Bariatric surgeons' experiences of working in the first year of the pandemic (2023)

Type of publication:
Journal article

Author(s):
Graham Y.N.H.; Mahawar K.; Singhal R.; Madhok B.; Yang W.; *Riera M.; Martinez-Duartez P.; Pouwels S.; Sharma M.; Hayes C.

Citation:
Obesity Science and Practice. 9(4) (pp 329-336), 2023. Date of Publication: August 2023.

Abstract:
Background: The first year of the Covid-19 pandemic saw drastic changes to bariatric surgical practice, including postponement of procedures, altered patient care and impacting on the role of bariatric surgeons. The consequences of this both personally and professionally amongst bariatric surgeons has not as yet been explored. Aim(s): The aim of this research was to understand bariatric surgeons' perspectives of working during the first year of the pandemic to explore the self-reported personal and professional impact. Method(s): Using a retrospective, two phased, study design with global participants recruited from closed, bariatric surgical units. The first phase used a qualitative thematic analytic framework to identify salient areas of importance to surgeons. Themes informed the construction of an on-line, confidential survey to test the potential generalizability of the interview findings with a larger representative population from the global bariatric surgical community. Finding(s): Findings of the study revealed that the first year of the pandemic had a detrimental effect on bariatric surgeons both personally and professionally globally. Conclusion(s): This study has identified the need to build resilience of bariatric surgeons so that the practice of self-care and the encouragement of help-seeking behaviors can potentially be normalized, which will in turn increase levels of mental health and wellbeing.

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Global Level of Harm experienced by Bariatric Surgeons for Bariatrics surgical interventions: An exploration of predictors (2022)

Type of publication:
Conference abstract

Author(s):
Cheruvu C.; Bangash A.H.; Isik A.; Parmar C.; Galanis M.; Yang W.; Kok J.H.H.; *Bandyopadhyay S.K.; Di Maggio F.; Atici S.D.; Abouelazayem M.; Viswanath Y.K.S.

Citation:
British Journal of Surgery. Conference: AUGIS Annual Scientific Meeting. Aberdeen United Kingdom. 109(Supplement 9) (pp ix17-ix18), 2022. Date of Publication: December 2022.

Abstract:
Background: COVID-19 pandemic has taken the world by surprise with the depth and breadth of its effect on all walks of life, bariatric surgery being no exception. With the scientific literature hitherto unable to comment and ascertain the influence of the COVID-19 pandemic on bariatric surgery and the level of harm experienced by bariatric surgeons, we- TUGS 'Level of Harm' collaborative group- attempted to gauge the effect of the said pandemic on bariatrics surgery specifically vis a vis the level of harm experienced by bariatric surgeons due to the pandemic. Method(s): A virtual questionnaire- developed on both: Google forms and Survey Monkey- was circulated via TUGS social media platforms to reach bariatric consultant surgeons, fellows and residents practising throughout the world in a bid to explore the influence of the COVID-19 pandemic on their surgical practice including but not limited to the annual surgical volume including re-do surgeries volume and postoperative complications. Moreover, they were also requested to categorise their respective level of harm vis a vis bariatric surgical interventions they undertake. After de-identification of the data, SPSS (V.26) was adopted to undergo statistical analysis. After exploring the dataset by descriptive analyses, the Chi-square test was applied to pursue the association of categorical variables with the reported level of harm. A double-sided p-value of less than 0.05 was considered statistically significant. Result(s): 16.8% of the respondents (21/125) indicated no harm vis a vis bariatrics surgery work whereas a comparative 18.4% of the respondents (23/125) reported moderate harm with significant worsening of symptoms. None of those who indicated less than 10% increase in surgery waitlisted patients being subjected to endoscopic interventions (0/14) reported Moderate Harm for bariatrics surgery work with significant worsening of symptoms whereas 1 in every 3 of those who indicated between 10% to 25% increase in surgery waitlisted patients being subjected to endoscopic interventions (5/15) reported such level of harm for bariatrics surgery work. (p < 0.001) Upon exhaustive sub-group analysis, it was uncovered that 33.6% of bariatrics surgical professionals perceived no harm (no evidence of change in clinical condition) during gastric band or related surgery work with only 4% perceiving Moderate Harm (significant worsening of symptoms/ comorbidities control/ minor increase in medications) for such surgical interventions. All of those who reported No harm for gastric band or related surgical work reported that Single anastomosis duodeno-ileal bypass (SADI-S) accounts for 10% of their practice whereas none of those who indicated that SADI-S accounts for more than 10% of their practice reported No harm for such surgical work. (p = 0.019) Conclusion(s): The global snapshot illustrates a trend of low harm vis a vis bariatrics surgery work in surgical professionals practising in the private sector with a lesser number of patients developing COVID-19 postoperatively and no postoperative COVID-19 related mortality. The patient being subjected to endoscopic intervention portends a higher level of harm for bariatrics surgical work- strict adherence to criteria and safety protocols being a logical inference. For gastric band and related surgery work, preoperative COVID-19 testing appears to be influenced by confounders in its effect on the surgeon's level of harm for the said interventions warranting further exploration. SADI-S, at a cut-off of 10%, exhibits strong interaction with the surgeon's level of harm for gastric band insertion and relation surgery work. Women surgical professionals came out to exhibit equivalent mental resilience and technical prowess at par with their male colleagues when it came to bariatrics surgical intervention

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A Retrospective Comparative Study of Long-Term Outcomes Following Cervical Total Disc Replacement Versus Anterior Cervical Discectomy and Fusion (2022)

Type of publication:
Journal article

Author(s):
Eseonu, Kelechi; Laurent, Edward; *Bishi, Habeeb; Raja, Hassan; Ravi, Kuppuswamy; Dannawi, Zaher

Citation:
Cureus.14(12):e32399, 2022 Dec.

Abstract:
Introduction: The traditional treatment for patients with radiculopathy and myelopathy caused by degenerative disc disease was anterior cervical discectomy and fusion (ACDF). However, a documented complication of ACDF is adjacent segment degeneration (ASD). An alternative that was developed was total disc replacement (TDR). The aim of this study was to determine and compare the short- and medium-to-long-term outcomes after a TDR or ACDF. Methods: A retrospective review of 154 patients who had single and two-level ACDFs and 90 TDRs performed by a single surgeon between 2011 and 2017 was conducted. Parameters for comparisons include both radiological evaluation and patient-reported outcome measures (PROMS) at six weeks, one year, and two years postoperatively. The Neck Disability Index (NDI) and the visual analogue scale (VAS) for neck and arm pain are used to evaluate pain, function, patient satisfaction, and overall clinical success. Results: TDR and ACDF showed significant improvement in NDI and VAS when compared to pre- and post-operatively at both six weeks (p<0.05 & P=0.032, respectively) and two years (p<0.05 & 0=0.026, respectively). TDR vs. ACDF showed no significant difference (p<0.05). VAS scores after ACDF showed improvement from 13.41 to 3.94 at two years (p<0.001). TDR showed similar scores of 12.5 to 3.55 (p<0.001). The radiological fusion rate at 12 or 24 months showed no significant difference between the two groups. There were two cases that required re-operation after ACDF (1.2%), and two that required TDR (2.2%). Conclusion: Both TDR and ACDF lead to clinically significant improvements in pain and function scores. We did not find a statistically significant difference in NDI and VAS in the neck and arm. The results are in agreement with others' assessments of these two treatment modalities. Our conclusions supplement the literature about these operative options for degenerative disc disease of the cervical spine and are a useful addition to the armamentarium in the assessment of patients with degenerative pathology of the c-spine.

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Folliculitis decalvans managed with long pulsed Nd:YAG; our experience and a review of the literature (2022)

Type of publication:
Conference abstract

Author(s):
*Oh S.; *Badrol S.; *Tzortzis S.; El Shimy N.; Murdoch S.;

Citation:
Lasers in Medical Science. Conference: British Medical Laser Association Annual Conference, BMLA 2022. Edinburgh United Kingdom. 37(9) (pp 3769), 2022. Date of Publication: December 2022.

Abstract:
Background Folliculitis decalvans (FD) is a rare inflammatory disorder predominantly of the scalp that can progress to cicatrical alopecia. Mainstay treatment is antibiotics; however, resolution is difficult, and relapse is common. Only three cases of FD treated with neodymium:yttrium aluminum garnet (Nd:YAG) laser exist in the literature. We present two cases of recalcitrant FD managed with long pulsed Nd:YAG laser and a literature review. Study Design Retrospective case series of two patients with FD treated with long pulsed Nd:YAG laser. Results The first case was a 49-year-old male with Fitzpatrick skin type II. Previous unsuccessful treatment included oral doxycycline and isotretinoin. A course of eight sessions of Nd:YAG laser (CynergyTM, Cynosure) was performed with settings of 50J/cm<inf>2</inf>, 20msec pulse duration, and 10mm spot size. Complete resolution of FD was achieved and remained stable without adjuvant treatment at 6 months post laser. The second case was a 46-year-old male with Fitzpatrick skin type IV with 9-years history of FD. Previously, oral antibiotics (clindamycin, rifampicin, erythromycin, ciprofloxacin) as well as dapsone, intralesional triamcinolone and acitretin treatment was trialled without success. A total of four successful treatments with Nd:YAG laser was completed with settings of 30J/cm<inf>2</inf>, 40msec pulse duration, and 15mm spot size. Treatment is ongoing. Conclusion Our experience of Nd:YAG laser treatment of FD have been positive. All cases from literature report full resolution of FD maintained without adjuvant treatment between 6 months to 1.5 years after final treatment. Treatment with Nd:YAG laser is an option for patients suffering from recalcitrant FD.

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Whole-genome sequencing reveals host factors underlying critical COVID-19 (2022)

Type of publication:
Journal article

Author(s):
Kousathanas A.; Pairo-Castineira E.; Rawlik K.; Stuckey A.; Odhams C.A.; Russell C.D.; Malinauskas T.; Wu Y.; Shen X.; Elliott K.S.; Griffiths F.; Oosthuyzen W.; Morrice K.; Keating S.; Wang B.; Rhodes D.; Klaric L.; Zechner M.; Parkinson N.; Siddiq A.; Goddard P.; Donovan S.; Maslove D.; Nichol A.; Semple M.G.; Zainy T.; Maleady-Crowe F.; Todd L.; Salehi S.; Knight J.; Elgar G.; Chan G.; Arumugam P.; Patch C.; Rendon A.; Bentley D.; Kingsley C.; Kosmicki J.A.; Horowitz J.E.; Baras A.; Abecasis G.R.; Ferreira M.A.R.; Justice A.; Mirshahi T.; Oetjens M.; Rader D.J.; Ritchie M.D.; Verma A.; Fowler T.A.; Shankar-Hari M.; Summers C.; Hinds C.; Horby P.; McAuley D.; Montgomery H.; Openshaw P.J.M.; Elliott P.; Walsh T.; Tenesa A.; Fawkes A.; Rowan K.; Ponting C.P.; Vitart V.; Wilson J.F.; Yang J.; Bretherick A.D.; Scott R.H.; Hendry S.C.; Moutsianas L.; Law A.; Caulfield M.J.; Baillie J.K.; Begg C.; Ling L.; Millar J.; Pereira A.C.; Aravindan L.; Armstrong R.; Biggs H.; Boz C.; Clark R.; Coutts A.; Coyle J.; Cullum L.; Das S.; Day N.; Donnelly L.; Finernan P.; Fourman M.H.; Furlong A.; Furniss J.; Gallagher B.; Gilchrist T.; Golightly A.; Hafezi K.; Hamilton D.; Hendry R.; Law D.; Law R.; Law S.; Lidstone-Scott R.; Macgillivray L.; Maclean A.; Mal H.; McCafferty S.; McMaster E.; Meikle J.; Moore S.C.; Murphy S.; Hellen M.; Zheng C.; Chen J.; Paterson T.; Schon K.; Stenhouse A.; Das M.; Swets M.; Szoor-McElhinney H.; Taneski F.; Turtle L.; Wackett T.; Ward M.; Weaver J.; Wrobel N.; Arbane G.; Bociek A.; Campos S.; Grau N.; Jones T.O.; Lim R.; Marotti M.; Ostermann M.; Whitton C.; Alldis Z.; Astin-Chamberlain R.; Bibi F.; Biddle J.; Blow S.; Bolton M.; Borra C.; Bowles R.; Burton M.; Choudhury Y.; Cox A.; Easthope A.; Ebano P.; Fotiadis S.; Gurasashvili J.; Halls R.; Hartridge P.; Kallon D.; Kassam J.; Lancoma-Malcolm I.; Matharu M.; May P.; Mitchelmore O.; Newman T.; Patel M.; Pheby J.; Pinzuti I.; Prime Z.; Prysyazhna O.; Shiel J.; Tierney C.; Wood S.; Zak A.; Zongo O.; Bonner S.; Hugill K.; Liggett S.; Headlam E.; Bandla N.; Gellamucho M.; Davies M.; Thompson C.; Abdelrazik M.; Bakthavatsalam D.; Elhassan M.; Ganesan A.; Haldeos A.; Moreno-Cuesta J.; Purohit D.; Vincent R.; Xavier K.; Frater A.; Saleem M.; Carter D.; Lamond Z.; Wall A.; Fernandez-Roman J.; Hamilton D.O.; Johnson E.; Johnston B.; Martinez M.L.; Mulla S.; Shaw D.; Waite A.A.C.; Waugh V.; Welters I.D.; Williams K.; Cavazza A.; Cockrell M.; Corcoran E.; Depante M.; Finney C.; Jerome E.; McPhail M.; Nayak M.; Noble H.; O'Reilly K.; Pappa E.; Saha S.; Knighton A.; Antcliffe D.; Banach D.; Brett S.; Coghlan P.; Fernandez Z.; Gordon A.; Rojo R.; Arias S.S.; Templeton M.; Meredith M.; Morris L.; Ryan L.; Clark A.; Sampson J.; Peters C.; Dent M.; Langley M.; Ashraf S.; Wei S.; Andrew A.; Bashyal A.; Davidson N.; Hutton P.; McKechnie S.; Wilson J.; Baptista D.; Crowe R.; Fernandes R.; Herdman-Grant R.; Joseph A.; O'Connor D.; Allen M.; Loveridge A.; McKenley I.; Morino E.; Naranjo A.; Simms R.; Sollesta K.; Swain A.; Venkatesh H.; Khera J.; Fox J.; Andrew G.; Barclay L.; Callaghan M.; Campbell R.; Clark S.; Hope D.; Marshall L.; McCulloch C.; Briton K.; Singleton J.; Birch S.; Brimfield L.; Daly Z.; Pogson D.; Rose S.; Nown A.; Battle C.; Brinkworth E.; Harford R.; Murphy C.; Newey L.; Rees T.; Williams M.; Arnold S.; Polgarova P.; Stroud K.; Meaney E.; Jones M.; Ng A.; Agrawal S.; Pathan N.; White D.; Daubney E.; Elston K.; Grauslyte L.; Hussain M.; Phull M.; Pogreban T.; Rosaroso L.; Salciute E.; Franke G.; Wong J.; George A.; de Gordoa L.O.-R.; Peasgood E.; Phillips C.; Bates M.; Dasgin J.; Gill J.; Nilsson A.; Scriven J.; Collins A.; Khaliq W.; Gude E.T.; Delgado C.C.; Dawson D.; Ding L.; Durrant G.; Ezeobu O.; Farnell-Ward S.; Kanu R.; Leaver S.; Maccacari E.; Manna S.; Saluzzio R.P.; Queiroz J.; Samakomva T.; Sicat C.; Texeira J.; Da Gloria E.F.; Lisboa A.; Rawlins J.; Mathew J.; Kinch A.; Hurt W.J.; Shah N.; Clark V.; Thanasi M.; Yun N.; Patel K.; Bennett S.; Goodwin E.; Jackson M.; Kent A.; Tibke C.; Woodyatt W.; Zaki A.; Abraheem A.; Bamford P.; Cawley K.; Dunmore C.; Faulkner M.; Girach R.; Jeffrey H.; Jones R.; London E.; Nagra I.; Nasir F.; Sainsbury H.; Smedley C.; Patel T.; Smith M.; Chukkambotla S.; Kazi A.; Hartley J.; Dykes J.; Hijazi M.; Keith S.; Khan M.; Ryan-Smith J.; Springle P.; Thomas J.; Truman N.; Saad S.; Coleman D.; Fine C.; Matt R.; Gay B.; Dalziel J.; Ali S.; Goodchild D.; Harling R.; Bhatterjee R.; Goddard W.; Davison C.; Duberly S.; Hargreaves J.; Bolton R.; Davey M.; Golden D.; Seaman R.; Cherian S.; Cutler S.; Heron A.E.; Roynon-Reed A.; Szakmany T.; Williams G.; Richards O.; Cheema Y.; Brooke H.; Buckley S.; Suarez J.C.; Charlesworth R.; Hansson K.; Norris J.; Poole A.; Rose A.; Sandhu R.; Sloan B.; Smithson E.; Thirumaran M.; Wagstaff V.; Metcalfe A.; Brunton M.; Caterson J.; Coles H.; Frise M.; Rai S.G.; Jacques N.; Keating L.; Tilney E.; Bartley S.; Bhuie P.; Gibson S.; Lyle A.; McNeela F.; Radhakrishnan J.; Hughes A.; Yates B.; Reynolds J.; Campbell H.; Thompsom M.; Dodds S.; Duffy S.; Greer S.; Shuker K.; Tridente A.; Khade R.; Sundar A.; Tsinaslanidis G.; Birkinshaw I.; Carter J.; Howard K.; Ingham J.; Joy R.; Pearson H.; Roche S.; Scott Z.; Bancroft H.; Bellamy M.; Carmody M.; Daglish J.; Moore F.; Rhodes J.; Sangombe M.; Kadiri S.; Croft M.; White I.; Frost V.; Aquino M.; Jha R.; Krishnamurthy V.; Lim L.; Combes E.; Joefield T.; Monnery S.; Beech V.; Trotman S.; Christine Almaden-Boyle; Austin P.; Cabrelli L.; Cole S.; Casey M.; Chapman S.; Whyte C.; Baird Y.; Butler A.; Chadbourn I.; Folkes L.; Fox H.; Gardner A.; Gomez R.; Hobden G.; Hodgson L.; King K.; Margarson M.; Martindale T.; Meadows E.; Raynard D.; Thirlwall Y.; Helm D.; Margalef J.; Criste K.; Cusack R.; Golder K.; Golding H.; Jones O.; Leggett S.; Male M.; Marani M.; Prager K.; Williams T.; Roberts B.; Salmon K.; Anderson P.; Archer K.; Austin K.; Davis C.; Durie A.; Kelsall O.; Thrush J.; Vigurs C.; Wild L.; Wood H.-L.; Tranter H.; Harrison A.; Cowley N.; McAlindon M.; Burtenshaw A.; Digby S.; Low E.; Morgan A.; Cother N.; Rankin T.; Clayton S.; McCurdy A.; Ahmed C.; Baines B.; Clamp S.; Colley J.; Haq R.; Hayes A.; Hulme J.; Hussain S.; Joseph S.; Kumar R.; Maqsood Z.; Purewal M.; Benham L.; Bradshaw Z.; Brown J.; Caswell M.; Cupitt J.; Melling S.; Preston S.; Slawson N.; Stoddard E.; Warden S.; Deacon B.; Lynch C.; Pothecary C.; Howe G.S.; Singh J.; Turner K.; Ellis H.; Stroud N.; Dearden J.; Dobson E.; Drummond A.; Mulcahy M.; Munt S.; O'Connor G.; Philbin J.; Rishton C.; Tully R.; Winnard S.; Cathcart S.; Duffy K.; Puxty A.; Puxty K.; Turner L.; Ireland J.; Semple G.; Long K.; Whiteley S.; Wilby E.; Ogg B.; Cowton A.; Kay A.; Kent M.; Potts K.; Wilkinson A.; Campbell S.; Brown E.; Melville J.; Naisbitt J.; Joseph R.; Lazo M.; Walton O.; Neal A.; Alexander P.; Allen S.; Bradley-Potts J.; Brantwood C.; Egan J.; Felton T.; Padden G.; Ward L.; Moss S.; Glasgow S.; Abel L.; Brett M.; Digby B.; Gemmell L.; Hornsby J.; MacGoey P.; O'Neil P.; Price R.; Rodden N.; Rooney K.; Sundaram R.; Thomson N.; Hopkins B.; Thrasyvoulou L.; Willis H.; Coulding M.; Jude E.; McCormick J.; Mercer O.; Potla D.; Rehman H.; Savill H.; Turner V.; Downes C.; Holding K.; Riches K.; Hilton M.; Hayman M.; Subramanian D.; Daniel P.; Adanini O.; Bhatia N.; Msiska M.; Collins R.; Clement I.; Gulati A.; Hays C.; Webster K.; Hudson A.; Webster A.; Stephenson E.; McCormack L.; Slater V.; Nixon R.; Hanson H.; Fearby M.; Kelly S.; Bridgett V.; Robinson P.; Camsooksai J.; Humphrey C.; Jenkins S.; Reschreiter H.; Wadams B.; Death Y.; Bastion V.; Clarke D.; David B.; Kent H.; Lorusso R.; Lubimbi G.; Murdoch S.; Penacerrada M.; Valentine J.; Vochin A.; Wulandari R.; Djeugam B.; Bell G.; English K.; Katary A.; Wilcox L.; Bruce M.; Connolly K.; Duncan T.; Michael H.T.; Lindergard G.; Hey S.; Fox C.; Alfonso J.; Durrans L.J.; Guerin J.; Blackledge B.; Harris J.; Hruska M.; Eltayeb A.; Lamb T.; Hodgkiss T.; Cooper L.; Rothwell J.; Allan A.; Anderson F.; Kaye C.; Liew J.; Medhora J.; Scott T.; Trumper E.; Botello A.; Lankester L.; Nikitas N.; Wells C.; Stowe B.; Spencer K.; Brandwood C.; Smith L.; Kolakaluri L.; Baines D.; Sukumaran A.; Apetri E.; Basikolo C.; Catlow L.; Charles B.; Dark P.; Doonan R.; Harvey A.; Horner D.; Knowles K.; Lee S.; Lomas D.; Lyons C.; Marsden T.; McLaughlan D.; McMorrow L.; Pendlebury J.; Perez J.; Poulaka M.; Proudfoot N.; Slaughter M.; Slevin K.; Thomas V.; Walker D.; Michael A.; Collis M.; Cosier T.; Millen G.; Richardson N.; Schumacher N.; Weston H.; Rand J.; Baxter N.; Henderson S.; Kennedy-Hay S.; Rooney L.; Sim M.; McCreath G.; Akeroyd L.; Bano S.; Bromley M.; Gurr L.; Lawton T.; Morgan J.; Sellick K.; Warren D.; Wilkinson B.; McGowan J.; Ledgard C.; Stacey A.; Pye K.; Bellwood R.; Bentley M.; Bewley J.; Garland Z.; Grimmer L.; Gumbrill B.; Johnson R.; Sweet K.; Webster D.; Efford G.; Convery K.; Fottrell-Gould D.; Hudig L.; Keshet-Price J.; Randell G.; Stammers K.; Bokhari M.; Linnett V.; Lucas R.; McCormick W.; Ritzema J.; Sanderson A.; Wild H.; Rostron A.; Roy A.; Woods L.; Cornell S.; Wakinshaw F.; Rogerson K.; Jarmain J.; Parker R.; Reddy A.; Turner-Bone I.; Harding P.; Abernathy C.; Foster L.; Gratrix A.; Martinson V.; Parkinson P.; Stones E.; Carbral-Ortega L.; Bercades G.; Brealey D.; Hass I.; MacCallum N.; Martir G.; Raith E.; Reyes A.; Smyth D.; Zitter L.; Benyon S.; Marriott S.; Park L.; Keenan S.; Gordon E.; Quinn H.; Baines K.; Cagova L.; Fofano A.; Garner L.; Holcombe H.; Mepham S.; Mitchell A.M.; Mwaura L.; Praman K.; Vuylsteke A.; Zamikula J.; Purewal B.; Rivers V.; Bell S.; Blakemore H.; Borislavova B.; Faulkner B.; Gendall E.; Goff E.; Hayes K.; Thomas M.; Worner R.; Smith K.; Stephens D.; Mew L.; Mwaura E.; Stewart R.; Williams F.; Wren L.; Sutherland S.-B.; Bevan E.; Martin J.; Trodd D.; Watson G.; Brown C.W.; Akinkugbe O.; Bamford A.; Beech E.; Belfield H.; Bell M.; Davies C.; Jones G.A.L.; McHugh T.; Meghari H.; O'Neill L.; Peters M.J.; Ray S.; Tomas A.L.; Burn I.; Hambrook G.; Manso K.; Penn R.; Shanmugasundaram P.; Tebbutt J.; Thornton D.; Davies R.; Duffin D.; Hill H.; Player B.; Thomas E.; Griffin D.; Muchenje N.; Mupudzi M.; Partridge R.; Conyngham J.-A.; Thomas R.; Wright M.; Corral M.A.; Jacob R.; Jones C.; Denmade C.; Beavis S.; Dale K.; Gascoyne R.; Hawes J.; Pritchard K.; Stevenson L.; Whileman A.; Doble P.; Hutter J.; Pawley C.; Shovelton C.; Vaida M.; Butcher D.; O'Sullivan S.; Butterworth-Cowin N.; Ahmad N.; Barker J.; Bauchmuller K.; Bird S.; Cawthron K.; Harrington K.; Jackson Y.; Kibutu F.; Lenagh B.; Masuko S.; Mills G.H.; Raithatha A.; Wiles M.; Willson J.; Newell H.; Lye A.; Nwafor L.; Jarman C.; Rowland-Jones S.; Foote D.; Cole J.; Thompson R.; Watson J.; Hesseldon L.; Macharia I.; Chetam L.; Ford A.; Birchall K.; Housley K.; Walker S.; Milner L.; Hanratty H.; Trower H.; Phillips P.; Oxspring S.; Donne B.; Jardine C.; Williams D.; Hay A.; Flanagan R.; Hughes G.; Latham S.; McKenna E.; Anderson J.; Hull R.; Rhead K.; Cruz C.; Pattison N.; Charnock R.; McFarland D.; Cosgrove D.; Ahmed A.; Morris A.; Jakkula S.; Nune A.; Brady M.; Dale S.; Dance A.; Gledhill L.; Greig J.; Hanson K.; Holdroyd K.; Home M.; Kelly D.; Kitson R.; Matapure L.; Melia D.; Mellor S.; Nortcliffe T.; Pinnell J.; Robinson M.; Shaw L.; Shaw R.; Thomis L.; Wilson A.; Wood T.; Bayo L.-A.; Merwaha E.; Ishaq T.; Hanley S.; Hibbert M.; Tetla D.; Woodford C.; Durga L.; Kennard-Holden G.; Branney D.; Frankham J.; Pitts S.; Laha S.; Verlander M.; Altabaibeh A.; Alvaro A.; Gilbert K.; Ma L.; Mostoles L.; Parmar C.; Jetha C.; Booker L.; Pratley A.; Adams C.; Agasou A.; Arden T.; Bowes A.; Boyle P.; Beekes M.; Button H.; Capps N.; Carnahan M.; Carter A.; Childs D.; Donaldson D.; Hard K.; Hurford F.; Hussain Y.; Javaid A.; Jones J.; Jose S.; Leigh M.; Martin T.; Millward H.; Motherwell N.; Rikunenko R.; Stickley J.; Summers J.; Ting L.; Tivenan H.; *Tonks L.; *Wilcox R.; Skinner D.; Gaylard J.; Mullan D.; Newman J.; Holland M.; Keenan N.; Lyons M.; Wassall H.; Marsh C.; Mahenthran M.; Carter E.; Kong T.; Blackman H.; Creagh-Brown B.; Donlon S.; Michalak-Glinska N.; Mtuwa S.; Pristopan V.; Salberg A.; Smith E.; Stone S.; Piercy C.; Verula J.; Burda D.; Montaser R.; Harden L.; Mayangao I.; Marriott C.; Bradley P.; Harris C.; Anderson S.; Andrews E.; Hammerton K.; O'Leary R.; Clark M.; Purvis S.; Barber R.; Hewitt C.; Hilldrith A.; Jackson-Lawrence K.; Shepardson S.; Wills M.; Butler S.; Tavares S.; Cunningham A.; Hindale J.; Arif S.; Bean S.; Burt K.; Spivey M.; Demetriou C.; Eckbad C.; Hierons S.; Howie L.; Mitchard S.; Ramos L.; Serrano-Ruiz A.; White K.; Kelly F.; Cristiano D.; Dormand N.; Farzad Z.; Gummadi M.; Liyanage K.; Patel B.; Salmi S.; Sloane G.; Thwaites V.; Varghese M.; Zborowski A.C.; Allan J.; Geary T.; Houston G.; Meikle A.; O'Brien P.; Forsey M.; Kaliappan A.; Riches J.; Vertue M.; Allan E.; Darlington K.; Davies F.; Easton J.; Kumar S.; Lean R.; Menzies D.; Pugh R.; Qiu X.; Davies L.; Williams H.; Scanlon J.; Davies G.; Mackay C.; Lewis J.; Rees S.; Oblak M.; Popescu M.; Thankachen M.; Higham A.; Simpson K.; Craig J.; Baruah R.; Morris S.; Ferguson S.; Shepherd A.; Moore L.S.P.; Vizcaychipi M.P.; de Almeida Martins L.G.; Carungcong J.; Ali I.A.M.; Beaumont K.; Blunt M.; Coton Z.; Curgenven H.; Elsaadany M.; Fernandes K.; Ally S.M.; Rangarajan H.; Sarathy V.; Selvanayagam S.; Vedage D.; White M.; Gill M.; Paul P.; Ratnam V.; Shelton S.; Wynter I.; Carmody S.; Page V.J.; Beith C.M.; Black K.; Clements S.; Morrison A.; Strachan D.; Taylor M.; Clarkson M.; D'Sylva S.; Norman K.; Auld F.; Donnachie J.; Edmond I.; Prentice L.; Runciman N.; Salutous D.; Symon L.; Todd A.; Turner P.; Short A.; Sweeney L.; Murdoch E.; Senaratne D.; Hill M.; Kannan T.; Crawley R.; Crew A.; Cunningham M.; Daniels A.; Harrison L.; Hope S.; Inweregbu K.; Jones S.; Lancaster N.; Matthews J.; Nicholson A.; Wray G.; Langton H.; Prout R.; Watters M.; Novis C.; Barron A.; Collins C.; Kaul S.; Passmore H.; Prendergast C.; Reed A.; Rogers P.; Shokkar R.; Woodruff M.; Middleton H.; Polgar O.; Nolan C.; Mahay K.; Collier D.; Hormis A.; Maynard V.; Graham C.; Walker R.; Knights E.; Price A.; Thomas A.; Thorpe C.; Behan T.; Burnett C.; Hatton J.; Heeney E.; Mitra A.; Newton M.; Pollard R.; Stead R.; Amin V.; Anastasescu E.; Anumakonda V.; Karthik K.; Kausar R.; Reid K.; Smith J.; Imeson-Wood J.; Brown A.; Crickmore V.; Debreceni G.; Wilkins J.; Nicol L.; Reece-Anthony R.; Birt M.; Ghosh A.; Williams E.; Allen L.; Beranova E.; Crisp N.; Deery J.; Hazelton T.; Knight A.; Price C.; Tilbey S.; Turki S.; Turney S.; Cooper J.; Finch C.; Liderth S.; Quinn A.; Waddington N.; Coventry T.; Fowler S.; MacMahon M.; Cowley A.; Highgate J.; Gregory J.; O'Connell S.; Smith T.; Barberis L.; Gopal S.; Harris N.; Lake V.; Metherell S.; Radford E.; Daniel A.; Finn J.; Saha R.; White N.; Donnison P.; Trim F.; Eapen B.; Birch J.; Bough L.; Goodsell J.; Tutton R.; Williams P.; Williams S.; Winter-Goodwin B.; Brickell K.; Smyth M.; Murphy L.; Coetzee S.; Gales A.; Raj M.; Sell C.; 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Alkwai S.; Alswailm M.; Almalki F.; Albeladi M.; Almohammed I.; Barhoush E.; Albader A.; Massadeh S.; AlMalik A.; Alotaibi S.; Alghamdi B.; Jung J.; Fawzy M.S.; Lee Y.; Magnus P.; Trogstad L.-I.S.; Helgeland O.; Harris J.R.; Mangino M.; Spector T.D.; Duncan E.; Smieszek S.P.; Przychodzen B.P.; Polymeropoulos C.; Polymeropoulos V.; Polymeropoulos M.H.; Fernandez-Cadenas I.; Perez-Tur J.; Llucia-Carol L.; Cullell N.; Muino E.; Carcel-Marquez J.; DeDiego M.L.; Iglesias L.L.; Planas A.M.; Soriano A.; Rico V.; Aguero D.; Bedini J.L.; Lozano F.; Domingo C.; Robles V.; Ruiz-Jaen F.; Marquez L.; Gomez J.; Coto E.; Albaiceta G.M.; Garcia-Clemente M.; Dalmau D.; Arranz M.J.; Dietl B.; Serra-Llovich A.; Soler P.; Colobran R.; Martin-Nalda A.; Martinez A.P.; Bernardo D.; Rojo S.; Fiz-Lopez A.; Arribas E.; de la Cal-Sabater P.; Segura T.; Gonzalez-Villa E.; Serrano-Heras G.; Marti-Fabregas J.; Jimenez-Xarrie E.; Mimbrera A.F.; Masjuan J.; Garcia-Madrona S.; Dominguez-Mayoral A.; Villalonga J.M.; Menendez-Valladares P.; Chasman D.I.; Buring J.E.; Ridker P.M.; Franco G.; Sesso H.D.; Manson J.E.; Glessner J.R.; Hakonarson H.; Medina-Gomez C.; Uitterlinden A.G.; Ikram M.A.; Kristiansson K.; Koskelainen S.; Perola M.; Donner K.; Kivinen K.; Palotie A.; Ripatti S.; Ruotsalainen S.; Kaunisto M.; Nakanishi T.; Butler-Laporte G.; Forgetta V.; Morrison D.R.; Ghosh B.; Laurent L.; Belisle A.; Henry D.; Abdullah T.; Adeleye O.; Mamlouk N.; Kimchi N.; Afrasiabi Z.; Rezk N.; Vulesevic B.; Bouab M.; Guzman C.; Petitjean L.; Tselios C.; Xue X.; Schurr E.; Afilalo J.; Afilalo M.; Oliveira M.; Brenner B.; Lepage P.; Ragoussis J.; Auld D.; Brassard N.; Durand M.; Chasse M.; Kaufmann D.E.; Lathrop G.M.; Mooser V.; Richards J.B.; Li R.; Adra D.; Rahmouni S.; Georges M.; Moutschen M.; Misset B.; Darcis G.; Guiot J.; Guntz J.; Azarzar S.; Gofflot S.; Beguin Y.; Claassen S.; Malaise O.; Huynen P.; Meuris C.; Thys M.; Jacques J.; Leonar P.; Frippiat F.; Giot J.-B.; Sauvage A.-S.; von Frenckell C.; Belhaj Y.; Lambermont B.; Pigazzini S.; Daya M.; Shortt J.; Rafaels N.; Wicks S.J.; Crooks K.; Barnes K.C.; Gignoux C.R.; Chavan S.; Laisk T.; Lall K.; Lepamets M.; Magi R.; Esko T.; Reimann E.; Milani L.; Alavere H.; Metsalu K.; Puusepp M.; Metspalu A.; Naaber P.; Laane E.; Pesukova J.; Peterson P.; Kisand K.; Tabri J.; Allos R.; Hensen K.; Starkopf J.; Ringmets I.; Tamm A.; Kallaste A.; Bochud P.-Y.; Rivolta C.; Bibert S.; Quinodoz M.; Kamdar D.; Boillat N.; Nussle S.G.; Albrich W.; Suh N.; Neofytos D.; Erard V.; Voide C.; de Cid R.; Galvan-Femenia I.; Blay N.; Carreras A.; Cortes B.; Farre X.; Sumoy L.; Moreno V.; Mercader J.M.; Guindo-Martinez M.; Torrents D.; Kogevinas M.; Garcia-Aymerich J.; Castano-Vinyals G.; Dobano C.; Renieri A.; Mari F.; Fallerini C.; Daga S.; Benetti E.; Baldassarri M.; Fava F.; Frullanti E.; Valentino F.; Doddato G.; Giliberti A.; Tita R.; Amitrano S.; Bruttini M.; Croci S.; Meloni I.; Mencarelli M.A.; Rizzo C.L.; Pinto A.M.; Beligni G.; Tommasi A.; Sarno L.D.; Palmieri M.; Carriero M.L.; Alaverdian D.; Busani S.; Bruno R.; Vecchia M.; Belli M.A.; Picchiotti N.; Sanarico M.; Gori M.; Furini S.; Mantovani S.; Ludovisi S.; Mondelli M.U.; Castelli F.; Quiros-Roldan E.; Antoni M.D.; Zanella I.; Vaghi M.; Rusconi S.; Siano M.; Montagnani F.; Emiliozzi A.; Fabbiani M.; Rossetti B.; Bargagli E.; Bergantini L.; D'Alessandro M.; Cameli P.; Bennett D.; Anedda F.; Marcantonio S.; Scolletta S.; Franchi F.; Mazzei M.A.; Guerrini S.; Conticini E.; Cantarini L.; Frediani B.; Tacconi D.; Spertilli C.; Feri M.; Donati A.; Scala R.; Guidelli L.; Spargi G.; Corridi M.; Nencioni C.; Croci L.; Bandini M.; Caldarelli G.P.; Piacentini P.; Desanctis E.; Cappelli S.; Canaccini A.; Verzuri A.; Anemoli V.; Ognibene A.; Pancrazzi A.; Lorubbio M.; Monforte A.D.; Miraglia F.G.; Girardis M.; Venturelli S.; Cossarizza A.; Antinori A.; Vergori A.; Gabrieli A.; Riva A.; Francisci D.; Schiaroli E.; Paciosi F.; Scotton P.G.; Andretta F.; Panese S.; Scaggiante R.; Gatti F.; Parisi S.G.; Baratti S.; Monica M.D.; Piscopo C.; Capasso M.; Russo R.; Andolfo I.; Iolascon A.; Fiorentino G.; Carella M.; Castori M.; Merla G.; Squeo G.M.; Aucella F.; Raggi P.; Marciano C.; Perna R.; Bassetti M.; Biagio A.D.; Sanguinetti M.; Masucci L.; Valente S.; Mandala M.; Giorli A.; Salerni L.; Zucchi P.; Parravicini P.; Menatti E.; Trotta T.; Giannattasio F.; Coiro G.; Lena F.; Coviello D.A.; Mussini C.; Martinelli E.; Mancarella S.; Tavecchia L.; Crotti L.; Gabbi C.; Rizzi M.; Maggiolo F.; Ripamonti D.; Bachetti T.; Rovere M.T.L.; Sarzi-Braga S.; Bussotti M.; Ceri S.; Pinoli P.; Raimondi F.; Biscarini F.; Stella A.; Zguro K.; Capitani K.; Suardi C.; Dei S.; Parati G.; Ravaglia S.; Artuso R.; Botta G.; Di Domenico P.; Rancan I.; Perrella A.; Bianchi F.; Romani D.; Bergomi P.; Catena E.; Colombo R.; Tanfoni M.; Vincenti A.; Ferri C.; Grassi D.; Pessina G.; Tumbarello M.; Di Pietro M.; Sabrina R.; Luchi S.; Barbieri C.; Acquilini D.; Andreucci E.; Segala F.V.; Tiseo G.; Falcone M.; Lista M.; Poscente M.; De Vivo O.; Petrocelli P.; Guarnaccia A.; Baroni S.; Smith A.V.; Boughton A.P.; Li K.W.; LeFaive J.; Annis A.; Chittoor G.; Josyula N.S.; Leader J.B.; Carey D.J.; Gass M.C.; Cantor M.N.; Yadav A.; van Heel D.A.; Hunt K.A.; Mason D.; Huang Q.Q.; Finer S.; Trivedi B.; Griffiths C.J.; Martin H.C.; Wright J.; Trembath R.C.; Soranzo N.; Zhao J.H.; Butterworth A.S.; Danesh J.; Di Angelantonio E.; Franke L.; Boezen M.; Deelen P.; Claringbould A.; Lopera E.; Warmerdam R.; Vonk J.M.; van Blokland I.; Lanting P.; Ori A.P.S.; Zollner S.; Wang J.; Beck A.; Peloso G.; Ho Y.-L.; Sun Y.V.; Huffman J.E.; O'Donnell C.J.; Cho K.; Tsao P.; Gaziano J.M.; Nivard M.; de Geus E.; Bartels M.; Hottenga J.J.; Weiss S.T.; Karlson E.W.; Smoller J.W.; Green R.C.; Feng Y.-C.A.; Mercader J.; Murphy S.N.; Meigs J.B.; Woolley A.E.; Perez E.F.; Rader D.; Li B.; Verma S.S.; Lucas A.; Bradford Y.; Zeberg H.; Frithiof R.; Hultstrom M.; Lipcsey M.; Nkambul L.; Tardif N.; Rooyackers O.; Grip J.; Maricic T.; Karczewski K.J.; Atkinson E.G.; Tsuo K.; Baya N.; Turley P.; Gupta R.; Callier S.; Walters R.K.; Palmer D.S.; Sarma G.; Cheng N.; Lu W.; Bryant S.; Churchhouse C.; Cusick C.; Goldstein J.I.; King D.; Seed C.; Finucane H.; Martin A.R.; Satterstrom F.K.; Wilson D.J.; Armstrong J.; Rudkin J.K.; Band G.; Earle S.G.; Lin S.-K.; Arning N.; Crook D.W.; Wyllie D.H.; O'Connell A.M.; Spencer C.C.A.; Koelling N.; Fowler T.; Pasko D.; Ball C.A.; Hong E.L.; Rand K.; Girshick A.; Guturu H.; Baltzell A.H.; Roberts G.; Park D.; Coignet M.; McCurdy S.; Knight S.; Partha R.; Rhead B.; Zhang M.; Berkowitz N.; Gaddis M.; Noto K.; Ruiz L.; Pavlovic M.; Sloofman L.G.; Charney A.W.; Beckmann N.D.; Schadt E.E.; Jordan D.M.; Thompson R.C.; Gettler K.; Abul-Husn N.S.; Ascolillo S.; Buxbaum J.D.; Chaudhary K.; Cho J.H.; Itan Y.; Kenny E.E.; Belbin G.M.; Sealfon S.C.; Sebra R.P.; Salib I.; Collins B.L.; Levy T.; Britvan B.; Keller K.; Tang L.; Peruggia M.; Hiester L.L.; Niblo K.; Aksentijevich A.; Labkowsky A.; Karp A.; Zlatopolsky M.; Preuss M.; Loos R.J.F.; Nadkarni G.N.; Do R.; Hoggart C.; Choi S.; Underwood S.J.; O'Reilly P.; Huckins L.M.; Zyndorf M.; Daly M.J.; Neale B.M.; Ganna A.

Citation:
Nature, 2022. Vol 607(7917) (pp 97-103)

Abstract:
Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2-4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes-including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)-in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease.

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Results of an audit of the Peristomal Body Profile Assessment Tool (2022)

Type of publication:
Journal article

Author(s):
*Nicola Tonks Natasha Rolls, Kimberly Bain, Paul Russell-Roberts and Mark Bain

Citation:
British Journal of Nursing, December 2022, Vol 31, No 22, S4-S12 (Stoma Care Supplement)

Abstract:
Background: Leakage is the number one concern for people with an ostomy. The 2019 Ostomy Life Study, a global study of more than 5000 ostomates, showed that 92% of people living with a stoma worry about leakage. Getting the right stoma appliance for each patient is key to increasing patient quality of life. Aim: The study was designed to assess the use of the PeristomalBody Profile Assessment Tool in helping choose the most appropriate stoma products for a given patient, decreasing incidents of leakage and peristomal skin complications. Methods: A multi-centre (33 sites, 147 patients) low-interventional clinical investigation was conducted in which the use of the Peristomal BodyProfile Assessment Tool was evaluated as a tool to reduce incidents of leakage, increase peristomal skin health and increase patient quality of life. A focus group of randomised participating clinicians (n=16) was held to explore the audit results. Results: The assessment tool most often took between 2 and 5 minutes to complete. It supported clinicians in selecting the right appliance for each patient, avoiding leakages and preventing associated peristomal skin complications. The assessment tool helped improve the accuracy and quality of documentation in the patients’ medical/nursing notes, increasing the quality and continuity of care. Participants reported that using the assessment tool helped reduce care costs by reducing the need for product changes, supporting product usage and return patient visits. Conclusion: Use of the Peristomal Body Profile Assessment Tool helped clinicians choose the most appropriate stoma appliance the first time, resulting in patients having healthier peristomal skin, fewer leakages, more confidence in their stoma appliance and a higher quality of life.

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Evaluating the perceptions of workplace-based assessments in surgical training: a systematic review (2022)

Type of publication:
Systematic Review

Author(s):
Mughal Z.; *Patel S.; Gupta K.K.; Metcalfe C.; Beech T.; Jennings C.

Citation:
Annals of the Royal College of Surgeons of England. (no pagination), 2022. Date of Publication: 14 Nov 2022. [epub ahead of print]

Abstract:
INTRODUCTION: Workplace-based assessments (WBAs) are intended to maximise learning opportunities in surgical training. There is speculation as to whether mandatory assessments in this form contribute to a tick-box culture. The objective of this review was to investigate surgical trainees' attitudes towards WBAs. METHOD(S): This systematic review of qualitative studies was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. The literature was searched on the Medline, Embase, PubMed and Web of Science databases on 22 March 2022. RESULT(S): Sixteen studies were included in the review, mostly carried out on users of the Intercollegiate Surgical Curriculum Programme portfolio in the UK. Trainees felt that WBAs were educationally useful, providing opportunity for feedback, but this was overshadowed by a pressure to reach a set annual quota for WBAs and achieve high scores. Other themes included inaccurate recording of WBAs, the role of WBAs as formative or summative assessments, engagement and accessibility of trainers, and lack of time to complete WBAs. CONCLUSION(S): Negative perceptions about WBAs were widespread among surgical trainees despite a recognition of their capacity to facilitate learning. This review supports the recent removal of the annual quota for WBAs in UK surgical training programmes.

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Resection and primary anastomosis is safe in selected patients with perforated diverticulitis: A cohort study (2022)

Type of publication:
Conference abstract

Author(s):
*Dowdeswell M.; *Chang J.; *Rajalingam V.; *Wolos M.; *McCloud J.; *Cheetham M.

Citation:
British Journal of Surgery. Conference: Association of Surgeons of Great Britain and Ireland Annual Congress, ASGBI 2022. Liverpool United Kingdom. 109(Supplement 5) (pp v30-v31), 2022. Date of Publication: 2022.

Abstract:
Aims: Historically, the preferred procedure for perforated diverticular disease is Hartmann's procedure (Hp). Although reliably achieving source control, it's associated with a high rate of post-operative complications and a stoma which of ten becomes permanent. We reviewed our experience of patients undergoing Hp vs primary anastomosis (PA) for perforated diverticulitis. Method(s): All patients undergoing emergency resectional surgery for perforated diverticulitis between March 2015 and Jan 2021 were identified from The Hospital Episode Statistics (HES) data. Demographics were collected and The patient groups were case matched for age and Charleson Comorbidity Index (CCI), Computed Tomography (CT) appearance and intraoperative contamination data. Post-operative morbidity/mortality data was compared. Result(s): 105 patients were included. 15 patients had PA (without diversion) and 90 Hp. In The PA cohort were10 males, median age 52 (range 27-76). There were no anastomotic leaks. 30-day morbidities were superficial wound dehiscence (1) and early incisional hernia (1). Median post-operative stay was 9 days (range 5-25). Hp control group (age below 76, Charlson score 10and below, Hinchey 1-3 intraoperatively). Included 58 patients, 26 males, median age 60.5 (range 30-76). Median post-operative stay was 10.5 days (range 5-227). 2 patients required re-operation. 5 patients developed wound infections. At the time of the study 18 patients have undergone reversal, 6 are On active waiting-list for reversal. There was a single 30-day mortality (post-discharge). Conclusion(s):We have shown that PA is safe in selected cohort of patients and have identified that over 50% of patients undergoing Hp could have been considered for PA.

The potential for day case total parathyroidectomy in patients with secondary hyperparathyroidism (2022)

Type of publication:
Conference abstract

Author(s):
*McDonald S.; *Al-Saadi N.; *Chang J.; *Neophytou C.; *Houghton A.

Citation:
British Journal of Surgery. Conference: Association of Surgeons of Great Britain and Ireland Annual Congress, ASGBI 2022. Liverpool United Kingdom. 109(Supplement 5) (pp v106), 2022. Date of Publication: 2022.

Abstract:
Aims: Hypocalcaemia is a common complication after parathyroidectomy for secondary hyperparathyroidism (SHpT) and is of ten The cause of a prolonged hospital stay post operatively. Although there is no current guidance on targets for total parathyroidectomy for SHpT, current guidance recommends a day-case rate of 90% for patients undergoing Surgery for primary hyperparathyroidism. Our centre has developed a safe protocol which allows us to perform total parathyroidectomies as a day-case procedure in patients with SHpT. This protocol, developed in conjunction with The renal physicians, involves giving The patients alpha calcidol pre-operatively for 5 days, to minimise The incidence of hypocalcaemia, and close monitoring of The calcium levels post operatively, to permit safe discharge. Method(s): We carried out a single centre retrospective study on all patients who underwent a total parathyroidectomy for SHpT between February 2005 and May 2021. All The patients received The alpha calcidol regimen pre-operatively. Data on patient baseline characteristics, peri-operative calcium, potassium and PTH levels, length of hospital stay, operative procedure details, hospital readmission and 30-day morbidity were collected. Result(s): 49 patients underwent a total parathyroidectomy during The study period. 67% of patients were discharged on day 0 or on day 1 post-operatively. Reasons for prolonged hospital stay in The remaining patients included refractory hyperkalaemia requiring dialysis, complications secondary to anaesthesia, as well as hypocalcaemia in a few cases. No patients required readmission during The 30-day post-operative period. Conclusion(s): Day-case Surgery for SHpT can be achieved safely with a pre-operative regimen of alpha calcidol and close monitoring of calcium levels post-operatively.

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Safety of in-hospital delay to appendicectomy in acute appendicitis: A retrospective study (2022)

Type of publication:
Conference abstract

Author(s):
Claydon O.; Down B.; *Kumar S.

Citation:
British Journal of Surgery. Conference: Association of Surgeons of Great Britain and Ireland Annual Congress, ASGBI 2022. Liverpool United Kingdom. 109(Supplement 5) (pp v72), 2022. Date of Publication: 2022.

Abstract:
Aims: In many hospitals the availability of operating theatres and access to senior surgical and anaesthetic support diminishes during night hours. Therefore urgent surgery is sometimes postponed until the following morning rather than performed overnight, if judged to be safe. We aim to determine if a delay to laparoscopic appendicectomy in cases of acute appendicitis of over 12 hours, analogous to an overnight delay, is correlated to worse patient outcomes. Our primary outcome was delayed discharge from hospital. Our secondary outcomes were appendicitis severity, conversion, and post-operative complications. Method(s): We undertook a retrospective review of The medical records of patients who underwent laparoscopic appendicectomy at a UK district General hospital between 01/01/2018 and 30/08/2019. For each patient clinical and demographic information; and times of hospital admission, surgery, and discharge; were collected. Delayed discharged was defined as 'time to discharge' >24 hours. Result(s): 506 patients were included. In 144 patients (28.5%) 'time to surgery' was under 12 hours; in 362 patients (71.5%) 'time to surgery' was over 12 hours. 362 patients (71.5%) had a delayed discharge. 303 patients (59.9%) had Simple appendicitis; 143 patients had severe appendicitis (28.3%); 60 patients had a macroscopically normal appendix (11.9%). No statistically significant association between 'time to surgery' and delayed discharge, appendicitis severity, conversion or 30 day re-presentations was observed. Conclusion(s): Time from admission to start of appendicectomy did not affect patient outcomes. Short in-hospital delays to appendicectomy, for example an overnight delay, may be safe in certain patients, taking account of clinical judgement.