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What is KnowledgeShare?

KnowledgeShare is a new resource which delivers the latest evidence of your chosen subject (or subjects) to your inbox.

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The emails you will receive contain links to high level evidence from a wide range of sources including journal articles, national reports and local professional development events.

“KnowledgeShare keeps you up-to-date without overwhelming you with information”.

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You can choose whether you receive them on a daily, weekly or monthly basis. If there are new items, these are sent out to you.

How do I sign up?

Complete the registration form, telling us which areas of health care you are interested in and we will set up an account for you on KnowledgeShare.

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To find out more ask a member of LKS staff for details or visit the KnowledgeShare website.

WUTH publication: A literature review of the complications following anterior and posterior ankle arthroscopy

Citation: Foot and ankle surgery. 2019, 25(5), 553-58. Epub 2018 Jul 18
Author: Zekry M, Shahban SA, El Gamal T, Platt S
Abstract: INTRODUCTION: There is a wealth of studies reporting the complications of anterior and posterior ankle arthroscopy. The aim of this study is to summarise and review the complication rate(s) associated with both anterior and posterior ankle arthroscopy, as described in the literature.
MATERIAL AND METHODS: The authors carried out a comprehensive review of the literature up until March 2018. An extensive search of the MEDLINE, Cochrane library and EMBASE databases was undertaken using the following keywords: complications of ankle arthroscopy, anterior ankle arthroscopy, and posterior ankle arthroscopy.
RESULTS: A total of 107 papers were identified and 55 were deemed appropriate for analysis. The overall complication rate of ankle arthroscopy was found to be between 3.4- 9%.
CONCLUSIONS: No life threatening complications were identified in the literature with both anterior and posterior ankle arthroscopy. The commonest complication after anterior and posterior ankle arthroscopy is superficial peroneal nerve injury and temporary Achilles tendon tightness, respectively.
Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
KEYWORDS: Anterior ankle arthroscopy; Complications; Posterior ankle arthroscopy

Link to PubMed record

WUTH publication: The effect of ultrasound-guided percutaneous ozone injection around cervical dorsal root ganglion in zoster-associated pain: a retrospective study

Citation: Journal of Pain Research. 2018, 11, 2179-88
Author: Lin SY, Zhang SZ, An JX, Qian XY, Gao XY, Wang Y, Zhao WX, Eastwood D, Cope DK, Williams JP
Abstract: OBJECTIVE: This study was to evaluate the effectiveness of ultrasound-guided percutaneous ozone injections around the cervical dorsal root ganglions of zoster-associated pain (ZAP) patients.
STUDY DESIGN: Retrospective comparative study.
SETTINGS: The study was conducted at a pain center of a university hospital.
PATIENTS AND METHODS: From June 2016 to July 2017, a total number of 30 patients with ZAP were treated with ultrasound-guided percutaneous ozone injection around the cervical dorsal root ganglion (DRG) at the injured nerve level (C2-C8). A volume of 3 mL ozone-oxygen mixture at a concentration of 30 µg/mL was injected into the area around the DRG. Patients were divided into two groups according to their disease duration: group A (at or <3 months) and group B (>3 months). The pain severity was assessed according to a visual analog scale, and imaging changes were evaluated by ultrasound. Patient improvements in pain and neurologic function were evaluated during a follow-up period from 1 to 3 months.
RESULTS: The data showed that ozone injections reduced pain in patients with ZAP. However, the success rate of group A was higher than group B. After the injection, the von Frey data demonstrated decreases in both groups, but, there were no significant differences between the groups. Moreover, univariate logistic regression analysis and multivariate regression analysis showed a history of diabetes mellitus had a significant effect on the treatment results.
CONCLUSIONS: Percutaneous ozone injection around the DRG might be a useful method for treatment-resistant cases of ZAP at the cervical level. Institutional Review Board (IRB) approval number: HK2017-1130.
KEYWORDS: herpes zoster; neuropathic pain; ozone injection; post-herpetic neuralgia

Link to PubMed record

WUTH publication: Pre-operative psoas major measurement compared to P-POSSUM as a prognostic indicator in over-80s undergoing emergency laparotomy

Citation: European Journal of Trauma and Emergency Surgery. 2020, 46(1), 215-220. Epub 2018 Oct 13
Author: Simpson G, Parker A, Hopley P, Wilson J, Magee C
Abstract: INTRODUCTION: Emergency laparotomy in patients over the age of 80 is associated with high morbidity and mortality. Accurate risk prediction in this patient population is desirable. Sarcopenia has been shown to be associated with outcome in multiple clinical settings and the psoas major muscle as measured on computed tomography (CT) imaging has been demonstrated as a marker of sarcopenia. We aim to assess the use of psoas major measurement on pre-operative CT as a prognostic indicator in over-80s undergoing emergency laparotomy and compare this measurement to P-POSSUM.
METHODS: A retrospective interrogation of the prospectively collected National Emergency Laparotomy Database including all over-80s undergoing emergency laparotomy between January 2014 and September 2016 was conducted. Demographic, operative data and P-POSSUM data were collected and analysed. Computed tomography (CT) images were accessed and analysed, and cross-sectional areas of psoas major and the corresponding lumbar vertebral body at the level of the L3 inferior end plate were calculated. The ratio of psoas major-to-L3 cross-sectional area (PM:L3) was calculated for each patient. Mann-Whitney U test and receiver-operating characteristics (ROC) curves were used for statistical analysis.
RESULTS: One hundred and three over-80s underwent emergency laparotomy. Male:female ratio was 60:43. Median age was 84 years (range 80-98 years). 30-day mortality was 19.4%.90-day mortality was 25.2%. Median PM:L3 ratio in patients who died as an inpatient was 0.3 and PM:L3 ratio in patients who survived to discharge was 0.52 (p < 0.0001). Median PM:L3 ratio in patient who died within 30 days post-op was 0.28 and 0.48 in those patients who survived to 30 days (p < 0.0001). Median PM:L3 ratio in patient who died within 90 days post-op was 0.28 and 0.51 in those patients who survived to 90 days (p < 0.0001). ROC analysis gave an area under the curve (AUC) of 0.85 for in-patient mortality, 0.86 for 30-day mortality, and 0.88 for 90-day mortality. ROC analysis for P-POSSUM in this data set demonstrated an AUC of 0.51 for in-patient mortality and 0.75 for 30- and 90-day mortality.
CONCLUSION: CT imaging of the abdomen and pelvis is routinely used in over-80s prior to emergency laparotomy making PM:L3 calculation feasible for the majority of patients in this group. PM:L3 ratio is a useful prognostic indicator for prediction of mortality in patients over the age of 80. PM:L3 is superior to the P-POSSUM score in this series.
KEYWORDS: Emergency laparotomy; Frailty; Psoas major dimensions; Sarcopenia

Link to PubMed record

Research / Library Drop-in Support session

Friday 19 October any time between 12-2pm

Library, Education Centre, APH​

Are you:

• interested in understanding/getting involved in research?
• undertaking Masters/PhD study?
• or just have questions about research that need answering? 

If so, we are here to help with any questions you may have, including: 

·         Where do I start?

·         How should I undertake a literature search?

·         What is a critical appraisal and how can I access tools to assist me to be more critical? 

·         What is the difference between research, audit and service evaluation?

·         What approvals do I need?

Bespoke support and advice will be given.

If you are unable to attend on the day please email either the Library on WUTH.LKS@NHS.NET or the Research Department wih-tr.ResearchDepartment@nhs.net who will be happy to help.​

WUTH publication: Saccular internal carotid artery aneurysm masquerading as a pituitary macroadenoma

Citation: BMJ Case Reports. 2018 Oct 2
Author: Goldsmith L, Williams S, Mohsin N, Srinivas-Shankar U
Abstract: KEYWORDS: neuroendocrinology; neuroimaging; pituitary disorders

Link to PubMed record

WUTH publication: United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services

Citation: The British Journal of Ophthalmology. 2019, 103(6), 837-43
Author: Denniston AK, Lee AY, Lee CS, Crabb DP, Bailey C, Lip PL, Taylor P, Pikoula M, Cook E, Akerele T, Antcliff R, Brand C, Chakravarthy U, Chavan R, Dhingra N, Downey L, Eleftheriadis H, Ghanchi F, Khan R, Kumar V, Lobo A, Lotery A, Menon G, Mukherjee R, Palmer H, Patra S, Paul B, Sim DA, Talks JS, Wilkinson E, Tufail A, Egan CA
Abstract: AIM: To assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service.
METHODS: This is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main  outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment.
RESULTS: 79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58).
CONCLUSIONS: This large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.
KEYWORDS: diabetes; electronic medical record

Link to PubMed record