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Effect of angioembolisation versus surgical packing on mortality in traumatic pelvic haemorrhage: A systematic review and meta-analysis

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World Journal of Emergency Medicine 2018年第2期9卷 85-92页

作者： Ahmed El Muntasar Ethan Toner Oddai A.Alkhazaaleh Danaradja Arumugam Nikhil Shah Shahab Hajibandeh Shahin Hajibandeh Department of General Surgery Royal Blackburn Hospital Department of Trauma and Orthopaedics WrightingtonWigan and Leigh NHS Foundation Trust Department of General Surgery Salford Royal Hospital Department of General Surgery North Manchester General Hospital

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 ***: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the CENTRAL; the World Health Organization International Clinical Trials Registry; Clinical ***; 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% confidence 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 significantly 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(I^2=0%, P=0.65).CONCLUSION: Our analysis found no significant difference in mortality between angioembolisation and pelvic packing in patients with traumatic pelvic haemorrhage. The current level of evidence in this context is very limited and insufficient to support the superiority of a treatment modality. Future research is required.

关键词： Pelvic trauma Pelvic packing Angiography Embolisation

Infectious Disease Update in Obstetrics: A Modern Approach to the Patient with a Positive Screening Test for Syphyilis in Pregnancy

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 102-109页

作者： Papa Essilfie wigan Wrtinghton and Leigh Teaching Hospitals Wigan Lane Wigan UK

Screening for maternal syphilis has been an essential component of routine antenatal screening tests in most countries for many years. This is not only because of the virulence of the spirochete which causes the infection but also because of its vertical transmission rate and the potential severe adverse complications/morbidity that can result from its transmission to the fetus. Although the incidence of maternal syphilis and its fetal sequalae in low-income countries has been considerable for several years, the disease has been almost non-existent in high income countries with wide antenatal screening coverage and effective treatment programmes for Syphilis. The recent alarming increase in the incidence of maternal syphilis in high income countries has spawned a renewed public health interest in the infection, with several countries updating and strengthening public health guidance in an attempt to stem this dramatic trend. This is a short clinical update for the practising obstetrician on how to manage the antenatal patient with a positive syphilis screening test.

关键词： Treponema Pallidum Chancre Condyloma Lata Gummas VDRL Test RPR Test Revere-Sequence Testing Jarisch-Herxheimer Reaction

Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2021年第1期7卷 54-62页

作者： Jamil Waqas Izzat Steve ENT Department Birmingham Heartland Hospital UK wrightington wigan and leigh NHS Foundation TrustUK

Objectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these *** systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube *** sources:A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English *** of included studies were ***:A systematic review was *** assessed were:primary outcomes-subjective improvement in symptoms(ETDQ-7),audiometric improvement of hearing,improvement of negative middle ear pressure noticed in tympanometry,objective improvement of tympanic membrane *** outcomes were-the ability to auto-insufflate Eustachian tube *** manoeuvre,improved quality of life,passive tubal opening,tubomanometry,swallowing test,reduction in mucosal inflammation of Eustachian tube orifice in the nose,complications from the procedure,the need for further *** are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous ***:Three studies were *** included studies were small-scale case series(13-38 par-ticipants).Studies were conducted outside the *** and objective improvement of Eustachian tube function was reported in all *** all included studies were at high risk of bias and subject to multiple *** major complications were reported in either ***:Based on current evidence,it is not possible to recommend the clinical use of either of these two interventions *** or Microdebrider Eustachian *** of controlled studies was identified as a gap in the *** research should be directed toward designing randomised controlled *** trials

关键词： Eustachian tuboplasty Eustachian tube Treatment of Eustachian tube dysfunction

Confirming longline position in neonates-Survey of practice in England and Wales

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World Journal of Clinical Pediatrics 2017年第3期6卷 149-153页

作者： Arunoday Arunoday Christos Zipitis Department of Paediatrics Royal Albert Edward Infirmary the University of Manchester Manchester Academic Health Science Centre Wrightington Wigan and Leigh NHS Foundation Trust Royal Albert Edward Infirmary

AIM To establish how neonatal units in England and Wales currently confirm longline tip position, immediately after insertion of a *** We conducted a telephone survey of 170 neonatal units(37 special care baby units, 81 local neonatal units and 52 neonatal intensive care units) across England and Wales over the period from January to May 2016. Data was collected on specifically designed proformas. We gathered information on the following: Unit Level designation; whether the unit used longlines and specific type used? Modality used to confirm longline tip position? Whether guide wires were routinely removed and contrast injected to determine longline position? The responders were primarily senior *** We had 100% response rate. Out of the total neonatal units surveyed(170) in England and Wales, 141 units(83%) used longlines. Fifty-five out of 81 local neonatal units(68%) using longlines, used ones that came with guide wires; a similar percentage of neonatal intensive care units, i.e., 31 out of 52 units(60%) did the same. All of those units used radiography, plain X-rays, to establish longline tip position. Out of 55 local neonatal units usinglonglines with guide wires, 42(76%) were not removing wire to use contrast while this figure was 58%(18 out of 31 units) for neonatal intensive care units. Overall, only 49 out of 141 units(35%) of the units using longlines were using contrast. However it was interesting to note that use of contrast increased as one moved from special care baby units(25%, 2 out of 8 units) to local neonatal units(28%, 23 out of 81 units) and neonatal intensive care units level(46%, 24 out of 52 units) designation. CONCLUSION Neonatal units in England and Wales are overwhelmingly relying on plain radiographs to assess longline tip position immediately after insertion. Despite evidence of its usefulness, and in the absence of perhaps more accurate methods of assessing longline tip position in a reliable and consistent way, i

关键词： Central venous catheters Newborn Contrast media Line placement Premature infants

Autologous Tendon Grafts Used in Upper Limb Surgery

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Open Journal of Orthopedics 2013年第2期3卷 74-78页

作者： Avinash Alva V. Kumar R. Sreekumar Chye Yew Ng S. C. Talwalkar Blackpool Victoria Hospital Blackpool UK Department of Orthopaedics Wrightington Hospital Wigan UK

Tendon autografts play an important role in upper limb reconstruction and a working knowledge of tendon autograft options is essential for the surgeon. Although palmaris longus is often the first choice, other options like plantaris, extensor Hallucis longus, flexor carpi radialis are readily available. Advantages of autografts include easy availability, satisfactory biomechanical properties and the human body tends to accept its own tendons than from a donor. This review highlights the various options available and their anatomical and surgical considerations in procuring grafts for upper limb reconstructive work.

关键词： Autologous Tendon Graft Palmaris Longus Plantaris Extensor Digitorum Longus Extensor Hallucis Longus Flexor Carpi Radialis Hamstrings

对于严重股骨骨质溶解应用带骨水泥的CHARNLEY翻修关节成形术

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中华骨科杂志 1996年第3期16卷 189-192页

作者：李德达 The John Charnley Research Institute Wrightington Hopsital for Joint Disease Hall Lane Appley Bridge Wigan WN6 9EP UK.

对于严重股骨骨质溶解应用带骨水泥的ＣＨＡＲＮＬＥＹ翻修关节成形术ＣＥＭＥＮＴＥＤＣＨＡＲＮＬＥＹＲＥＶＩＳＩＯＮＡＲＴＨＲＯＰＬＡＳＴＹＦＯＲＳＥＶＥＲＥＦＥＭＯＲＡＬＯＳＴＥＯＬＹＳＩＳＶＶＲＡＵＴ，ＰＤＳＩＮＥＹ... 详细信息

对于严重股骨骨质溶解应用带骨水泥的ＣＨＡＲＮＬＥＹ翻修关节成形术ＣＥＭＥＮＴＥＤＣＨＡＲＮＬＥＹＲＥＶＩＳＩＯＮＡＲＴＨＲＯＰＬＡＳＴＹＦＯＲＳＥＶＥＲＥＦＥＭＯＲＡＬＯＳＴＥＯＬＹＳＩＳＶＶＲＡＵＴ，ＰＤＳＩＮＥＹ，ＢＭＷＲＯＢＬＥＷＳＫＩ我们对１...

关键词：肌骨骨质溶解关节成形术带骨水泥

Polymorphisms of MTHFR and susceptibility to oesophageal adenocarcinoma in a Caucasian United Kingdom population

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World Journal of Gastroenterology 2014年第34期20卷 12212-12216页

作者： Richard Keld Manyi Thian Chia Hau Jamil Sajid Narveen Kumar Yeng Ang Department of Gastroenterology Royal Albert Edward InfirmaryWiganLancashire WN1 2NNUnited Kingdom Faculty of Human and Medical Sciences University of ManchesterManchesterSalford M6 8HDUnited Kingdom

AIM: To identify if methylene tetra-hydrofolatereductase (MTHFR) C677T polymorphisms are associated with oesophageal adenocarcnomas in a Caucasian population and to test whether folic acid and homocysteine levels are ... 详细信息

关键词： Polymorphisms of 5,10-methylenetetrahydrofolate reductase Oesophageal adenocarcinoma Caucasian population Helicobacter pylori Polymorphism

Targeting key signalling pathways in oesophageal adenocarcinoma:A reality for personalised medicine?

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World Journal of Gastroenterology 2011年第23期17卷 2781-2790页

作者： Richard R Keld Yeng S Ang Department of Gastroenterology Royal Albert Edward InfirmaryWigan LaneWiganGreater ManchesterWN1 2NNUnited Kingdom School of Translational Medicine Faculty of Medical and Human SciencesThe University of ManchesterManchesterM13 9PLUnited Kingdom

Cancer treatments are rapidly *** treatment for oesophageal adenocarcinoma currently involves surgery and cytotoxic chemotherapy or *** for both regimes are generally poor as a result of tumor *** have reviewed the key signalling pathways associated with oesophageal adenocarcinomas and discussed the recent trials of novel agents that attempt to target these *** are many trials underway with the aim of improving survival in oesophageal ***,phase 2 and 3 trials are focused on MAP kinase inhibition,either through inhibition of growth factor receptors or signal transducer *** order to avoid tumor resistance,it appears to be clear that targeted therapy will be needed to combat the multiple signalling pathways that are in operation in oesophageal *** may be achievable in the future with the advent of gene signatures and a combinatorial approach.

关键词： Oesophageal adenocarcinoma Signallingpathways MAP and PI3 Kinase pathways Wnt signalling Transforming growth factor-13 pathway Nuclear factor-KBpathways Transcription factors Tyrosine kinase receptors

金属对金属-髋关节置换与其他材质及普通人群术后最初七年的癌症风险：英格兰与威尔士国家关节注册机构与医院统计机构的联合研究

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英国医学杂志中文版 2012年第6期15卷 363-364页

作者： Smith Alison J Dieppe Paul Porter Martyn Blom Ashley W 杜长征(译者) 顾晋(审校者) on behalf of the National Joint Registry of England and Wales Musculosketal Research Unit School of Clinical Sciences University of Bristol Avon Orthopaedic Centre Bristol BS10 5NB UK Peninsula Medical School Universities of Plymouth and Exeter University of Exeter Exeter EX1 2LU Centre for Hip Surgery Wrightington Hospital Wigan Lancashire WN6 9EP 北京大学肿瘤医院结直肠肿瘤外科

目的确定应用金属对金属材质的表面在髋关节置换术后早期是否与癌症，特别是与恶性黑色素瘤、血液病、前列腺癌和泌尿系肿瘤的风险增高有关。

关键词：髋关节置换金属对金属术后早期统计机构普通人群风险癌症材质