Al-Najjim M; Mustafa A; Fenton C; Morapudi S; Waseem M; 2013

Giant solitary synovial osteochondromatosis of the elbow causing ulnar nerve neuropathy: a case report and review of literature.
Citation: Journal of Brachial Plexus & Peripheral Nerve Injury, 2013, vol./is. 8/1(1), 1749-7221;1749-7221 (2013)

Abstract: Giant or solitary osteochondroma is part of a rare disorder known as synovial osteochondromatosis. It forms part of a spectrum of disease characterized by metaplastic changes within the joint synovium that are eventually extruded as loose bodies. It has been suggested that solitary synovial osteochondroma forms as progression of synovial osteochondromatosis through a process of either coalescence of multiple smaller bodies or the growth of a dominant synovial osteochondroma. Previous studies have shown that it occurs as a late phase of the disease. We report a rare case of giant synovial osteochondromatosis at the elbow causing ulnar nerve neuropathy and mechanical symptoms which has not been previously reported in the literature.

CASE REPORT: We report a case of a 56 year old Western European gentleman who presented with ulnar nerve neuropathy and swelling behind the elbow. The patient underwent MR imaging and subsequent biopsy that demonstrated synovial osteochondromatosis. Initially the patient declined surgery and opted for a watch and wait approach. Five years later he returned with worsening symptoms and underwent successful surgical resection of a giant solitary synovial osteochondroma.

CONCLUSION: The unique outcome in our patient despite the long interval between presentation and surgical treatment resulted in early full resolution of symptoms within a short period. It may suggest an improved prognosis as compared to multiple synovial osteochondromatosis in terms of mechanical and neurological outcomes.

Publication Type: Journal Article
Source: MEDLINE
Full Text: Available from BioMedCentral in Journal of Brachial Plexus and Peripheral Nerve Injury

Journal of Clinical Pharmacy and Therapeutics; Yates J.; Choudhry M.; Keys G; April 2013

A case report describing a suspected rivaroxaban hypersensitivity reaction in a surgical patient was published in April 2013, vol./is. 38/2(159-161), 0269-4727;1365-2710

Abstract:    Rivaroxaban is an oral anticoagulant, currently licensed for use as a venous thromboembolism (VTE) prophylaxis, and recommended by the National Institute for Clinical Excellence (NICE) for all patients undergoing elective hip and knee replacement surgery in the UK. We present the first case of a suspected hypersensitivity to rivaroxaban.

Case summary: A 57-year-old man with no previous allergies underwent an uncomplicated, elective partial knee replacement, after which he was prescribed a routine 2-week course of rivaroxaban 10 mg. He developed an allergic response requiring readmission for assessment and treatment 7 days post-operatively.

Conclusion: We believe this to be the first published case of hypersensitivity associated with rivaroxaban. More research is needed to determine this association. At the same time, given the growing range and increasing use of anticoagulants, particular vigilance is required regarding potential side effects so that these may be managed quickly and effectively in the early stages.

2012 Blackwell Publishing Ltd.
Publication Type: Journal: Article
Source: EMBASE

BMJ Case Reports; Jain Y.K.; Kokan J.S; 2013

An interesting case of screen-detected breast cancer encasing a ventriculoperitoneal shunt was published recently in BMJ Case Reports, 2013, 1757-790X (2013)

Abstract:  A 67-year-old woman was diagnosed with a breast cancer via screening encasing the ventriculoperitoneal shunt. Triple assessment including MRI scan of the breast confirmed the presence of a breast mass and the tubing of the ventriculoperitoneal shunt was running directly through the mass. She underwent wide local excision of the breast cancer as well as rerouting of VP shunt as a joint procedure with the neurosurgery team and recovered uneventfully. This is a very rare and an interesting case and required management involving a different specialty.

Source: Embase

Leadership course for frontline nurses and midwives

A new eight-day leadership course is helping front-line staff become better role models for their colleagues and provide excellent patient care across primary, community and secondary healthcare settings.

Around 1,200 nurses and midwives should complete the course, developed and delivered by the NHS Leadership Academy, by March 2014.

The programme focuses on the approach and behaviours of frontline nurses and midwives with leadership responsibilities, such as team leaders, ward sisters and supervisors, and the environment they create for their colleagues and patients.  It was developed with input from nursing and midwifery leaders from across the country.

In October 2012, the Government pledged £46m toward NHE leadership development in the name of better patient care.

Read the full article

WebWatch: Cancer Commons

Extract from website at: http://www.cancercommons.org/researchers-clinicians/

cancercommons_model

CANCER COMMONS “is an open science initiative linking patients, physicians and scientists in rapid learning communities. Our mission is to ensure that patients are treated in accord with the latest knowledge on targeted- and immunotherapies, and to continually update that knowledge based on each patient’s response.”

Model

Advisory boards, comprising leading physicians and scientists in each cancer, curate the molecular model that identifies the most relevant tests, treatments, and trials for each molecular sub type of that cancer, based on the best current knowledge.

Test and Treat

Patients and physicians access knowledge derived from the model, as soon as it’s deemed actionable, through alerts, notifications, news, and applications that inform testing and treatment decisions.

Report and Analyze

Physicians, researchers, and patients report clinical observations and outcomes and new data are analyzed in our Rapid Learning Communities by collaborative, interinstitutional teams to validate, refute, and amplify the current model’s knowledge and hypotheses.

Learn

The advisory boards review these results and update the framework in real time.