King Edward VII's Hospital (formal name: King Edward VII's Hospital Sister Agnes) is a private hospital located on Beaumont Street in the Marylebone district of central London.Agnes Keyser, later known as Sister Agnes, established the hospital in her home at 17 Grosvenor Crescent in 1899 in the wake of the Second Boer War and at the suggestion of the Prince of Wales (later King Edward VII) who went on to become the hospital's patron. Its first intake of sick and mostly gunshot-wounded British Army officers arrived in February 1900.The hospital continued to operate during peacetime. During the First World War it continued to specialise in treatment of wounded officers by a select group of honorary staff, drawn up by Sister Agnes and made up of eminent London surgeons of the time. Military personnel treated included the future prime minister Harold Macmillan who was injured in 1916. He was admitted again in 1963. In 1948, following the Second World War, the hospital moved to Beaumont Street where the current premises were opened by Queen Mary. It has also treated members of the British Royal Family including Queen Elizabeth II, Princess Anne, the Queen Mother and Prince Philip, Duke of Edinburgh.In December 2012, the hospital received international media attention when, while Catherine, Duchess of Cambridge was staying there, two DJs from the Australian radio station 2Day FM made a hoax telephone call to the hospital. Soon afterwards, nurse Jacintha Saldanha, who had passed on the hoax call to the other nurse in the Duchess's private ward, was found dead.
BackgroundWith the rapid growth of women's elite sport, there is an increasing need to optimise healthcare for female athletes. These athletes can present unique clinical challenges, including high physical demands, altered energy availability, increased rates of pelvic floor dysfunction, and sport-related psychological pressures. Gynaecological surgery may significantly disrupt training and competition schedules, impacting both short- and long-term performance.ObjectivesThis narrative review provides a practical, evidence-based framework to support clinicians in delivering tailored peri-operative care for female athletes undergoing gynaecological surgery.Key findingsDrawing from current literature and multidisciplinary expertise, the review outlines key considerations across the pre-, intra-, and post-operative phases. It emphasises the importance of pre-operative assessment of menstrual health, bone density, nutritional status, and psychological readiness, particularly in athletes at risk of Relative Energy Deficiency in Sport (RED-S). Intra-operatively, surgical techniques should account for anatomical variations in lean athletes, and measures should be taken to minimise complications such as neuropathy, wound breakdown and delayed recovery. Post-operative rehabilitation requires a coordinated, multidisciplinary approach integrating physiotherapy, nutrition, pain management, and psychological support to facilitate a safe and timely return to sport.ConclusionsThis review highlights the need for athlete-specific surgical strategies that align with the physiological and performance demands of elite sport. Future studies are essential to inform sport-specific guidelines and optimise outcomes for this understudied population.
Background Infections are rare and poorly studied complications of unicompartmental knee arthroplasty (UKA) surgery. They are significantly less common compared to infections after total knee arthroplasties (TKAs). Optimal management of periprosthetic joint infections (PJIs) after a UKA is not clearly defined in the literature. This article presents the results of the largest multicentre clinical study of UKA PJIs treated with Debridement, Antibiotics and Implant Retention (DAIR). Materials and Methods In this retrospective case series, patients presenting between January 2016 and December 2019 with early UKA infection were identified at three specialist centres using the Musculoskeletal Infection Society (MSIS) criteria. All patients underwent a standardized treatment protocol consisting of the DAIR procedure and antibiotic therapy comprising two weeks of intravenous (IV) antibiotics followed by six weeks of oral therapy. The main outcome measure was overall survivorship free from reoperation for infection. Results A total of 3225 UKAs (2793 (86.2%) medial and 432 (13.8%) lateral UKAs) were performed between January 2016 and December 2019. Nineteen patients had early infections necessitating DAIR. The mean follow-up period was 32.5 months. DAIR showed an overall survivorship free from septic reoperation of 84.2%, with overall survivorship free from all-cause reoperation of 78.95%. The most common bacteria were Coagulase-negative Staphylococci, Staphylococcus aureus and Group B Streptococci. Three patients required a second DAIR procedure but remained free from re-infection at follow-up obviating the need for more demanding, staged revision surgery. Conclusions In infected UKAs, the DAIR procedure produces a high rate of success, with a high survivorship of the implant. Key messages Debridement, Antibiotics and Implant Retention (DAIR) is a successful and minimally invasive surgical option for the management of periprosthetic joint infections (PJIs) after UKA. The surface area available for bacteria to colonise is much smaller in UKAs compared to total knee arthroplasties (TKAs), and this may account for the higher success rates of the DAIR procedure in infected UKAs versus infected TKAs. A second DAIR procedure can be considered in the management of the early recurrence of PJIs with a well-fixed UKA.
Crises do not affect populations equally but expose and exacerbate long-standing vulnerabilities and inequalities. Recovery language such as 'build back better', or 'bounce forward' has been criticised for neglecting underlying inequalities. This paper reports on the process and early outcomes of an inclusive Community Recovery Planning process for the Falkland Islands, in response to Covid-19. The Falkland Islands is home to a complex community, with close ties and short power distances (due to its small size and remoteness), with differences institutionalised in citizenship statuses and entitlements, and shaped by geopolitical tensions. We aimed to use the 'pandemic as a portal', seeking out previously 'less heard' voices, to make visible previously hidden impacts, and initiate incremental systemic change to tackle them. Community Impact Assessments evidenced specific areas of vulnerability (e.g., housing and income insecurity) and inequalities, largely shaped by differing citizenship status. In tandem with other government currents, the Community Recovery Planning process has contributed to progressive policy changes in Equalities legislation and Income Support. We offer this paper as a demonstration of our methodology for inclusive recovery planning that could be adapted elsewhere. We argue that the inclusion of previously unheard voices contributed to incremental systemic change to reduce inequalities.
We present a unique immunocytochemistry-based organ-specific antibody profiling assay of CTCs in suspected lung tumors (TruBlood® Lung) for non-invasive diagnosis and histological subtyping and its utility in patients unable to undergo physical biopsies. In a prospective blinded study, blood samples from suspected lung cancer patients (n= 99) were profiled for detection of CTCs. Along with EPCAM/CK/CD45, organ-specific antibody profiling with TTF1, CK7, Napsin A, CD45, p40, Synaptophysin, and Chromogranin was performed to detect lung adenocarcinoma, squamous cell carcinoma and neuroendocrine tumors (TruBlood® Lung). After unblinding, the performance was compared with histopathology of the corresponding tissue samples. Concordance analysis could be performed in ninety-three patients. Tissue HPE was inconclusive in 4 patients and CTC assay (TruBlood® Lung) could not be performed in 4 patients. The concordance rate between cancer diagnosis by the CTC assay and histopathology was 97.8% (91/93). Among cases identified to be positive for lung cancer on CTC assay (n=91), HPE subtyping of lung cancer could be performed in 83.5% of the cases (76/91). The CTC assay was able to detect presence of cancer but unable to assign a histological subtype (subtype indeterminate) in 16.4% of the cases (15/91). Among cases that were able to be subtyped by CTC assay, the concordance rate with HPE diagnosis was 93.4% (71/76), with concordant subtyping in 76.3% of the total evaluable cohort (71/93). Discordance with histological subtyping was seen in 6.5% (5/76) cases, with CTC assay failing to identify adeno-squamous (n=3), small cell (n=1) and squamous cell carcinoma (n=1) subtypes. Interestingly, in five cases of poorly differentiated carcinomas where conclusive histological subtyping was not possible on tissue HPE examination, CTC assay profiling was able to assign a subtype. Our results demonstrate sensitivity of this CTC assay (TruBlood® Lung) to provide concordant HPE subtyping in 76.3% of the total evaluable cohort (71/93) and in 93.4% (71/76) of the cases subtyped by CTC assay. Thus, this assay can be useful in patients unable to undergo tissue sampling, to establish a diagnosis and conclude histopathological subtype.
