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Wishaw General Hospital

HealthcareWishaw, Scotland, United Kingdom
About: Wishaw General Hospital is a healthcare organization based out in Wishaw, Scotland, United Kingdom. It is known for research contribution in the topics: Population & Survival rate. The organization has 256 authors who have published 222 publications receiving 4324 citations.


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Journal ArticleDOI
TL;DR: The 'apple core' cement spacer allows massive bone defects to be effectively managed between staged revision procedures and was performed in patients who underwent two-stage salvage revision for complex, recurrent infected total knee arthroplasty at a single institution.
Abstract: Antibiotic-loaded cement spacers are used in two-stage revision knee arthroplasty for infection, but commercially available spacers may not always be suitable for significant bone loss or soft tissue failure in multiply revised cases. We describe a technique for producing an on-table, static, reinforced cement spacer – the ‘apple core’ spacer – with the intended outcome of providing joint stability in such patients, prior to undertaking a second-stage procedure. Following a radical debridement, the spacer is made of three components: (1) a ‘central bar’ of external fixator connecting rods, combined using cerclage wires as needed; (2) a standard polymethylmethacrylate cement ‘apple core’; and (3) a covering ‘skin’ of high dose antibiotic-loaded cement, which is stippled as it sets, to increase the surface area and facilitate antibiotic elution. This technique was performed in nine patients who underwent two-stage salvage revision for complex, recurrent infected total knee arthroplasty at a single institution. All patients successfully went on to definitive second-stage reimplantation and have retained their limbs. The ‘apple core’ cement spacer allows massive bone defects to be effectively managed between staged revision procedures.

3 citations

Journal ArticleDOI
TL;DR: The use of thiopurine therapy in EBV-naive inflammatory bowel disease (IBD) patients remains controversial due to a risk of EBVassociated complications as mentioned in this paper.
Abstract: The use of thiopurine therapy in Epstein-Barr virus (EBV)-naive inflammatory bowel disease (IBD) patients remains controversial due to a risk of EBV-associated complications. We evaluated EBV status and outcomes within our paediatric IBD population over an 8-year period; finding that 217 of 409 (53%) screened patients were seropositive for EBV at IBD diagnosis; that thiopurines were used in 189 of 217 (87%) seropositive and 159 of 192 (83%) seronegative patients (P = 0.22); and that 7 of 192 (4%) previously seronegative patients subsequently tested positive for EBV with 6 of 7 (86%) patients having concurrently recorded thiopurine use. All six patients continued thiopurine with/without a period of cessation; no EBV-associated lymphoproliferative disorders/serious complications were recorded within our cohort. A significant proportion of our patients would not receive thiopurine therapy should their use be avoided in EBV-negative patients (47%) or seronegative males (30%). The small but significant risks of thiopurine treatment must be balanced against the potential benefits of successful IBD management; further research into this is required.

2 citations

Journal ArticleDOI
P. Tripathi1, H. Batool1, K. Surampudi1, C. Willocks1, D. McLellan1 
TL;DR: The experiences confirm the efficacy of embryofetoscopy for early diagnosis in the first trimester of pregnancy and procedure-related risks are to be established by multicenter studies.
Abstract: Results: Excellent visualization of the external fetal anatomy was obtained in 83% of cases (5/6) with the duration of procedures ranging 15 to 40 minutes. A diagnosis of Meckel-Gruber syndrome was made at 13 + 1 weeks of gestation by visualizing postaxial polydactyly and an occipital encephalocele. Subsequently the pregnancy was terminated. Three full-term infants were delivered with no gross limb or facial abnormalities. Amniotic fluid leakage after the procedure occurred in 2 cases resulting in termination of pregnancy. Conclusion: Our experiences confirm the efficacy of embryofetoscopy for early diagnosis in the first trimester of pregnancy. Procedure-related risks are to be established by multicenter studies.

2 citations

01 Aug 2012
TL;DR: This study found a maximum mean of 31.7 degrees of wrist rotation, which indicates that considerable rotational movement occurs at the wrist during certain functional tasks, and investigates the potential relationship between carpal surgery and rotational laxity.
Abstract: Several authors have used 3D motion analysis to measure upper limb kinematics, but none have focused solely on wrist movements, in six degrees of freedom, during activities of daily living (ADL). This study aimed to determine the role of the different planar wrist movements during three standardised tasks, which may be affected by surgical procedures. Nine volunteers (age range 22-45) were recruited and each participant performed three simulated ADLs: using a door lever, a door knob and opening/closing a jam jar. The ADLs were simulated using a work-sim kit on an isokinetic dynamometer. Motion analysis was performed by a 10-camera Oqus system (Qualisys Medical AB, Gothenburg, Sweden). All raw kinematic data were exported to Visual3D (C-Motion Inc.), where the biomechanical model was defined and joint kinematics calculated. Table 1 shows a similar range of radial-ulnar deviation and flexion-extension as previous studies. However a substantial amount of wrist rotation also occurred in all tasks. This was significantly greater when using the door lever compared with the door knob and jam jar tasks. Previous studies have stated that a negligible degree of rotation occurs at the wrist. This study found a maximum mean of 31.7 degrees of wrist rotation. This indicates that considerable rotational movement occurs at the wrist during certain functional tasks. Surgical approaches and clinical pathology may disrupt structures responsible for rotational stability. Further investigation of this rotational component of carpal movement during additional ADLs is proposed in both normal and clinical subjects, to explore the potential relationship between carpal surgery and rotational laxity.

2 citations

Journal ArticleDOI
01 Jun 2015-Gut
TL;DR: Considerable potential exists with using faecal haemoglobin concentration (f-Hb) measurements to assist with triaging symptomatic patients within in a clinical pathway, to either colonoscopy or clinic assessment, with high negative predictive value suggesting that it can rule out colorectal cancer and other significant coloreCTal disease with a negative test.
Abstract: Introduction Colonoscopy is an invasive test with associated risks and the majority performed in our NHS Trust are not associated with serious pathology. We aimed to determine whether colorectal cancer could be excluded, and colonoscopy resources better utilised, using faecal haemoglobin concentration (f-Hb) measurements to triage patients presenting in primary care with lower abdominal symptoms. Method Patients referred from primary care to NHS Lanarkshire with colorectal symptoms, who were vetted straight to test for colonoscopy, were asked to participate. Patients were asked to complete a single faecal immunochemical test (FIT) for f-Hb measurement prior to colonoscopy. F-Hb levels were then correlated with colonoscopic and histopathological findings. Results This was a diagnostic accuracy study. From 909 invited patients, 507 patients completed a FIT test. Four hundred and eighty four (484) of them had a colonoscopy. Findings at colonoscopy revealed a total of 45 cases (9.3%) with significant pathology (11 colorectal cancers, 19 high-risk adenomas, 3 inflammatory bowel disease and 12 other colitides). These had a significantly higher (p When a f-Hb cut-off of 10 µg Hb/g faeces is used the sensitivity was 68.9% (95% CI: 53.2–81.4) with a specificity of 80.2% (95% CI: 76.1–83.7). The negative predictive value was particularly high at 96.2% (95% CI: 93.5–97.8) with a positive predictive value of 26.3% (95% CI: 18.8–35.3). Of the 243 with normal colonoscopies, 81.2% had f-Hb Conclusion Considerable potential exists with using f-Hb measurements to assist with triaging symptomatic patients within in a clinical pathway, to either colonoscopy or clinic assessment. This is particularly true with the high negative predictive value of f-Hb suggesting that it can rule out colorectal cancer and other significant colorectal disease with a negative test. No cases of colorectal cancer, in our population, would be missed when using a f-Hb level of Disclosure of interest None Declared.

2 citations


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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20231
20222
202111
20207
20199
201812