Effective diabetes service models should be commissioned to reduce diabetes admissions

Sphere full of words to do with diabetes and health care.

This document is aimed at clinical commissioning groups, health care planners, hospital senior managers, and clinical teams in primary and secondary care. It is an amalgamation of good practice examples where diabetes services have improved, with bed occupancy and costs being reduced. There is a specific focus on elderly, diabetic patients, and other similarly vulnerable [read the full story…]

Does vomer or palatal flap have less adverse effect on maxillary growth in cleft patients? – No good evidence available

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Cleft lip (CL) and cleft palate (CP) are common birth defects that affect around 1 in 700 children born.  Surgery to repair the palate is thought to affect maxillary growth. The vomer flap is assumed to cause less scarring and therefore have less impact on growth. The aim of this review was to investigate the [read the full story…]

“Surgeons and commissioners used a different language when they met” according to project findings

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Rational commissioning This report describes a project, led by Right Care, to involve surgeons in the commissioning decision-making process, because observations made by the Department of Health and Surgical Specialty Associations showed that there were inconsistencies in the rates of elective surgical procedures between Primary Care Trusts, and that sometimes existing surgical procedures were “classified [read the full story…]

Management of the greater trochanteric pain syndrome

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During last winter several elves slipped on ice and landed heavily. Although initially embarrassed, most forgot the incident but a few still struggle with lateral hip pain when climbing stairs or sleeping in bed. Previously known as trochanteric bursitis, this condition is now defined as Greater Trochanteric Pain Syndrome (GTPS). This umbrella term covers a [read the full story…]

Review finds good success rates with sialendoscopy for treating salivary gland obstruction

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About 50% of benign salivary gland disease results from obstructive sialadenitis. The majority of cases are seen in the submandibular gland (80-90%) with 10-15% in the parotid and  < 1% in the sublingual gland.  The aim of this review was to summarize the current literature and determine the efficacy and safety of sialendoscopy in the [read the full story…]

Small but potential benefits of cryotherapy following total knee replacement surgery

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Osteoarthritis of the knee is a common condition and typically presents with painful and restricted function and sometimes varus (bow legs) and valgus (knock knees) deformity of the knee. Once the condition and pain worsens knee joint replacement surgery is a treatment option. Patients typically improve in terms of pain and function but there is [read the full story…]

keratocystic odontogenic tumour recurrence rates

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The keratocystic odontogenic tumour (KCOT, odontogenic keratocyst (OKC)) was first described in the literature in 1956 and is classified by the World Health Organization classified as a benign odontogenic tumour. It is generally accepted that they arise from the remnants of the dental lamina and are benign but locally aggressive and tend to reoccur.  They [read the full story…]

Interventions for drooling in children with cerebral palsy

Logo of The Cochrane Collaboration

Drooling is a common problem for children with cerebral palsy (CP). Drooling varies in severity and can be distressing for the children, families and caregivers. It can cause chapped or sore skin around the mouth and chin, skin and mouth infections, dehydration, difficulties chewing and a range of other social issues.  The main aim of [read the full story…]

Intrabony defects treated with conservative periodontal surgery show clinical improvements

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Periodontal bony lesions associated with deep pockets are frequent anatomical sequelae to periodontitis.  The aim of this systematic review was to assess the effectiveness of conservative periodontal surgery (CS)  for the treatment of periodontitis-related intrabony defects. The authors searched the Cochrane Oral Health Group specialist trials, Medline and Embase databases and three leading periodontal journals.  [read the full story…]

Value based clinical commissioning of elective surgical care: from low to high value?

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This report on Phase 1 of work by the QIPP Right Care Team looks at emerging views of commissioners and surgeons on the issue of commissioning policies on “low value” procedures. The studies were commissioned by Professor Sir Bruce Keogh, NHS medical director. Background Recent years have seen the emergence of several listings of procedures [read the full story…]