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Northampton, United Kingdom

McGowan S.E.,University of Cambridge | Greaves C.D.,University of Leicester | Evans S.,Northampton General Hospital NHS Trust
Nuclear Medicine Communications | Year: 2012

BACKGROUND: In SPECT images truncation artefacts may occur when the object does not remain in the field of view (FOV). This truncation may lead to distortions in the transmission map (μ map), which would affect the attenuation correction (AC) and possibly the final image. Our aim was to investigate this distortion on our dedicated small FOV cardiac camera and evaluate the efficacy of the truncation correction. METHODS: Using a phantom, transmission data were acquired with our cardiac camera using arrays of Gd sources. The width of the phantom was varied by adding attenuating material. AC and non-AC images were analysed. RESULTS: The results showed that distorted μ maps were produced, which remained distorted even after the application of correction algorithms for chest width measurements greater than 43±1 cm. This distortion was observed to worsen with increasing chest width measurements. Artefacts were not seen for chest width measurements smaller than 43 cm, even when significant anterior attenuation was modelled. CONCLUSION: Our findings demonstrate that AC-corrected images acquired with our dedicated small FOV cardiac camera are not suitable for patients with chest width measurements greater than 43 cm. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Joseph J.,Northampton General Hospital NHS Trust | Lim K.,Leeds Teaching Hospitals NHS Trust | Ramsden J.,University of Oxford
Annals of the Royal College of Surgeons of England | Year: 2012

Introduction: Investigation of the anterior midline neck lump has been debated over the years with little agreement on best practice. Thyroglossal duct cysts (TDCs) are the most common aetiology. A TDC may contain ectopic thyroid tissue, which may affect the decision to excise. Methods: A computerised survey was sent to a representative sample of UK-based ENT surgeons to determine current practice in investigation of presumed TDCs and the incidence of ectopic thyroid tissue. Results: Overall, 95% of those surveyed use ultrasonography, with 32% also arranging thyroid function tests. Fifteen per cent had encountered absent normal thyroid tissue in the presence of a midline neck swelling. In 64% of cases this represented the only functioning thyroid tissue. Thyroid function tests were normal in all but two cases. Conclusions: The results show a significant change in practice over the last decade. All surgeons would arrange some form of investigation of a presumed TDC, with the vast majority using ultrasonography. Radioisotope scanning should only be used if the ultrasonography or thyroid function tests are abnormal. The incidence of ectopic thyroid tissue in this survey was higher than previously calculated, with a 0.17% prevalence of midline neck lumps representing the only functioning thyroid tissue.

Pickering W.,Northampton General Hospital NHS Trust
Journal of Renal Care | Year: 2013

Background: Home dialysis (peritoneal or haemodialysis) in any reasonable guise offers potential benefits compared with in-centre dialysis. Benefits may be overtly patient centred (independence, quality of life), outcome oriented (survival, resolution of left ventricular hypertrophy) or resource friendly (savings on staff costs). The priority placed on each of these areas is likely to vary from patient to patient, and possibly provider to provider. This is the one strength of home haemodialysis (HHD) rather than being viewed as a weakness, as it can offer different benefits to different people. Intuitively, more haemodialysis is better than less, and this is most realistically achieved at home. Indications are that both long nocturnal dialysis and short daily dialysis can offer real objective benefits. Literature review: Critics argue correctly that there is a paucity of robust randomised controlled study data. The complexity of HHD regimens and practice and in-homogeneity of patients means such firm data are unlikely to be forthcoming. However, the positive reports both subjective and objective of patients dialysing at home, and results from the available research suggest that advantages may be seen purely with changing the location of dialysis to home, and independently with enhancing dialysis schedules. Conclusion: The logical conclusion is that patients undertaking haemodialysis at home should have at least the recommended minimum of four hours three times per week (or equivalent), preferably avoiding the long inter-dialytic interval, but beyond that rigid adherence to a schedule as dogma should be subjugated to patient choice and flexibility, albeit by prior agreement with supervising medical and nursing staff. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Davies E.,Northampton General Hospital NHS Trust | Yeoh K.-W.,Churchill Hospital
British Journal of Cancer | Year: 2012

BACKGROUND: Reliable information can improve patients' knowledge of chemotherapy. As internet chemotherapy information (ICI) is increasingly viewed as a valuable patient education tool, we investigated the impact of ICI on patient care and analysed health professionals' (HPs') attitudes towards ICI. METHODS: The following questionnaires were distributed: (1) self-administered questionnaire randomly given to 261 patients receiving chemotherapy (80% returned); and (2) separate questionnaire given to 58 HPs at the same UK Oncology Centre (83% returned). RESULTS: Just over half of the patient respondents accessed the internet regularly. They were younger, with higher incomes and qualifications. Key search topics included chemotherapy modes of action, symptom management and treatment success, and most considered ICI useful. More than half wanted to discuss ICI with HPs but most did not get the opportunity. Although the majority of HP respondents supported the need for patients to retrieve ICI, most questioned the accuracy of ICI and did not routinely recommend its use. CONCLUSION: This study has shown that ICI is generally perceived by patients to be a valuable information resource. Given the potential impact of ICI, the following should be addressed in future studies: (1) inequalities in accessing ICI; (2) maintaining the quality of ICI (with clear guidance on recommended websites); (3) bridging the gap between the perception of ICI by patients and HPs; (4) integration of ICI with traditional consultation models. © 2012 Cancer Research UK. All rights reserved.

Barnes N.,Northampton General Hospital NHS Trust
Progress in Neurology and Psychiatry | Year: 2012

In the first of a new series on managing neurological and psychiatric conditions in children and adolescents, Dr Nick Barnes discusses the presentation, diagnosis and treatment of paediatric migraine. © 2012 John Wiley & Sons, Ltd.

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