2025

Severe hypocalcemia and hypophosphatemia following Denosumab administration in a multi-comorbidity patient (2025)

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Type of publication:

Journal article

Author(s):

*Sagdeo, Anuja; *Elshehawy, Mahmoud; Rakieh, Chadi; Ball, Patrick; Morrissey, Hana.

Citation:

Medicine & Pharmacy Reports. 98(1):144-148, 2025 Jan.

Abstract:

The case is presented of an elderly patient (DCP) with extensive medical history, including osteoporosis, who developed hypocalcaemia and hypophosphataemia whilst treated with denosumab, while prescribed concomitant calcium and vitamin D therapies. The management of this complex case involved a multidisciplinary team (MDT) approach, incorporating the patient's wishes. It included discontinuation of denosumab and intravenous (IV) and oral mineral supplementation that yielded gradual amelioration of calcium and phosphate levels. This case demonstrates the importance of vigilant monitoring and appropriate management in patients receiving denosumab, particularly those with multiple comorbidities. It carries important considerations for using denosumab for osteoporosis treatment in patients with complex medical backgrounds. Ethical clearance waiver was granted by the Trust Research Ethics Committee on 18/01/2024.

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Leadership and service improvement (2025)

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Type of publication:

Journal article

Author(s):

*Hamer, Chelsea

Citation:

OTnews, March 2025, p. 48-50

Abstract:

Last year, Chelsea Hamer completed a leadership placement which saw her focus on upskilling staff and introducing splinting within an inpatient occupational therapy service for neurological patients. Here she shares the outcomes.

Ethnic and Socioeconomic Variation in Pre-Conception Long-Term Conditions: A Cross-Sectional Electronic Health Record Study of 3.4 Million Pregnancies in CPRD Aurum (2025)

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Type of publication:

Journal article

Author(s):

Cockburn N.; Singh M.; Wambua S.; Gonzalez-Izquierda A.; Lee S.I.; Phillips K.; *Elsmore A.; *Ilaalagan R.; Holland R.; Hanley S.J.; Laws E.; Hodgetts-Morton V.; Gibbon M.; Judd N.A.; Seymour R.G.; Taylor B.; Chandan J.S.; *Parry-Smith W.; Nirantharakumar K.

Citation:

SSRN. (no pagination), 2025. Date of Publication: 23 Jan 2025 [preprint]

Abstract:

Background: Inequalities in pregnancy outcomes between different ethnic groups and backgrounds of deprivation have been observed in the UK and elsewhere for several decades. Pre-existing long-term health conditions increase risks of adverse outcomes and require focussed action to diagnose, prevent, and manage these conditions. We aimed to estimate differences in the prevalence of pre-conception long-term conditions between different groups to assess health needs.

Methods: This was a cross-sectional study conducted in primary care using Clinical Practice Research Datalink (CPRD) Aurum data. Diagnostic information was extracted from CPRD Aurum at the beginning of all eligible pregnancies for 79 conditions between 2000 and 2021. Age-standardised was estimated and risk ratios calculated between the overall population, and ethnic groups and Index of Multiple Deprivation quintiles. Statistical process control was used to detect conditions with elevated prevalence within groups.

Findings: In 2021, at the start of a pregnancy, women from ethnic minority groups were less likely to have been diagnosed with any one of the 79 conditions than the general population. Women from mixed ethnic groups were 4% more likely to be diagnosed, and from white ethnic groups 2% more likely to be diagnosed. Women from black groups were 5% less likely to be diagnosed, from Asian groups 26%, other ethnic groups 32%, and women missing ethnic group information 13%. Women living in the most deprived quintile of areas were 8% more likely to have been diagnosed than the overall population, and from least deprived areas 8% less likely to have been diagnosed.

Interpretation: Pre-existing long-term conditions are a major driver of maternal morbidity and mortality, but the healthcare needs and policy priorities differ substantially between ethnic and socially disadvantaged groups. Universal health policies that narrow inequalities and targeted action are both needed to meet health needs equitably.

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Assessing SPECT/CT for the identification of cartilage lesions in the knee joint: A systematic review (2025)

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Type of publication:

Systematic review

Author(s):

Rix L.; *Tushingham S.; Wright K.; Snow M.;

Citation:

Osteoarthritis and Cartilage Open. 7(1) (no pagination), 2025. Article Number: 100577. Date of Publication: 01 Mar 2025.

Abstract:

Background: Single-photon emission computerised tomography with conventional computer tomography (SPECT/CT) is an emerging technology which may hold clinical value for the identification of cartilage lesions in the knee joint. The intensity and distribution of SPECT/CT uptake tracer may identify physiological and structural information in the absence of structural change on other imaging modalities.

Objective(s): To systematically assess the utility of SPECT/CT in the detection of chondral lesions within the knee joint, in patients presenting with knee pain, with or without structural change.

Result(s): PubMed, Science Direct, Web of Knowledge, and NHS databases were searched for English language articles focusing on the diagnostic value of SPECT/CT for knee chondral lesions and knee pain. Animal studies, cadaver studies, comparator radiological technique other than SPECT/CT or patients with a pathology other than knee chondral lesions were excluded. From the search, 11,982 manuscripts were identified, and screened for relevance. Seven studies were identified and scored low on QUADAS-2 bias review. SPECT/CT correlated with lesions found on other imaging modalities and during intraoperative assessment. Furthermore, in some cases, SPECT/CT out-performed other modalities in the detection of cartilage lesions.

Conclusion(s): Evidence suggests SPECT/CT may be a useful tool for the detection and localisation of cartilage lesions, particularly in discrepant cases when there is an absence of lesions on other imaging modalities, or a lack of correlation with patients' symptoms. Further studies are required to confirm the conclusions of this review.

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Base of Thumb Fractures: A Review of Anatomy, Classification, and Management (2025)

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Type of publication:

Journal article

Author(s):

Younis, Zubair; Hamid, Muhammad A; Devasia, Thomas; *Khan, Muhammad Murtaza; *Abdullah, Faliq; *Singh, Rohit; Simons, Adrian William.

Citation:

Cureus. 17(1):e76729, 2025 Jan.

Abstract:

Fractures of the thumb metacarpal base are uncommon but significant due to their critical role in hand functionality and hand grip strength. These fractures exhibit diverse patterns, including extra-articular, Bennett, Rolando, and highly comminuted fractures, each with unique implications for management and outcomes. Each type presents unique challenges in achieving anatomical reduction, stability, and favorable long-term outcomes. This review explores the anatomy of the trapeziometacarpal joint, classification systems, clinical presentation, imaging techniques, and management strategies for these fractures. Stable extra-articular fractures often respond well to closed reduction and casting, while displaced intra-articular fractures generally require surgical intervention. Bennett fractures are typically treated using closed reduction and percutaneous pinning or open reduction and internal fixation. Rolando and comminuted fractures pose greater challenges due to their inherent instability and often necessitate advanced techniques such as locking plates, external fixation, or arthroscopic-assisted procedures. Achieving anatomical reduction is paramount to prevent complications such as joint incongruity, instability, and post-traumatic arthritis. Optimal treatment approaches depend on fracture patterns, stability, and patient-specific factors, with surgical techniques tailored to preserve thumb function and minimize long-term morbidity.

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Fish Tank-Associated Mycobacterium Marinum Infection in an Immunocompromised Host (2025)

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Type of publication:

Journal article

Author(s):

*Khan, Attam; *Jain, Dimple.

Citation:

BMJ Case Reports. 18(2), 2025 Feb 05.

Abstract:

Mycobacterium marinum infection can be challenging to diagnose and treat, especially in immunocompromised patients on tumour necrosis factor alpha inhibitors. A patient with collagenous colitis on infliximab presented with ulcerated plaques accompanied by nodules in a sporotrichoid fashion. Initial treatments failed until a biopsy confirmed M. marinum Multiple antibiotic regimens, including rifampicin and ciprofloxacin, were required due to resistance. The case underscores the importance of patient education on avoiding aquatic environments, considering atypical mycobacterial infections in differentials for immunocompromised patients with sporotrichoid lesions, and prioritising urgent diagnostic biopsies. Treatment can be lengthy, often requiring up to 12 months, emphasising the need for ongoing patient counselling and multidisciplinary management. Current guidelines recommend a combination of ethambutol and macrolides, though further research is necessary to optimise treatment protocols.

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Bilateral corneal endothelial decompensation following airbag-induced trauma (2025)

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Type of publication:

Journal article

Author(s):

*Khaliq, Tayyib; *Pummiram, Srivarshini; *Iqbal, Naeem; *Jenyon, Tom.

Citation:

BMJ Case Reports. 18(1), 2025 Jan 27.

Abstract:

Approximately 3% of individuals in road traffic accidents suffer ocular injuries. We present a case of a man in his late 80s who presented with bilateral corneal decompensation following airbag deployment during a road traffic accident. Ocular examination revealed multilevel ocular injury with severe bilateral corneal oedema. This was managed with topical steroids, mydriatics and antibiotic therapy. At 1-month follow-up, the left eye had persistent corneal oedema. Specular microscopy was performed which confirmed endothelial cell loss making the patient a candidate for a corneal endothelial graft. We observed blunt trauma from airbag deployment causing endothelial cell loss and subsequent corneal decompensation. Our findings suggest that patients presenting to the emergency department with facial trauma from airbag injury should be referred for comprehensive ophthalmological assessment and that the reviewing ophthalmologist should have endothelial cell loss in mind during examination.

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Placenta accreta spectrum: imaging and diagnosis (2025)

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Type of publication:

Journal article

Author(s):

*Self A.; Cavallaro A.; Collins S.L.;

Citation:

Obstetrician and Gynaecologist. (no pagination), 2025. Date of Publication: 2025.

Abstract:

Key content: Antenatal imaging is a screening tool integral to ensuring women are cared for in the most appropriate setting. The pretest probability of PAS should be considered before any imaging is performed. PAS is an iatrogenic disease. Any process which disrupts the endometrium increases the risk. Caesarean birth is the most common cause. Specialist placental assessment in asymptomatic women should be offered between 24 and 28 weeks. Ultrasound and MRI have similar diagnostic value, and MRI should only be used as an adjunct following ultrasound assessment by a specialist in placental imaging. Learning objectives: To understand the pathophysiology of PAS. To understand the distinction between screening for and diagnosis of PAS. To increase confidence in the interpretation of sonographic features of PAS. To provide a rationale for PAS care being provided in centres of excellence. Ethical issues: If women increasingly prefer caesarean section over vaginal birth, it is likely that this trend will result in increasing numbers of complex caesarean deliveries and PAS cases. Many studies have shown decreased morbidity and mortality if PAS cases are managed by an experienced multi-disciplinary team (MDT) in a PAS centre of excellence; therefore, accurate screening and timely referral are vital to improve patient care for women with risk factors.

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Examining perioperative factors in latex-allergic reactions (2025)

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Type of publication:

Journal article

Author(s):

*Patel, Ravi; *Parmar, Dilen; *Bhojwani, Ajay; Singh, Rohit; Nandra, Rajpal; Banerjee, Robin.

Citation:

Journal of Perioperative Practice. 2025 Jan 16. [epub ahead of print]

Abstract:

Despite the implementation of latex-free gloves, the issue of natural rubber latex hypersensitivity persists within medical practice, posing challenges for both patients and health care professionals. A comprehensive understanding of the demographic groups susceptible to this condition is essential, along with the establishment of robust perioperative assessment and management protocols aimed at minimising complications and enhancing safety. This article endeavours to delve into the intricacies of perioperative management concerning latex hypersensitivity among patients, while also elucidating its ramifications for health care practitioners.

Oral and maxillofacial surgery (OMFS) controlled' second-degree places in the UK - there are sufficient numbers (with high application ratios) to meet current and future OMFS recruitment needs in the UK (2025)

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Type of publication:

Journal article

Author(s):

Magennis, Catherine; Davies, Anna; King, Rhydian; Ilahi, Nida; Morgan, Roseanna; Stonier, Gemma; Howson, Kate; Dattani, Amit; *Hamps, Christopher; Rowe, Aimee; Jenkyn, Ian; Basyuni, Shadi; Magennis, Patrick.

Citation:

British Journal of Oral & Maxillofacial Surgery.  63(2):104-111, 2025 Feb.

Abstract:

In 2008 the Postgraduate Medical Education and Training Board (PMETB) Review of Oral and Maxillofacial Surgery (OMFS) recommended that OMFS specialty training should start with second-degree studies. This recommendation has not yet happened. Currently, no OMFS controlled places at medical/dental schools are directly linked to OMFS Specialty Training (ST) posts. 'OMFS controlled' in this paper refers to dedicated places on shortened second degree courses to which OMFS specialists/trainers have the key role in selection. Freedom of Information requests were sent to 14 medical schools known to have OMFS 'controlled' second-degree MB places: Aberdeen, Birmingham, Bristol, Cambridge, Cardiff, Glasgow, Leeds, Liverpool, Manchester, London-Kings, London-QMUL, Newcastle, Plymouth and York/Hull. Information was also requested from the London-Kings BDS Dental Programme for Medical Graduates (DPMG). These data were supplemented by information from consultants and trainees with experience of the processes. Replies were received from six medical schools in Birmingham, Cambridge, Glasgow, Liverpool, London-Kings, and London-QMUL, plus the dental school of London – Kings DPMG. These seven programmes provide approximately 30 OMFS controlled places per year. The application ratios, between 5:1 and 29:1, are significantly more competitive than selection to ST1 and ST3 places. There are more OMFS controlled second degree places than presented in this paper which only details universities from whom replies were received. If all students in OMFS controlled second-degree places progressed to ST without loss, there are more than sufficient to fill all available OMFS ST places. Linking OMFS controlled second degree places through to OMFS ST posts would deliver the key PMETB recommendation in a process which would be more competitive than current ST selection. For OMFS trainees whose first degree was medicine, OMFS selected places at shortened dental courses are needed outside London.