Nottingham University Hospitals NHS Trust Research Articles

The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared to standard or no treatment: A systematic review.

The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared to standard or no treatment: A systematic review.

Interventions to reduce Staphylococcus aureus in the management of atopic eczema: an updated Cochrane review

British Journal of DermatologyVolume 164, Issue 1 p. 228-228 Interventions to reduce Staphylococcus aureus in the management of atopic eczema: an updated Cochrane review F.J. Bath-Hextall, F.J. Bath-Hextall Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorA.J. Birnie, A.J. Birnie Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorJ.C. Ravenscroft, J.C. Ravenscroft Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorH.C. Williams, H.C. Williams Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this author F.J. Bath-Hextall, F.J. Bath-Hextall Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorA.J. Birnie, A.J. Birnie Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorJ.C. Ravenscroft, J.C. Ravenscroft Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this authorH.C. Williams, H.C. Williams Nottingham University Hospitals NHS Trust,Nottingham, U.K.E-mail: fiona.bath-hextall@nottingham.ac.ukSearch for more papers by this author First published: 28 September 2010 https://doi.org/10.1111/j.1365-2133.2010.10078.xCitations: 20 Funding sources: none. Conflicts of interest: none declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume164, Issue1January 2011Pages 228-228 RelatedInformation

Guideline for the systematic assessment of perineal trauma

This article discusses the prevalence of occult anal sphincter injuries (OASIS) and highlights the importance of recognition and accurate classification of perineal trauma. It is suggested that many ‘occult’ injuries may, in fact, be ‘overt’ injuries, which have been missed or wrongly classified as second degree tears. Even with recognition and immediate repair of OASIS the prevalence of distressing symptoms such as anal incontinence remains high and it is vital that practitioners are competent in the diagnosis of anal sphincter injury. Clinical assessment at the time of delivery, before and following suturing, is the optimum method to accurately diagnose OASIS. It is recommended that systematic assessment, including a rectal examination, should be carried out following all vaginal births or, at the very least, where genital trauma is identified, with referral to a more experienced clinician if required. Clarification of the preferred method for performing this examination is necessary and a guideline has been drafted to assist in the accurate diagnosis of OASIS at Nottingham University Hospitals NHS Trust (NUHS).

Are Fractures Secondary to LHRH Agonist Therapy in Prostate Cancer a Significant Problem?

Are Fractures Secondary to LHRH Agonist Therapy in Prostate Cancer a Significant Problem?

Survival Analysis for Gross Distribution Patterns of Unresected Liver Metastases in Patients Undergoing Resection of the Primary Tumour in Advanced Colorectal Cancers

Survival Analysis for Gross Distribution Patterns of Unresected Liver Metastases in Patients Undergoing Resection of the Primary Tumour in Advanced Colorectal Cancers

Diffuse cerebellar MR imaging changes in anti-Yo positive paraneoplastic cerebellar degeneration

A 48 year old lady presented with a month’s history of vertigo, nausea, and vomiting. Examination revealed nystagmus, mild limb-clumsiness (predominantly left sided) and mild gait ataxia. MR imaging demonstrated diffuse signal change within the cerebellar hemispheres (most prominent on the left), predominantly affecting the white matter but also the cerebellar cortex (Fig. 1). CSF examination revealed 52 lymphocytes (‘‘bland’’ on cytology), oligoclonal bands were not detected. The cerebellar findings progressed rapidly and she developed dysarthric speech and marked limb/truncal ataxia. Her symptoms plateaued within 3 months, by which time she was bedbound. An Anti-Yo antibody was detected in the serum. CT imaging demonstrated an area of abnormal tissue in the left breast; biopsy confirmed breast adenocarcinoma with axillary lymph node spread. She declined repeat cerebral imaging. While our patient’s clinical course is typical for an anti-Yo positive paraneoplastic cerebellar degeneration (PCD), the imaging findings are most unusual. Despite profound ataxia, brain imaging in PCD is usually ‘‘remarkably unremarkable’’, although cerebellar atrophy may be observed eventually [5, 6]. Very rarely PCD has been reported with imaging abnormalities, early in the course of the disease, in the context of anti-Tr [1] and anti-CRMP5 (anti-CV2) antibodies [2]. McHugh et al. [4] reported a case of anti-Yo positive PCD (secondary to ovarian adenocarcinoma) associated with signal abnormality in the right mesial temporal lobe on MRI. Interval imaging, following tumour resection, showed resolution of the temporal abnormality but a new focal cerebellar hyperintensity. To our knowledge, our case is the first to demonstrate diffuse cerebellar signal change on MRI in the context of anti-Yo positive PCD, expanding the radiological features recognised in this condition. The sensitivity of MRI for detecting such changes may be increased by imaging at high field strengths, as in this case (3.0 Telsa Philips Achieva; Best, The Netherlands). The pathological substrate of these imaging changes is unclear. Peterson et al. [5] examined three cases of anti-Yo positive PCD at postmortem, observing a diffuse loss of Purkinje cells but a notable absence of inflammatory infiltrates in the cerebellar cortex. However, inflammatory changes may be seen much earlier in the disease course. Giometto et al. [3] reported the post-mortem findings in a patient who died of a myocardial infarct 4 months after developing an anti-Yo positive PCD, observing CD8? lymphocyte infiltration in the cerebellum and cerebral cortex, and diffuse microglial upregulation of MHC-II throughout the brain. In conclusion, we describe a case of PCD with very unusual imaging features, characterised by diffuse signal abnormality within the cerebellar hemispheres. In order to C. P. Gilmore (&) P. Maddison Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK e-mail: chris.gilmore@nottingham.ac.uk

REFINE (Reducing Falls in In-patient Elderly)--a randomised controlled trial.

BackgroundFalls in hospitals are common, resulting in injury and anxiety to patients, and large costs to NHS organisations. More than half of all in-patient falls in elderly people in acute care settings occur at the bedside, during transfers or whilst getting up to go to the toilet. In the majority of cases these falls are unwitnessed. There is insufficient evidence underpinning the effectiveness of interventions to guide clinical staff regarding the reduction of falls in the elderly inpatient. New patient monitoring technologies have the potential to offer advances in falls prevention. Bedside sensor equipment can alert staff, not in the immediate vicinity, to a potential problem and avert a fall. However no studies utilizing this assistive technology have demonstrated a significant reduction in falls rates in a randomised controlled trial setting.Methods/DesignThe research design is an individual patient randomised controlled trial of bedside chair and bed pressure sensors, incorporating a radio-paging alerting mode to alert staff to patients rising from their bed or chair, across five acute elderly care wards in Nottingham University Hospitals NHS Trust. Participants will be randomised to bedside chair and bed sensors or to usual care (without the use of sensors). The primary outcome is the number of bedside in-patient falls.DiscussionThe REFINE study is the first randomised controlled trial of bedside pressure sensors in elderly inpatients in an acute NHS Trust. We will assess whether falls can be successfully and cost effectively reduced using this technology, and report on its acceptability to both patients and staff.Trial RegistrationISRCTN trial number: ISRCTN44972300.

Compositae allergy in three children with hand dermatitis

Contact DermatitisVolume 59, Issue 6 p. 370-371 Compositae allergy in three children with hand dermatitis C. Flohr, Corresponding Author C. Flohr Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKDr C. FlohrDepartment of DermatologyQueens Medical Centre CampusNottingham University HospitalsNottinghamNG7 2UHTel: +44-115-9249924Fax: +44-115-8231046e-mail: [email protected]Search for more papers by this authorJ. Ravenscroft, J. Ravenscroft Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKSearch for more papers by this authorJ. English, J. English Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKSearch for more papers by this author C. Flohr, Corresponding Author C. Flohr Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKDr C. FlohrDepartment of DermatologyQueens Medical Centre CampusNottingham University HospitalsNottinghamNG7 2UHTel: +44-115-9249924Fax: +44-115-8231046e-mail: [email protected]Search for more papers by this authorJ. Ravenscroft, J. Ravenscroft Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKSearch for more papers by this authorJ. English, J. English Department of Dermatology, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UKSearch for more papers by this author First published: 02 December 2008 https://doi.org/10.1111/j.1600-0536.2008.01445.xCitations: 14Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume59, Issue6December 2008Pages 370-371 RelatedInformation

Preoxygenation in Pregnancy: An Investigation Using Physiological Modeling

Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, UK

Chest imaging

IntroductionChest imagingKlaus Irion and Kate PointonKlaus IrionDepartment of Radiology, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK Search for more papers by this author and Kate PointonDepartment of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK Search for more papers by this authorPublished Online:13 Feb 2014https://doi.org/10.1259/imaging/12689946SectionsPDF/EPUBFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About"Chest imaging." Imaging, 20(4), p. vi Previous article FiguresReferencesRelatedDetails Volume 20, Issue 4December 2008Pages: 219-vi 2008 The British Institute of Radiology History Published onlineFebruary 13,2014 Metrics Download PDF

Pneumonia in the context of severe sepsis: a significant diagnostic problem: Table 1—

To the Editors: The Surviving Sepsis guidelines 1 highlighted a need to improve clinical standards for the management of severe sepsis and septic shock within the Nottingham University Hospitals NHS Trust (Nottingham, UK). We formed a multi-directorate task group to conduct a near real-time retrospective gap analysis of all adults with significant positive blood cultures of a pathogenic organism within the Queen's Medical Centre (Nottingham), between November 1, 2005 and March 31, 2006. The design, objectives and outcomes have been described previously 2. Patients were included if they met the criteria for severe sepsis or septic …

News

Pest control: a senior infection control nurse manager has defended her trust's pest control record, following a Conservative Party survey cataloguing the NHS's problems with rats, ants and cockroaches. Nottingham University Hospitals NHS Trust made 1,070 calls to pest extermination teams in just over two years: the highest number among 127 trusts surveyed. The trust's deputy director of infection prevention and control and patient safety, Sue Smith, said: 'As one of the biggest trusts in the country we would expect to have higher numbers of incidents. We have a pro-active approach and ask our staff to report any concerns.' The trust has cut rates of hospital-acquired infection, she added.

Methodological considerations for the correct application of quantitative three‐dimensional power Doppler angiography

Methodological considerations for the correct application of quantitative three‐dimensional power Doppler angiography

Caroline Shaw

The people from whom I learned the most are Dr Helen Bevan OBE, Director of Service Transformation at the NHS Institute for Innovation and Improvement, and Dr Peter Homa, Chief Executive of Nottingham University Hospitals NHS Trust.

Antibiotics in cutaneous surgery: why aren't we following the guidelines? Reply from authors

Clinical and Experimental DermatologyVolume 31, Issue 2 p. 283-283 Antibiotics in cutaneous surgery: why aren't we following the guidelines? Reply from authors A. G. Affleck, A. G. Affleck Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorA. J. Birnie, A. J. Birnie Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorT. M. Gee, T. M. Gee Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorB. C. Gee, B. C. Gee Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this author A. G. Affleck, A. G. Affleck Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorA. J. Birnie, A. J. Birnie Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorT. M. Gee, T. M. Gee Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this authorB. C. Gee, B. C. Gee Departments of Dermatology and Microbiology, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK E-mail: andyaffleck@doctors.org.ukSearch for more papers by this author First published: 08 February 2006 https://doi.org/10.1111/j.1365-2230.2006.02070.x Conflict of interest: none declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume31, Issue2March 2006Pages 283-283 RelatedInformation

Multifactorial day hospital intervention to reduce falls in high risk older people in primary care: a multi-centre randomised controlled trial [ISRCTN46584556

Falls in older people are a major public health concern in terms of morbidity, mortality and cost. Previous studies suggest that multifactorial interventions can reduce falls, and many geriatric day hospitals are now offering falls intervention programmes. However, no studies have investigated whether these programmes, based in the day hospital are effective, nor whether they can be successfully applied to high-risk older people screened in primary care.The hypothesis is that a multidisciplinary falls assessment and intervention at Day hospitals can reduce the incidence of falls in older people identified within primary care as being at high risk of falling. This will be tested by a pragmatic parallel-group randomised controlled trial in which the participants, identified as at high risk of falling, will be randomised into either the intervention Day hospital arm or to a control (current practice) arm. Those participants preferring not to enter the full randomised study will be offered the opportunity to complete brief diaries only at monthly intervals. This data will be used to validate the screening questionnaire. Three day hospitals (2 Nottingham, 1 Derby) will provide the interventions, and the University of Nottingham's Departments of Primary Care, the Division of Rehabilitation and Ageing Unit, and the Trent Institute for Health Service Research will provide the methodological and statistical expertise. Four hundred subjects will be randomised into the two arms. The primary outcome measure will be the rate of falls over one year. Secondary outcome measures will include the proportion of people experiencing at least one fall, the proportion of people experiencing recurrent falls (>1), injuries, fear of falling, quality of life, institutionalisation rates, and use of health services. Cost-effectiveness analyses will be performed to inform health commissioners about resource allocation issues. The importance of this trial is that the results may be applicable to any UK day hospital setting.SitesGeneral practices across Nottinghamshire and Derbyshire.Day hospitals:Derbyshire Royal Infirmary (Southern Derbyshire Acute Hospitals NHS Trust)Sherwood Day Service (Nottingham City Hospital Trust)Leengate Day Hospital (Queen's Medical Centre Nottingham University Hospital NHS Trust)

Newyear's honours ' raise profile and value of nursing'.

Stephen Moss (left), former director of nursing and acting chief executive at the Queen's Medical Centre, Nottingham University Hospital NHS Trust, and former chair of the Nurse Directors Association, was knighted in the New Year's honours list.