As a registrar working with consultant geriatrician Dr Michael Fertleman, I was increasingly called to the trauma ward to offer geriatric assessments to patients who struggled with multiple issues. Best practice is to give a patient with suspected frailty a comprehensive geriatric assessment within 72 hours, but the volume of patients we receive who qualify has grown so much that this cannot be done without having a consultant geriatrician embedded in the service full time.
As a result, I became the first geriatrician in London to run a dedicated, embedded service in the trauma department. I will sit in the multidisciplinary team meeting with trauma surgeons, go on joint ward rounds with them throughout the week, and see major trauma patients whenever I am needed. I also help look after our surgical rehabilitation ward, which is for patients who are stable but require a longer period in hospital to recover. It is very rewarding to be able to offer continuity of care to our older trauma patients. (more…)
Karim Hamaoui provides an insight into an innovative solution for the organ donation shortage – a technique that allows the pancreas to be preserved for longer and for better function.
The pancreas responsible for producing one of the body’s most important hormones: insulin. Since the first pancreas transplant in 1966, this procedure has revolutionised the treatment of type 1 diabetes. To date, pancreas transplantation is the only definitive treatment to render patients free from daily insulin injections and provide a better quality of life for these patients.
A key problem in the UK and worldwide is the limited supply of organs available and suitable for transplantation. The majority of pancreases used for transplantation in the UK come from a person who has died, and whose relatives have given permission for them to become an organ donor. To meet demand, the criteria used to identify suitable donors can be expanded from ‘ideal’ to ‘extended’ criteria. Extended criteria donors can also be euphemistically referred to as donors with ‘medical complexities’. They are normally aged 60 years or older, or aged over 50 years but with at least two of the following conditions: high blood pressure history, degree of kidney impairment, cause of death from a stroke. Unfortunately, complications are more pronounced for these types of organs. (more…)
Dr Ben Mullish and Dr Julie McDonald explore the ins and outs of faecal microbiota transplants – it may sound unpleasant but this procedure is proving to be an effective way of treating chronic gut infections.
Most of us can name (or may have had first-hand experience of) a number of different bacteria that can cause serious gut infections, such as Salmonella or Campylobacter. However, what is less well-known is that we also have billions of bacteria living in our guts that normally do us no harm at all. Some actually have important contributions towards our health – including prevention of bacterial pathogens entering our gut and causing infections. Collectively, this huge population of microorganisms living inside our digestive tracts is often referred to as the ‘gut microbiota’. If anything happens to us that disturbs or kills off members of this gut microbiota – such as exposure to antibiotics, or surgery – then we have greater vulnerability to gut infections, and particularly from a form of bacteria called Clostridium difficile. (more…)
This Breast Cancer Awareness Month, Dr Luca Magnani unravels the complexity of cancer research, from recent advances in genomics to the power of patients in research.
In today’s fast-paced world in which everything quickly rotates, spins loudly for your clicks and sights, deciding where to focus our attention is a decisive factor. When trends come and go at lightning pace, it is somewhat surprising that October is still Breast Cancer Awareness Month. I’m glad we can still manage to stop and reflect on what this means. Last year we discussed how Breast Cancer Awareness Month has evolved in the era of social media and marketing. This year I thought we could be more optimistic and discuss when October becomes ‘tea and crumpet’ appreciation month. (more…)
Healthcare and Design MSc student Peter White makes the case for why we need to think outside the box when it comes to innovation in healthcare.
Have you ever looked at something and thought, “how on earth did no-one invent that before?” You know the feeling. It’s the one you get while staring numbly at a copy of Harry Potter – all the while wondering how the idea of a boy who goes to school went unwritten for so long. It’s the one people probably had when the first guy rolled by with casters on the bottom of his chair. Even Facebook seems like such a simple idea in hindsight.
Forget happiness or sadness or the feeling of ‘it’s coming home’. It’s this constant ‘so close yet so far’ that’s the prevailing emotion in my life right now. A perpetual reminder that, yes, I’ll never be Mark Zuckerburg, or even a Google elf for that matter. All this is compounded by the fact that, according to my shiny laminated ID card, I’m supposed to be a healthcare design masters student at St Mary’s hospital in London, a building so old it seems to look down enviously at the geriatric ward within. (more…)
Originally published on the NIHR Blog and reproduced here with permission, Professor Andrea Rockall, Clinical Chair of Radiology at Imperial, provides an insight into whether AI can enhance human detection of bone disease.
Myeloma is a disease that affects the skeleton and can be difficult to pick up at an early stage because symptoms are often quite vague. People who suffer from myeloma may be generally more tired than usual due to anaemia and may have aching bones. As the disease progresses, thinning of the bones may result in fractures, particularly of the spine, and this may be the first time that the diagnosis is picked up. The kidneys may also be affected due to an increase in myeloma proteins circulating in the bloodstream getting caught up in the delicate kidney tubules that filter the blood. If the disease is picked up early, some of these problems can be prevented. (more…)
In this post, Dr Aruchuna Mohanaruban tackles the most asked questions about the EndoBarrier – a medical device for the treatment of type 2 diabetes and obesity.
UK obesity rates have continued to rise at an alarming rate, with figures higher than any other developed nation. Strongly associated with obesity is the increased susceptibility to developing type 2 diabetes (T2DM) which currently affects 3.2 million of the UK population. Bariatric surgery – a type of surgery aimed at inducing weight loss – usually by altering the stomach and/or intestines has revolutionised the treatment of these conditions and can lead to a 60% remission in diabetes. However, with demand for this type of surgery outstripping supply, there is a greater need to develop non-surgical alternatives to combat the ever-rising obesity and diabetes epidemic. (more…)
Dr Christopher Peters provides an insight into life behind the scenes as a TV medical advisor for leading programmes such as Eastenders and Holby City.
It is a favourite pastime of anyone who works in healthcare to scoff at the mistakes we see when medicine is portrayed on film. From the back-to-front chest X-ray on Scrubs to the miraculous success rates of chest compressions in soaps we love to mock. However, for the last four years I have been working with various TV programmes to try to inject a degree of realism without dampening the drama.
This started with Holby City when I helped out on set, making sure that operating scenes looked realistic and that the actors could pass off as surgeons. This was my introduction to the tension between realism and plot. Being a medical drama, Holby had the budget and resources to try and get things right, but even they couldn’t keep viewers interested if they showed a lovely routine list of day cases where nothing goes wrong! (more…)
Dr Tim Hoogenboom, a Research Sonographer, looks at the promise and perils of machine learning in medical imaging.
Medical imaging is key in today’s delivery of modern healthcare, with an immense 41 million imaging tests taking place in England in every year. Thousands upon thousands of patients safely undergo imaging procedures such as X-ray, ultrasound, and MRI every day, and the product of these tests – the images – play an essential role in informing the decisions of medical professionals and patients in nearly every area of disease. (more…)
It is the season of giving, so we look at how kidney donations from strangers are giving kidney disease patients a second chance at life.
As far as generous Christmas presents go, donating your kidney seems for many at the extreme end. However, for a few lucky kidney disease patients, this is the gift of a lifetime. Known as unspecified or non-directed altruistic kidney donation, this form of live organ donation is on the rise, and could potentially wipe the waiting list if more stepped forward. I met Frank Dor, a consultant transplant surgeon and Head of Transplantation at Imperial College Healthcare NHS Trust, who has carried out hundreds of live organ donations. (more…)