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Publication What Is Current Venting Gastrostomy Practice in Patients with Malignant Bowel Obstruction in the UK?(SAGE Publications, 2024-03) Oussena, Sarah; Clark, Yvonne; Mullan, Damian; Laasch, Hans-Ulrich; Perkins, Paul; Oussena, Sarah; Clark, Yvonne; Perkins, Paul; Medical and DentalBackground/aims: Malignant Bowel Obstruction (MBO) is a serious complication of advanced cancer, occurring in 3-15% of cases. If inoperable, mean survival is 4-5 weeks, and management includes symptom relieving medication and stomach decompression via nasogastric tube (NGT) or venting gastrostomy (VG). While VG appears effective in reducing symptoms, it is associated with complications compared with medical management. There is debate about the role of VG in the management of MBO, however consensus guidelines from EAPC in 2001 suggest that VG is preferable to NGT in the long-term and should be considered in all patients whose symptoms have not responded to pharmacological therapy. Aims: To determine the current practice of VG in the treatment of MBO in the UK, with a focus on two themes: 1. The number of VGs placed, and technical details related to their placement. 2. Current pathways including referral criteria, patient information and training. Methods: An electronic survey was distributed to HCPs who place VG for MBO in the UK. The analyses for the study will be descriptive. Where multiple responses are received from a centre, the mean/average as well as range will be reported. Results: Our study is currently in the data collection phase, but early results suggest a significant variation in VG practice across the UK, without a clear consensus. Conclusions: We will present our data at the conference. Preliminary results show great variation in VG practice. This is an opportunity for the production of consensus guidelines on the role of VG in MBO, so that patients who could be helped by this intervention can receive it.Publication What do hospice websites communicate about the meaning of palliative care?(SAGE Publications, 2025-05-21) Browne, Charlotte; Williams, Lucy; Perkins, Paul; Taylor, Vanessa; Perkins, Paul; Medical and DentalBackground: The public has a limited understanding of the term palliative care and the role of hospices, creating misunderstanding and influencing access to these services. Globally, the public will access hospice websites to source information, reinforcing the importance of clear and concise messaging. Few studies have focused on how hospice websites communicate with service users and the public about what they do. Aim/Research question or hypothesis: To explore how adult hospices communicate to the public via their websites about the meaning of palliative care, what palliative care involves and who it can help. Methods: We identified key terms in the International Association for Hospice & Palliative Care (IAHPC) and World Health Organisation (WHO) published definitions of palliative care to develop a framework for analysis. An artificial intelligence assisted algorithm was used to scan through n=130 United Kingdom hospice websites and identify how frequently these key terms were included. In addition, a manual in-depth review of n=24 hospice websites was undertaken to obtain detailed information about palliative care definitions, description of service and service users. These data were analysed using the developed framework. Results: There was wide variability in information on hospice websites. Some key terms were used frequently - ‘family’, ‘support’ and ‘end of life’ were included on >90% of sites. Whereas, other terms were rarely used - ‘relieves’, ‘natural process’ and ‘throughout illness’ were included on <20% of sites. The in-depth review identified that only 8 out of 24 hospice websites included a definition of palliative care, and these were generally poorly aligned with the published WHO and IAHPC definitions. Discussion: Hospice websites provide limited and inadequate information regarding what palliative care is or the services provided. Hospice websites should be updated to include a clear and consistent definition of palliative care to help address misunderstandings and to improve engagement with the public.Publication CALIBER: a phase II randomized feasibility trial of chemoablation with mitomycin-C vs surgical management in low-risk non-muscle-invasive bladder cancer(Wiley, 2020-04-03) Mostafid, Hugh; Porta, Nuria; Cresswell, Joanne; Griffiths, Thomas; Kelly, John; Penegar, Steven; Davenport, Kim; McGrath, John; Campain, Nicholas; Cooke, Peter; Masood, Shikohe; Knowles, Margaret; Feber, Andrew; Knight, Allen; Catto, James; Lewis, Rebecca; Hall, Emma; Davenport, Kim; Knight, Allen; Medical and Dental; Patient and Community PartnersObjectives: To evaluate the activity of intravesical mitomycin-C (MMC) to ablate recurrent low-risk non-muscle-invasive bladder cancer (NMIBC) and assess whether it may enable patients to avoid surgical intervention for treatment of recurrence. Patients and methods: CALIBER is a phase II feasibility study. Participants were randomized (2:1) to treatment with four once-weekly MMC 40-mg intravesical instillations (chemoablation arm) or to surgical management. The surgical group was included to assess the feasibility of randomization. The primary endpoint was complete response to intravesical MMC in the chemoablation arm at 3 months, reported with exact 95% confidence intervals (CIs). Secondary endpoints included time to subsequent recurrence, summarized by Kaplan-Meier methods. Results: Between February 2015 and August 2017, 82 patients with visual diagnosis of recurrent low-risk NMIBC were enrolled from 24 UK hospitals (chemoablation, n = 54; surgical management, n =28). The median follow-up was 24 months. Complete response at 3 months was 37.0% (20/54; 95% CI 24.3-51.3) with chemoablation and 80.8% (21/26; 95% CI 60.6-93.4) with surgical management. Amongst patients with complete response at 3 months, a similar proportion was recurrence-free by 12 months in both groups (84%). Amongst those with residual disease at 3 months, the 12-month recurrence-free proportion was lower in the surgical management group (40.0%) than in the chemoablation group (84%). Recruitment stopped early as chemoablation did not meet the prespecified threshold of 45% complete responses at 3 months. Conclusion: Intravesical chemoablation in low-risk NMIBC is feasible and safe, but did not demonstrate sufficient response in the present trial. After chemoablation there may be a reduction in recurrence rate, even in non-responders, that is greater than with surgery alone. Further research is required to investigate the role and optimal schedule of neoadjuvant intravesical chemotherapy prior to surgery for NMIBC.Publication Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying(BMJ Publishing Group, 2020-05-06) Perkins, Paul; Parkinson, Anne; Kwame Akyea, Ralph; Husbands, Emma; Perkins, Paul; Parkinson, Anne; Husbands, Emma; Medical and Dental; Nursing and Midwifery RegisteredIntroduction: Many patients want to stay at home to die. They invariably become unable to take oral medication during their terminal phase. Symptoms are usually controlled by subcutaneous medications. There have been no studies on nasal fentanyl (NF) or buccal midazolam (BM) to control symptoms in the dying. Objective: To establish how best to conduct a definitive, randomised controlled trial (RCT) to determine whether NF and BM administered by families, for patients dying at home, lead to faster and better symptom control and fewer community nursing visits than standard breakthrough medication by healthcare professionals. Methods: This open-label mixed-method feasibility RCT compared the efficacy of NF and BM by family members to standard breakthrough medication by nurses for the terminally ill in a specialist palliative care unit. Partway through the study, a third observational arm was introduced where BM alone was used. The primary outcomes were whether recruitment and randomisation were possible, assessment of withdrawal and drop-out, and whether the methods were acceptable and appropriate. Results: Administration of NF and BM was acceptable to patients and families. Both were well tolerated. We were unable to obtain quality of life data consistently but did get time period data for dose-controlled symptoms. Conclusions: Study participation in a hospice population of the dying was acceptable. The results will help guide future community study planning.Publication False-Positive Axillary Lymph Nodes on FDG PET/CT Resulting From COVID-19 Immunization(Lippincott, Williams & Wilkins, 2021-12-01) Nawwar, Ayah; Searle, Julie; Hopkins, Richard; Lyburn, Iain; Nawwar, Ayah; Searle, Julie; Hopkins, Richard; Lyburn, Iain; Medical and Dental; Healthcare ScientistsWorld-wide mass COVID-19 vaccination has been deployed starting with those most vulnerable, including the elderly and cancer patients. A 70-year-old man with right lung cancer underwent staging FDG PET/CT, which demonstrated an avid right lung mass with avid hilar and mediastinal nodes. Avid left axillary nodes of benign configuration were also noted. The patient had the Oxford-AstraZeneca COVID-19 vaccination in the left arm a week earlier. On reflection, the axillary nodes were concluded to be reactive related to this. This is a potential COVID-19 vaccination associated pitfall on PET/CT that should be considered when interpreting FDG PET/CT images.Publication COVID-19-Related Lung Parenchymal Uptake on 18F-PSMA-1007 PET/CT(Lippincott, Williams & Wilkins, 2021-12-01) Nawwar, Ayah; Searle, Julie; Green, Jes; LYBURN, IAIN; Nawwar, Ayah; Searle, Julie; Green, Jes; Lyburn, Iain; Medical and DentalA 70-year-old man with newly diagnosed prostate cancer underwent 18F-PSMA-1007 PET/CT for staging. PSMA-avid primary prostatic malignancy was identified. Incidental intense patchy peripheral lung uptake was also noted. The patient tested positive for COVID-19 infection.Publication The effects of COVID-19 restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities(Elsevier, 2021-01-22) Theis, Nicola; Campbell, Natalie; de leeuw, Julie; Owen, Marie; Schenke, Kimberley; Theis, Nicola; Campbell, Natalie; De Leeuw, Julie; Owen, Marie; Schenke, Kimberley; Additional Professional Scientific and TechnicalAbstract Background: COVID-19 has caused unprecedented restrictions, significantly affecting the most vulnerable groups in society, such as those with a disability. Objective: The aim of the study was to investigate the effects of COVID-19 lockdown restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities. Methods: The study was a cross-sectional design. Parents/carers completed an electronic survey in the UK between June-July 2020 on behalf of their child. Through Likert scales and free-text questions, the survey asked about physical activity levels and mental health during lockdown compared to before, access to specialist facilities and equipment to aid with physical activity, and the short- and long-term concerns around ongoing lockdown restrictions. Results: Generally, respondents reported negative effects of lockdown restrictions, with 61% reporting a reduction in physical activity levels and over 90% reporting a negative impact on mental health (including poorer behaviour, mood, fitness and social and learning regression). Many respondents cited a lack of access to specialist facilities, therapies and equipment as reasons for this, and raised concerns about the long-term effects of this lack of access on their child's mental health and physical activity levels. Conclusions: The survey highlights the negative impact of the COVID-19 lockdown on the physical activity levels and mental health of children and young adults with disabilities and highlights the importance of addressing the needs of the disabled community as restrictions are eased.Publication Malignant pleural effusions: the patient experience(BMJ Publishing Group, 2021-03-11) Jones, Rachel; Steer, Henry; Preston, Nancy; Perkins, Paul; Jones, Rachel; Steer, Henry; Perkins, Paul; Medical and DentalNo abstract availablePublication Costs and underuse of insulin and diabetes supplies: Findings from the 2020 T1International cross-sectional web-based survey(Elsevier, 2021-08-04) Pfiester, Elizabeth; Braune, Katarina; Thieffry, Axel; Ballhausen, Hanne; Gajewska, Katarzyna; O'Donnell, Shane; Pfiester, Elizabeth; Braune, Katarina; Patient and Community PartnersAims: To investigate self-reported out-of-pocket expenses (OoPE) associated with insulin and diabetes supplies for people living with type 1 diabetes (T1D) worldwide. Methods: A web-based, cross-sectional survey was conducted from August to December 2020. The analysis included comparisons between responses from countries with no, partial, and full healthcare coverage. Results: 1,066 participants from 64 countries took part in the study. ~25% of respondents reported having underused insulin at least once within the last year due to perceived cost. A significant correlation was observed between OoPEs and reported household income for respondents with partial healthcare coverage. 63.2% of participants reported disruption of insulin supplies and 25.3% reported an increase of prices related to the COVID-19 pandemic. Conclusions: This study confirms previous reports of ~25% of people in the United States with T1D using less insulin and/or fewer supplies at least once in the last year due to cost, a trend associated with the extent of healthcare coverage. Similar trends were observed in some middle/low income countries. Moreover, patients reported an increase in insulin prices and disruption of supplies during the COVID-19 pandemic. This study highlights the importance of self-reported OoPEs and its association with underuse/rationing of insulin.Publication Exploring the Impact of a Remote Monitoring System for Palliative and End-of-Life Care (CARE-PAC): Mixed Methods Feasibility Study(JMIR Publications, 2025-09-23) Maguire, Roma; McCann, Lisa; Singleton, Claire; Perkins, Paul; Minton, Ollie; McCann, Nicola; Longford, Emma; McKeown, Alistair; Kavanagh, Kimberley; Miller, Morven; Perkins, Paul; Medical and DentalBackground: In the United Kingdom, access to and the quality of palliative and end-of-life care (PEOLC) vary widely. In the final months of life, many patients face avoidable accident and emergency (A&E) visits and hospital admissions, driven by gaps in out-of-hours support and poorly coordinated care. This not only increases stress for patients and carers but also places avoidable strain and cost on the National Health Service (NHS). There is an urgent need for more compassionate, person-centered models that support people to remain at home, improve their quality of life (QoL), and reduce unnecessary use of acute services. Objective: This study aimed to explore the usability, user experiences, and impact of the digital dyadic remote monitoring Care and Support System for Patients and Carers (CARE-PAC) for patients in the last year of life, their informal carers, and health professionals involved in their care. Methods: Patients and informal carers were recruited to use CARE-PAC for up to 12 weeks. A mixed methods approach was used. Quantitative methods included the use of validated QoL scales and the System Usability Scale (SUS). Paired QoL and usability data were analyzed using the Wilcoxon (Pratt) signed-rank test, while unpaired usability data were analyzed using the Wilcoxon rank-sum test. Qualitative methods involved short catch-up calls, in-depth interviews, and focus groups conducted using topic guides informed by the domains of the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. Data were analyzed thematically. Results: CARE-PAC was implemented across 5 UK clinical sites with 26 participants (13 patient-carer dyads). No significant changes were observed in patients’ total QoL scores; however, significant improvements were seen in the “overall QoL” and “social” domains, alongside a significant decline in the “physical” domain. Carers showed no significant changes across total or domain-specific QoL scores. Usability was rated highly by patients (mean 87.9, SD 12.4) and carers (mean 94.7, SD 3.8), indicating an excellent user experience. Health care professionals (HCPs) reported lower usability scores (mean 63.6, SD 15.6), falling below average but above the threshold for poor usability. Thematic analysis of qualitative data gathered via catch-up calls (all patient-carer dyads), in-depth interviews (2 patients-2 carers), and 4 focus groups/1 interview (12 HCPs) identified 4 key themes: impact on care experiences, reflections and satisfaction, implementation challenges, and future directions. Conclusions: CARE-PAC is a usable, feasible, and acceptable remote monitoring and support system for patients in the last year of life, their carers, and HCPs. It enables real-time identification of needs and has shown positive impacts on the QoL of both patients and carers. These findings support the need for further research to evaluate its effectiveness at scale and explore pathways for wider implementation in PEOLC.Publication Increased FDG Uptake of the Pectoral Girdle and Serratus Anterior Due to Wallpaper Stripping on PET/CT-Exquisite Demonstration of the Biomechanics(Lippincott, Williams & Wilkins, 2021-09-01) Nawwar, Ayah; Vekeria, Monique; Searle, Julie; Singh, Rajiv; LYBURN, IAIN; Nawwar, Ayah; Vekeria, Monique; Lyburn, Iain; Singh, Rajiv; Searle, Julie; Medical and DentalAccording to published guidelines and routine procedures, patients are instructed to avoid strenuous exercise for 6 to 24 hours before FDG imaging, avoiding unfavorable muscular uptake. A 40-year-old man with esophageal carcinoma underwent FDG PET/CT for response assessment. Intense uptake was noted in the muscles of the right upper limb and chest. The patient stated he had avoided exercise before scanning. On further questioning, he was found to be a professional painter and decorator and had been working stripping wallpaper. Marked skeletal FDG uptake occurs in subjects who have strenuously exerted themselves before or after the injection of FDG.Publication Nasal fentanyl and buccal midazolam carer administration 'as needed' for breakthrough symptom control in a specialist palliative care unit: a nested qualitative study(BMJ Publishing Group, 2021-03-25) Perkins, Paul; Parkinson, Anne; Taylor, Vanessa; Husbands, Emma; Perkins, Paul; Parkinson, Anne; Husbands, Emma; Medical and DentalIntroduction: When people are dying and unable to take oral medication, injectable medication is commonly used, usually administered by healthcare professionals. There may be delays to symptom relief due to travel to the person's home. In a randomised controlled trial (RCT) previously reported, nasal fentanyl (NF) or buccal midazolam (BM) were administered by lay carers in a hospice. Objective: (1) To report experiences of lay carers who administered NF and BM for symptom control and (2) To use feedback to develop guidance informing a future definitive RCT to determine whether NF and BM administered by lay carers can lead to timely, improved symptom control for people dying at home and fewer 'emergency' community nursing visits than standard breakthrough medication administered by healthcare professionals. Material and methods: Semistructured interviews with lay carers who gave trial medication were conducted. Interview data were analysed using a stage by stage method to code and categorise transcripts. Findings: The six themes were: (1) Participation-lay carers welcomed the opportunity to administer medication; (2) Ease of use-lay carers found preparations easy to use; (3) How things could have been done differently-lay carers would have liked access to trial drugs at home; (4) Training-lay carers were happy with the training they received; (5) Timing-lay carers liked the immediacy of trial drugs and (6) Evaluation-assessing symptom intensity and drug efficacy. Conclusions: Participation was acceptable to patients and lay carers, and beneficial for symptom relief. The findings will inform planning for a future community-based study.Publication UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG)(Elsevier, 2020-12-18) Turton, Philip; El-Sharkawi, Dima; LYBURN, IAIN; Sharma, Bhupinder; Mahalingam, Preethika; Turner, Suzanne; MacNeill, Fiona; Johnson, Laura; Hamilton, Stephen; Burton, Cathy; Mercer, Nigel; Lyburn, Iain; Medical and DentalBreast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the aspirated peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes.Publication P-170 The development of a regional community pathway for the management of patients with suspected metastatic spinal cord compression (MSCC)(BMJ Publishing Group, 2022-11-19) Harris, Becky; Harris, Becky; Allied Health ProfessionalNo abstract availablePublication Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’(Elsevier, 2022-02-02) Perkins, Paul; Parkinson, Anne; Hebdon, Rob; Akyea, Ralph; Perkins, Paul; Parkinson, Anne; Medical and Dental; Nursing and Midwifery RegisteredContext: Some patients take their strong opioid painkillers as unmeasured sips. Objectives: To investigate how and why patients take their medication in this way. Methods: Patient receiving specialist palliative care who take their strong opioid painkillers as unmeasured sips were recruited. Measurement was made of the mass of two sips per patient and qualitative interviews using a topic guide were conducted. Interview transcripts were thematically analyzed using a phenomenological approach. Results: Only two of 16 patients were taking within 20% of the correct dose of their breakthrough liquid strong analgesia. Many varied the dose depending on the severity of the pain episode. Convenience, confusion about the correct dose, and issues with spoons were the other main reasons for people choosing to sip. Conclusion: This is the first published study exploring the behavior of patients who take their strong analgesia as unmeasured sips. Knowing that patients who sip are likely to be taking an incorrect dose, and the reasons behind sipping may help clinicians to help these patients to manage their pain better.Publication Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial(BMJ Publishing Group, 2022-04-11) Perkins, Paul; Parkinson, Anne; Parker, Rebecca; Blaken, Alison; Akyea, Ralph; Perkins, Paul; Parkinson, Anne; Parker, Rebecca; Medical and Dental; Nursing and Midwifery RegisteredIntroduction: Nausea and vomiting are common symptoms for patients with advanced cancer. While there is evidence for acupuncture point stimulation for treatment of these symptoms for patients having anticancer treatment, there is little for when they are not related to such treatment. Objective: To determine whether acupressure at the pericardium 6 site can help in the treatment of nausea and vomiting suffered by palliative care patients with advanced cancer. Materials and methods: Double blind randomised controlled trial-active versus placebo acupressure wristbands. In-patients with advanced cancer in two specialist palliative care units who fitted either or both of the following criteria were approached: Nausea that was at least moderate; Vomiting daily on average for the prior 3 days. Results: 57 patients were randomised to have either active or placebo acupressure wristbands. There was no difference in any of the outcome measures between the two groups: change from baseline number of vomits; Visual Analogue Scale for 'did acupressure wristbands help you to feel better?'; total number of as needed doses of antiemetic medication; need for escalation of antiemetics. Conclusions: In contrast to a previously published feasibility study, active acupressure wristbands were no better than placebo for specialist palliative care in-patients with advanced cancer and nausea and vomiting.Publication Systemic Immune Response Syndrome After COVID-19 Immunization—Initial and Follow-up 18F-FDG PET/CT Imaging Appearances(Lippincott, Williams & Wilkins, 2022-01) Nawwar, Ayah; Searle, Julie; Hagan, Ian; Lyburn, Iain; Nawwar, Ayah; Searle, Julie; Hagan, Ian; Lyburn, Iain; Medical and DentalA 46-year-old woman with previous history of breast cancer had follow-up 18F-FDG PET/CT 5 days after COVID-19 vaccination. In addition to avid axillary nodes, a well-documented feature, the scan demonstrated diffuse splenic and marrow uptake. Clinical history, laboratory, and scan findings were in keeping with SIRS (systemic inflammatory response). The patient recovered with supportive management. On follow-up, 18F-FDG PET/CT imaging 3 months later features had resolved. SIRS after vaccination may be observed on 18F-FDG PET/CT.Publication Anisotropy visualisation from X-ray diffraction of biological apatite in mixed phase calcified tissue samples(Nature Research |, 2025-02-14) Scott, Robert; Lyburn, Iain; Cornford, Eleanor; Bouzy, Pascaline; Stone, Nicholas; Greenwood, Charlene; Gosling, Sarah; Arnold, Emily; Bouybayoune, Ihsanne; Pinder, Sarah; Rogers, Keith; Lyburn, Iain; Cornford, Eleanor; Medical and DentalX-ray diffraction is widely used to characterise the mineral component of calcified tissue. Broadening of the diffraction peaks yields valuable information on the size of coherently diffracting domains, sometimes loosely described as crystallite size or crystallinity. These domains are markedly anisotropic, hence a single number describing their size is misleading. We present a novel variation on a method for visualising crystallographic anisotropy in X-ray diffraction data. This provides an intuitively interpretable depiction of crystalline domain size and anisotropy. The new method involves creating a polar plot of calculated domain thickness for peaks in a diffractogram versus crystallographic direction. Points with the least error are emphasised. Anisotropic domain dimensions are calculated by refining an ellipsoidal model in a whole pattern fit. These dimensions are then used to overlay an ellipse on the peak broadening plot. This is illustrated by application of the method to calcifications in breast tissue with suspected cancer, which frequently contain whitlockite as well as nanocrystalline apatite. Like most biogenic apatite, this exhibits markedly anisotropic peak broadening. The nature of this anisotropy offers potentially useful information on normal function and pathology of calcified tissue and is a frequently neglected crystallographic feature of these materials.Publication Role of FDG PET/CT in bacteremia and fever of unknown origin: a pictorial overview of finding the culprit(Edizioni Minerva Medica, 2025-03) Nawwar, Ayah; Hess, Soren; Leccisotti, Lucia; Jamar, Francois; Noriega-Alvarez, Edel; Albano, Domineco; Gheysens, Olivier; Nawwar, Ayah; Medical and Dental18F fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has established itself as a critical diagnostic tool in the evaluation of patients with bacteremia and fever of unknown origin (FUO), particularly following futile conventional investigations. These conditions are often challenging due to diverse underlying etiologies, including infections, inflammatory conditions and malignancies. PET/CT has the advantage of being a whole-body imaging technique with high sensitivity for detecting areas of increased metabolism often associated with infection or inflammation. In bacteremia, [18F]FDG PET/CT can help identify metastatic infections, endocarditis, or abscesses which may be clinically silent and missed on conventional imaging. In FUO, it helps to identify underlying etiologies, directing treatment and management strategies. This review aims to describe the role of PET/CT imaging in these diverse clinical scenarios. Perspectives in the field, including novel equipment and tracers, will be briefly discussed.Publication Can using the Mollii Suit improve the function and muscle tone in young adults with cerebral palsy(Elsevier, 2025-03-25) Madondo, Anesu; Williams, Olivia; Mandondo, Anesu; Williams, Olivia; Allied Health ProfessionalPurpose: Young adults living with cerebral palsy often require assistive devices or technologies to enhance independent function. To this end, researchers, practitioners, and policy makers collectively seek and trial innovative solutions to enable independent function and improve quality of life. With its built-in electro-stimulation, the Mollii suit offers great promise to facilitate mobility and function among several patient populations with spasticity or other motor dysfunction. Our pilot study explores the utility of the Mollii Suit in improving key outcome measures in young adults aged 16-25 with Cerebral Palsy