Royal Hallamshire Hospital

..This article focuses on a practical approach to managing menorrhagia, dysmenorrhoea, oligomenorrhoea and premenstrual syndrome (PMS) and reviews the literature on this topic...

..We also identified recent research developments and highlighted some ongoing clinical trials to explore future directions in drug treatment and prevention of delirium...

..The accompanying flowchart has been formulated to guide emergency physicians and general practitioners through the decision-making process regarding treatment and admission for specialist care...

..To evaluate the efficacy of a large-spot subthreshold infrared laser protocol to treat diabetic maculopathy...

..Childhood absence epilepsy (CAE) is the prototype IGE with typical absence seizures. We report a child who had prominent ictal hiccups during an absence seizure, and discuss the possible mechanisms. [Published with video sequences]...

..The emergence of large well-conducted clinical trials may provide the evidence to support or refute the outcome-based assumptions of developmental care...

..Using the technique described, a prolonged course of systemic antibiotics does not appear to be essential and the high cost of the administration of antibiotics can be avoided...

..To review the evidence of effectiveness of dressings applied to venous leg ulcers...

..To study retrospectively the epidemiology, demography and clinical issues related to varicella in pregnancy in a UK city over a 5-year period and help inform the debate on the potential of varicella immunisation in prevention...

..Accurate record-keeping is integral to professional practice. This article provides an overview of the importance of good record-keeping in nursing practice...

..To assess the risk of radiosurgery to cause malignant transformation in benign tumors or to induce new malignancies...

..It is important therefore that these patients are given advice specific for NF2. Considering this, we believe that radiosurgery remains a valuable minimally invasive treatment option for selected NF2 patients...

..The new assay is considered to be a suitable assay for the routine diagnosis of protein C deficiency...

..Compliance with a strict, lifelong gluten-free diet is the cornerstone of management, improving symptoms and reducing complications of the disease...

..3% of people with epilepsy who were 85 and older had been referred. The results raise the possibility of inadvertent age discrimination, putting older adults with seizures at greater risk for misdiagnoses and suboptimal management...

..We also discuss the results of clinical trials of analogues of ghrelin, amylin and GLP-2 in the treatment of low bone density, and the potential bone effects of GLP-1 mimetics that are used in the treatment of type 2 diabetes...

..To investigate the time lapse prior to provision of emergency dental care and appropriateness of earliest treatment provided for children with dental trauma...

..Adjuvant trastuzumab was well tolerated overall. The new guidelines potentially allow more patients to complete trastuzumab on schedule but require higher levels of cardiological intervention...

..A further aim is to establish if the fast-track route is adequately meeting the training and development needs of staff within the organisation and supporting service requirements...

....

..Mean duration for breastfeeding was similar across epidural groups (Control 13.3, Combined Spinal Epidural 15.5, Low Dose Infusion 15.0 weeks). Our data do not support an effect of epidural fentanyl on breastfeeding initiation...

..We examined the clinical efficacy and cost-effectiveness of an OPAT service based in a large UK teaching hospital, predominantly using the outpatient 'infusion centre' and patient/carer administration models of service delivery...

..7% (71.4%) and a specificity of 84.6% (92.3%). This blinded, prospective multirater study confirms the diagnostic value of linguistic and interactional observations in the seizure clinic setting...

..Chloracne can be a difficult diagnosis to make when it occurs in a novel setting: occupational physicians and dermatologists need to be vigilant when dealing with unusual eruptions in discovery chemists...

..To obtain information about peritoneal dialysis (PD) access practices in the United Kingdom...

..Colonoscopy can be uncomfortable. To increase safety, there is a trend, in the UK, towards reduced sedative use. We aimed to determine factors predictive of discomfort during colonoscopy...

..P. mosselii is a highly unusual cause of endocarditis and there are few case reports of curative treatment of pseudomonal prosthetic valve endocarditis with antibiotics alone...

..To assess the incidence of hypomagnesaemia, the influence of different cisplatin dosages on the degree of hypomagnesaemia and the effect of routine magnesium supplementation on magnesium levels...

..To report experience with a minimally invasive technique for palliation of urinary fistula/incontinence complicating advanced pelvic malignancy or its treatment...

..Although 45% of GPs may provide Level 2 care, it is unlikely to include partner notification. Many GPs are too busy and require extra training and funding. These needs must be addressed if the Strategy is to be implemented...

..Newer non-benzodiazepine hypnotics offer little practical advantage. Melatonin and atypical antipsychotics require further investigation before their routine use can be recommended...

..The recurrent admission of infants in this group for active resuscitation and/or intensive care may not always be the wisest management, and important medical, ethical and legal dilemmas are faced by families and carers of these infants...

..As time-resolved techniques become more sophisticated and 3D acquisitions can be obtained with high isotropic spatial resolution we may start to see the demise of catheter angiography as a diagnostic procedure...

....

..Regular audit is essential. This study identified the need to improve the format of the request card and to obtain additional referral information from the referrer...

..Sixty per cent of intensive care units use corticosteroids in septic shock patients, but only 22% use a short synacthen test to guide therapy...

..This article present two cases that illustrate this problem, and will briefly look at known internal and external causes of artefact...

..We must remember however that some outreach teams have only been in post for 12 months and so it may therefore be far too early to reliably demonstrate any effect...

..To describe the pattern of pregnancy loss in women with a history of recurrent miscarriage (RM)...

..In particular this paper highlights the effectiveness of the scoring system contained within the Trent and National EQA protocols...

..Bupivacaine irrigation used in this manner does not appear to offer an effective contribution to postoperative analgesia...

..g. for outdoor workers, the need to cover up in the sun and use sun protective creams and a campaign for earlier recognition of skin cancers, which are usually curable if treated in their early stages...

..To identify the proportion of patients testing positive for deep vein thrombosis (DVT) who are injecting drug users (IDUs), and examine differences in the investigation and management of this group compared with non-IDUs...

....

..Traditional contrast venography is mandatory where there is suspicion of central vein stenosis. In predialysis patients where there is a risk of contrast nephropathy MR venography is emerging as a possible alternative...

..In an attempt to optimize the fluid management of patients within the intensive therapy unit, this article outlines the development and implementation of a fluid prescription for ventilated patients with suspected hypovolaemia...

....

....

..The underlying cause of the enhancement remains to be elucidated, but it should be recognized that leptomeningeal enhancement may occur after surgery and that this does not necessarily imply tumour spread...

..We therefore attempted to determine the analytical imprecision of our total hCG method over a 4-week period at concentrations up to 20,000 IU/L...

..To compare intensity-modulated radiotherapy (IMRT) treatment plans with three-dimensional conformal radiotherapy (3D-CRT) plans to investigate the suitability of IMRT for the treatment of tumors of the parotid gland...

..Also, analysis of the results will provide the range of variation for the analysed parameters among the different groups of subjects studied and allow for refinement and standardisation of these techniques. ..