Stockport NHS Foundation Trust is an NHS foundation trust, which runs Stepping Hill Hospital as well as other community and specialist services in Stockport.Stockport NHS Foundation Trust provides hospital services for children and adults across Stockport and the High Peak area of Derbyshire, as well as community health services for Stockport, Tameside and Glossop. Adrian Belton is the Trust's Chairman, who took over as Chair in June 2017. On 1 April 2004 Foundation Trust status was established, one of the first NHS organisations in the country to achieve the foundation trust position. The Trust provides acute hospital care predominantly across Stockport and the High Peak and employs over 5,800 staff working across two hospital sites and over 41 community clinics.
Carpal Tunnel Syndrome (CTS) is the most prevalent entrapment neuropathy. While surgical decompression and local corticosteroid injections are established treatments, their relative long-term efficacy remains debated. This meta-analysis evaluates the comparative efficacy of surgery versus corticosteroid injections, incorporating the recent large-scale DISTRICTS trial. Following PRISMA guidelines, we searched PubMed, Cochrane Library, Scopus, and Embase through December 20, 2025, for randomised controlled trials (RCTs) comparing surgery to corticosteroid injections. Primary outcomes included patient recovery (Risk Ratio [RR]) and mean symptom severity (Standardised Mean Difference [SMD]). Meta-analysis was performed using a random-effects model, and evidence quality was assessed via the GRADE scale. Seven RCTs involving 1,463 wrists were included. Initial pooled analysis showed no significant difference between surgery and corticosteroid injections in post-procedural symptom severity (SMD: −0.55; 95
Introduction Surgery in patients with diabetes mellitus is associated with increased morbidity and mortality compared with those who do not have diabetes mellitus. This is likely multifactorial and could be attributed to organisational issues; dysglycaemia; hospital-acquired diabetic ketoacidosis; errors with insulin prescribing and administration; issues with fluids and electrolytes; and systemic and surgical site infections. There was a need to update guidance for the peri-operative management of diabetes mellitus given improvements in our understanding, introduction of novel drugs and development of wearable technologies. Methods This was a multidisciplinary consensus statement with a diverse authorship group, including diabetologists; anaesthetists; surgeons; pharmacists; surgical diabetes inpatient specialist nurses; and patients with lived experience. We undertook a directed literature search and a three-round Delphi process to develop, refine and agree recommendations. Results Following three rounds, 38 recommendations were included, spanning all phases of the peri-operative pathway. Recommendations were made for organisations and general principles for the management of patients with diabetes, aiming to improve pathways, implement protocols and support training. We prioritise individualised care plans, encourage clinical judgement regarding proceeding with surgery with out-of-range HbA1c concentrations and recommend ensuring appropriate insulin regimens are prescribed and administered. We also provide guidance for capillary blood glucose and ketone monitoring and management; safe handovers of care; and multidisciplinary care plans for the peri-operative use of wearables. Discussion This consensus statement provides principles to be applied throughout the entire peri-operative pathway by healthcare professionals, institutions and patients. It is hoped that the implementation of these key recommendations will improve experience and outcomes for patients with diabetes mellitus having surgery.
Fragility fractures in young men are uncommon and should prompt evaluation for underlying pathology. This report describes the case of a 42-year-old male patient who presented with multiple fragility fractures following a low-impact fall in the context of severe depression, alcohol misuse, and prolonged self-neglect. He was underweight (BMI 18 kg/m²), sarcopenic, functionally dependent, and had biochemical evidence of malnutrition. Management was multidisciplinary and involved orthopaedics, dietetics, and psychiatry. Following initiation of venlafaxine, there was a rapid and sustained improvement in mood, appetite, and nutritional intake. This resulted in weight gain and marked functional recovery. The development of refeeding syndrome during treatment further supported the severity of preceding malnutrition. This case highlights the importance of thorough and holistic assessment in patients with unexplained fragility fractures. Early recognition of malnutrition and its underlying drivers may prevent severe systemic complications and improve outcomes.
This report describes the case of a 58-year-old female patient with a history of hypertension, dyslipidemia, and childhood asthma, who presented with neck stiffness, headache, and mild fever, raising concern for meningitis. Despite her high BMI and reluctance to undergo a lumbar puncture, she was initially treated with intravenous aciclovir and ceftriaxone while microbiological tests, including procalcitonin, ruled out bacterial infection. Laboratory markers, such as CRP and white blood cell count, improved over time, and cervical spine X-rays revealed cervical spondylosis with C4-C5 protrusion, explaining her symptoms. As a result, antimicrobial therapy was discontinued, and she was referred to a local spine specialist. This case underscores the need to consider cervical spine pathology as a differential diagnosis in patients with meningitis-like symptoms, particularly when invasive investigations are not feasible.
