Hull Royal Infirmary is a tertiary teaching hospital and is one of the two main hospitals for Kingston upon Hull (the other being Castle Hill Hospital in nearby Cottingham). It is situated on Anlaby Road, just outside the city centre, and is run by Hull University Teaching Hospitals NHS Trust.
Pulmonary nodules with increased metabolic activity on positron emission tomography (PET) are frequently presumed malignant; however, inflammatory and rare benign neoplastic processes may produce false-positive findings. A 61-year-old African American male with a history of calcified and non-calcified pulmonary nodules and severe emphysema was referred to our pulmonary nodule clinic from the emergency department after a newly discovered lung nodule was identified on computed tomography (CT) of the chest. Subsequent evaluation demonstrated metabolic activity on PET, raising concern for malignancy; however, tissue diagnosis revealed organizing pneumonia. This case highlights diagnostic pitfalls associated with commonly used imaging and biomarker modalities in the evaluation of pulmonary nodules and emphasizes the importance of clinical awareness of a rare tumor, granular cell tumor (GCT), among physicians who may be unfamiliar with or have never encountered this condition.
Bone-anchored prostheses (BAPs) are an alternative option for lower-limb amputees with problematic suspended socket prostheses (SSPs). We sought to meta-analytically quantify complication burden and revision-free survival for BAPs, whilst investigating possible differences in complication rates between common screw-fit (OPRA) and press-fit (ILP/OPL) designs. A multi-database search of PubMed, EMBASE, CiNAHL, Cochrane Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus and Web of Science from inception to September 2025 was conducted. Proportions were pooled using a random-effects model. This review was registered in PROPSPERO (ID: CRD42024507070). A total of 22 studies reporting 979 patients were included. An overall complication rate of 65
ABSTRACT Background and Aims Necrotizing fasciitis (NF) is a rapidly progressive, life‐threatening infection, with the lower limbs being a common site. Diabetes mellitus (DM) is a significant risk factor that influences the progression, outcome, and management of NF. Despite its clinical relevance, comparative data on diabetic versus non‐diabetic NF outcomes remain limited. This study aimed to compare mortality, amputation rates, and other key outcomes between diabetic and non‐diabetic patients with NF. Methods A systematic review and meta‐analysis were conducted in accordance with PRISMA guidelines. Eligible studies assessed outcomes in diabetic and non‐diabetic NF patients. Primary outcome measures included amputation rates, mortality, admission length, debridement frequency, and microbial growth. Secondary outcomes included the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and unplanned reoperations. Pooled analyses were performed using OpenMeta[Analyst] software, reporting odds ratios (OR) and mean differences (MD) with 95% confidence intervals. Results Nine studies comprising 1,890 patients met the inclusion criteria. Diabetic patients had significantly higher rates of amputation (OR 3.77, 95% CI 3.04 to 4.68; p < 0.001) and polymicrobial infections (OR 2.53, 95% CI 1.50 to 4.26; p < 0.001). Mortality was higher among diabetic patients after sensitivity analysis (OR 1.60, 95% CI 1.09 to 2.33; p = 0.02). Length of admission did not differ significantly between groups, whereas the pooled number of debridements was marginally higher in diabetic patients (MD 0.28, 95% CI 0.05 to 0.52; p = 0.02), based on only two studies. Diabetic patients had significantly higher LRINEC scores (MD 2.02, 95% CI 1.33 to 2.72; p < 0.001). Conclusion Diabetic patients with NF experience worse clinical outcomes, including increased amputation, mortality, and polymicrobial infection. These findings highlight DM as a key prognostic factor and underscore necessity for aggressive intervention and risk stratification. Further high‐quality prospective studies are needed.
Background Isthmic spondylolisthesis is commonly associated with back pain and neurological symptoms. The primary localised kyphotic deformity at the level of the spondylolisthesis is counterbalanced by increased lordosis across the lumbar spine. Spondylolisthesis reduction and fusion corrects the initial deformity and may also restore lumbar lordosis and sacral slope. In this study, we aimed to investigate how lumbar lordosis normalises following short-segment transforaminal lumbar interbody fusion (TLIF) for isthmic spondylolisthesis. Methodology In total, 54 consecutive patients from a single surgeon series of isthmic spondylolisthesis undergoing reduction and TLIF performed between 2013 and 2023 underwent retrospective radiological analysis by two independent observers. Measurements of the lumbar lordosis, sagittal cobb angle across the lumbar spine as a whole, and individual motion segments were taken using pre and postoperative standing radiographs. Results A total of 39 fusions were performed at L5/S1, 12 at L4/5, two on both levels L5/S1 and L4/5, and one at L3/4. Normalisation of lordosis was noted at all spinal levels, including those distant from the surgical site. Global lumbar lordosis decreased from a median of 66° to 50° (p < 0.001). All segmental levels showed significant reductions in lordotic angle (p < 0.05), with the greatest proportional change at L1/2 and the largest angular correction at L5/S1. Conclusions This study is the first to demonstrate that surgical reduction of isthmic spondylolisthesis can restore global sagittal harmony by correcting the compensatory hyperlordosis across all lumbar segments.
