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Limb D.,Leeds Teaching Hospitals Trust
Bone and Joint Journal | Year: 2014

Continuing professional development (CPD) refers to the ongoing participation in activities that keep a doctor up to date and fit to practise once they have completed formal training. It is something that most will do naturally to serve their patients and to enable them to run a safe and profitable practice. Increasingly, regulators are formalising the requirements for evidence of CPD, often as part of a process of revalidation or relicensing. This paper reviews how orthopaedic journals can be used as part of the process of continuing professional development. ©2014 The British Editorial Society of Bone & Joint Surgery. Source


Prajapati H.,Leeds Teaching Hospitals Trust
BMJ case reports | Year: 2012

Hypertension is becoming a more common problem in childhood and adolescence. About 5-10% of paediatric patients with hypertension have underlying renovascular disease. Although renal artery aneurysms (RAAs) are an uncommon cause of disease of the renal vessels, they are recognised as a cause of hypertension. We describe a 15-year-old man with symptomatic hypertension who after extensive investigation was found to have a right RAA. Our patient responded to conservative management with two antihypertensive agents, but as a young sports enthusiast, he was keen to pursue more definitive options. Complex anatomy of the aneurysm precluded the use of endovascular treatment. Surgical options were explored, and after counselling, our patient underwent a nephrectomy, ex vivo aneurysm repair and autotransplantation with which his hypertension resolved. Our case highlights the difficulty of diagnosing RAAs in hypertensive patients and that, in carefully selected patients, invasive surgical intervention of RAAs is a viable treatment option. Source


Speight R.,St Jamess Hospital | Sykes J.,St Jamess Hospital | Lindsay R.,St Jamess Hospital | Franks K.,Leeds Teaching Hospitals Trust | Thwaites D.,St Jamess Hospital
Radiotherapy and Oncology | Year: 2011

Purpose: To evaluate a deformable image registration (DIR) segmentation technique for semi-automating ITV production from 4DCT for lung patients, in terms of accuracy and efficiency. Methods: Twenty-five stereotactic body radiotherapy lung patients were selected in this retrospective study. ITVs were manually delineated by an oncologist and semi-automatically produced by propagating the GTV manually delineated on the mid-ventilation phase to all other phases using two different DIR algorithms, using commercial software. The two ITVs produced by DIR were compared to the manually delineated ITV using the dice similarity coefficient (DSC), mean distance between agreement and normalised DSC. DIR-produced ITVs were assessed for their clinical suitability and also the time savings were estimated. Results: Eighteen out of 25 ITVs had normalised DSC > 1 indicating an agreement with the manually produced ITV within 1 mm uncertainty. Four of the other seven ITVs were deemed clinically acceptable and three would require a small amount of editing. In general, ITVs produced by DIR were smoother than those produced by manual delineation. It was estimated that using this technique would save clinicians on average 28 min/patient. Conclusions: ABAS was found to be a useful tool in the production of ITVs for lung patients. The ITVs produced are either immediately clinically acceptable or require minimal editing. This approach represents a significant time saving for clinicians. © 2010 Elsevier Ireland Ltd. All rights reserved. Source


Pysden K.,Leeds Teaching Hospitals Trust | Fallon P.,St. Georges Hospital | Moorthy B.,Frimley Park Hospital | Ganesan V.,University College London
Developmental Medicine and Child Neurology | Year: 2010

Moyamoya disease describes a cerebral arteriopathy characterized by stenosis or occlusion of the terminal internal carotid and/or the proximal middle cerebral arteries. We report a female child with trisomy 21 and bilateral moyamoya disease who presented, unusually, with a presumed perinatal cerebral infarct. The clinical, radiological, and angiographic features of moyamoya disease in children with Down syndrome are similar to those with other aetiologies or idiopathic cases. Early recognition is important as moyamoya disease presenting in childhood is associated with a high rate of recurrent stroke and there is evidence that surgical revascularization can prevent further events. An important practical lesson arising from this case is that although the evaluation of children with presumed perinatal stroke tends to be limited relative to the evaluation of arterial ischaemic stroke in older children, this may need to be more comprehensive in infants at high risk of arteriopathy. The parents of the child gave informed consent to the publication of this report. © 2009 The Authors. Journal compilation © Mac Keith Press 2009. Source


Calaminus G.,University of Munster | Birch J.R.,University of Manchester | Hollis R.,Leeds Teaching Hospitals Trust | Pau B.,International Confederation of Childhood Cancer Parent Organizations c o VOKK Schouwstede | Kruger M.,Stellenbosch University
Pediatric Blood and Cancer | Year: 2013

Since the year 2000, there has been a 35% annual decrease in mortality among children under the age of five worldwide. The decrease is mainly attributed to the decrease in childhood epidemic infections, for example, due to vaccination programs. In the near future, this decrease will draw attention to paediatric non-communicable diseases (NCDs), and cancer is one of the most common. Access to care for children with cancer and survival rates have improved dramatically in high-income countries. However, it is important that a global perspective addresses problems in developing countries in particular. To meet this challenge, it is critical that emphasis is placed on demands such as access to care and drugs that are known to be effective, and which can be safely administered in resource-limited settings. Additionally, cancer registries and improved health care structures that include care for children with cancer, are paramount for further progress to increase awareness and the survival of children with cancer. The purpose of this paper is to describe current worldwide interventions to improve childhood cancer from the perspective of the International Society of Paediatric Oncology (SIOP). This global perspective will serve as an introduction to a series of papers from six SIOP continental branches, which will highlight the specific and/or common issues related to children with cancer worldwide. To strengthen the communication among and synergistic effects of various paediatric cancer stakeholders, SIOP could serve as a global platform for a proposed Global Paediatric Cancer Network through the interaction of its continental branches and partner collaborations. Pediatr Blood Cancer 2013;60:2080-2086. © 2013 Wiley Periodicals, Inc. Source

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