Wishaw General Hospital

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 & Medicine. The organization has 256 authors who have published 222 publications receiving 4324 citations.

Scottish rheumatology sonography course: five-year experience of delivering a mentorship-model rheumatology ultrasound training programme accredited by the consortium for the accreditation of sonographic education:

Abstract: Background and aimsUltrasound training for rheumatology practice in the UK is variable. Currently, there is no agreed minimum standard for training in ultrasound applied to rheumatology patient man...

Oxford hip and knee scores deteriorate in patients awaiting lower limb arthroplasty during the COVID-19 pandemic and predict a health state ‘worse than death’

Abstract: The COVID-19 pandemic has caused unprecedented disruption to elective orthopaedic services. The primary objective of this study was to examine changes in functional scores in patients awaiting total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA). Secondary objectives were to investigate differences between these groups and identify those in a health state 'worse than death' (WTD). In this prospective cohort study, preoperative Oxford hip and knee scores (OHS/OKS) were recorded for patients added to a waiting list for THA, TKA, or UKA, during the initial eight months of the COVID-19 pandemic, and repeated at 14 months into the pandemic (mean interval nine months (SD 2.84)). EuroQoL five-dimension five-level health questionnaire (EQ-5D-5L) index scores were also calculated at this point in time, with a negative score representing a state WTD. OHS/OKS were analyzed over time and in relation to the EQ-5D-5L. A total of 174 patients (58 THA, 74 TKA, 42 UKA) were eligible, after 27 were excluded (one died, seven underwent surgery, 19 non-responders). The overall mean OHS/OKS deteriorated from 15.43 (SD 6.92), when patients were added to the waiting list, to 11.77 (SD 6.45) during the pandemic (p < 0.001). There were significantly worse EQ-5D-5L index scores in the THA group (p = 0.005), with 22 of these patients (38%) in a health state WTD, than either the TKA group (20 patients; 27% WTD), or the UKA group (nine patients; 21% WTD). A strong positive correlation between the EQ-5D-5L index score and OHS/OKS was observed (r = 0.818; p < 0.001). Receiver operating characteristic analysis revealed that an OHS/OKS lower than nine predicted a health state WTD (88% sensitivity and 73% specificity). OHS/OKS deteriorated significantly among patients awaiting lower limb arthroplasty during the COVID-19 pandemic. Overall, 51 patients were in a health state WTD, representing 29% of our entire cohort, which is considerably worse than existing pre-pandemic data.

Congenital hypothyroidism associated with congenital diaphragmatic hernia.

Abstract: To the Editor:A female infant was born by normal delivery at full term with birth weight of 2.95 kg. The antenatal period was uneventful except mild polyhydramnios that resolved in repeat scan done after two weeks. Baby was vigorous at birth with Apgar’s of eight and nine at one and five minutes respectively. She developed respiratory distress at four hours of age and chest radiograph revealed left sided diaphragmatic hernia with moderate shift of the mediastinum to the right side (Fig. 1). Subsequently, she was intubated and commenced on mechanical ventilation. She underwent surgical repair of diaphragmatic hernia at 12 h of age. Post-operative recovery was uneventful. Blood taken for newborn screening by heel prick on day 5 of life revealed high thyroid stimulating hormone (TSH) with value 43 mU/L. Subsequent thyroid function tests (TFT) revealed total T4 and TSH levels as 8 mcg/dL and 51 mU/L respectively. Ultrasound of the neck could not localise thyroid gland. One hundred twenty-three Iodine Radionuclide thyroid scan performed on day eight of life showed zero uptake at neck. She was commenced on thyroxin supplement immediately. Free T4 and TSH levels normalised after 3 wk of commencement of therapy. Cytogenetic study revealed normal female karyotype and DNA microarray did not reveal any genetic mutation. Congenital hypothyroidism (CH) is the most common cause of preventable intellectual disability in pediatric population. Its incidence has been cited around 1:4000 in several studies [1]. CH has been associated with various congenital malformations with cardiac being the most common [2]. Associations of CH, mainly of syndromic varieties, have also been sought with various renal, urologic, skeletal, gastrointestinal, and neurological (ataxia) abnormalities [3–5]. Though neonatal respiratory distress has been ascribed as an association of congenital hypothyroidism by Doyle et al., our extensive literature search could not reveal any case or incidence of Congenital diaphragmatic hernia (CDH) associated with congenital hypothyroidism, though umbilical hernia is a commonly reported finding in CH. Few genetic

Metastatic breast cancer deluding as a papular skin rash.

Abstract: Dermatological metastases from internal malignancies are relatively less common than other sites. We describe an interesting case of an elderly lady who initially presented with symptomatic normocytic anaemia, and then developed a widespread papular rash over a period of ten days. The rash was found to be metastatic breast cancer.