​Author(s): El Muntasar A.; Toner E.; Alkhazaaleh O.A.; Arumugam D.; Shah N.; Hajibandah S.; Hajibandeh S.
Source: World Journal of Emergency Medicine; 2018; vol. 9 (no. 2); p. 85-92
Publication Date: 2018
Publication Type(s): Review
Available  at World Journal of Emergency Medicine -  from Europe PubMed Central - Open Access
Abstract:BACKGROUND: The management of complex pattern of bleeding associated with pelvic trauma remains a big challenge for trauma surgeons. We aimed to conduct a comprehensive meta-analysis to compare the outcomes of angioembolisation and pelvic packing in patients with pelvic trauma. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register, and bibliographic reference lists. The primary outcome was defined as mortality. Combined overall effect sizes were calculated using randomeffects models. Results are reported as the odds ratio (OR) and 95% confi dence interval (CI). RESULTS: We identified 3 observational studies reporting a total of 120 patients undergoing angioembolisation (n=60) or pelvic packing (n=60) for pelvic trauma. Reporting of the Injury Severity Score (ISS) was variable, with higher ISS in the pelvic packing group. The risk of bias was low in two studies, and moderate in one. The pooled analysis demonstrated that angioembolisation did not signifi cantly reduce mortality in patients with pelvic trauma compared to surgery (OR=1.99; 95% CI= 0.83-4.78, P=0.12). There was mild between-study heterogeneity (I2=0%, P=0.65). CONCLUSION: Our analysis found no signi f icant di fference in mortal i ty between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insuffi cient to support the superiority of a treatment modality. Future research is required.Copyright © 2017 World Journal of Emergency Medicine.
Database: EMBASE

​Author(s): Her A.-Y.; Shin E.-S.; Lee J.M.; Garg S.; Doh J.-H.; Nam C.-W.; Koo B.-K.
Source: International Journal of Cardiovascular Imaging; Apr 2018 ; p. 1-9
Publication Date: Apr 2018
Publication Type(s): Article In Press
Abstract:There is limited data on the efficacy of paclitaxel-coated balloon (PCB) compared to stents for de novo coronary lesions. The purpose of this study was to compare the efficacy of PCB treatment with stent implantation for de novo coronary lesions after successful plain old balloon angioplasty (POBA) guided by fractional flow reserve (FFR). In 200 patients scheduled for elective percutaneous coronary intervention (PCI) for de novo lesions, FFR was measured after POBA (POBA-FFR). If POBA-FFR was >= 0.75, patients were treated with PCB (PCB group, n = 78) or stent (Stent group, n = 73). If POBA-FFR was < 0.75, stent was implanted as planned (Reference group, n = 42). The primary endpoint was late lumen loss at 9 months and the secondary endpoint was adverse cardiac events (cardiac death, myocardial infarction, target lesion thrombosis, or repeat revascularization) at 12 months follow-up. There was no between-group differences in the POBA-FFR (0.87 +/- 0.05 in PCB, 0.89 +/- 0.06 in stent, p = 0.101). At 9 months, late lumen loss was significantly lower in the PCB group compared to the Stent group (0.05 +/- 0.33 vs. 0.59 +/- 0.76 mm, p < 0.001). Adverse cardiac events were not different between the PCB, Stent and Reference groups (2.6, 5.5, and 9.5% respectively; p = 0.430 for PCB vs. Stent group; p = 0.229 for the reference vs. both other groups). PCB treatment guided by POBA-FFR showed excellent 9 months angiographic and functional results, as well as comparable 12 months clinical outcomes, compared with stent implantation for de novo coronary lesions.Copyright © 2018 Springer Science+Business Media B.V., part of Springer Nature
Database: EMBASE

​Author(s): Abdulla, Omar; Ahmad, Sarfraz
Source: British Journal of Hospital Medicine (17508460); May 2018; vol. 79 (no. 5); p. 294-294
Publication Date: May 2018
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine -  from MAG Online Library
Abstract:The article presents a case study of a 60-year-old man with abdominal pain and distention which was diagnosed as the rare azygos vein thrombosis which in turn helped to prevent the development of pulmonary embolism.
Database: CINAHL

​Author(s): Tomlinson, Robert
Source: Journal of perioperative practice; May 2018; vol. 28 (no. 5); p. 115-119
Publication Date: May 2018
Publication Type(s): Journal Article
PubMedID: 29734935
Abstract:Reacting to a never event is difficult and often embarrassing for staff involved. East Lancashire Hospitals NHS Trust has demonstrated that treating staff with respect after a never event, creates an open culture that encourages problem solving and service improvement. The approach has allowed learning to be shared and paved the way for the trust to be the first in the UK to launch the patient centric behavioural noise reduction strategy 'Below ten thousand'.
Database: Medline

Author(s): Campbell R.; Nelson E.; Hocking J.; Hickey T.; Hodgins J.; Geraghty V.
Source: Journal of Crohn's and Colitis; Feb 2018; vol. 12
Publication Date: Feb 2018
Publication Type(s): Conference Abstract
Abstract:Background: In the current financial climate the NHS is under pressure to change medications in order to improve the cost-effectiveness of prescribing. Despite this practice being widespread, there is a paucity of information on how patients feel about these changes. A key strategy for preventing relapses in patients with inflammatory bowel disease (IBD) is treatment with Mesalazine. Anecdotal reports have suggested that IBD patients find changes in their IBD medication worrying and that this may destabilise symptom control. 
Database: EMBASE

​Author(s): Doherty C.; Bowler M.; Sadadcharam M.; Perkins R.; Bateman N.; Bruce I.A.; Monks S.; English C.; Atkinson D.; McGrath B.
Source: Clinical Otolaryngology; Apr 2018; vol. 43 (no. 2); p. 674-678
Publication Date: Apr 2018
Publication Type(s): Letter
Available  at Clinical Otolaryngology -  from Wiley Online Library Medicine and Nursing Collection 2018 - NHS
Database: EMBASE

Author(s): Patel L.B.; Stuart-Booth S.; Rakshi K.
Source: Archives of Disease in Childhood; Mar 2018; vol. 103
Publication Date: Mar 2018
Publication Type(s): Conference Abstract
Available  at Archives of Disease in Childhood -  from BMJ Journals - NHS
Abstract:Aims The incidence of autism in the UK is predicted at 0.1%; 1 00 000 children and 7 00 000 adults. Diagnosis of Autism Spectrum Disorder (ASD) varies regionally though national standards are outlined; NICE Clinical guideline (CG128) and Quality standard (QS51). 
Database: EMBASE

Author(s): Hajibandeh, S.; Deering, R.; McEleney, D.; Guirguis, J.; Dix, S.; Sreh, A.; Toner, E.; El Muntasar, A.; Kausar, A.; Sheikh, G.; OShea, D.; Shafiq, A.; Kelly, A.; Khan, A.; Arumugam, D.; Evan, A.; Evans, A
Source: Hernia; Apr 2018; vol. 22 (no. 2); p. 243-248
Publication Date: Apr 2018
Publication Type(s): Academic Journal
PubMedID: 29243213
Available  at Hernia -  from EBSCO (MEDLINE Complete)
Abstract:Objectives: To determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routinely collected co-morbidity data in patients undergoing abdominal wall hernia repair.
Database: CINAHL

Author(s): Abdulla, Omar
Source: British Journal of Hospital Medicine (17508460); Apr 2018; vol. 79 (no. 4); p. 233-233
Publication Date: Apr 2018
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine (17508460) -  from MAG Online Library
Abstract:The article describes the case of a 56-year-old woman diagnosed with a liver cyst that causes significant pressure effect according to echocardiogram.
Database: CINAHL

Author(s): Kumar, Shyam; Sonar, Ulhas; Singh, Iqbal
Source: British Journal of Hospital Medicine (17508460); Mar 2018; vol. 79 (no. 3); p. 148-150
Publication Date: Mar 2018
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine (17508460) -  from MAG Online Library
Abstract:The incidence of fragility fractures of the humerus is increasing worldwide. Although clinicians are aware of fractures of hips and wrists, fractures of the shoulder and elbow do not receive much attention. A considerable proportion of the elderly population (estimated at 10-24%) is dependent on walking aids. A well-functioning and pain-free shoulder and elbow is essential for use of these aids. The impact of loss of mobility in the elderly is well known, hence the overall impact of these fractures on the individual can be considerable. This article increases the awareness of these fractures among non-orthopaedic colleagues and provides a brief outline of their management. In the elderly population using walking aids, the shoulder and elbow are effectively weightbearing joints. Fractures of the shoulder or elbow in the elderly require extra attention to maintain their mobility during this period by physiotherapy to the lower limbs and chest. In patients who mobilize using a frame, the use of a stick on the opposite side of the injury may have to be considered while recovery is in progress.
Database: CINAHL

Author(s): Patel L.B.; El Gamal M.; Murray D.; Nair P.
Source: Archives of Disease in Childhood; Mar 2018; vol. 103
Publication Date: Mar 2018
Publication Type(s): Conference Abstract
Available  at Archives of Disease in Childhood -  from BMJ Journals - NHS
Abstract:Aims 34,000 Children and Young People (CYP) in England have a diagnosis of epilepsy and receive anti-epileptic drugs. NICE have described high-priority areas for quality improvement; The Epilepsy in CYP, Quality Standard (QS27). Our local service aims to provide an excellent multidiscipli-nary service to serve its patients and their families in a holistic manner. It is delivered by consultants, a specialist nurse, rotating junior doctors and the nursing team. 
Database: EMBASE
 

​Author(s): Kelly C.; Relph N.; Spencer S.; Chalmers J.D.; Crossingham I.; Felix L.M.; Evans D.J.; Milan S.J.
Source: Cochrane Database of Systematic Reviews; Mar 2018; vol. 2018 (no. 3)
Publication Date: Mar 2018
Publication Type(s): Review
Abstract:Background: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance. 

Author(s): Krishnamoorthy U.; Waddington T.; Choudhry S.
Source: BJOG: An International Journal of Obstetrics and Gynaecology; Mar 2018; vol. 125 ; p. 129-130
Publication Date: Mar 2018
Publication Type(s): Conference Abstract
Available  at BJOG: An International Journal of Obstetrics and Gynaecology -  from Wiley Online Library Medicine and Nursing Collection 2018 - NHS
Abstract:Introduction Post coital bleeding (PCB) consists of spotting or bleeding that occurs during or after sexual intercourse can be alarming for patients as is a cardinal symptom of cervical cancer although mostly due to benign causes. There is ambiguity in management of PCB and paucity of national/college guidance. Given the anxiety it evokes in patients and association with cervical cancer, there is the need for streamlined National pathway. Objectives Review aimed to improve standard of care provided for management of PCB. Objectives were to evaluate current management and extrapolate audit results and evidence from literature guide development and implementation of PCB Care pathway locally. 
Database: EMBASE
 

Author(s): McCarthy, Eoghan M.; Sutton, Emily; Nesbit, Stephanie; White, James; Parker, Ben; Jayne, David; Griffiths, Bridget; Isenberg, David A.; Rahman, Anisur; Gordon, Caroline; D'Cruz, David P.; Rhodes, Benjamin; Lanyon, Peter; Vital, Edward M.; Chee-Seng Yee; Edwards, Christopher J.; Lee-Suan Teh; Akil, Mohammed; McHugh, Neil J.; Zoma, Asad
Source: Rheumatology; Mar 2018; vol. 57 (no. 3); p. 470-479
Publication Date: Mar 2018
Publication Type(s): Academic Journal
Available  at Rheumatology -  from EBSCO (MEDLINE Complete)
Abstract:Objectives. To describe the baseline characteristics of SLE patients requiring biologic therapy in the UK and to explore short term efficacy and infection rates associated with rituximab (RTX) use. 
Database: CINAHL
 

Author(s): Ringrose, Hollie; Brown, Mary; Walton, Krystyna; Sivan, Manoj
Source: NeuroRehabilitation; Feb 2018; vol. 42 (no. 2); p. 207-212
Publication Date: Feb 2018
Publication Type(s): Academic Journal
Available  at NeuroRehabilitation -  from EBSCO (MEDLINE Complete)
Abstract:BACKGROUND: Rehabilitation following severe Traumatic Brain Injury (TBI) often involves the use of temporary tracheostomies. Tracheostomy weaning is influenced by physiological parameters, which are abnormal in the concomitant complication of Paroxysmal Sympathetic Hyperactivity (PSH). OBJECTIVE: To investigate the association between PSH and tracheostomy weaning in severe TBI. 
Database: CINAHL

Author(s): Paul P Dean and Claire Horsfield
Source: Journal of the Intensive Care Society, 2018, Vol. 19(1) 84
Publication Date: Feb 2018
Publication Type(s): Correspondence

We have read with interest the multicentre audit into the application of protective mechanical lung ventilation across the Severn and Wessex regions.1 Through the Critical Care Network (CCN) in Lancashire
and South Cumbria, we have undertaken a quality improvement project associated with lung-protective
ventilation over the last year. Our initial findings were similar to those reported with only 31% of patients
being ventilated in a manner consistent with lung protection (57 ml/kg ideal body weight) and only 11%
were ventilated at 46 ml/kg ideal body weight).

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​Author(s): Yap D.; Chaudhury M.; Mbakada N.; Ng M.
Source: American Journal of Emergency Medicine; Jan 2018; vol. 36 (no. 1); p. 171
Publication Date: Jan 2018
Publication Type(s): Article
PubMedID: 29079373
Available  at American Journal of Emergency Medicine -  from ProQuest (Hospital Premium Collection) - NHS Version
Abstract:Introduction Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30 days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. Case report A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2 weeks after having slipped on a wet surface at home. His initial chest X-ray showed fractures of the right 7th and 8th ribs without a hemothorax or pneumothorax. He returned 30 days after the initial consultation (44 days post-trauma) having increasing shortness of breath. A chest X-ray this time revealed a large right hemothorax and 1850 ml of blood drained from his chest. There was a complete resolution of the hemothorax within 48 h and the patient was discharged after a 6-week follow-up with the chest physicians. Discussion Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. Why should an emergency physician be aware of this? Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention. Copyright © 2017 Elsevier Inc.
Database: EMBASE

​Author(s): Topps A.R.; Barr S.P.; Pikoulas P.; Maxwell A.J.; Pritchard S.A.
Source: Annals of Surgical Oncology; Jan 2018; vol. 25 (no. 1); p. 148-153
Publication Date: Jan 2018
Publication Type(s): Article
Abstract:Background: Pre-operative ultrasound-guided needle sampling (UNS) of abnormal axillary lymph nodes in breast cancer can identify patients with axillary metastases and therefore rationalize patient care and inform decision-making. To obtain tissue diagnosis, UNS can be performed by either fine needle aspiration (FNA) or core needle biopsy (CNB). However, few studies have compared the sensitivity of these techniques and the majority show no difference. Methods: All node-positive patients (those with micro- and macrometastases but not isolated tumor cells) treated at a tertiary referral center between January 2012 and December 2015 were retrospectively identified from pathology records. The result of the first axillary UNS performed on each patient was compared with postoperative histopathology results. The UNS method used was according to individual radiologist preference. Results: A total of 215 patients underwent FNA (1 patient had bilateral breast cancer and underwent bilateral FNA), and 92 underwent CNB. Sensitivity of CNB was significantly higher than FNA (83.7 vs. 69.0%, P = 0.008). The false-negative rate in the FNA group was therefore higher than in the CNB group by a factor of 2.5. There was no difference in inadequacy rate between the two techniques. There were no complications in the FNA group, and only one hematoma (which did not require operative intervention) in the CNB group. Conclusions: CNB is safe and should be the preferred technique for UNS to improve sensitivity. Copyright © 2017, Society of Surgical Oncology.
Database: EMBASE

​Author(s): Ashraf A.; Saeed U.; Alhadi O.; Asad-ur-Rehman; Iqbal S.
Source: International Journal of Pharmaceutical Sciences and Research; Jan 2018; vol. 9 (no. 1); p. 369-372
Publication Date: Jan 2018
Publication Type(s): Article
Abstract:Prostaglandins (PG) are commonly used in neonates with cyanotic congenital heart diseases to keep the ductus arteriosus patent. The definite treatment for these conditions is surgery. It is occasionally used for longer duration (weeks to months) in preterm babies. Reversible cortical hyperostosis is a relatively recently recognized side effect of prolonged prostaglandin therapy. We describe the case of an infant presenting this complication secondary to prolonged use of PGE1, with typical and extensive radiological findings. The enzymes (prostaglandin 15-OH dehydrogenase & prostaglandin -13 reductase) that catalyze the degradation of prostaglandins are widely distributed in many vascular beds including those of the spleen, kidney, adipose tissue, intestine, liver, testicles and lungs. PGE is normally rapidly inactivated by these tissues, particularly during passage through the lungs.18 However, infants with cyanotic congenital heart diseases that cause decreased pulmonary blood flow and reduced clearance of PGE may have a higher systemic concentration of PGE. In addition, these patients often receive pharmacologic doses of PGE to maintain the patency of the ductus arteriosus. The resultant higher PGE concentration in the blood may result in osseous changes. However the exact mechanism of cortical hyperostosis is not yet known. It may be a direct, dose-related stimulation of osteoblastic cells. Copyright © 2013 are reserved by International Journal of Pharmaceutical Sciences and Research.
Database: EMBASE

​Author(s): Jabbar-Lopez Z.K.; Smith C.H.; Yiu Z.Z.N.; Warren R.B.; Ward V.; Exton L.S.; Mohd Mustapa M.F.; Samarasekera E.; Burden A.D.; Murphy R.; Owen C.M.; Parslew R.; Venning V.
Source: Journal of Investigative Dermatology; Dec 2017; vol. 137 (no. 12); p. 2644-2646
Publication Date: Dec 2017
Publication Type(s): Article
Database: EMBASE
 

​Author(s): Armer J.; De Goede C.
Source: Archives of Disease in Childhood: Education and Practice Edition; Dec 2017; vol. 102 (no. 6); p. 319-326
Publication Date: Dec 2017
Publication Type(s): Article
Available  at Archives of Disease in Childhood: Education and Practice Edition -  from BMJ Journals - NHS
Abstract:In paediatrics, one of our main aims in the diagnostic process is to identify any treatable conditions. The copper metabolism disorder Wilson's disease (WD) is one such condition that is caused by mutations in the ATP7B gene. Delay in treatment could result in irreversible disability or even death. Although liver disease is the most common presenting feature in children, some children may initially present with a subtle neurological presentation only. In patients presenting with dystonia, tremor, dysarthria or with a deterioration in school performance, there should be a high index of suspicion for WD. However, the differential of these clinical presentations is wide and exclusion of WD is difficult. No single diagnostic test can exclude WD and each of the biochemical tests has limitations. In this article, we discuss copper metabolism disorders including WD and Menke's disease. We then discuss the available diagnostic tests and how to investigate children for these rare disorders. Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
Database: EMBASE

Author(s): Her A.-Y.; Kim Y.H.; Cho K.-I.; Garg S.; Shin E.-S.
Source: Yonsei Medical Journal; 2017; vol. 58 (no. 5); p. 954-958
Publication Date: 2017
Publication Type(s): Article
PubMedID: 28792138
Available  at Yonsei Medical Journal -  from EBSCO (MEDLINE Complete)
Available  at Yonsei Medical Journal -  from Europe PubMed Central - Open Access
Available  at Yonsei Medical Journal -  from nih.gov
Abstract:Purpose: There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS. Materials and Methods: Patients who had >=3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; >=10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system. Results: A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (>=6 mm Hg) was significantly associated with CACS >=300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference >=6 mm Hg was also significantly associated with CACS >=300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036). Conclusion: An increased inter-arm SBP difference (>=6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors. Copyright © Yonsei University College of Medicine 2017.
Database: EMBASE

​Author(s): Hajibandeh S.; Khan R.M.A.; Malik S.; Mansour M.; Kausar A.; Subar D.
Source: International Journal of Surgery; Dec 2017; vol. 48 ; p. 1-8
Publication Date: Dec 2017
Publication Type(s): Review
Abstract:Background Controversy exists regarding the best anastomotic method for pancreaticoduodenectomy (PD). We aimed to evaluate the perioperative outcomes of PD with stapled anastomosis (SA) versus hand-sewn anastomosis (HA) of gastrojejunostomy or duodenojejunostomy. Methods We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the Cochrane Central Register of Controlled Trials (CENTRAL); the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register, and bibliographic reference lists. We applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits in each of the above databases. Delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), anastomotic bleeding, anastomotic leak, intra-abdominal abscess and mortality were defined as the outcome parameters. Combined overall effect sizes were calculated using fixed-effect or random-effects models. Results We identified 1 randomised controlled trial (RCT) and 5 observational studies reporting a total of 890 patients who underwent PD with SA (n = 300) or conventional HA (n = 590). Our analysis demonstrated that SA significantly reduced postoperative DGE (OR: 0.37, 95% CI 0.25-0.54, P Copyright © 2017
Database: EMBASE

​Author(s): Slawinski, C. G. V.; O'Reilly, D. A.
Source: British Journal of Hospital Medicine (17508460); Nov 2017; vol. 78 (no. 11)
Publication Date: Nov 2017
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine (17508460) -  from MAG Online Library
Abstract:The article discusses a practical guide for the management of the surgical emergency called acute pancreatitis, which covers the focus on early diagnosis and exclusion of differential diagnoses when making initial assessment and investigation, ensuring pain relief, and being clear on the goals of initial management.
Database: CINAHL

​Author(s): Abdulla, Omar; White, Emily
Source: British Journal of Hospital Medicine (17508460); Nov 2017; vol. 78 (no. 11); p. 654-654
Publication Date: Nov 2017
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine (17508460) -  from MAG Online Library
Abstract:The article describes the case of a 70-year-old woman who presented with severe abdominal pain and computed tomography of the abdomen and pelvis revealed a long, smooth distal sigmoid stricture with a proximal bowel dilatation and perforation probably caused by radiotherapy.
Database: CINAHL