North Bristol NHS Trust

About: North Bristol NHS Trust is a healthcare organization based out in Bristol, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 2204 authors who have published 2811 publications receiving 61110 citations.

Collision tumors of the thyroid: A case report and review of the literature.

Abstract: Background Collision tumors of the thyroid are a rare pathology that present a diagnostic and treatment challenge. In this report, we present an interesting case and a review of the current literature as to inform management. Methods and Results An 88-year-old woman presented with acute airway compromise and vocal cord paralysis. CT identified a thyroid mass and widespread metastasis. Histopathology identified the lesion as a collision tumor consisting of a squamous cell carcinoma (SCC) and papillary thyroid carcinoma. The patient was managed with surgery and palliative radiotherapy. However, she died from complications of a lower respiratory tract infection. We also present a review of the literature with 33 cases reviewed. Conclusion Management of collision tumors is complex because of the duality of the pathology. They should be managed in a multidisciplinary team setting and treatment should be patient specific. Generally, the most aggressive neoplasm should guide treatment. We recommend surgical management with adjunct therapy. © 2015 Wiley Periodicals, Inc. Head Neck 37: E125–E129, 2015

Characteristics of neighbourhoods with high incidence of out-of-hospital cardiac arrest and low bystander cardiopulmonary resuscitation rates in England.

Abstract: Aims The aim of the project was to identify the neighbourhood characteristics of areas in England where out-of-hospital cardiac arrest (OHCA) incidence was high and bystander cardiopulmonary resuscitation (BCPR) was low using registry data. Methods and results Analysis was based on 67 219 cardiac arrest events between 1 April 2013 and 31 December 2015. Arrest locations were geocoded to give latitude/longitude. Postcode district was chosen as the proxy for neighbourhood. High-risk neighbourhoods, where OHCA incidence based on residential population was >127.6/100 000, or based on workday population was >130/100 000, and BCPR in bystander witnessed arrest was <60% were observed to have: a greater mean residential population density, a lower workday population density, a lower rural–urban index, a higher proportion of people in routine occupations and lower proportion in managerial occupations, a greater proportion of population from ethnic minorities, a greater proportion of people not born in UK, and greater level of deprivation. High-risk areas were observed in the North-East, Yorkshire, South-East, and Birmingham. Conclusion The study identified neighbourhood characteristics of high-risk areas that experience a high incidence of OHCA and low bystander resuscitation rate that could be targeted for programmes of training in cardiopulmonary resuscitation and automated external defibrillator use.

Emergency subtotal colectomy for fulminant Clostridium difficile colitis--is a surgical solution considered for all patients?

Abstract: INTRODUCTIONClostridium difficile has been an increasing problem in UK hospitals At the time of this study, there was a high incidence of C difficile within our trust and a number of patients developed acute fulminant colitis requiring subtotal colectomy We review a series of colectomies for C difficile, examining the associated morbidity and mortality and the factors that predispose to acute fulminant colitis PATIENTS AND METHODSThis is a retrospective study of patients undergoing subtotal colectomy for C difficile colitis in an NHS trust over 18 months Case notes were reviewed for antibiotic use, duration of diarrhoea, treatment, blood results, pre-operative imaging and surgical morbidity and mortality RESULTSA total of 1398 patients tested positive for C difficile in this period Of these, 18 (129%) underwent colectomy All were emergency admissions, 35% medical, 35% surgical, 24% neurosurgical and 6% orthopaedic In the cohort, 29% were aged less than 65 years Patients had a median of three

Cervical range of movement in relation to neck dimension

Abstract: The authors investigated the effect of neck dimension upon cervical range of motion. Data relating to 100 healthy subjects, aged between 20 and 40 years, were recorded with respect to age, gender and range of motion in three planes. Additionally, two widely used methods of measuring neck motion, chin-sternal distance and uniplanar goniometer, were assessed against a validated measurement tool, the ‘CROM goniometer’. Using multiple linear regression analysis it was determined that sagittal flexion (P = 0.002) and lateral rotation (P < 0.0001) were most closely related to neck circumference alone whereas lateral flexion (P < 0.0001) was most closely related to a ratio of circumference and length of neck. Hence, assessing cervical range of motion as outcome variable or as a measure at posttreatment follow-up, neck circumference was shown to be one of the factors influencing total neck motion, particularly sagittal flexion and lateral tilt. Comparison of cervical range of motion assessed with a validated measurement tool, the CROM goniometer, with results of both frequently applied clinician’s instruments, the uniplanar goniometer and measurement of chin-sternal distance, showed low reliability with the latter techniques, and motion values measured with these techniques should be interpreted with caution if using them for comparison of cervical range of motion of alike groups. We demonstrated that neck dimension should be incorporated into cervical functional outcome assessment and one should be wary about recorded values for neck motion from non-validated measurement tools.