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Surgery in the United Kingdom

Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
October 25, 2016: World Journal of Surgery
Ruggero De Paulis, Salvatore D'Aleo, Alessandro Bellisario, Andrea Salica, Luca P Weltert, Raffaele Scaffa, Lorenzo Guerrieri Wolf, Daniele Maselli, Michele Di Mauro
BACKGROUND: Structural valve deterioration (SVD) is the Achilles' heel of bioprostheses. Its correlation with younger age is well known. In recent years we exclusively reserved use of small-size Mitroflow valve prostheses (LivaNova, London, United Kingdom) to an older patient population with small aortic annuli. This study aimed to assess the incidence of SVD and its effect on patient survival and need for reoperation. MATERIALS AND METHODS: Two hundred five patients (aged 75...
September 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Ignacio Rodriguez-Una, Augusto Azuara-Blanco, Anthony J King
BACKGROUND: To evaluate the spectrum of glaucoma surgery and the post-operative follow-up regimes undertaken among glaucoma specialists in the United Kingdom. DESIGN: National survey. PARTICIPANTS: Seventy-five glaucoma specialists (consultants and fellows). METHODS: An eight-question survey was emailed to all glaucoma subspecialists members of the United Kingdom and Eire Glaucoma Society. MAIN OUTCOME MEASURES: Surgery undertaken, post-operative management, awareness of intervention tariff and handling of the follow-up burden generated through surgery...
October 11, 2016: Clinical & Experimental Ophthalmology
Dong Young Park, Andrew Walkden, Timothy A De Klerk
PURPOSE: To determine the effect of specialty training on cataract operation times and operating room efficiency. SETTING: Manchester Royal Eye Hospital, Manchester, United Kingdom. DESIGN: Retrospective consecutive case series. METHODS: Specialty training and consultant case times with preparation times were recorded between August 2014 and May 2015. Cases with posterior capsule rupture requiring anterior vitrectomy or iris hook insertion were analyzed...
September 2016: Journal of Cataract and Refractive Surgery
Béatrice Cochener
PURPOSE: To analyze the clinical outcomes after implantation of an extended range of vision intraocular lens (IOL), the Tecnis Symfony, in a routine clinical setting. SETTING: Forty clinical sites in Finland, France, Germany, Norway, Spain, Sweden, and the United Kingdom. DESIGN: Prospective case series. METHODS: The study comprised 411 patients who had bilateral implantation of the extended range of vision IOL, with intended micro-monovision in 1 group (monovision group) and intended emmetropia in the other group (non-monovision group)...
September 2016: Journal of Cataract and Refractive Surgery
Joanne F Irons, Lachlan F Miles, Kaustuv R Joshi, Andrew A Klein, Marco Scarci, Piergiorgio Solli, Guillermo Martinez
OBJECTIVE: General anesthesia with endobronchial intubation and one-lung positive-pressure ventilation always has been considered mandatory for thoracic surgery. Recently, there has been interest in nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients. The authors' center developed a nonintubated technique with spontaneous ventilation with the patient under general anesthesia using a supraglottic airway device. The authors believe that this was the first study to compare a nonintubated general anesthetic technique with an intubated general anesthetic technique for VATS...
July 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mohamed H Boshnaq, Nabeel Merali, Islam H El Abbassy, Sayed A Eldesouky, Mohamed A Rabie
AIM OF THE STUDY: The guidelines recommend that patients with mild gallstones pancreatitis should undergo a definitive management for gallstones during the same admission or within the next two weeks. The aim of this study was to estimate the financial cost resulting from a delay in surgical management following mild gallstones pancreatitis. This includes the costs of readmissions with biliary events and the subsequent investigations required during these admissions. MATERIALS AND METHODS: A retrospective analysis included patients with gallstone pancreatitis who were admitted to a district general hospital in the United Kingdom over one year...
September 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Oliver James, Richard Payne, Andrew Bathe, Tim Greet, Claire Wylie
OBJECTIVE: To describe the clinical details and pathology within the dorsal and plantar pouches of the tarsocrural joint of a population of horses that underwent arthroscopic surgery for tarsocrural osteochondritis dissecans (OCD). STUDY DESIGN: Retrospective cohort study. ANIMALS: Horses referred for arthroscopic treatment of tarsocrural OCD between 2005 and 2013 (102 horses; 144 joints). METHODS: Case records of all horses that had tarsocrural arthroscopy for OCD at Rossdales Equine Hospital, Newmarket, United Kingdom were included...
September 29, 2016: Veterinary Surgery: VS
J Nekolová, H Langrová, P Rozsíval, N Jirásková
PURPOSE: To prospectively compare postoperative results of two premium intraocular lenses EnVISTA (Bausch and Lomb) and AcrySof IQ (Alcon), focussing on glistenings and posterior capsule opacification. The evaluation of glistenings was done using Image J software and posterior capsule opacifications were quantified with OSCA system. METHODS: Twenty patients (7 men and 13 women) with bilateral cataract were included. EnVista intraocular lens (IOL) was implanted in one eye and AcrySof IQ IOL in the second eye of each patient...
2016: Ceská a Slovenská Oftalmologie
Lily Gutnik, Gavin Yamey, Robert Riviello, John G Meara, Anna J Dare, Mark G Shrime
BACKGROUND: The non-profit and volunteer sector has made notable contributions to delivering surgical services in low-and middle-income countries (LMICs). As an estimated 55 % of surgical care delivered in some LMICs is via charitable organizations; the financial contributions of this sector provides valuable insight into understanding financing priorities in global surgery. METHODS: Databases of registered charitable organizations in five high-income nations (United States, United Kingdom, Canada, Australia, and New Zealand) were searched to identify organizations committed exclusively to surgery in LMICs and their financial data...
2016: SpringerPlus
Taren Roughead, Darreul Sewell, Christopher J Ryerson, Jolene H Fisher, Alana M Flexman
Preoperative fasting is important to avoid morbidity and surgery delays, yet recommendations available on the Internet may be inaccurate. Our objectives were to describe the characteristics and recommendations of Internet resources on preoperative fasting and assess the quality and readability of these websites. We searched the Internet for common search terms on preoperative fasting using Google® search engines from 4 English-speaking countries (Canada, the United States, Australia, and the United Kingdom)...
September 16, 2016: Anesthesia and Analgesia
J Cornish, R L Harries, D Bosanquet, B Rees, J Ansell, N Frewer, P K Dhruva Rao, C Parry, R Ellis-Owen, S M Phillips, C Morris, J Horwood, M L Davies, M M Davies, R Hargest, Z Davies, J Hilton, D Harris, A Ben-Sassi, R Rajagopal, D Hanratty, S Islam, A Watkins, N Bashir, S Jones, I R Russell, J Torkington
BACKGROUND: Incisional hernias are common complications of midline closure following abdominal surgery and cause significant morbidity, impaired quality of life and increased health care costs. The 'Hughes Repair' combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. This theoretically distributes the load along the incision length as well as across it. There is evidence to suggest that this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared the Hughes Repair with standard mass closure for the prevention of incisional hernia formation following a midline incision...
September 15, 2016: Trials
Ahmed ELHadi, Sarah Ashford-Wilson, Stephanie Brown, Atanu Pal, Roshan Lal, Kamal Aryal
PURPOSE: Based in a hospital serving one of the most deprived areas in the United Kingdom (UK), we aimed to investigate, using the Indices of Deprivation 2010, the hypothesis that deprivation affects the stage and mode of presentation of colorectal cancer. METHODS: All newly diagnosed patients with colorectal cancer presenting to a District General Hospital in the UK between January 2010 and December 2014 were included. Data were collected from the Somerset National Cancer Database...
August 2016: Annals of Coloproctology
Sonali T Nagendran, We Fong Siah, Andre Litwin, Christine Barbosa, Jan Jayatilake, Raman Malhotra
Operating theatre utilization has become the principal measure of NHS operating theatre service performance. We analysed data from oculoplastic theatres in a tertiary centre to identify factors influencing theatre efficiency. We conducted three audits on operating theatre utilization in 2011, 2014 and 2015. Data was collected from real time information entered into the hospital database, including time of arrival, induction, first cut and close of operation. The primary outcome measure was the operating list utilization rate, a combined value of anaesthetic and surgical time as a proportion of the total planned session time...
September 12, 2016: Orbit
Jemma Bhoday, Fraser Smith, Muhammed R Siddiqui, Svetlana Balyasnikova, Robert I Swift, Rodrigo Perez, Angelita Habr-Gama, Gina Brown
BACKGROUND: Pathological complete response after chemoradiotherapy for rectal cancer occurs in 10% to 30% of patients. The best method to identify such patients remains unclear. Clinical assessment of residual mucosal abnormality is considered the most accurate method. In our institution, magnetic resonance tumor regression grade is performed as routine to assess response. OBJECTIVE: The purpose of this study was to compare the sensitivity of magnetic tumor regression grade against residual mucosal abnormality in detecting patients with a pathological complete response...
October 2016: Diseases of the Colon and Rectum
Ramya Ramaswami, David J Pinato, Keiichi Kubota, Mitsuru Ishizuka, Tadaaki Arizumi, Masatoshi Kudo, Jeong Won Jang, Young Woon Kim, Mario Pirisi, Elias Allara, Rohini Sharma
There is significant heterogeneity in the clinicopathological characteristics of intermediate hepatocellular carcinoma (IHCC). This also translates to treatment as transarterial chemoembolization (TACE) is used as first-line therapy for patients with IHCC; however, in Asia liver resection (LR) is preferred. Prognostic tools are required to help guide clinicians in deciding treatment options. This study evaluates the prognostic impact of the Intermediate Stage Score (ISS) on overall survival (OS) in a large, multicenter cohort study of patients with IHCC treated with TACE or surgery LR...
October 2016: Medical Oncology
Claire Coles, Muhammad Umair Javed, Sarah Hemington Gorse, Dai Nguyen
BACKGROUND: Nail adhesives are widely available beauty products that are used in the cosmetic industry and households to attach false nails. Nail adhesive burns are uncommon, and it is crucial that healthcare providers and the public are aware of its potential to cause chemical burn. CASE PRESENTATION: Case series of accidental burns secondary to cyanoacrylate nail glue treated at the Welsh Centre for Burns and Plastic Surgery (WCBPS) in Swansea, United Kingdom...
2016: Burns and trauma
Patrick A Calvert, David B Northridge, Iqbal S Malik, Leonard Shapiro, Peter Ludman, Shakeel A Qureshi, Michael Mullen, Robert Henderson, Mark Turner, Martin Been, Kevin P Walsh, Ivan Casserly, Lindsay Morrison, Nicola L Walker, John Thomson, Mark S Spence, Vaikom S Mahadevan, Angela Hoye, Philip A MacCarthy, Matthew J Daniels, Paul Clift, William R Davies, Philip D Adamson, Gareth Morgan, Suneil K Aggarwal, Yasmin Ismail, Julian O M Ormerod, Habib R Khan, Sujay Subash Chandran, Joseph de Giovanni, Bushra S Rana, Oliver Ormerod, David Hildick-Smith
BACKGROUND: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. METHODS: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. RESULTS: Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015)...
September 27, 2016: Circulation
Hossein Ghaeminia, John Perry, Marloes E L Nienhuijs, Verena Toedtling, Marcia Tummers, Theo J M Hoppenreijs, Wil J M Van der Sanden, Theodorus G Mettes
BACKGROUND: Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is carried out in older people, the risk of postoperative complications, pain and discomfort is increased...
2016: Cochrane Database of Systematic Reviews
Fawzia E Al-Otaibi, Elham E Bukhari, Mona Badr, Abdulkarim A Alrabiaa
OBJECTIVES: To evaluate the epidemiology, risk factors, and antibiotic resistance of Gram negative bacteria (GNB) in patients with hematologic or solid organ malignancies.   METHODS: This is a retrospective study of 61 episodes of GNB bacteremia occurring in 56 patients with malignancy admitted to the Oncology Units in King Khalid University Hospital, Riyadh. Kingdom of Saudi Arabia during the period from January 2013 to October 2015. Data were retrieved from the computerized database of the microbiology laboratory and the patient's medical records...
September 2016: Saudi Medical Journal
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