WUTH publication: Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies

Citation: Supportive care in cancer. 2023, 31(8), 471
Author: Doughty HC; Hill RA; Riley A; Midgley AW; Patterson JM; Boddy LM; Rogers SN; Maden M; Williams NH; 
Abstract: Purpose: Physical activity can improve health outcomes for cancer patients; however, only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour.

Methods: CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour model and Theoretical Domains Framework.

Results: Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity.

Conclusion: Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptakeand adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.

WUTH publication: Simultaneous Bilateral Patellar Tendon Rupture: A Systematic Review

Citation: Cureus. 2023, 15(7), e41512
Author: Fernandes A; Rufino M; Hamal D; Mousa A; Fossett E; Cheema KS; 
Abstract: The extensor mechanism of the knee can be damaged due to various modes of injury, which, in most cases, will require urgent surgical intervention for repair. Single patellar tendon ruptures are uncommon, but simultaneous bilateral events are even rarer and have been scarcely reviewed in English literature. Research in this area is mainly confined to case series, with some literature reviews but no evidence of more substantial analysis. Therefore, this systematic review was done to analyse the existing literature on bilateral simultaneous patellar tendon ruptures and propose a systematic and standardised approach to diagnosing and managing these injuries. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search terms included 'bilateral patellar tendon rupture', 'bilateral', 'patellar', 'tendon' and 'rupture'. Three independent reviewers conducted searches in PubMed, OvidSP for Medline, Embase and the Cochrane Library using the same search strategy. The eligibility criteria included studies on bilateral concomitant patellar tendon rupture published in English. Bilateral simultaneous patellar tendon ruptures of traumatic and atraumatic origin in human patients were included. The study types comprised case reports and literature reviews. The key limitation of this study was the low number of patients covered by the eligible literature. Patellar tendon ruptures are a rare and scarcely documented injury, and there is a need for studies with a high level of evidence, especially regarding surgical treatment choice and methods, as well as post-operative management, which could potentially lead to improved outcomes in the management of this injury.

WUTH publication: Shared Decision-making Among Clinicians and Patients With Low-risk Differentiated Thyroid Cancer-Reply

Citation: JAMA otolaryngology-- head & neck surgery. 2023, 149(9), 851-2
Author: Yang W; Rogers SN; Kim D; 

WUTH publication: Urinary tissue inhibitor of metalloproteinase-2 as an early predictor for acute kidney injury in critically ill children

Citation: International journal of health sciences. 2023, 17(4), 22-28
Author: Abouhadid MA; Gawad TAA; Gebaly HHE; Abdallah AA; Refay ASE; Helmy NM; Allam AM;
Abstract: Objectives: Acute kidney injury (AKI) is one of the most devastating complications of critical illness in children. Serum creatinine (Scr) is considered the gold standard for AKI diagnosis yet noted to be late and inaccurate. This raises the need for an early and accurate biochemical parameter for the early detection of AKI. This research aimed to explore the role of urinary tissue inhibitor metalloproteinase 2 (TIMP-2) in the early prediction of AKI, compared to standard biomarkers, in critically ill children admitted to pediatric intensive care unit (PICU). Urine TIMP2 was previously explored in multiple adult studies and showed promising results; however, the study of its role in pediatric population was limited.
Methods: This study was a prospective cohort study including 42 critically ill children who are at increased risk of AKI. Cases were recruited from the PICU in the Children's Hospital of Ain-Shams University, Cairo - Egypt over 10 months' duration. Urine samples were collected to measure urinary TIMP-2 and blood samples were taken to measure the levels of Scr, creatinine clearance, and blood urea nitrogen. Urine output in 24 h was also calculated.
Results: Urinary TIMP-2 showed considerably higher levels in AKI compared to non-AKI patients as early as day 1, whereas increased levels of Scr and decreased urine output were noticed later (day 3 and day 5, respectively). A notable correlation existed between TIMP-2 at day 1 and creatinine at day 3.
Conclusion: The present study revealed that urinary TIMP-2 could have an important role in the early prediction of AKI before the increase in Scr and more deterioration in kidney functions.
Competing Interests: The authors declare that they have no competing interests.

WUTH publication: Diverticular abscess, pelvic and other intra-abdominal abscesses

Citation: Surgery (Oxford). 2023, 41(7), 440-8
Author: Reid, Rebecca; Boyce, Kathryn; Guy, Richard

WUTH publication: Spontaneous colonic perforation and abdominal wall extrusion of an orally ingested fork handle

Citation: Annals of the Royal College of Surgeons of England. 2023, 105(6), 585-8
Author: Tan JR; Buckley K; Guy R;
Abstract: Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but a small number of cases lead to complications and necessitate surgical intervention. We present a rare case of an ingested fork handle that perforated silently through the colon and fistulated through the abdominal wall. This case highlights the importance of balancing the risks and benefits of surgical intervention and the multidisciplinary approach to complex situations.