The King’s Fund Update: Jan 2013

Estates and facilities alert
This alert relates to window restrictors that may be inadequate in preventing a determined effort to force a window open beyond the 100mm restriction. This follows an incident in which a patient died following a fall from a second floor hospital window. All healthcare organisations are asked to review the guidance.

Case Report: Symptomatic cholecystolithiasis after cholecystectomy

BMJ Case Reports 2013; doi:10.1136/bcr-2012-007692

Symptomatic cholecystolithiasis after cholecystectomy

A 43-year-old woman was admitted to the gastroenterology department with colicky pain in the upper abdomen. Four years earlier, she had undergone a laparoscopic cholecystectomy because of cholecystitis. She recognised her current complaints from that previous episode. An endoscopic retrograde cholangiopancreatography showed a cavity with a diameter of 2 cm which contained multiple concrements near the liver hilus. An elective surgical exploration was performed. Near the clip of the previous cholecystectomy a bulging of the biliary tract with its own duct was visualised and resected. Histological examination of this “neo” gallbladder showed that the bulging was consistent with the formation of a reservoir secondary to bile leakage, probably caused by a small peroperative lesion of the common bile duct during the previous cholecystectomy. In conclusion, our patient presented with colicky pain caused by concrements inside a ‘neo’ gallbladder.

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European Radiology, July 2012; Imaging vascular function for early stage clinical trials …

Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging
Citation: European Radiology, July 2012, vol./is. 22/7(1451-1464), 0938-7994;1432-1084 (July 2012)
Author(s): Leach M.O.; Morgan B.; Tofts P.S.; Buckley D.L.; Huang W.; Horsfield M.A.; Chenevert T.L.; Collins D.J.; Jackson A.; Lomas D.; Whitcher B.; Clarke L.; Plummer R.; Judson I.; Jones R.; Alonzi R.; Brunner T.; Koh D.M.; Murphy P.; Waterton J.C.; Parker G.; Graves M.J.; Scheenen T.W.J.; Redpath T.W.; Orton M.; Karczmar G.; Huisman H.; Barentsz J.; Padhani A.

Abstract: Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCEMRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. Key Points Tumour vascular function is key to tumour development and treatment Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess tumour vascular function Thus DCE-MRI with pharmacokinetic models can assess novel treatments Many recent developments are advancing the accuracy of and information from DCE-MRI Establishing common methodology across multiple centres is challenging and requires accepted guidelines.

European Society of Radiology 2012.

Publication Type: Journal: Article
Source: EMBASE

Knight, S, et al; Annals of the Rheumatic Diseases, June 2012

The influence of anti-TNF therapy upon incidence of keratinocyte skin cancer in patients with rheumatoid arthritis:    Longitudinal results from the British Society for Rheumatology Biologics Register
Citation: Annals of the Rheumatic Diseases, June 2012, vol./is. 71/6(869-874),
0003-4967;1468-2060 (June 2012)
Author(s): Mercer L.K.; Green A.C.; Galloway J.B.; Davies R.; Lunt M.; Dixon W.G.; Watson K.D.; Symmons D.P.M.; Hyrich K.L.; Maiden N.; Price T.; Hopkinson N.; O’Reilly S.; Hordon L.; Griffiths I.; Porter D.; Capell H.; Hassell A.; Benitha R.; Choy E.; Walsh D.; Emery P.; Knight S.; Bruce I.; Taggart A.; Scott D.; Thompson P.; McCrae F.; Goodfellow R.; Kitas G.; Jubb R.; Abernethy R.; Clarke S.; Green S.; Sanders P.; Coulson A.; Harrison B.; Bukhari M.; Klimiuk P.
Source: EMBASE

Heathcote, JA, Nyholm E; Journal of Family Planning & Reproductive Health Care, 2013

Foundations for the future: preparing tomorrow’s medical educators today

JA Heathcote, E Nyholm – Journal of Family Planning and .., 2013 – jfprhc.bmj.com
Good teachers have a major influence on the quality and safety of medical care delivered to patients. As the area of sexual and reproductive health care (SRH) has evolved there has always been a strong commitment to supporting the development of sexual