Management of the unstable shoulder

The shoulder is the most commonly dislocated joint in the human body. The incidence of shoulder dislocation is increasing. Recurrence is common and occurs in as many as 67% of cases. Patients often mention a painful, weak arm and a shoulder that readily dislocates with trivial movements.

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The aim of this review is to provide a simple framework for the clinical assessment, investigation, and treatment of the unstable shoulder for non-specialists and to highlight key patient groups that benefit from early specialist input.

Diagnosis and treatment of cancer using genomics

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The field of cancer diagnostics is in constant flux as a result of the rapid discovery of new genes associated with cancer, improvements in laboratory techniques for identifying disease causing events, and novel analytic methods that enable the integration of many different types of data. These advances have helped in the identification of novel, informative biomarkers

No blood pressure lowering agents prolong survival in diabetes and kidney disease, review shows

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No blood pressure lowering agents used either alone or in combination prolong survival in adults with diabetes and kidney disease, a meta-analysis published in the Lancet has found.

Researchers analysed 157 studies comparing blood pressure lowering agents in a total of 43 256 patients with diabetic kidney disease, mostly type 2 diabetes and chronic kidney disease

Use of coloured overlays and lenses are unlikely to help children with dyslexia, study finds

Vision problems are rare in dyslexic children, and most have perfect eyesight, a large UK population based study has found.

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The study’s findings, published in Pediatrics on 25 May, reinforced the argument that coloured overlays and lenses are unlikely to help with reading difficulties in children with dyslexia. Around 375 000 UK children have dyslexia, and the use of coloured overlays and lenses by such children is common in educational establishments. Parents can spend hundreds of pounds on them, but their effectiveness remains uncertain

Identifying and managing common childhood language and speech impairments

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Learning to speak is one of life’s most important accomplishments. Language, usually acquired so effortlessly, underpins every child’s learning and ability to interact with others and to establish relationships.

The aim of this clinical review is to summarise the current information on language and speech impairments to help general practitioners, universal well child services, and paediatricians to identify the most common problems, understand their clinical course, decide when to refer and for what services, and understand what improvements can be expected.

Piece of string can assess cardiovascular risk, study finds

Measuring a person’s waist with a piece of string is a better predictor of cardiovascular risk than using body mass index (BMI) alone, researchers have said.

A study published at the European Congress on Obesity in Prague this week supported the finding that a person was at lower cardiovascular risk if they kept their waist measurement to less than half their height measurement.

Evidence is insufficient to recommend e-cigarettes for quitting, US committee concludes

There are not enough data on the effectiveness of electronic cigarettes to determine whether the devices can help smokers quit, the US Preventive Services Task Force has concluded.1

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The Task Force, which makes recommendations on the effectiveness of preventive healthcare services such as screening, counselling, and use of drugs, issued its draft evaluation of tobacco smoking cessation in adults and pregnant women on 5 May.

Learning @ Work starts soon!

 

 

 

Learning at work

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The Library and Knowledge Service is taking part in 2015’s Learning at Work week:

Are you interested in learning how to use computers from scratch? Amanda Gardner will be providing computer skills training for those who want to start from the beginning, as well as something for those who are a little more advanced.

Do you want to know how to use Athens resources? Carole Keeling will be helping people set up accounts and running basic training sessions.

Do you want to use social media in your job, but aren’t sure how it all works? Steve Collman will be running drop-in sessions Friday 15th May and Monday 18th May to show the basics, plus a little bit more for those who are interested.

Why not drop in and learn something new?

Assessment of chest pain in a low risk patient: is the exercise tolerance test obsolete?

The coronary artery calcium score has high sensitivity for detecting coronary stenosis—so a negative result makes significant coronary stenosis unlikely—but low specificity, and 60% of those without coronary artery disease will also have a positive result

 

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Thus many low risk patients may be diagnosed with coronary artery disease using the calcium score, although they may have clinically insignificant or “bystander” disease. These patients may benefit little from investigation and treatment and may be harmed

 

The exercise tolerance test is a quick, functional investigation that measures maximum exercise tolerance. In low risk patients who are likely to achieve a high workload the test can identify patients with high relative survival without the need for further imaging

The long wait for a breakthrough in chronic fatigue syndrome

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There hasn’t been much good news for patients with the prevalent but enigmatic disorder chronic fatigue syndrome (also referred to as myalgic encephalomyelitis). Over decades, research into the pathophysiology has failed to find convincing evidence of either persistent infection or immunological, endocrine, or metabolic change, and has rejected simplistic notions of depression (typical or atypical) or primary sleep disorder. Several notable “breakthroughs” have failed independent replication.

The most noteworthy is the recent rise and fall of xenotropic murine leukaemia virus related virus (XMRV) as the cause, which was ultimately established as a murine DNA laboratory contaminant.

Similarly, an exhaustive array of randomised controlled trials seeking curative outcomes from antiviral, immunological, hormonal, antidepressant, and many other therapies have failed to show any benefit over placebo, or failed the replication test.

Hospitalisation leads to functional decline in the over 70s

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Two in five patients aged over 70 who are hospitalised with acute conditions are discharged with reduced functioning compared with when they were admitted, a study has found.

Staying in bed, being attached to urinary catheters unnecessarily, taking sleeping pills, and inadequate nutrition are some of the reasons for a decline in function, the researchers wrote in the Journal of the American Geriatrics Society

New award scheme to spark NHS digital revolution

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A unique partnership of patients and health professionals has launched a new awards scheme to unearth the digital technologies improving people’s health and wellbeing across the UK.

Sponsored by the NHS Confederation and four leading digital technology organisations, the unAwards aims to find, develop and disseminate the best innovations making acute and chronic health problems easier to live with.

Countries are ill prepared to fight antimicrobial resistance, WHO says

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Three quarters of countries have no national plan to tackle antimicrobial resistance, despite such plans being seen as one of the most important components in combating the problem.

A survey of 133 countries conducted by the World Health Organization in 2013 and 2014 found that just 34 had a comprehensive national plan to tackle antimicrobial resistance.

Self-service soon to be available in the Library and Knowledge service!

Macclesfield’s Library and Knowledge Service has taken delivery of a new self-service machine. Once it is installed in about two weeks, library users will be able to use it to borrow, return and renew books, pay fines and check their accounts.

Why not contact the library for more information? Email ecn-tr.stafflibrary@nhs.net or phone 01625 661362, or drop in to see the machine for yourself!