inSPIRE (Somerset NHS)
Not a member yet
683 research outputs found
Sort by
Safe timing for pregnancy after adjuvant immunotherapy (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Occupational therapy support for adults with a learning disability and sensory challenges (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Research & Development bulletin December 2025 (current awareness bulletin)
No full textThis is a bulletin produced by the Somerset NHS Foundation Trust Knowledge and Library Service. It is intended to provide a range of the most up-to-date resources, including recently published guidelines and research articles, news and policy items at the time of the production. Please note, you may not get access to full-text articles or links may be disabled
Midwives' knowledge, barriers, and enablers of proving warm compresses in the second stage of labour: a clinical audit
Full text linkThis work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
General rights
All content in PEARL is protected by copyright law. Author manuscripts are made available in accordance with publisher
policies. Please cite only the published version using the details provided on the item record or document. In the absence of an
open licence (e.g. Creative Commons), permissions for further reuse of content should be sought from the publisher or author
Sinking Skin Flap Syndrome as a Post-craniectomy Complication after Malignant Middle Cerebral Artery Infarct: a Case Report
No full textOne of the possible, though rare, complications of surgical decompressive craniectomy is the sinking skin flap (SSF) syndrome. This occurs in a wide variety of neurovascular, neurosurgical or neuro-traumatic conditions. Though symptoms are non-specific, this condition could be potentially fatal if not promptly identified and managed. We report a case of a 59-year-old Caucasian man admitted with a malignant middle cerebral artery (MCA) infarct who subsequently had decompressive hemicraniectomy. Following worsening consciousness and neurologic deficit associated with sunken skin 3 weeks after decompressive hemicraniectomy, an urgent repeat CT imaging revealed an SSF syndrome. A protective 3-dimensional-printed helmet, elevated bed at about 30° and an elective autologous cranioplasty improved his outcome. This is a rare case of further neurologic complication in a patient with malignant MCA infarct with decompressive hemicraniectomy. This case highlights the high suspicion index of this non-specific, potentially life-threatening condition in a patient with large territory stroke treated by hemicraniectomy
Fragmentation of epidural catheter-need consensus on management.
No full textThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.Lumbar epidural anesthesia is an important part of labor analgesia. Despite common complications, lumbar epidurals are considered the most effective pain management option during childbirth. Fracture of the epidural catheter during removal is an uncommon but known complication, but fragmentation of the catheter during insertion is extremely uncommon. There are several reasons for catheter fracture during removal; however, catheter fracture during insertion can occur for two main reasons in labor epidurals. The first reason is if the anesthetist pulls the catheter while the Tuohy needle is still in place, and the second is when the catheter is removed during active labor contractions. We describe the occurrence of such an event in a primiparous patient, where the epidural catheter fractured during insertion. A brief review is provided to prevent and manage such complications
Validation of childhood lupus specific targets: ensuring accurate assessment of disease control in younger, lighter paediatric patients.
No full text© The Author(s) 2025. Published by Oxford University Press on behalf of the British Society for Rheumatology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Objectives: To validate novel childhood-onset systemic lupus erythematosus (cSLE) treat-to-target targets including childhood lupus low disease activity state (cLLDAS), cSLE clinical remission on steroids (cCR) and cSLE clinical remission off steroids (cCR-0), as compared with adult-onset SLE (aSLE) targets.
Methods: Attainment of the aforementioned cSLE-specific and aSLE-specific targets (LLDAS, DORIS 2021 Remission) was assessed at each visit in UK JSLE Cohort Study patients. Univariable and multivariable Prentice-Williams-Peterson (PWP) gap-time models investigated the impact of target attainment on new damage and severe flare.
Results: The cohort included 430 cSLE patients. Attainability was comparable between corresponding cSLE and aSLE targets. Achieving cLLDAS (hazard ratio [HR] 0.18 [95% CI: 0.14, 0.23]), cCR (HR 0.18 [0.13, 0.23]) and cCR-0 (HR 0.17 [0.13, 0.23]) reduced the risk of severe flare (all P < 0.001). Risk of new damage was reduced in those reaching cLLDAS (HR 0.22 [0.11, 0.44]), cCR (HR 0.25 [0.13, 0.49]) and cCR-0 (HR 0.30 [0.15, 0.60]) (all P < 0.001). Inappropriate attainment of LLDAS and DORIS remission occurred at 35 and 52 visits, respectively, in younger (median age 7.3 and 8.8 years, respectively) and lighter (median weight 26.8 and 37.1 kg, respectively) patients whilst on prednisolone doses that precluded cSLE target attainment (median 0.17 [IQR 0.16-0.24] and 0.13 [IQR 0.11-0.16] mg/kg/day, respectively).
Conclusions: This study validates novel paediatric-specific targets, demonstrating that achieving cLLDAS, cCR and cCR-0 reduces risks of new damage and severe flare, which is comparable to aSLE targets. Using cSLE-specific targets prevents misclassification of disease activity in paediatric patients, enabling more accurate disease control assessments in younger, lighter patients
Early intervention and support for Parkinson's Disease (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Literature search relating to infected haematomas in closed fractures managed conservatively (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created
Manual therapy for back, neck and shoulder pain (evidence summary)
No full textThis is an evidence summary produced by the Somerset NHS Foundation Trust Knowledge and Library Service
Disclaimer: We will endeavour to use the best, most appropriate and most recent sources available to ensure that the information supplied is accurate, up-to-date and evidence-based. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the search results. No responsibility can be taken by the library for any action taken on the basis of this information. New evidence may have been published since the date this evidence summary was created