New Nursing journal bundle

All staff and students have access to a new collection of nursing and midwifery journals, which includes key titles such as the British Journal of Nursing, British Journal of Community Nursing, Nurse Prescribing, Journal of Wound Care and British Journal of Midwifery.

This new bundle complements our existing nursing and midwifery resources, which will help to keep you up to date with practice, support your continuing professional development, and help you to gather evidence for your Revalidation portfolio. 

To access this journal bundle you need an OpenAthens account, which will allow you to log in to the MAG online website from work or from home. 

WUTH publication: Takotsubo cardiomyopathy case series: typical, atypical and recurrence

Citation: BMJ Case Reports. 2015
Author: Lagan J, Connor V, Saravanan P
Abstract: Takotsubo cardiomyopathy (TCM) is characterised by a transient left ventricular (LV) dysfunction, ECG changes that can imitate acute myocardial infarction and positive cardiac biomarkers in the absence of obstructive coronary artery disease. The exact pathogenesis of TCM is unclear but emotional or physical stress is a common denominator. We present three cases encompassing a spectrum of the disease: A typical TCM with apical LV dyskinesis, an atypical TCM with mid-ventricular regions affected and a TCM recurrence. Our cases show that TCM symptoms vary between individuals and may vary in the same patient. All our patients reported acute emotional stress prior to the onset of symptoms, had LV systolic dysfunction, positive cardiac biomarkers and non-obstructed coronary arteries. In all cases, LV systolic dysfunction eventually improved. TCM may account for 0.7-2.5% of acute coronary syndromes. It is more prevalent in the female population and can reoccur. Treatment is mainly supportive

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Explore England's prescribing data

Explore Open Prescribing.
Every month, the NHS in England publishes anonymised data about the drugs prescribed by GPs. But the raw data files are large and unwieldy, with more than 600 million rows. We're making it easier for GPs, managers and everyone to explore - supporting safer, more efficient prescribing.

WUTH publication: Atrial fibrillation during pregnancy: cardioversion with flecainide

Citation: British Journal of Hospital Medicine. 2015, 76(12), 720-1
Author: Lewis G, Currie P

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WUTH publication: Tolerability and Adherence Problems in Patients on a Stable Dose of Methotrexate: Results of a Multicentre Survey

Citation: Musculoskeletal Care. 2016, 14(3), 152-5. Epub 2015 Dec 8
Author: Robinson S, Gibson S, George E, Martin U, Heslop P, Wrightson H, Prowse P, Kalinowski M, Marshall D, Reed M, Adebajo A, Walker D
Abstract:  INTRODUCTION: Methotrexate is commonly used in patients with inflammatory arthritis. The aim of the present study was to ascertain the prevalence of side effects that patients on methotrexate were tolerating and to establish their adherence to the medication.
METHOD: A questionnaire was developed for completion by the healthcare professional with the patient, and piloted in one centre. The questionnaire was then used in six other centres, with the addition of a question about the attractiveness of stopping methotrexate treatment. Efficacy and toxicities were scored for severity on a 10-cm visual analogue scale (VAS). Adherence to the drug was also explored.
RESULTS: The prevalence of 'any side effect' ranged from 57% to 86%. The most frequent side effects were fatigue (53%); nausea (38%); mouth ulcers (23%) and hair loss (23%). Efficacy averaged 6.5 cm on the VAS. Results from the combined survey revealed that toxicity averaged 5.9 cm for fatigue, 4.8 cm for nausea, 4.4 for mouth ulcers, 3.9 cm for hair loss and 5.7 cm for 'other' side effects. 13.5% of patients revealed that they had forgotten to take the drug for an average of two weeks, and 25% for an average of 2.5 weeks in the previous year. Participants were more likely to reveal this to a nurse than a doctor.
CONCLUSION: Patients put up with a considerable number of side effects in order to benefit from methotrexate therapy. Adherence to this drug merits further study. Copyright © 2015 John Wiley & Sons, Ltd.

KEYWORDS: Methotrexate; adherence; side effects; tolerance

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WUTH publication: An Alternative Technique for External Fixation of Traumatic Intra-articular Fractures of Proximal and Middle Phalanx.

Citation: Techniques in hand & upper extremity surgery. 2015, 19(4), 163-167
Author: Kapur, Benjamin; Paniker, Jayanath; Casaletto, John
Abstract: BACKGROUND: Intra-articular fractures of the proximal interphalangeal (PIP) joint are commonly treated with dynamic external fixation. Most commonly used is the Suzuki modification of the pins and rubber traction system (PRTS). There are a few other modifications of the PRTS external fixators. We present an alternative pin external fixator that is simple and effective.
METHODS: Under a suitable anesthesia and image intensification a true lateral view of the head of the proximal phalanx is obtained. A K-wire construct holds the affected digit out to length with the fracture reduced and Jurgan pin-balls hold the construct into position. Under image intensification the whole device is checked to ensure the joint and fracture is reduced and the joint is not over distracted. The PIP joint is also checked to ensure good range of motion. The device was checked in clinic at 1 week with radiographs. The wires are removed at 4 weeks followed by intensive hand physiotherapy.
RESULTS: Over 20 patients with intra-articular fractures of the proximal and middle phalangeal were treated with this technique. In all cases the fracture healed with good joint congruency. All patients achieved good range of motion of the PIP joint but with some restriction of full flexion (mean, 20 degrees). There was no loss of position or pin-site infections. There was good compliance with the treatment.
DISCUSSION: The main advantages of the technique we describe are: (1) the compact design, making it less cumbersome for the patient compared with other PRTS external fixators; (2) it is straightforward to assemble and the device is easy to adjust in clinic if there is any loss of reduction; (3) the pin-balls prevent sharp ends of the wire protruding causing morbidity to the patient; (4) there is less chance of loss of traction compared with traction devices using rubber bands. It is a dynamic device, which allows mobilization of the joints reducing stiffness

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