Tracking

Monday 22 June 2015

WUTH publication: Safety and performance evaluation of a next-generation antimicrobial dressing in patients with chronic venous leg ulcers. Posted: Related Articles Safety and performance evaluation of a next-generation antimicrobial dressing in patients with chronic venous leg ulcers

Citation: International Wound Journal. Int Wound J. 2016 Aug;13(4):442-8. Epub 2015 Jun 21.
Author: Harding KG, Szczepkowski M, Mikosiński J, Twardowska-Saucha K, Blair S, Ivins NM, Saucha W, Cains J, Peters K, Parsons D, Bowler P
Abstract: The objective of this study was to investigate the safety and performance of AQUACEL™ Ag+ dressing, a wound dressing containing a combination of anti-biofilm and antimicrobial agents, in the management of chronic wounds. Patients (n = 42) with venous leg ulcers exhibiting signs of clinical infection were treated for 4 weeks with AQUACEL™ Ag+ dressing, followed by management with AQUACEL™ wound dressings for 4 weeks. Wound progression, wound size, ulcer pain and clinical evolution of the wound were assessed for up to 8 weeks. Adverse events were recorded throughout the study. AQUACEL™ Ag+ dressing had an acceptable safety profile, with only one patient discontinuing from the study, because of a non-treatment-related adverse event. After 8 weeks, substantial wound improvements were observed: 5 patients (11·9%) had healed ulcers and 32 patients (76·2%) showed improvement in ulcer condition. The mean ulcer size had reduced by 54·5%. Patients reported less pain as the study progressed. Notable improvements were observed in patients with ulcers that were considered to require treatment with systemic antibiotics or topical antimicrobials at baseline (n = 10), with a mean 70·2% reduction in wound area. These data indicate that AQUACEL™ Ag+ dressing has an acceptable safety profile in the management of venous leg ulcers that may be impeded by biofilm.

Link to PubMed record

Friday 19 June 2015

WUTH publication: Management of Posterior Malleolar Fractures: A Systematic Review

Citation: Journal of Foot & Ankle Surgery. 2015 Jun 19
Author: Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S
Abstract: Posterior malleolar fractures are relatively common and usually result from rotational ankle injuries. Although treatment of associated lateral and medial structures is well established, several controversies exist in the management of posterior malleolus fractures. We performed a systematic review of the current published data with regard to the diagnosis, management, and prognosis of posterior malleolus fractures. A total of 33 studies (8 biomechanical and 25 clinical) with >950 patients were reviewed. The outcome of ankle fractures with posterior malleolar involvement was poor; however, the evidence was not enough to prove that the size of the posterior malleolus affects the outcome. Significant heterogeneity was noted in the cutoff size of the posterior malleolar fragment in determining management. The outcome was related to other factors, such as fracture displacement, congruency of the articular surface, and residual tibiotalar subluxation. Indirect evidence showed that large fracture fragments were associated with fracture dislocations and ankle instability and, thus, might require surgical fixation. We have concluded that the evidence to prove that the size of the posterior malleolar affects the outcome of ankle fractures is not enough, and the decision to treat these fractures should be determined by other factors, as stated previously.

Link to PubMed record

WUTH Publication: Longitudinal studies are required.


Citation: Longitudinal studies are required.
J R Soc Med. 2015 Jun;108(6):210
Authors: Ahmad N, Thomas GN, Gill P, Chan C, Torella F

PMID: 26085558 [PubMed - in process]

Link to Pubmed record

Wednesday 17 June 2015

WUTH Publication: Prophylactic balloon occlusion of the common iliac arteries for the management of suspected placenta accreta/percreta: conclusions from a short case series.

Citation: Prophylactic balloon occlusion of the common iliac arteries for the management of suspected placenta accreta/percreta: conclusions from a short case series.
Arch Gynecol Obstet. 2015 Feb;291(2):461-5
Authors: Minas V, Gul N, Shaw E, Mwenenchanya S
Abstract: PURPOSE: The management of women with abnormally invasive placenta remains one of the most challenging aspects of obstetric care. Various surgical and interventional radiological techniques have been developed to limit the risk of massive haemorrhage at caesarean section. Here we describe our experience with three such cases that required caesarean hysterectomy and were managed with prophylactic balloon catheterisation of the common iliac arteries. METHODS: The details of three cases that received prophylactic balloon catheterisation of the common iliac arteries for the surgical management of placenta accreta/percreta are presented. Observational conclusions from these cases as well as a review of the relevant literature are discussed. RESULTS: Our three cases required caesarean hysterectomy for suspected placenta accreta/percreta. The mean estimated blood loss was 3,333 ml. In one of the cases, we observed notable reduction in blood loss during occlusion of the common iliac arteries, as the balloons were deflated every 5 min to avoid lower limb ischemia. CONCLUSIONS: The cases presented here, and also our literature review, suggest that occlusion of the common iliac arteries appears to be more effective than, and as safe as the occlusion of the internal iliac arteries. Clinicians need to be aware of the potential risks and employ measures to prevent them. Further research is required to investigate the optimum length of occlusion and balance between reducing blood loss and risking ischemia of the limbs when occluding the common iliac arteries. PMID: 25178185 [PubMed - indexed for MEDLINE]

Link to PubMed record

Friday 5 June 2015

UpToDate mobile app

A new demonstration video is now available on the help section of the UpToDate website for downloading and using the mobile app.

UpToDate provides evidence based summaries of clinical topics covering more than 20 specialties, as well as nearly 1,500 patient information topics, and more than 27,000 graphics, tables and videos available to download into presentations.  Use UpToDate as a starting point to gain a comprehensive overview of your topic.

Find out more about UpToDate and how to access it here.

Wednesday 3 June 2015

WUTH Publication: Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability.

Citation: Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability.
Foot Ankle Int. 2015 Jun 1;
Authors: Odak S, Ahluwalia R, Shivarhatre DG, Mahmood A, Blucher N, Hennessy M, Platt S
Abstract: BACKGROUND: Anterolateral impingement associated with intra-articular synovitis, scarring, and fibrosis is a less recognized feature in patients with chronic lateral ankle instability. The aim of our study was to ascertain the incidence of intra-articular synovitis, osteochondral lesions (OCLs), impingement lesions (both intra- and extra-articular), and other associated pathologies in patients undergoing modified Broström-Gould ankle ligament reconstruction. METHODS: We performed a retrospective review of all patients who underwent arthroscopically assisted modified Broström-Gould ankle ligament reconstruction for symptomatic recurrent ankle instability. Patients who had previous ankle surgery or inflammatory arthropathy were excluded. Ankle arthroscopy was performed prior to reconstruction in all patients. Data were obtained from clinical and radiological records including magnetic resonance imaging scans. Arthroscopic findings were recorded in detail intraoperatively. A total of 100 patients (53 females and 47 males) with an average age of 37 years (range, 15-65 years) were reviewed over a 10-year period. RESULTS: Sixty-three patients (63%) had intra-articular synovitis mostly in the anterior and/or anterolateral compartment, which required arthroscopic debridement. Seventeen patients (17%) were found to have OCLs, and 12 (12%) patients had anterior bony impingement lesions. CONCLUSION: This study found a high incidence of anterior/anterolateral synovitis in patients with chronic lateral ankle instability. However, there was a relatively low incidence of anterior bony impingement lesions or OCLs in our series.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
PMID: 26031851 [PubMed - as supplied by publisher]

Link to Pubmed record

Medline and PsycInfo now fully functional

The Medline and PsycInfo databases available via NICE Evidence are now fully functional.  Work had taken place to update the databases which resulted in some limit options being unavailable.  All limts are now available in all databases.

You can access the databases by visiting www.evidence.nhs.uk and selecting 'Journals and databases'.


BMA One Day Courses

http://bma.org.uk/about-the-bma/bma-library/library-courses 
The BMA Library runs a number of different one day courses aimed at all health care professionals.                Each course costs £160+VAT for BMA Members and £320+VAT for non-members.

Understanding Medical Statistics Workshop
This course will cover basic statistical concepts as used in papers, such as confidence intervals and p-values and communicate about statistics, particularly about risk and measures of risks.
Monday, 9 March
Monday, 12 October
Monday, 7 December

Analysing Medical Statistics Workshop
This course will introduce basic statistical analysis that will help delegates to plan and undertake their research, covering sampling and sample size estimation.
The trainers strongly recommend that anybody considering this course should first attend the Understanding Statistics Workshop.
Tuesday, 10 March
Tuesday, 13 October
Tuesday, 8 December

Critical Appraisal Skills Basic Workshop
Intensive overview of the skills needed and resources available for critical appraisal, and will provide ideas on how these can be used on return to the workplace.
Thursday, 19 March
Friday, 5 June
Thursday, 17 September

Critical Appraisal Skills Extended Workshop
Interactive and practical with advanced tips and advice. Delegates must have basic knowledge of evidence-based healthcare and be aware of the main resources.
Friday, 20 March
Monday, 29 June
Friday, 18 September

Research Methods Workshop
Detailed overview of the main quantitative research methods, what they are, when and how each method is applied, and how the resulting data are analysed and interpreted.
Monday, 8 June
Friday, 26 June

If you have any queries about our courses please email the Library Administrator, Euphemia Abraham -
eabraham@bma.org.uk
Medline Bespoke Tutorial
We also offer an on-demand, by appointment only, one-to-one half day session to cover all the essentials of searching Medline using the OvidSP interface and can be tailored to your individual needs.
These tutorials are completely free for BMA Members. (The cost for Library Institutional Members is £80+VAT.)

To book a session please contact Helen Elwell on Tel: 020 7383 6582 or email:
helwell@bma.org.uk


Tuesday 2 June 2015

WUTH Publication: The treatment of penile carcinoma in situ (CIS) within a UK supra-regional network.

Citation: The treatment of penile carcinoma in situ (CIS) within a UK supra-regional network.
BJU Int. 2015 Apr;115(4):595-8
Authors: Lucky M, Murthy KV, Rogers B, Jones S, Lau MW, Sangar VK, Parr NJ
Abstract: OBJECTIVES: To review outcomes of the treatment of carcinoma in situ (CIS) of the penis at a large supra-regional penile cancer network, where centralisation has permitted greater experience with treatment outcomes, and suggest treatment strategies. PATIENTS AND METHODS: The network penile cancer database, which details presentation, treatment and complications was analysed from 2003 to 2010, identifying patients with CIS, with a minimum follow-up of 2 years, looking at treatments administered and outcomes. RESULTS: In all, 57 patients with mean (range) age of 61 (34-91) years were identified. In all, 18 were treated by circumcision only, 20 by circumcision and local excision (LE) and 19 by circumcision and 5-flurouracil (5-FU). The mean (range) follow-up was 3.5 (2-8) years. Of those treated by circumcision none subsequently developed CIS on the glans. For those who underwent circumcision + LE, five of 20 (25%) developed recurrence requiring further treatment. Of those treated by circumcision + 5-FU, 14/19 (73.7%) completely responded. Of the five incomplete responders, two had focal invasive malignancy at repeat biopsy. One incomplete responder underwent glansectomy and four grafting. No complete responders relapsed. Complications of 5-FU included significant inflammatory response in seven (36.8%), with two requiring hospital admission and one neo-phimosis (5.3%). CONCLUSION: This study suggests that patients undergoing circumcision for isolated CIS and complete responders to 5-FU may require only short-term follow-up, as recurrence is unlikely, whereas longer follow up is required for all other patients. However, numbers in this study are small and larger studies are needed to support this. An incomplete response to 5-FU dictates immediate re-biopsy, as it carries a significant chance of previously undetected invasive disease.
PMID: 25060513 [PubMed - indexed for MEDLINE]


Link to Pubmed record

WUTH Publication: Response to Dawson S, 'Blood culture contaminants', J Hosp Infect 2014, vol. 87, pp. 1-10.

Citation: Response to Dawson S, 'Blood culture contaminants', J Hosp Infect 2014, vol. 87, pp. 1-10.
J Hosp Infect. 2014 Oct;88(2):120
Authors: Shakeshaft M, Cunniffe J, Harvey D
PMID: 25218657 [PubMed - indexed for MEDLINE]

Link to Pubmed record

Monday 1 June 2015

WUTH Publication: Early triaging using the Modified Early Warning Score (MEWS) and dedicated emergency teams leads to improved clinical outcomes in acute emergencies.

Citation: Early triaging using the Modified Early Warning Score (MEWS) and dedicated emergency teams leads to improved clinical outcomes in acute emergencies.
Clin Med. 2015 Jun 1;15(Suppl 3):s3
Authors: Patel A, Hassan S, Ullah A, Hamid T, Kirk H
PMID: 26026024 [PubMed - as supplied by publisher]

Link to Pubmed record

WUTH Publication: Management of migrated intravesical staples post laparoscopic colposuspension.

Citation: Management of migrated intravesical staples post laparoscopic colposuspension.
Urol J. 2014 Jul-Aug;11(4):1853
Authors: Floyd MS, Hughes D, Kutarski PW
PMID: 25194092 [PubMed - indexed for MEDLINE]

Link to Pubmed record

2015-2016 training prospectus published

The WUTH training prospectus 2015-16 has been published, signposting a whole range of development opportunities for WUTH staff.  There are a wide range of courses available across the organisation, from clinical skills to leadership and manegement.

You'll find the library training sessions outlined on pages 78-80.  Our sessions will teach you to find, retrieve and appraise information gathered from an ever expanding range of health related resources (both print and electronic formats). Used effectively this information can help to change clinical practice, support continuing education, research, service development and business decision making in a health service that requires evidence based practice.