Military Cross Award for Naval Medical Assistant Kate Nesbitt

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SHARING EXPERTISE Microbiology in the Community Staff in the Microbiology department have been working closely with colleagues from the Health Protection Agency and Plymouth City Environmental Health Office to screen stool samples from children attending the ‘Going Places’ Nursery in Plymouth. The nursery was closed while the outbreak was investigated. Several children attending this nursery had become ill with the organism Escherichia coli type 0157, a bacterium which can cause diarrhoea. In a small minority of patients, especially the young, infection can lead to haemorrhagic colitis (Bloodstained stools and abdominal cramps) or Haemolytic uraemic syndrome (HUS), where haemolytic anaemia, acute renal failure and thrombocytopenia are features. Around 370 stool samples were tested, two for each contact, to ensure children and staff were clear before returning to the nursery. Samples were examined over a two week period, and Microbiology staff attended regular teleconferences with professional colleagues to ensure the management of the outbreak went smoothly, and the nursery could be reopened as soon as possible. Staff processing samples use a biological safety cabinet and extra safety precautions as this organism is a potential hazard to laboratory personnel. The nursery was commended for good hygiene levels, and cooperated fully with the investigation. The source of the outbreak remains unknown, although the Plymouth area has seen several sporadic cases of E.coli 0157 infection over the last few months. This is a great example of how different departments within the Trust are of value to the wider community and in this case can help to contain and resolve serious issues. Stereotactic Radiosurgery Workshop Participants in the Workshop study hard The Trust, as one of only a few centres in the UK to provide Stereotactic Radiosurgery (SRS) and Radiotherapy (SRT), recently hosted a workshop where clinical staff were provided with a detailed insight into the clinical applications of these treatments. This specialist service, using the BrainLAB m3 micro- Multileaf Collimator, was first introduced to the Trust in 2005 and to date more than 250 patients with intracranial tumours have been referred for Radiosurgery and treated locally in Plymouth. The workshop was an educational event where specialists from Plymouth as well as invited guest speakers from Singapore and Brussels shared their clinical experience and results in treatments of patients along with 30 participants from other centres across the country. Peter Whitfield, Consultant Neurosurgeon said: “Stereotactic Radiosurgery is a proven treatment for some intracranial tumours as an alternative to surgical methods and also in some cases where surgery is not technically feasible. While such a service is routinely available across Europe and the United States, we at the Trust are very privileged to be able to offer such treatments as only one of a handful of centres in the UK.” “We were delighted to be able to host this essential two-day workshop, and to be able to share in the experiences of practitioners from other countries and Trusts.” David James, Area Sales Manager for BrainLAB, added: “We have been very pleased with the development of the stereotactic radiosurgery service at Plymouth. For patients in Devon and Cornwall, access to the treatment is not only local but also usually within a shorter period of time than is the case nationally.” Stereotactic Radiosurgery uses precision equipment which allows for a high degree of accuracy to enable the treatment to be applied in a single session. The Plymouth Stereotactic Radiosurgery Programme has grown steadily since becoming clinically available in 2005 and for more than four years the Trust has treated patients with different brain tumours and malformations and is now a leading centre for SRS in the UK. James Palmer, Consultant Nuerosurgeon presents at the workshop 8 Autumn 2009 Cascade
SHARING EXPERTISE Inaugural Global Spine Conference Earlier this year, members of the Trust’s Neurological and spinal team were privileged enough to be invited to the Inaugural Global Spine Conference, in San Francisco. This conference was the first of its kind and included neurological and spinal specialists from all over the world. The Trust’s team have helped to produce three research papers of such excellent standard that they were invited to present them during the course of the conference. Clinical Outcome Measurements The first of these papers was a piece of research into clinical outcome measurements in spinal surgery. The team at Derriford worked closely with Dr Jeremy Hobart, Reader in Neurosciences and Consultant Neurologist, a world authority in clinical outcomes measurement, to determine which outcomes were the best for the patients concerned. For example whether it is the ability to walk, work, sit or sleep comfortably “There are more than 100 ways of measuring outcome, but these are based on what we think is important for patients, rather than what they say is important. What we have done is listened to what the patients said rather than what the text books said” said Tim Germon, Consultant Neurosurgeon based at Derriford Hospital. The results of this paper highlighted that by using the appropriate scales of outcome measurement, clinicians are able to treat patients in the best possible way. Chronic Back Pain The second paper presented by the team was concerning the causes and treatment of chronic back pain. As highlighted by Tim: “Over 70% of adults in the UK suffer from some form of back pain. This not only impacts on the patients themselves, but can have a huge impact on the NHS and the economy as a whole.” The Trust’s team, along with Mr Hobart, has conducted extensive research into possible causes of chronic back pain and its evidence suggested that pressure on nerves at the base of the spine is one of the main causes. The paper presented at the conference highlighted these findings and also introduced a new form of microsurgery done on the base of the patient’s spine. This new form of surgery is beneficial to the patient as it means that they only spend up to one night in hospital and therefore reduces the average length of stay of the patient. Interspineas Implants The third paper to be presented highlighted the results of a new technique that has been trialled at the Trust for interspineas implants. These are implants placed between the spineas frame that makes more room available for squashed nerves. The technique was developed for the treatment of the condition Formenal Stenosis, a relatively rare cause of sciatica. The results showed that the technique is relatively easy and had a low complication rate. The Trust, has 15 patients, 13 of which have been successfully treated, which Tim states: “Is better than any other treatment published for this condition before!” The team consisted of Dr Jeremy Hobart, Reader in Neurosciences and Consultant Neurologist, Timothy Germon, Consultant Neurosurgeon, Will Adams, and trainees Kevin Tsangs and Katie Jilkes who collated much of the data. Other consultants who were involved in the research papers were Mr Sudhakar, Neurosurgery Consultant and Nick Haden, Consultant Neurosurgeon. Tim Germon said: “Everyone worked closely as a team to produce these three papers and we were honoured to be chosen to present at such a prestigious event. It also reflects the level of research work that is being carried out by the Trust and it was great that we were recognised in this way. I would like to thank everyone who contributed for their hard work.” Consultant Neurosurgeon Tim Germon (left) and Neurologist Dr Jeremy Hobart We welcome your submissions! Contact the Editor: Please send in your ideas, stories and letters, for the next edition, the sooner the better. And if you have any comments about this edition, or suggestions on making Cascade even better, we would love to hear from you. The deadline for submissions for the next edition is Friday 8th January 2010. Laura Young, Communications Officer Tel: 0845 155 8207 Ext: 55011 E: Laura.Young@phnt.swest.nhs.uk Cascade Autumn 2009 9
Page 1 and 2: Military Cross Award for Naval Medi
Page 3 and 4: Kate Nesbitt THE BIG INTERVIEW Kate
Page 5 and 6: SPECIALITIES AROUND THE TRUST End o
Page 7: H H CHARITY H H H H WORK H H H & FU
Page 11 and 12: DID YOU KNOW? What do you know abou
Page 13 and 14: Immunology Patient Forum More than
Page 15 and 16: You Talked, We Listened We know - b
Page 17 and 18: FLU SEASON Seasonal Flu Vaccine - H
Page 19 and 20: John Yarnold John Yarnold, the Depu

Military Cross Award for Naval Medical Assistant Kate Nesbitt

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