Author(s) Anderson D.C.; Grimes D.S.
Source Clinical Medicine, Journal of the Royal College of Physicians of London; Nov 2020; vol. 20 (no. 6)
Language English
Publication Date Nov 2020

• Available in full text at Clinical medicine (London, England) from EBSCO (MEDLINE Complete)

​Author(s) Cousin G.C.; Yousaf I.
Source BMJ; Nov 2020; vol. 371
Language English
Publication Date Nov 2020

• Available in full text at BMJ (Clinical research ed.) from BMJ Publishing Group

Author(s) Abdulqawi R.; Satia I.; Kanemitsu Y.; Khalid S.; Holt K. et al.
Source The journal of allergy and clinical immunology. In practice; Nov 2020
Language English
Publication Date Nov 2020
BACKGROUND: Refractory chronic cough (RCC) is a debilitating condition for which there are no licensed treatments. Lidocaine is a non-selective inhibitor of voltage gated sodium channels (VGSC) with potential anti-tussive effects, but randomized placebo-controlled studies evaluating its efficacy in RCC are lacking. 

​Author(s) Badenoch J.; Cross B.; Hafeez D.; Song J.; Watson C.; Butler M.; Nicholson T.R.; Rooney A.G.
Source Psychological medicine; Nov 2020 ; p. 1-5
Language English
Publication Date Nov 2020

• Available in full text at Psychological medicine from Unpaywall

Author(s) Bhatia K.; Columb M.; Bewlay A.; Eccles J.; Hulgur M. et al.
Source Anaesthesia; 2020
Language English
Publication Date 2020
At the onset of the global pandemic of COVID-19 (SARS-CoV-2), guidelines recommended using regional anaesthesia for caesarean section in preference to general anaesthesia. National figures from the UK suggest that 8.75% of over 170,000 caesarean sections are performed under general anaesthetic. We explored whether general anaesthesia rates for caesarean section changed during the peak of the pandemic across six maternity units in the north-west of England. We analysed anaesthetic information for 2480 caesarean sections across six maternity units from 1 April to 1 July 2020 (during the pandemic) and compared this information with data from 2555 caesarean sections performed at the same hospitals over a similar period in 2019. Primary outcome was change in general anaesthesia rate for caesarean section. Secondary outcomes included overall caesarean section rates, obstetric indications for caesarean section and regional to general anaesthesia conversion rates. A significant reduction (7.7 to 3.7%, p < 0.0001) in general anaesthetic rates, risk ratio (95%CI) 0.50 (0.39-0.93), was noted across hospitals during the pandemic. Regional to general anaesthesia conversion rates reduced (1.7 to 0.8%, p = 0.012), risk ratio (95%CI) 0.50 (0.29-0.86). Obstetric indications for caesarean sections did not change (p = 0.17) while the overall caesarean section rate increased (28.3 to 29.7%), risk ratio (95%CI) 1.02 (1.00-1.04), p = 0.052. Our analysis shows that general anaesthesia rates for caesarean section declined during the peak of the pandemic. Anaesthetic decision-making, recommendations from anaesthetic guidelines and presence of an on-site anaesthetic consultant in the delivery suite seem to be the key factors that influenced this decline.Copyright © 2020 Association of Anaesthetists

• Available in full text at Anaesthesia from Unpaywall

Author(s) Hansrani V.; Moughal S.; Elmetwally A.; Al-Khaffaf H.
Source Journal of Vascular Surgery: Venous and Lymphatic Disorders; Nov 2020; vol. 8 (no. 6); p. 1104-1110
Language English
Publication Date Nov 2020
Objective: To investigate the presentation, etiology, management and outcomes of May-Thurner syndrome (MTS) in adolescents aged under 18. Method(s): We searched electronic bibliographic databases to identify published reports of MTS in patients under 18 years of age. We conducted our review according to the PRISMA statement standards. 

Author(s) Halim U.A.; Elbayouk A.; Javed S.; Ali A.M.; Cullen C.M.
Source Bone and Joint Journal; Nov 2020 (no. 11); p. 1446-1456
Language English
Publication Date Nov 2020
Aims Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. methods A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. Results Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. conclusion GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty.Copyright © 2020 The British Editorial Society of Bone & Joint Surgery

Author(s) Rashed R.A.; Abdalaziz A.; Veivenn V.Y.; Tetali S.R.; Choudry Q.A. et al.
Source Injury; Nov 2020; vol. 51 (no. 11); p. 2676-2681
Language English
Publication Date Nov 2020
DOI 10.1016/j.injury.2020.07.045
ISSN 0020-1383
Database EMBASE
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Introduction: The incidence of heterotopic ossification after total hip replacement is variable in the literature. If symptomatic, it may cause pain and reduced range of motion. Dual mobility total hip replacements have been considered a valuable option for the treatment of femoral neck fractures in the active patients, achieving good range of motion with reduced risk of dislocation. The occurrence of HO may have detrimental effect on this type of articulation and may accelerate polyethylene wear and predispose to intra-prosthetic dislocation. We compared the incidence of HO in DMC versus conventional THR in femoral neck fracture patients across 3 large trauma institutes 

Author(s) Gray W.K.; Day J.; Morton M.
Source British Journal of Oral and Maxillofacial Surgery; Nov 2020; vol. 58 (no. 9); p. 1151-1157
Language English
Publication Date Nov 2020
When patients attend the emergency department with facial fractures that require surgery and are immediately admitted, surgery can be delayed as theatre time is prioritised for other more urgent patients. One solution is to send the patient home and admit them as an elective patient at a later date. The aim of this study was to investigate the outcomes of patients admitted directly and those seen as elective patients following fracture of the mandible or zygomatic complex. Data were taken from the hospital episodes statistics (HES) dataset for 2011-2018, and all hospital admissions for mandibular and zygomatic complex fractures within the National Health Service (NHS) in England were extracted. Patients were categorised as those admitted on attendance at the emergency department and given definitive treatment during the admission, and those not admitted on attendance at the emergency department but discharged home and seen as elective admissions within 30 days of attendance. Data were available for 39 606 patients. For both types of fracture there was substantial variation between NHS trusts in the proportion of patients admitted electively and the proportion admitted directly as emergencies. Elective admission was independently associated with shorter overall stay and lower emergency readmission rates. We found no evidence that delays to definitive surgery through elective admission had a negative impact on emergency readmission rates. Patients admitted electively had a significantly shorter hospital stay.Copyright © 2020