New Resource!

Now available!  New resource for doctors preparing for their MRCP exams on Medical-Masterclass.com

Medical Masterclass is now available to all staff until 19th February 2016.

The website includes PACES video clips and over 3,000 MRCP(UK) part 1 and part 2 written examination-style questions for interactive self-assessment. You can also:

• Create a new self-assessment or mock exam

• View and listen to audio-visual files to help you prepare for the MRCP(UK) PACES exam

• Undertake a 30 question, 60 minute timed exam
  
  To access, ask at the library desk for a user name and password or contact the Library at mcardle.library@nhs.net. 

Please let us know what you think of this new resource.

WUTH publication: Creative cutting to contour and correct Hallux bone graft for three planes of correction

Citation: Foot & Ankle Surgery. 2013, 19(3), 199-201
Author: Ahluwalia RS, Blucher NC, Platt SR, Hennessy MS

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

Oxford Handbooks and Textbooks

New electronic Oxford Handbooks and Textbooks have been added to our stock. New topics include:

Echocardiography
Heart Failure
Paediatrics and Neonatology
Anaesthesia for Emergency Care
Pulmonary Hypertension
Surgical Consent
Renal Nursing
Medical Imaging
Palliative Nursing
Nutrition and Dietetics
Prescribing for Nurses and Allied Health Professionals
Oral and Maxillofacial Surgery
and many more ...

You can access these electronic resources via the Library Catalogue. 
Please view our helpsheet on accessing e-books.
Please ask library staff if you need any assistance.

WUTH publication: Ethnic differences in lower limb revascularisation and amputation rates. Implications for the aetiopathology of atherosclerosis?

Citataion: Atherosclerosis. 2014, 233(2), 503-507.
Author: Ahmad N, Thomas GN, Chan C, Gill P
Abstract: OBJECTIVE: Peripheral arterial disease, as a result of atherosclerosis, is the commonest reason for lower limb revascularisation and amputation in England. We describe the prevalence rate of these procedures among the White, South Asian and Black populations living in England and describe the association of ethnicity to amputation, both with and without, revascularisation.
METHOD: We extracted data from 90 million English hospital admissions between 2003 and 2009 and calculated prevalence rates among 50-84 year olds using census data. Logistic regression demonstrated whether ethnicity was related to amputation, both with and without revascularisation, independent of demographic (age, sex, social class) and disease risk factors (diabetes, hypertension, hypercholesterolaemia, coronary and cerebral vascular disease, smoking).
RESULTS: There were 25 308 amputations and 136 215 revascularisations. The age adjusted prevalence rate for amputation was 26/100 000 and revascularisation 142/100 000. The prevalence ratio (95% confidence intervals) (White British = 100) of amputation in the Asian and Black populations was; 60 (54-66) and 169 (155-183) respectively with revascularisation ratios; 89 (86-92) and 94 (89-98) respectively. South Asians had approximately half the risk of amputation both with and without a revascularisation than Whites despite much higher rates of known atherosclerotic risk factors. The odds of having an amputation without any revascularisation was 63% higher in Blacks but fully attenuated by demographic and disease risk factors.
CONCLUSION: South Asians experience the lowest rate of both major lower limb amputation and revascularisation in England. The association cannot be explained by demographic or cardiovascular risk factors. This may have implications in the aetiopathology of atherosclerosis.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: Traumatic disorders of forearm rotation: anatomy, biomechanics and treatment

Citation: British Journal of Hospital Medicine. 2014, 75(2), 72-7
Author: Mehta N, J Macfarlane R, Brown D
Abstract: The forearm is a complex structure which produces a wide range of movement. Forearm injuries are very common, but many injuries are missed or poorly treated. This article examines the anatomy and biomechanics of the forearm, and describes the important injuries to be recognized.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: Prosthetic iris devices

Citation: Canadian Journal of Ophthalmology. 2014, 49(1), 6-17
Author: Srinivasan S, Ting DS, Snyder ME, Prasad S, Koch HR
Abstract: Congenital iris defects may usually present either as subtotal aniridia or colobomatous iris defects. Acquired iris defects are secondary to penetrating iris injury, iatrogenic after surgical excision of iris tumours, collateral trauma after anterior segment surgery, or can be postinflammatory in nature. These iris defects can cause severe visual disability in the form of glare, loss of contrast sensitivity, and loss of best corrected visual acuity. The structural loss of iris can be reconstructed with iris suturing, use of prosthetic iris implants, or by a combination of these, depending on the relative amount of residual iris stromal tissue and health of the underlying pigment epithelium. Since the first implant of a black iris diaphragm posterior chamber intraocular lens in 1994, advances in material and design technology over the last decade have led to advances in the prosthetic material, surgical technique, and instrumentation in the field of prosthetic iris implants. In this article, we review the classification of iris defects, types of iris prosthetic devices, implantation techniques, and complications.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: Closure of minor tracheoesophageal fistulae with calcium hydroxlapatite

Citation: Auris, Nasus, Larynx. 2013, 40(5), 491-2
Author: Kasbekar AV, Sherman IW
Abstract: OBJECTIVE: To demonstrate a novel technique for the closure of a pinhole tracheoesophageal fistula using Radiesse (calcium hydroxylapatite).
METHODS: Two patients underwent closure of a persistent tracheoesophageal fistula with four quadrant injections of Radiesse around the fistulous tract.
RESULTS: Both patients had their fistulas successful closed. The first patient died after 3 months due to lung metastasis. The second patient required a further attempt at closure with Radiesse injection and has been without a leak for 18 months at his last follow up appointment.
CONCLUSION: We feel this is an acceptable minimally invasive method to close a persistent pinhole tracheoesophageal fistula after failed management with chemical cautery.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: The use of hip radiographs in primary care: the inter-observer agreement of reporting native hip pathology

Citation: Hip International, 2014, 24(3), 290-4
Author: Kenyon PJ, Perry D, Barrett M, Carroll FA, Thomas G
Abstract: Plain radiographs are often the first line investigation in identifying the cause of hip pain, though they do not differentiate all morphologically normal and abnormal hips. Interpretation of radiographs is subjective, depending on the patient history and physical signs. A radiological report can be misleading and may lead to, unnecessary radiation exposure, a delay in referral and a delay to definitive treatment. This study was to investigate the inter-observer reliability in the reporting of plain radiographs. <bold>Methods:</bold> Sixty-one consecutive antero-posterior (AP) radiographs of native hips were identified that had been referred to one of the senior authors from the community with "hip pain". Images were anonymised within PACS (picture archiving and communication system) and reviewed by a consultant orthopaedic surgeon, two consultant musculoskeletal radiologists, one senior orthopaedic registrar and one senior radiology registrar. Each reviewer was given a pre-constructed proforma, and asked to report the radiographs. <bold>Results:</bold> There is a varying degree of 'agreement' for many of the commonly used terms on a hip radiograph. Agreement between all observers varied, by description, between 23.3% (CAM Lesion) to 93.3% (AVN). Multi-rater agreement showed Kappa values ranging from 0.12 (poor) to 0.6 (moderate). Overall there were widespread inconsistencies, even amongst the most widely used terms. <bold>Conclusion:</bold> There is variable agreement amongst musculoskeletal radiology and orthopaedic experts when analysing plain radiographs of the native hip. This has implications for utility of reporting and therefore treatment in the community setting.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: Obturator hernia - MRI image

Citation: The Indian Journal of Surgery. 2013, 75(4), 322
Author: Vitone L, Joel A, Masters A, Lea S
Abstract: Obturator hernia although considered a rare entity is the most frequently encountered pelvic floor hernia. Since the first published report in the 18th century, their unusual and unfamiliar clinical presentation still represents a diagnostic dilemma for the modern day clinician. A detailed history and clinical examination in our thin, elderly female patient who presented with intermittent small bowel obstruction and symptoms of right obturator nerve compression with a positive Howship-Romberg sign was crucial in establishing a diagnosis. Sophisticated radiologic modalities such as MRI as shown below in the case of our patient can reliably confirm the diagnosis of obturator hernia.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.

WUTH publication: MRI features most often associated with surgically proven tears of the spring ligament complex

Citation: Skeletal Radiology. 2013, 42(7), 969-73
Author: Williams G, Widnall J, Evans P, Platt S
Abstract:  OBJECTIVES: The authors aim to present the common MRI appearances of surgically proven spring ligament tears as minimal radiological literature exists regarding injury to this increasingly important structure.
MATERIALS AND METHODS: Our retrospective review identified a treatment group comprising 13 cases of surgically proven spring ligament injury and a 96-patient comparison group. All patients underwent standard musculoskeletal MRI sequences of the foot and ankle. Images were reviewed by a registrar-grade orthopedic surgeon and a consultant musculoskeletal radiologist for abnormalities of the spring ligament complex.
RESULTS: MRI findings in relation to surgically proven injury of the superior-medial portion of the spring ligament included proximal thickening >5 mm in 92 % and distal thinning <2 mm in 85 % of proven injures to the spring ligament complex. Common abnormalities of the medio-plantar portion comprised ligament thickening >7 mm in 31 % and intra-substance signal heterogenicity demonstrated in 38 % of cases. CONCLUSIONS: The complex orientation of the medio-plantar ligament makes its evaluation unreliable due to the difficulty obtaining diagnostic quality imaging and our inability to correlate MRI findings in this portion of the ligament with surgically proven injury. However, MRI abnormalities of the superior-medial ligament are consistent, reproducible, and correlate with surgical pathology. As our incomplete understanding of the flexible flatfoot deformity evolves, our ability to recognize injury to the spring ligament may encourage novel surgical treatments looking to incorporate its repair or reconstruction into deformity correction.

Link to Pubmed record

For more information about obtaining the full text of journal articles, please visit our Document / Book Supply service.

To view all WUTH publications please link here.