Staff Publication

Rising incidence of necrotising fasciitis: a gynaecological perspective (2025)

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Type of publication:

Journal article

Author(s):

*Kaur, Harpreet; *Adekunle, Adeoye; *Ritchie, Joanne; *Rachaneni, Suneetha.

Citation:

BMJ Case Reports. 18(4), 2025 Apr 08.

Abstract:

Necrotising fasciitis is an uncommon and rapidly progressive surgical emergency. A high index of clinical suspicion, prompt administration of broad-spectrum antibiotics and emergency surgery to debride affected tissues are key to improving survival. With our review of three cases, we aim to raise awareness of this condition among gynaecologists, who have limited familiarity with it. Two of our patients presented to emergency with vulval necrotising fasciitis while the third developed it as a complication of postoperative wound infection. All patients underwent extensive surgical debridement and required a multidisciplinary approach from gynaecologists, surgeons, the intensive care team and the tissue viability team.

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39MO Genomic framework of lung carcinoid: Analysis of the AACR GENIE database (2025)

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Type of publication:

Conference abstract

Author(s):

Immanuel A.; *Arunachalam J.; Advani K.

Citation:

ESMO Open. Conference: The ESMO Sarcoma and Rare Cancers Congress 2025. Lugano Switzerland. 10(Supplement 3) (no pagination), 2025. Article Number: 104350. Date of Publication: 01 Mar 2025.

Abstract:

Background: Carcinoid tumors, rare neuroendocrine tumors, occur in the lungs in approximately 25% of cases. The 5-year survival rate for lung carcinoid in the US is 98% for localized disease and 86% for regional disease, with a drop to 55% for metastatic cases. Patients with metastasis are often treated with temozolomide-based chemotherapy, mTOR inhibitors (everolimus), platinum-based chemotherapy, or peptide receptor radionuclide therapy. We aim to investigate potential unexplored genetic targets. We intend to explore if there is a role for immunotherapy for treatment for lung carcinoid as it is generally better tolerated and less toxic compared to chemotherapy. Method(s): Using the cBioPortal platform, we accessed the AACR GENIE version 15.0 database. Demographic data were gathered from patients with lung carcinoid. We outlined the frequency of mutated genes, copy number alterations, and structural variations in the population. Result(s): We analyzed 242 patients and 253 samples. 73.1% of the patients were females and 26.9% were males. 74.7% of samples were collected from a lung primary, while 16.2% of samples were from metastatic sites. The median age at sequencing was 62 years. The highest frequency of mutations was seen in LRP1B gene (18.4%), followed by the MN1 gene (15.8%) and the ARID1A gene (11.8%). The most structural variants were found in the MEN1 gene at 0.9% (n =2, total number of profiled samples = 226). The most common copy number alteration was PDCD1 (n=5, number of profiled samples=134) at 3.7% and CCND1 on 11q13.3 (n=4, number of profiled samples=201) at 2%. Conclusion(s): Prior studies have shown that one of the most frequently mutated pathways in pulmonary carcinoids involves MEN1 gene. We found that genomic alterations in LRP1B, ARID1A, PDCD1 and CCND1 are also frequently observed. It is well known that anti-PD1 therapy is efficient in PD1 expressing cancers. LRP1B mutation in lung cancers has been shown to affect the immune microenvironment and enhance the efficacy of immune checkpoint inhibitors. While ARID1A mutations correlate with longer median overall survival when treated with immunotherapy. The limited number of ongoing clinical trials on targeted therapies underscores the clear need to explore the genomic targets for precision therapies in lung carcinoids.

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BHSeP26 Abdominal wall reconstruction outcomes of the first 50 cases in a district general hospital (2025)

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Type of publication:

Conference abstract

Author(s):

*Gungadin P.; *Bhandari M.; *Cheetham M.; *Chakravartty S.; *Mccloud J.; *Parampalli U.

Citation:

British Journal of Surgery. Conference: 13th British Hernia Society Conference. Oxford United Kingdom. 112(Supplement 3) (pp iii6), 2025. Date of Publication: 01 Jan 2025.

Abstract:

Background: The purpose of this study was to evaluate the short-term clinical outcomes of patients undergoing reconstruction of abdominal wall following repair of complex hernias at a recently established unit. Method(s): This retrospective study included all patients who underwent abdominal wall reconstruction for complex incisional hernias between January 2022 and March 2024. Clinical data encompassing patient demographics, operative parameters, post-operative complications, length of hospital stay and 30-day mortality was analysed. Result(s): 50 patients were included with a male to female ratio of 1:1. The median age of the participants was 62 (26-82). 25% of participants had a BMI of 35. The majority of hernias were approached with a vertical elliptical incision; Fleur de Lys incision was used in 1 case and abdominoplasty incision in 3 cases. The following reconstruction techniques were used: 27 patients underwent Rives Stoppa repair and 16 patients underwent Transversus Abdominis Muscle Release. 30% patients had Botulinum toxin injection pre-operatively. The types of mesh used included: Ultrapro 80 %, Phasix 16 % and Parietex 4 %. Complications included: Surgical site occurrence 6%, cardiorespiratory complications 10%, vascular complications 2% and bowel obstruction 4%. ICU admission included 3 out of 50 patients. Length of hospital stay in 90% patients was 5 days. 60% patients had a 6-monthly follow up where 1 recurrence was noted. Conclusion(s): The early outcomes in our patients demonstrates the feasibility to achieve acceptable outcomes in a district general hospital, by following a multidisciplinary approach and optimising modifiable risk factors preoperatively.

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Orthodontic Patient Initiated Follow Up (2025)

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Type of publication:

Service improvement case study

Author(s):

*Leonie Seager and *Rebekah Tudor

Citation:

SaTH Improvement Hub, February 2025

Abstract:

To reduce the number of retainer review patients who don’t attend (DNA) by 20% by 28th February 2025.
Sub Aim: Increase the number of PIFU by 20% by 28th February 2025

Link to PDF poster

Deteriorating patient response sticker (2024)

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Type of publication:

Service improvement case study

Author(s):

*Teresa Cole

Citation:

SaTH Improvement Hub, August 2024

Abstract:

To improve documented response on deteriorating patients on AMU to (PRH) to 60% to include: investigation plan, treatment plan, escalation plan and review plan by reviewing clinicians by the end of September 2024 using CQUIN data as a baseline for improvement

Link to PDF poster

Improving CareFlow documentation in PRH Emergency Department (2025)

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Type of publication:

Service improvement case study

Author(s):

*Luke Moss

Citation:

SaTH Improvement Hub, January 2025

Abstract:

To increase the number of ED Cas-cards that have allergy status recorded to 100% and to increase the number of Careflow allergy alerts by 100% by 23/11/24.

Link to PDF poster