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Sutton in Ashfield, United Kingdom

Burbage G.,Kings Mill Hospital
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2014

Gout is a painful inflammatory condition that can affect a variety of joints, causes significant distress and is associated with a number of comorbidities. This article aims to dispel the myths surrounding this condition and explore the pathogenesis, clinical presentation, risk factors and diagnosis. It also describes the treatment options and lifestyle changes that can reduce the effects of this condition and the incidence of reoccurring episodes. Source

Rajapakse S.,University of Colombo | Rodrigo C.,University of Colombo | Rajapakse A.,Kings Mill Hospital
Infection and Drug Resistance | Year: 2012

The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last fve decades at an alarming rate. In the endemic areas, waves of infection occur in epidemics, with thousands of individuals affected, creating a huge burden on the limited resources of a country's health care system. While the illness passes off as a simple febrile episode in many, a few have a severe illness marked by hypovolemic shock and bleeding. Iatrogenic fuid overload in the management may further complicate the picture. In this severe form dengue can be fatal. Tackling the burden of dengue is impeded by several issues, including a lack of understanding about the exact pathophysiology of the infection, inability to successfully control the vector population, lack of specifc therapy against the virus, and the technical diffculties in developing a vaccine. This review provides an overview on the epidemiology, natural history, management strategies, and future directions for research on dengue, including the potential for development of a vaccine. © 2012 Rajapakse et al, publisher and licensee Dove Medical Press Ltd. T. Source

McMahon M.A.,University of Nottingham | Squirrell C.A.,Kings Mill Hospital
Radiographics | Year: 2010

Aortic dissection is the most common acute emergency condition of the aorta and often has a fatal outcome. Outcome is determined by the type and extent of dissection and the presence of associated complications (eg, cerebral sequelae, aortic branch involvement, pericardial involvement, and visceral involvement), with early diagnosis and treatment being essential for improved prognosis. Aortic dissections are classified on the basis of the site of the intimal tear according to the Stanford classification system. Type A aortic dissection involves the ascending thoracic aorta and may extend into the descending aorta, whereas in a type B dissection the intimal tear is located distal to the left subclavian artery. Type A dissection typically requires urgent surgical intervention, whereas type B dissection can often be treated medically. Modern multidetector computed tomography (CT) is a fast, widely available imaging modality with high sensitivity and specificity. Multidetector CT allows the early recognition and characterization of aortic dissection as well as determination of the presence of any associated complications, findings that are essential for optimizing treatment and improving clinical outcomes. © RSNA, 2010. Source

Hutchinson A.J.P.,Imperial College London | Ball S.,Chelsea and Westminster Hospital | Andrews J.C.H.,Kings Mill Hospital | Jones G.G.,Chelsea and Westminster Hospital
Journal of Orthopaedic Surgery and Research | Year: 2012

Background: Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. Low back pain results in high health costs and incapacity to work causing an economic burden to society. The optimal management of non-specific low back pain appears to be undecided. Recently published guidelines support the use of acupuncture for treating non-specific low back pain and it has become a popular alternative treatment modality for patients with low back pain.Methods: A comprehensive systematic literature search was conducted through Medline using Ovid and Medical Subject Headings for randomized controlled trials published in the last 10 years. The outcomes scored were subjective pain scores and functional outcome scores.Results: Eighty two randomized studies were identified, of which 7 met our inclusion criteria. Three studies found a significant difference in pain scores when comparing acupuncture, or sham acupuncture, with conventional therapy or no care. Two studies demonstrated a significant difference between acupuncture treatment and no treatment or routine care at 8 weeks and 3 months. Three studies demonstrated no significant difference between acupuncture and minimal/sham acupuncture with no difference in pain relief or function over 6 to 12 months.Conclusions: This review provides some evidence to support acupuncture as more effective than no treatment, but no conclusions can be drawn about its effectiveness over other treatment modalities as the evidence is conflicting. © 2012 Hutchinson et al.; licensee BioMed Central Ltd. Source

Vivegananthan B.,Kings Mill Hospital
BMJ case reports | Year: 2014

A 70-year-old woman presented with right knee pain and a 'grinding' sensation 6 months after a total knee replacement for osteoarthritis. Clinical examination revealed a valgus deformity, patellofemoral crepitus and a reduced knee flexion. Radiographs revealed distinctive findings including the 'bubble sign', 'cloud sign' and the 'metal line sign', which are diagnostic of metallosis. Metallosis is an uncommon complication of total joint replacements, where bone and periprosthetic soft tissues are infiltrated by metallic debris from wearing of the prostheses. This usually occurs in high-wear joints such as hips and knees. Treatment for patients diagnosed with metallosis is synovectomy and a revision surgery. Our patient underwent revision surgery 5 years after her initial surgery. Source

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