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Surgery in the United Kingdom

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https://www.readbyqxmd.com/read/28425888/-satisfa%C3%A3-%C3%A3-o-com-o-internato-m%C3%A3-dico-em-portugal
#1
Miguel Bigotte Vieira, Pedro Godinho, Nuno Gaibino, Raquel Dias, Agostinho Sousa, Inês Madanelo, Francisco Ribeiro-Mourão, Mariana Brandão, Sónia Duarte, Tiago Meirinhos, Ana Luísa Catarino, Cláudio Espírito Santo, Ricardo Caiado, Ricardo Marques, Ana Gonçalves Ferreira, Carlos Ramalheira, João Valente Jorge, Marta Losada, Mário Santos, Edson Oliveira, João Paulo Farias, José Manuel Silva
INTRODUCTION: In the last years, the global context of medical education and Medical Residency programs in Portugal suffered substantial changes. The primary objective of this study was to evaluate and characterize medical residents ́ satisfaction with medical residency programs in Portugal and to identify features that could be improved. MATERIAL AND METHODS: We utilized as model the survey Postgraduate Hospital Educational Environment Measure that has been developed in the United Kingdom and is speci cally targeted to medical residents...
December 30, 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28407998/a-cost-effectiveness-evaluation-of-germline-brca1-and-brca2-testing-in-uk-women-with-ovarian-cancer
#2
Anthony Eccleston, Anthony Bentley, Matthew Dyer, Ann Strydom, Wim Vereecken, Angela George, Nazneen Rahman
OBJECTIVES: To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 (collectively termed "BRCA") testing in women with epithelial ovarian cancer, and testing for the relevant mutation in first- and second-degree relatives of BRCA mutation-positive individuals, compared with no testing. Female BRCA mutation-positive relatives of patients with ovarian cancer could undergo risk-reducing mastectomy and/or bilateral salpingo-oophorectomy. METHODS: A cost-effectiveness model was developed that included the risks of breast and ovarian cancer; the costs, utilities, and effects of risk-reducing surgery on cancer rates; and the costs, utilities, and mortality rates associated with cancer...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28390609/peri-operative-management-of-high-risk-paediatric-adenotonsillectomy-patients-a-survey-of-35-uk-tertiary-referral-centres
#3
Ryan Chin Taw Cheong, Philippe Bowles, Andrew Moore, Simon Watts
INTRODUCTION: Peri-operative management of high-risk paediatric patients undergoing adenotonsillectomy for treatment of obstructive sleep apnoea varies between tertiary referral hospitals. 'Day of surgery cancellation' (DoSC) rates of up to 11% have been reported due to pre-booked critical care being unavailable on the day of surgery as a result of competing needs from other hospital departments. We report the results of a survey of peri-operative management in UK tertiary care centres of high-risk paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea (OSA)...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28388718/abobotulinumtoxina-a-25-year-history
#4
Gary D Monheit, Andy Pickett
During the late 1960s and early 1970s, Alan Scott showed that intramuscular injections of botulinum toxin (BoNT) corrected nonaccommodative strabismus without resorting to surgery. The UK doctors who trained with Scott soon realized the significant potential offered by BoNT type A as a therapeutic option for several difficult-to-treat diseases. This led to a collaboration between these pioneering clinicians and the Centre for Applied Microbiology and Research at Porton Down, United Kingdom, and, in turn, to the development and commercialization of abobotulinumtoxinA as Dysport (Dystonia/Porton Down; Ipsen Biopharm Ltd...
May 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28352146/power-morcellation-using-a-contained-bag-system
#5
Courtney Steller, Aarathi Cholkeri-Singh, Kirsten Sasaki, Charles E Miller
BACKGROUND AND OBJECTIVES: The well-known advantages of minimally invasive surgery make the approach well suited for hysterectomy and other gynecological procedures. The removal of specimens excised during surgery has been a challenge that has been answered by the use of power morcellation. With this study we sought to assess the feasibility of power morcellation within a specimen bag. METHODS: This was a retrospective cohort study including patients from a private practice in suburban Chicago, Illinois, who underwent contained electromechanical power morcellation during a laparoscopic or robot-assisted hysterectomy or myomectomy from May 2014 through December 2015...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28328654/outcomes-for-children-receiving-noninvasive-ventilation-as-the-first-line-mode-of-mechanical-ventilation-at-intensive-care-admission-a-propensity-score-matched-cohort-study
#6
Jenny V Morris, Padmanabhan Ramnarayan, Roger C Parslow, Sarah J Fleming
OBJECTIVES: To compare outcomes of children receiving noninvasive ventilation with those receiving invasive ventilation as first-line mode of mechanical ventilation following unplanned intensive care admission. DESIGN: Propensity score-matched cohort study analyzing data prospectively collected by the Pediatric Intensive Care Audit Network over 8 years (2007-2014). SETTING: Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of whom submitted Pediatric Critical Care Minimum Dataset data for the entire study period...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#7
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318512/understanding-children-s-heart-surgery-data-a-cross-disciplinary-approach-to-codevelop-a-website
#8
REVIEW
Christina Pagel, Emily Jesper, Joanne Thomas, Emily Blackshaw, Tim Rakow, Mike Pearson, David Spiegelhalter
Risk-adjusted survival statistics after children's heart surgery are published annually in the United Kingdom. Interpreting these statistics is difficult, and better resources about how to interpret survival data are needed. Here we describe how a multidisciplinary team of mathematicians, psychologists, and a charity worked with parents of heart surgery children and other users to codevelop online resources to present survival outcomes. Early and ongoing involvement of users was crucial and considerably changed the content, scope, and look of the website, and the formal psychology experiments provided deeper insight...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#9
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28292204/a-national-survey-of-the-management-of-patients-with-incidental-meningioma-in-the-united-kingdom
#10
Mujtaba H Mohammad, Emmanuel Chavredakis, Rasheed Zakaria, Andrew Brodbelt, Michael D Jenkinson
BACKGROUND: Incidental meningiomas are increasingly being diagnosed due to widespread use of brain imaging. Treatment options include surveillance, surgery and stereotactic radiosurgery, but the natural history of these tumours is not fully understood and there are no accepted management guidelines to aid clinical decision-making. The aim of this study was to assess current practice in the United Kingdom and identify areas of variation for further study. METHODS: A questionnaire was distributed to all members of the Society of British Neurosurgeons (SBNS)...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291608/acute-type-a-aortic-dissection-in-the-united-kingdom-surgeon-volume-outcome-relation
#11
Mohamad Bashir, Amer Harky, Matthew Fok, Matthew Shaw, Graeme L Hickey, Stuart W Grant, Rakesh Uppal, Aung Oo
OBJECTIVES: Surgery for acute type A aortic dissection (ATAD) carries a high risk of operative mortality. We examined the surgeon volume-outcome relation with respect to in-hospital mortality for patients presenting with this pathology in the United Kingdom. METHOD: Between April 2007 and March 2013, 1550 ATAD procedures were identified from the National Institute for Cardiovascular Outcomes Research database. A total of 249 responsible consultant cardiac surgeons from the United Kingdom recorded 1 or more of these procedures in their surgical activity over this period...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28271250/cost-effectiveness-of-vedolizumab-compared-with-infliximab-adalimumab-and-golimumab-in-patients-with-ulcerative-colitis-in-the-united-kingdom
#12
Michele R Wilson, Annika Bergman, Helene Chevrou-Severac, Ross Selby, Michael Smyth, Matthew C Kerrigan
OBJECTIVE: To examine the clinical and economic impact of vedolizumab compared with infliximab, adalimumab, and golimumab in the treatment of moderately to severely active ulcerative colitis (UC) in the United Kingdom (UK). METHODS: A decision analytic model in Microsoft Excel was used to compare vedolizumab with other biologic treatments (infliximab, adalimumab, and golimumab) for the treatment of biologic-naïve patients with UC in the UK. Efficacy data were obtained from a network meta-analysis using placebo as the common comparator...
March 8, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28249677/factors-influencing-patient-experience-and-satisfaction-following-surgical-management-of-ankle-fractures
#13
Fiona Ashton, Khalid Hamid, Shazali Sulieman, William Eardley, Paul Baker
BACKGROUND: Patient feedback is increasingly important to inform and develop effective healthcare within the United Kingdom. In order to optimise patient experience of ankle fracture care in our unit, we sought to identify elements of practice associated with poor patient experience and low levels of satisfaction. METHODS: Adult patients with closed ankle fractures requiring fixation over a ten month period were prospectively identified. Prior to discharge all patients completed the Picker Patient Experience Questionnaire (PPE-15), satisfaction visual analogue scale (VAS: 0-10) and a demographic questionnaire...
February 22, 2017: Injury
https://www.readbyqxmd.com/read/28249343/predictors-of-outcome-in-modern-surgery-for-lung-abscess
#14
Michael Schweigert, Norbert Solymosi, Attila Dubecz, Joseph John, Doug West, Paul Leonhard Boenisch, Riyad Karmy-Jones, Carlos F Giraldo Ospina, Ana Beatriz Almeida, Helmut Witzigmann, Hubert J Stein
Background Surgery for lung abscess is a challenging task. Timing and indications for surgery are not well established. Identification of predictors of outcome could help to clarify the role of surgery. Methods Patients who underwent major thoracic surgery for infectious lung abscess were identified at six centers for general thoracic surgery in Germany, Spain, the United Kingdom, and the United States. Study period was 2000 to 2016. Results There were 91 patients. Pulmonary sepsis (48), pleural empyema (43), persistent air leakage (25), acute renal failure (12), and respiratory failure with mechanical ventilation (25) were already preoperatively present...
March 1, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28235642/national-survey-of-neurosurgeons-and-stroke-physicians-on-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#15
Pallavi Basu, Harri Jenkins, Kevin Tsang, Vejay N Vakharia
BACKGROUND: Several studies have evaluated the use of decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMCAI). In the United Kingdom (UK), the National Institute for Health and Care Excellence (NICE) has set criteria for selection of patients for DHC in MMCAI. We set out to survey the attitudes and practice of neurosurgeons and stroke physicians within the UK towards DHC in MMCAI. METHODS: An electronic survey of questions on management of MMCAI in various clinical scenarios was submitted to the academic committees of the Society of British Neurological Surgeons (SBNS) and the British Association of Stroke Physicians (BASP) for approval, prior to dissemination through the consultant members...
February 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28231649/optimal-timing-for-hemoglobin-concentration-determination-after-total-knee-arthroplasty-day-1-versus-day-2
#16
Mahdi Yacine Khalfaoui, Charles Godavitarne, Michael C P Wilkinson
Purpose: Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods: This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28228048/use-of-google-scholar-public-profiles-in-orthopedics
#17
Kevin Tetsworth, Dave Fraser, Vaida Glatt, Erik Hohmann
INTRODUCTION: The purpose of this study was to survey the growth of Google Scholar public profiles in orthopedics over a 12-month period and to investigate global patterns. METHODS: Data was prospectively acquired from June 2013 to June 2014. Google Scholar queries specific to orthopedic surgery were performed at 90-day intervals. Demographic aspects of each user were also compiled, including gender, current location, and primary interests. To determine differences between the growth of Google Scholar public profile registrations and citation counts, as well as differences in growth in different regions, repeated measures of analysis of variance (RMANOVA) were used...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#18
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28165610/diabetic-macular-edema-outcomes-in-eyes-treated-with-fluocinolone-acetonide-0-2-%C3%A2%C2%B5g-d-intravitreal-implant-real-world-uk-experience
#19
Ibraheem El-Ghrably, David H W Steel, Maged Habib, Daniela Vaideanu-Collins, Sridhar Manvikar, Roxane J Hillier
PURPOSE: To conduct an observational, multicenter study to evaluate real-world clinical efficacy and safety of the 0.2 µg/day fluocinolone acetonide (FAc) implant in the treatment of patients with chronic diabetic macular edema (DME) in 3 large hospital ophthalmology departments in the United Kingdom. METHODS: Fluocinolone acetonide implants were inserted into the study eyes following a suitable washout period; phakic eyes received FAc implant following cataract surgery...
February 6, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28164272/anaphylaxis-during-general-anaesthesia-experience-from-a-drug-allergy-centre-in-the-uk
#20
J Meng, G Rotiroti, E Burdett, J J Lukawska
BACKGROUND: Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge. METHODS: A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively...
March 2017: Acta Anaesthesiologica Scandinavica
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