Carotid Ultrasound Assessment Prior to Coronary Artery Bypass Grafting - An Irish Cardiac Surgery Center's Experience.

Background: Carotid stenosis is a risk factor for cerebrovascular accident (CVA) following coronary artery bypass grafting (CABG). Guidelines recommend selective preoperative screening with Doppler ultrasound (US) but nonselective application is commonplace. Recent data has questioned the efficacy of perioperative carotid intervention, challenging the value of this practice.

Impact of aesthetic surgery performed abroad on the Irish healthcare system.

Introduction: Aesthetic surgery tourism is a flourishing trend, and challenges often arise when patients return home with post-operative complications, necessitating follow-up care.

Methods: Between July 2021 and June 2023, we conducted a retrospective analysis of patients who presented with complications from aesthetic surgery tourism in two major teaching hospitals in Ireland.

Results: Thirty-three patients with a mean age of 41 years were identified.

Impact of Mentoring for Underrepresented Groups in Undergraduate Medical Education: A Systematic Review.

Objectives: Despite efforts to mitigate challenges to advance underrepresented groups (URG) groups' representation in medical education, diversity remains underwhelming. In response to this several mentoring programs to increase diversification within medical education have been implemented. However, the impact of these programs on URG representation across disciplines is unknown.

Results from an expedited spinal nerve root block clinic at a UK tertiary neurosurgical centre.

Study Design: Retrospective Observational Study.

Introduction: Lumbar radicular pain has a prevalence of 3-5%. Level 1 evidence has demonstrated equivalence between surgical and injection treatment.

Extended-Duration Work Shifts in Surgical Specialties: A Systematic Review.

Introduction: There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature.

Methods: This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses.

Preoperative priming results in improved operative performance with surgical trainees.

Background: Preoperative warm-up regimens are increasingly utilised in the surgical field, however no consensus on benefits of priming across surgical experience has been realised. The aim of this study was to evaluate the impact of simulation preoperative priming on operative performance across levels of resident experience.

Methods: A single-blinded randomised control trial was carried out in a regional surgical training centre.

Surgical Priming Improves Operative Performance in Surgical Trainees: A Crossover Randomized Control Trial.

Objective: The aim of this study was to evaluate the impact of a surgical warm-up using a virtual reality simulator on operative performance.

Design: This was a single-blinded cross-over randomized control trial in a single tertiary Orthopedic training center.

Participants: Orthopedic trainees were recruited, and each morning participants rostered to theatre were randomized to either undergo a simulated surgical procedure on a virtual reality simulation system prior to their first case as primary operator (priming arm), or to perform their usual preparatory routine for surgery (control arm).

Evaluating the Impact of Supervision on Surgical Trainees Stress Response During Simulated Surgical Procedures; A Crossover Randomized Trial.

Objective: The aim of this study was to evaluate the cumulative impact of supervision on technical skills and surrogate stress markers in surgical trainees.

Design: This was a quasi-experimental crossover study to evaluate the impact of attending supervision on orthopedic trainee stress response during a simulated surgical procedure. Enrolled residents performed a proximal femoral nail module with the Precision OS system twice; once independently, and once under direct attending supervision, whilst wearing a heart rate monitor.

Use of procedure specific preoperative warm-up during surgical priming improves operative outcomes: A systematic review.

Background: Preoperative warm-up in preparation for surgery is a technique used in recognition of similarities between surgeons and performance based professionals. The aim of this review was to evaluate the use of simulation-based preoperative warm-up on surgical performance in the operating room and its impact on both clinical and patient outcomes.

Materials And Methods: A systematic review of the literature was carried out in accordance with PRISMA guidelines between August-September 2021.

Rates of complications in Achilles tendon rupture repair using absorbable and nonabsorbable suture material; A systematic review.

Background: The impact of suture type on tensile strength, re-rupture rates and infection risk in Achilles tendon rupture repair is not been well established. The aim of this review is to evaluate existing literature on the associated risk of postoperative infection with absorbable and non-absorbable suture materials in Achilles tendon rupture repair.

Methods: A systematic review of search databases PubMed; Google Scholar; and OVID Medline was made to identify studies related to complications associated with Achilles tendon rupture repair.

Hand dominance and experience improve bimanual performance on arthroscopic simulator task.

Purpose: The aim of this study was to identify if experience in arthroscopy confers ambidexterity to the operator and the role of baseline characteristics in arthroscopic simulator performance.

Methods: A prospective comparative study was carried out across four regional Orthopaedic training centres. Participants were divided into novice, intermediate or experienced groups based on arthroscopic experience.

Obesity: An Independent Risk Factor for Complications in Anterior Lumbar Interbody Fusion? A Systematic Review.

Study Design: Systematic Review and Meta-analysis.

Objectives: Raised patient BMI is recognised as a relative contraindication to posterior lumbar interbody fusion (PLIF) due to the anaesthetic challenges, difficult positioning and increased intraoperative and postoperative complications, with the relative risk rising in patients with a BMI >25 kg/m2. The impact of obesity defined as a BMI > 30 kg/m on Anterior Lumbar Interbody Fusion (ALIF) outcomes is not yet established.

The specialty mentor effect in enhancing surgical experience of medical students: A randomised control trial.

Introduction: The positive learning experiences of students on surgical rotations which subsequently influence career choice may be delineated into practical and interpersonal themed factors. It remains unclear the relative impact each component has on the student experience and subsequent specialisation.

Aims: We evaluate the influence of having senior resident mentor during practical simulation in orthopaedic surgery has on medical student interest in surgery; their comfort in theatre; and its role in enhancing knowledge acquisition within the rotation.

Acquisition of Surgical Skills in Medical Students via Telementoring: A Randomized Controlled Trial.

Background: Pandemic related changes have radically altered the delivery of medical teaching. The practical skills of medicine which students should be proficient in at time of graduation have tended to require in-person tutelage, with reduced access resulting in the risk of skill deficits in newly qualified doctors. Small group teaching sessions are amenable to a virtual mode of delivery, with the ability of the virtual platform to confer practical skills unproven.

Under viral attack: An orthopaedic response to challenges faced by regional referral centres during a national cyber-attack.

Background: A national ransomware attack on the Irish Health Service Executive left the Healthcare system bereft of access to IT systems, electronic patient records, and the national imaging system. Widespread disruption to internal and external referral pathways, and both trauma and elective Orthopaedic services occurred as a result. The purpose of this paper to discuss the challenges faced by Regional trauma units and adjustments made to overcome these.

Student Acceptance of Virtual Bedside Surgical Tutorials During COVID-19: A Randomized Controlled Trial.

Background: The social distancing recommendations from the WHO during the pandemic has resulted in a pivot point in the delivery of medical education. With the medical student clinical experience constantly under threat; novel methods to maintain adequate surgical patient exposure and student interaction on a platform amenable to the interactive format required were devised using a virtual platform to compliment current pedagogical approaches.

Methods: A parallel randomized controlled trial evaluated the perceived use of remote learning in place of bedside teaching.

A Portable Hip Arthroscopy Simulator Demonstrates Good Face and Content Validity with Incomplete Construct Validity.

Purpose: We evaluate the face, content, and construct validity of a portable hip arthroscopy module in a regional orthopaedic unit.

Methods: Participants were recruited from a regional orthopaedic centre, and categorized into novice (0 arthroscopies), intermediate (1-29 arthroscopies), and expert (>50 arthroscopies) groups based on reported experience in arthroscopy. Face and content validity was evaluated by feedback from users immediately following completion of modules.

Is there a variance in complication types associated with ALIF approaches? A systematic review.

Purpose: Anterior lumbar interbody fusion (ALIF) is a well-established alternative to posterior-based interbody fusion techniques, with approach variations, such as retroperitoneal, transperitoneal, open, and laparoscopic well described. Variable rates of complications for each approach have been enumerated in the literature. The purpose of this study was to elucidate the comparative rates of complications across approach type.

Achilles' tendon rupture dancing the 'Jerusalema' - A case series.

Introduction And Importance: The weekend warrior has long been prey to musculoskeletal injuries as a result of intermittent, high intensity activity. The Achilles tendon is known to be particularly vulnerable in this population cohort but during the COVID-19 lockdowns in Ireland and all over the world there has been a certain level of detraining and deconditioning among all age groups and populations. Throughout the worldwide restrictions, viral internet challenges and dances have encapsulated the spirit of a global community with the 'Jerusalema' dance being no exception.

Use of biomaterials in scaphoid fracture fixation, a systematic review.

Background: Scaphoid fractures account for 60-70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging.

A pilot study to evaluate the face & construct validity of an orthopaedic virtual reality simulator.

Aims: This study aimed to identify the face and construct validity of the Precision OS trauma module proximal femoral nail procedure. Secondary outcomes included perceived use of simulation in surgical training, with structured feedback from participants.

Methods: A comparative interventional study was carried out in a regional orthopaedics trauma unit hospital.

Postoperative Infection Risk in Total Joint Arthroplasty After Perioperative IV Corticosteroid Administration: A Systematic Review and Meta-Analysis of Comparative Studies.

Background: Perioperative corticosteroid administration is associated with reduced postoperative nausea, pain, and enhanced recovery after surgery. However, potential complications including wound and periprosthetic joint infections remain a concern for surgeons after total joint arthroplasty (TJA).

Methods: A systematic review of the search databases PubMed, Google Scholar, and EMBASE was made in January 2021 to identify comparative studies evaluating infection risk after perioperative corticosteroid administration in TJA.

Acute respiratory failure in immunosuppressed patients admitted to ICU.

Introduction: The number of hospitalized immunosuppressed adults is a growing and often develop severe complications that require admission to an Intensive Care Unit (ICU). The main cause of admission is acute respiratory failure (ARF). The goal of the study was to determine if ARF represents an independent risk factor for hospital mortality and in particular, we sought to ascertain if any risk factors were independently and identifiably associated with a bad outcome.

Fast acquisition abdominal MRI study for the investigation of suspected acute appendicitis in paediatric patients.

Objectives: To assess the diagnostic accuracy of fast acquisition MRI in suspected cases of paediatric appendicitis presenting to a tertiary referral hospital.

Materials And Methods: A prospective study was undertaken between May and October 2017 of 52 children who presented with suspected appendicitis and were referred for an abdominal ultrasound. All patients included in this study received both an abdominal ultrasound and five-sequence MRI consisting of axial and coronal gradient echo T2 scans, fat-saturated SSFSE and a diffusion-weighted scan.