Aintree -Results of Flap Reconstruction: Categorisation to Reflect Outcomes and Process in the Management of Head and Neck Defects.

Authors: Ho MW, Nugent M, Puglia F, Shaw RJ, Blackburn TK, Parmar S, Dhanda J, Fry AM, Brennan P, Barry CP, McMahon J.

Source: Br J Oral Maxillofac Surg. 2019 Aug 22. pii: S0266-4356(19)30321-3.

doi: 10.1016/j.bjoms.2019.08.005. [Epub ahead of print]

PMID: 31447074 [PubMed – as supplied by publisher]

Aintree – Non-Typeable Haemophilus Influenzae Protein Vaccine in Adults with COPD: A Phase 2 Clinical Trial.

Authors: Wilkinson TMA, Schembri S, Brightling C, Bakerly ND, Lewis K, MacNee W, Rombo L, Hedner J, Allen M, Walker PP, De Ryck I, Tasciotti A, Casula D, Moris P, Testa M, Arora AK.

Source: Vaccine. 2019 Aug 22. pii: S0264-410X(19)31021-7. doi: 10.1016/j.vaccine.2019.07.100. [Epub ahead of print]

PMID: 31447126 [PubMed – as supplied by publisher] Free Article

Aintree – Plate and Screw Fixation of Arthroscopically Assisted Tibial Tuberosity Osteotomy: Technique and Results.

Authors: Stevens JM, Barton SB, Alexander M, Eldridge JD, Clark D.

Source: Eur J Orthop Surg Traumatol. 2019 Aug 28.

doi: 10.1007/s00590-019-02536-x. [Epub ahead of print]

PMID: 31456034 [PubMed – as supplied by publisher]

Aintree – Lung Health and Exposure to Air Pollution in Malawian Children (CAPS): A Cross-Sectional Study.

Authors: Rylance S, Nightingale R, Naunje A, Mbalume F, Jewell C, Balmes JR, Grigg J, Mortimer K.

Source: Thorax. 2019 Aug 29. pii: thoraxjnl-2018-212945.

doi: 10.1136/thoraxjnl-2018-212945. [Epub ahead of print]

PMID: 31467192 [PubMed – as supplied by publisher] Free Article

Aintree – A Mixed-Methods Pilot Study to Evaluate a Collaborative Anaesthetic and Surgical Training Package for Emergency Surgical Cricothyroidotomy.

 Authors: Berwick RJ, Gauntlett W, Silverio SA, Wallace H, Mercer SA, Brown JM, Sandars JE, Morton B, Groom P.

Source: Anaesth Intensive Care. 2019 Aug 18:310057X19861978.

doi: 10.1177/0310057X19861978. [Epub ahead of print] No abstract available.

PMID: 31423804 [PubMed – as supplied by publisher]

Aintree: Analysis of Head and Neck Carcinoma Progression Reveals Novel and Relevant Stage-Specific Changes Associated with Immortalisation and Malignancy.

Authors: Veeramachaneni R, Walker T, Revil T, Weck A, Badescu D, O’Sullivan J, Higgins C, Elliott L, Liloglou T, Risk JM, Shaw R, Hampson L, Hampson I, Dearden S, Woodwards R, Prime S, Hunter K, Parkinson EK, Ragoussis J, Thakker N.

Source: Sci Rep. 2019 Aug 19;9(1):11992.

doi: 10.1038/s41598-019-48229-7.

PMID: 31427592 [PubMed – in process] Free PMC Article

Aintree – Performance of Urgent Surgical Front of Neck Airway Access by Head and Neck Surgeons, General Surgeons, or Anaesthetists: An In Situ Simulation Study

Author(s): Groom P.; Schofield L.; Hettiarachchi N.; Pickard S.; Brown J.; Sandars J.; Morton B.

Source: British Journal of Anaesthesia; 2019

Publication Date: 2019

Publication Type(s): Article

Abstract:Background: The ‘cannot intubate cannot oxygenate’ (CICO) emergency requires urgent front of neck airway (FONA) access to prevent death. In cases reported to the 4th National Audit Project, the most successful FONA was a surgical technique, almost all of which were performed by surgeons. Subsequently, UK guidelines adopted surgical cricothyroidotomy as the preferred emergency surgical FONA technique. Despite regular skills-based training, anaesthetists may still be unwilling to perform an emergency surgical FONA. Consultant anaesthetists, head and neck surgeons, and general surgeons were compared in a high-fidelity simulated emergency. We hypothesised that head and neck surgeons would successfully execute emergency surgical FONA faster than anaesthetists and general surgeons. Method(s): We recruited 15 consultants from each specialty (total of 45) at a single tertiary care hospital in the UK. All agreed to participate in an in situ high-fidelity simulation of an ‘anaesthetic emergency’. Participants were not told in advance that this would be a CICO scenario. Result(s): There were no significant differences in total time to successful ventilation between anaesthetists, head and neck surgeons and general surgeons (median 86 vs 98 vs 126 s, respectively, P=0.078). Anaesthetists completed the emergency surgical FONA procedure significantly faster than general surgeons (median 50 vs 86 s, P=0.018). Despite this strong performance, qualitative data suggested some anaesthetists still believed ‘surgeons’ best placed to perform emergency surgical FONA in a genuine CICO situation. Conclusion(s): Anaesthetists regularly trained in emergency surgical FONA function at levels comparable with head and neck surgeons and should feel empowered to lead this procedure in the event of a CICO emergency.

Copyright © 2019 British Journal of Anaesthesia

Database: EMBASE

Aintree – The Liverpool Head Injury Tomography Score (HITS)-A CT Scoring System to Reduce Avoidable Referrals for Mild TBI

Author(s): Gillespie C.; McLeavy C.M.; McMahon C.

Source: British Journal of Neurosurgery; 2019; vol. 33 (no. 4); p. 458

Publication Date: 2019

Publication Type(s): Conference Abstract

Abstract:Objectives: No criteria currently exists to guide referrers to which patients with Traumatic Brain Injury (TBI) require referral to neurosurgery and what is ‘surgically significant’. The aim of this study is to develop a CTB scoring system and referral criteria to reduce unnecessary referrals to tertiary Neurosurgical centres in patients with mild TBI. Design(s): Retrospective analysis of 258 patients with mild TBI to create a CT scoring system and referral criteria. Subjects: Patients referred to the Neurosurgical centre with GCS 13-15 with a history of head injury during the months of June and December 2017 were eligible for the study. Method(s): Radiological and clinical features of patients were reviewed. The CT score and referral guidelines were tested for those accepted and not accepted. This was then analysed. Result(s): 258 patients were referred with TBI and GCS of 13-15 during the months analysed. Of these 85.7% (n = 221) were not accepted and 14.3% (n = 37) accepted. Of the 221 patients not accepted, if the referral guidelines had been followed, 119 would not have required discussion and subsequent referral. None of the patients accepted would have been missed under the referral guidelines. The CT scoring system and referral guidelines would therefore have reduced referrals by 54%. Conclusion(s): The implementation of a new CT scoring system and referral guidelines could reduce the number of mild TBI referrals to tertiary Neurosurgical centres by up to 54%. This could therefore reduce workload for referrers and Neurosurgical on-call teams.

Database: EMBASE

Aintree – Myopericarditis as a Presentation of Eosinophilic Granulomatosus with Polyangiitis (EGPA)

Author(s): Dey M.; Nair J.; Sankaranarayanan R.; Kanagala P.

Source: BMJ Case Reports; Aug 2019; vol. 12 (no. 8)

Publication Date: Aug 2019

Publication Type(s): Article

Available  at BMJ Case Reports –  from ProQuest (Health Research Premium) – NHS Version

Abstract:A 60-year-old woman was admitted to the hospital with worsening dyspnoea, cough and chest pain. This was on a background of weight loss, decreased appetite, mononeuritis multiplex, chronic eosinophilia and a single episode of a non-blanching rash. Investigations demonstrated a raised troponin and ischaemic changes on ECG, and she was therefore initially treated for a presumed myocardial infarction. However, her symptoms failed to improve with treatment for the acute coronary syndrome. A coronary angiogram revealed no significant flow-limiting disease, and further investigations yielded confirmation of raised eosinophils and a positive perinuclear antineutrophil cytoplasmic antibody test. An echocardiogram demonstrated a pericardial effusion, and subsequent cardiac magnetic resonance features were compatible with myopericarditis. In light of these findings, the patient was diagnosed with eosinophilic granulomatous with polyangiitis and commenced on high-dose intravenous methylprednisolone and cyclophosphamide. She made an excellent recovery and remains in remission on azathioprine and a tapering dose of corticosteroids.

Copyright © 2019 Author(s).

Database: EMBASE