increased expectations of people with CF to have a complete lifestyle. In turn, the scope of strategies used in physiotherapy for CF have also changed dramatically over the years, moving away from routine postural drainage and manual techniques toward an individualized regimen including the choice of many different forms of airway clearance, such as both independent and assisted, exercise, treatments to promote continence and good posture, inhalation therapy, oxygen, and noninvasive ventilation.

Promoting safe administration of subcutaneous infusions.

Despite the many benefits of subcutaneous therapy, this route is less commonly used in general patients than the intravenous route. The authors discuss safe practice for subcutaneous infusions, including anatomical sites, guidelines for insertion and patient care.

The care home activity project: does introducing an occupational therapy programme reduce depression in care homes?

The primary aim of the study was to test the hypothesis that depression severity in care homes for older people would be reduced by an occupational therapy programme. This was a feasibility study for a cluster randomised controlled trial and involved four intervention and four control homes in northern England. In each intervention home a registered occupational therapist worked full-time for one year delivering an individualised programme to participants.

Guidance for first-line treatment of anogenital gonorrhoea infection.

Gonorrhoea is currently the second most common bacterial sexually transmitted infection in England and Wales (Public Health Laboratory Service, 2002). Early initiation of treatment is important in the reduction of the onward transmission of infection and contributes to the overall control of the spread of gonorrhoea. A central tenet of this is the use of effective antimicrobial treatment.

The choice, application and review of topical treatments for skin conditions.

Topical treatments are essential in the management of skin conditions. However, for the nurse working outside the specialty of dermatology, knowing exactly what topical treatment to use, and where and when to apply it, can be extremely daunting.

Make the right choice of vascular access device.

Patients may require the insertion of an intravenous line for a range of reasons, from blood sampling to total parenteral nutrition. This review looks at the range of vascular access devices available and examines the criteria that must be considered when selecting devices, to ensure that the therapeutic and personal needs of the patient are fully met.

How workshops can support health staff helping patients move to insulin therapy.

The need to start insulin therapy for patients with Type 2 diabetes marks a significant turning point in disease progression. It can be an anxious time for patients, who may fear the thought of insulin treatment. This paper looks at a model of insulin initiation in primary care, with an emphasis on patient self-management.

Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital.

Objective: The purpose of the study was to investigate the effects of introducing a critical care outreach service on in-hospital mortality and length of stay in a general acute hospital.

Design: A pragmatic ward-randomised trial design was used, with intervention introduced to all wards in sequence. No blinding was possible.