Citation: Annals of the Royal College of Surgeons of England. 2017, 99(7), 573-578
Author: Lau AS, Mamais C, McChesney E, Upile NS, Vaughan C, Veitch J, Abbas JR, Markey A, Brown NG, Evans M, Thomas J, Gaines M, Shehata Z, Wilkie MD, Leong SC
Abstract: Introduction Tonsillopharyngitis is the most common ear, nose and throat emergency admission, with 80,000 episodes recorded in England in 2015-2016. Despite this, there is a paucity of evidence addressing the supportive management of tonsillopharyngitis in inpatients. The aim of this retrospective multicentre observational study was to consider the Best Supportive Management for Adults Referred with Tonsillopharyngitis (BeSMART) in the inpatient setting, and to establish any associations between practice and outcomes. Methods Seven hospitals in North West England and North East Scotland participated in the study. Overall, 236 adult patients admitted with tonsillopharyngitis were included. The main outcome measures were interval to return to soft diet, length of stay (LOS), pain scores and readmissions. Results Women were more likely to seek professional help before presenting to secondary care (p=0.04). Patients admitted at the weekend were more likely to have a shorter LOS (p=0.03). There was no relationship between day of admission and seniority or specialty of the doctor initially seen. Prescription of corticosteroid, analgesia and a higher initial intravenous fluid infusion rate were not related to a shorter LOS. Conclusions This study is the first to yield valuable insights into the inpatient management of tonsillopharyngitis. This work represents part of an ongoing project to establish the evidence for common medical interventions for sore throat. Patient and professional surveys as well as a prospective interventional study are planned for the future.
KEYWORDS: Analgesia; Corticosteroid; Length of stay; Tonsillitis
Link to PubMed record
Thursday 31 August 2017
Friday 25 August 2017
Wednesday 16 August 2017
Out of hours access to the McArdle library is back!
Due to unforeseen circumstances we require you to call in to the library between 9am-4.30pm (Mon-Fri) to have your access re-enabled.
This process will take 5 minutes. Apologies for any inconvenience.
This process will take 5 minutes. Apologies for any inconvenience.
Monday 7 August 2017
WUTH publication: Salivary duct carcinoma arising from the inferior turbinate
Citation: Journal of Surgical Case Reports. 2017(7). eCollection 2017 Jul.
Author: Vallabh N, Srinivasan V, Hughes D, Agbamu D
Abstract: Salivary duct carcinoma (SDC) is an uncommon, aggressive tumour, which carries a poor prognosis. SDC affects the major salivary glands, usually occurring in the parotid gland. A 76-year-old male patient presented with right-sided nasal obstruction and rhinorrhoea. A polypoidal mass was seen in the right inferior turbinate mimicking a benign neoplasm. Histological examination following wide excision led to a diagnosis of SDC. There are no therapeutic guidelines and management is based on experience with SDC of the major salivary glands. Given the aggressive nature and poor prognosis of the disease, it is a rare but important differential to consider in patients with unilateral nasal mass.
Link to PubMed record
Author: Vallabh N, Srinivasan V, Hughes D, Agbamu D
Abstract: Salivary duct carcinoma (SDC) is an uncommon, aggressive tumour, which carries a poor prognosis. SDC affects the major salivary glands, usually occurring in the parotid gland. A 76-year-old male patient presented with right-sided nasal obstruction and rhinorrhoea. A polypoidal mass was seen in the right inferior turbinate mimicking a benign neoplasm. Histological examination following wide excision led to a diagnosis of SDC. There are no therapeutic guidelines and management is based on experience with SDC of the major salivary glands. Given the aggressive nature and poor prognosis of the disease, it is a rare but important differential to consider in patients with unilateral nasal mass.
Link to PubMed record
Thursday 3 August 2017
Learning & Development and Library & Knowledge Service Showcase events
Don't miss our Learning & Development and Library & Knowledge Service Showcase events which
highlight the training, services and support available to you
They are taking place on the following dates and times
Tuesday 8th August 1100-13.30 Elm House Training Room, Clatterbridge Hospital
Friday 11th August 11.00-14.00 Education Centre, Arrowe Park Hospital, Room 6a/6b
Tuesday 5th September 11.00-13.30 Elm House Training Room, Clatterbridge Hospital
Thursday 7th September 8.30-10.30 Education Centre, Arrowe Park Hospital, Room 6a/6b
Tuesday 12th September 11.30-14.00 Education Centre, Arrowe Park Hospital, Room 6a/6b
We look forward to seeing you
highlight the training, services and support available to you
They are taking place on the following dates and times
Tuesday 8th August 1100-13.30 Elm House Training Room, Clatterbridge Hospital
Friday 11th August 11.00-14.00 Education Centre, Arrowe Park Hospital, Room 6a/6b
Tuesday 5th September 11.00-13.30 Elm House Training Room, Clatterbridge Hospital
Thursday 7th September 8.30-10.30 Education Centre, Arrowe Park Hospital, Room 6a/6b
Tuesday 12th September 11.30-14.00 Education Centre, Arrowe Park Hospital, Room 6a/6b
We look forward to seeing you
Wednesday 2 August 2017
WUTH publication: Altered theta oscillations in resting EEG of fibromyalgia syndrome patients
Citation: European Journal of Pain. 2018, 22(1), 49-57. Epub 2017 Jul 31.
Author: Fallon N, Chiu Y, Nurmikko T, Stancak A
Abstract: BACKGROUND: Fibromyalgia syndrome (FM) is a chronic pain disorder characterized by widespread pain, sleep disturbance, fatigue and cognitive/affective symptoms. Functional imaging studies have revealed that FM and other chronic pain syndromes can affect resting brain activity. This study utilized electroencephalographic (EEG) recordings to investigate the relative power of ongoing oscillatory activity in the resting brain.
METHODS: A 64-channel EEG was recorded at rest in 19 female FM patients and 18 healthy, age-matched, control subjects. The Manual Tender Point Scale (MTPS) examination was performed to quantify tonic pain and tenderness on the day of testing along with measures of mood, arousal and fatigue. Oscillations in delta, theta, alpha, beta and gamma frequency bands were analysed using Standardised Low-Resolution Brain Electromagnetic Tomography to evaluate sources of spectral activity throughout the whole brain.
RESULTS: FM patients exhibited greater pain, tiredness and tension on the day of testing relative to healthy control participants and augmented theta activity in prefrontal and anterior cingulate cortices. No significant differences were seen in other frequency bands. Augmented frontal theta activity in FM patients significantly correlated with measures of tenderness and mean tiredness scores.
CONCLUSIONS: The findings indicate that alterations to resting-state oscillatory activity may relate to ongoing tonic pain and fatigue in FM, and manifest in brain regions relevant for cognitive-attentional aspects of pain processing and endogenous pain inhibition. Enhanced low-frequency oscillations were previously seen in FM and other chronic pain syndromes, and may relate to pathophysiological mechanisms for ongoing pain such as thalamocortical dysrhythmia.
SIGNIFICANCE: Increased prefrontal theta activity may contribute to persistent pain in fibromyalgia or represent the outcome of prolonged symptoms. The findings point to the potential for therapeutic interventions aimed at normalizing neural oscillations, while further research utilizing quantitative analysis of resting EEG could benefit our understanding of fibromyalgia pathophysiology.
© 2017 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.
Link to PubMed record
Author: Fallon N, Chiu Y, Nurmikko T, Stancak A
Abstract: BACKGROUND: Fibromyalgia syndrome (FM) is a chronic pain disorder characterized by widespread pain, sleep disturbance, fatigue and cognitive/affective symptoms. Functional imaging studies have revealed that FM and other chronic pain syndromes can affect resting brain activity. This study utilized electroencephalographic (EEG) recordings to investigate the relative power of ongoing oscillatory activity in the resting brain.
METHODS: A 64-channel EEG was recorded at rest in 19 female FM patients and 18 healthy, age-matched, control subjects. The Manual Tender Point Scale (MTPS) examination was performed to quantify tonic pain and tenderness on the day of testing along with measures of mood, arousal and fatigue. Oscillations in delta, theta, alpha, beta and gamma frequency bands were analysed using Standardised Low-Resolution Brain Electromagnetic Tomography to evaluate sources of spectral activity throughout the whole brain.
RESULTS: FM patients exhibited greater pain, tiredness and tension on the day of testing relative to healthy control participants and augmented theta activity in prefrontal and anterior cingulate cortices. No significant differences were seen in other frequency bands. Augmented frontal theta activity in FM patients significantly correlated with measures of tenderness and mean tiredness scores.
CONCLUSIONS: The findings indicate that alterations to resting-state oscillatory activity may relate to ongoing tonic pain and fatigue in FM, and manifest in brain regions relevant for cognitive-attentional aspects of pain processing and endogenous pain inhibition. Enhanced low-frequency oscillations were previously seen in FM and other chronic pain syndromes, and may relate to pathophysiological mechanisms for ongoing pain such as thalamocortical dysrhythmia.
SIGNIFICANCE: Increased prefrontal theta activity may contribute to persistent pain in fibromyalgia or represent the outcome of prolonged symptoms. The findings point to the potential for therapeutic interventions aimed at normalizing neural oscillations, while further research utilizing quantitative analysis of resting EEG could benefit our understanding of fibromyalgia pathophysiology.
© 2017 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.
Link to PubMed record
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