Frimley Park Hospital is a large, 938-bed general hospital in Frimley, Surrey. It is managed by Frimley Health NHS Foundation Trust, and houses a private wing.
There is a need to understand the predictors of prostatic urethral lift (PUL) durability to help physicians counsel patients and optimize outcomes. A simple logistic regression analysis was performed on a pooled dataset of 331 subjects across 5 PUL controlled studies with up to 5 years follow up. Predictors of “surgical durability” (no surgical treatment for return of symptoms) and “total durability” (no surgical or medical treatment for return of symptoms) were assessed at 1- and 5-year post-procedure. Placing ≤4 implants regardless of baseline prostate volume was associated with increased surgical retreatment within the first year. Through one year, more implants were protective of retreatment; for every incremental implant placed, surgical retreatment odds decreased an additional 41.2
Artificial intelligence (AI) has shown significant potential in enhancing diagnostic accuracy, refining prognostic models, guiding personalized treatment decisions, and improving clinical workflows. Across the spectrum of blood cancers, AI-based tools have demonstrated strong performance in tasks such as automated image classification, genomic and biomarker analysis, prediction of treatment response and toxicity, and estimation of measurable residual disease. Despite these promising developments, challenges remain, including limited dataset size, lack of prospective validation, concerns regarding interpretability, and ethical considerations related to data privacy and bias. The review emphasizes the need for robust clinical integration strategies, high-quality data, and multiple teams' collaboration to fully harness AI's potential in transforming the management of hematologic malignancies.
BACKGROUND:Epistaxis is a common ear, nose, throat (ENT) presentation in the emergency department (ED), with the majority of the population having experienced an episode during their lifetime and required hospitalization. Like many district general hospitals (DGHs) in the country, St Peter's Hospital does not offer adult inpatient or out-of-hours emergency cover for ENT, necessitating patients who require intranasal packing with a Rapid Rhino® (Smith & Nephew, Hull, UK) to be transferred to another hospital for assessment and admission, with most transfers being via ambulance. Apart from being resource-heavy, both the procedure itself and the prolonged stay in ED awaiting transport are a distressing experience for the patient. Therefore, the present quality improvement analysis was performed for the assessment of the effectiveness of Floseal® (Baxter Healthcare, Deerfield, IL, USA) and NasoPore® (Stryker, Kalamazoo, MI, USA), a bioresorbable material for epistaxis. METHODS:We introduced the revised Royal College of Surgeons (RCS) ENT UK guidelines for epistaxis management in our department. Two Plan-Do-Study-Act (PDSA) cycles were conducted in parallel. To assess the patient experience, a feedback form was designed with particular focus on pain score using the Visual Analog Scale (VAS). IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York, United States) was used for descriptive analysis, and cost-effectiveness analysis was also performed to compare the outcomes with rapid rhino nasal packing. A telephonic follow-up on days 2 and 5 was organized to document any adverse features. RESULTS:The use of bioresorbable nasal packing among 60 patients demonstrated a clear benefit over the conventional practice of a non-absorbable packing, like Rapid Rhino. It reduced the length of stay (LOS) in ED and allowed the patients to go home with self-care instructions. In addition to much better patient comfort and tolerability (drop in pain score from 7 to 2 on VAS), this intervention also had a significant cost-saving impact with more than 65% cost reduction. CONCLUSION:Floseal bioresorbable material can be used as a replacement for traditional nasal packing, as it was found to be more effective and cost-effective.
Background: Vertebral fractures are the most common osteoporotic fractures and are frequently underdiagnosed. Although prior fragility fractures increase the risk of subsequent fractures, the magnitude and distribution of extremity fracture risk following vertebral fractures remain incompletely defined. Objective: The objective of this study is to evaluate the risk of subsequent extremity fractures following vertebral fractures in adults aged ≥50 years and to characterize fracture patterns and timing. Methods: A systematic review was conducted using three databases (PubMed, OVID, and Scopus) covering studies published between January 2005 and December 2025. Studies reporting subsequent extremity fractures after an index vertebral fracture in adults aged ≥50 years were included. Data extraction included patient demographics, fracture characteristics, treatment variables, and incidence of subsequent fractures. Results: Eight studies were included in the qualitative (narrative) synthesis, comprising a total of 488,770 patients with an index vertebral fracture. The reported incidence of subsequent extremity fractures ranged from 1.4% to 12.4%, with a crude aggregated incidence of 6.90% (33,605 patients). Hip fractures accounted for 73.3% of extremity fractures, followed by forearm/wrist (11.8%), humerus (10.3%), and ankle fractures (3.26%). Most subsequent extremity fractures occurred within 1-3 years after the index vertebral fracture. Additionally, 23,542 patients (4.82%) experienced subsequent vertebral fractures. Rates of dual-energy X-ray absorptiometry utilization and pharmacologic treatment ranged from 5% to 34.5%. Conclusions: Vertebral fractures in adults aged ≥50 years are strong predictors of subsequent extremity fractures, particularly hip fractures, with risk concentrated in the early post-fracture period. These findings support the concept of a systemic fracture cascade and emphasize the need for early detection and structured secondary prevention strategies.
