Anal sphincter function in rectal intussusception and high and low "take-off" external rectal prolapse-A prospective observational study.

Aim: Rectal intussusception (RI) and external rectal prolapse (ERP) are associated with anal sphincter dysfunction. The aim of this study was to examine sphincter function with anal acoustic reflectometry (AAR) in RI and two distinct phenotypes of ERP termed high and low "take-off".

Methods: A prospective study of patients with RI and ERP attending a tertiary pelvic floor unit.

How surgical Trainee Research Collaboratives achieve success: a mixed methods study to develop trainee engagement strategies.

Objectives: This study aimed to understand the role of surgical Trainee Research Collaboratives (TRCs) in conducting randomised controlled trials and identify strategies to enhance trainee engagement in trials.

Design: This is a mixed methods study. We used observation of TRC meetings, semi-structured interviews and an online survey to explore trainees' motivations for engagement in trials and TRCs, including barriers and facilitators.

Surgical stress: the muscle and cognitive demands of robotic and laparoscopic surgery.

Introduction: Surgeons are among the most at-risk professionals for work-related musculoskeletal decline and experience high mental demands. This study examined the electromyographic (EMG) and electroencephalographic (EEG) activities of surgeons during surgery.

Methods: Surgeons who performed live laparoscopic (LS) and robotic (RS) surgeries underwent EMG and EEG measurements.

Using COVID-19 Opportunities to Enrich Student Experiences.

Background: The coronavirus disease 2019 (COVID-19) pandemic has and continues to challenge nursing faculty in providing students with traditional capstone experiences. Because of the pandemic, nursing students have been limited in participating in traditional capstone projects within community and health care settings.

Method: In collaboration with the local public health department, senior nursing students were asked to volunteer in a public health project called a Serosurvey.

Accuracy of Case-Based Seroprevalence of SARS-CoV-2 Antibodies in Maricopa County, Arizona.

We conducted a community seroprevalence survey in Arizona, from September 12 to October 1, 2020, to determine the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used the seroprevalence estimate to predict SARS-CoV-2 infections in the jurisdiction by applying the adjusted seroprevalence to the county's population. The estimated community seroprevalence of SARS-CoV-2 infections was 4.

The laparoscopy in emergency general surgery (LEGS) study: a questionnaire survey of UK practice.

Introduction: Recent consensus guidelines suggest that the laparoscopic approach may be a useful, safe and feasible approach in emergency general surgery. Despite this, the UK National Emergency Laparotomy Audit (NELA) suggests the rate of laparoscopy is low (9% fully laparoscopic) and slow to increase over time. A European survey found uptake to be variable.

Placement of a fine-bore rectal balloon catheter in the anal canal does not affect anal sphincter pressures: improving our understanding of physiological function with anal acoustic reflectometry.

Aim: The recto-anal inhibitory reflex (RAIR) is currently measured using anorectal manometry catheters, which may distort the anal canal. Anal acoustic reflectometry (AAR) is considered a catheter-free technique for evaluating the physiological function of the anal canal; however, it has yet to be used to elicit the RAIR. For the RAIR to be measured with AAR, the effect of placing an additional rectal balloon catheter on the measured AAR parameters needs to be investigated: that is the aim of this work.

A novel method for measurement of the recto-anal inhibitory reflex using anal acoustic reflectometry.

Aim: The recto-anal inhibitory reflex (RAIR) is currently measured using manometry catheters, which potentially distort the anal canal. Anal acoustic reflectometry (AAR) is considered to be a catheter-free technique and primarily measures the function of the internal anal sphincter. We sought to determine if RAIR could be measured using AAR.

Continuous vs stepwise anal acoustic reflectometry: An improved technique for physiological measurement of anal sphincter function?

Background: Anal acoustic reflectometry (AAR) is a technique for measuring the physiological profile of the anal canal, primarily the internal anal sphincter. Evaluation of a new continuous method, recently developed for the urethra, would enable its future application for investigation of rectal reflexes.

Methods: Patients aged 18 and over with fecal incontinence (FI) were included.

Exercise for Solid Organ Transplant Candidates and Recipients: A Joint Position Statement of the Canadian Society of Transplantation and CAN-RESTORE.

Background: The objectives of this position statement were to provide evidence-based and expert-informed recommendations for exercise training in adult and children solid organ transplant (SOT) candidates and recipients and on the outcomes relevant to exercise training and physical function that should be evaluated in SOT.

Methods: We identified randomized controlled trials (RCTs) and systematic reviews of exercise interventions in adult and pediatric SOT candidates and recipients. When RCTs were not available, studies of any design were reviewed.

Methodologic Validation of a Faster Pelvic Floor Test: Two Randomized Studies in Anal Acoustic Reflectometry.

Background: Anal acoustic reflectometry investigates the opening and closing function of the anal canal using reflected sound waves to measure a cross-sectional area at different pressures. Anal acoustic reflectometry is reliable and repeatable, distinguishes between continence and incontinence and between subgroups of incontinence, correlates with symptom severity, and does not distort the anal canal during investigation.

Objective: The purpose of this study was to validate anal acoustic reflectometry methodology by asking 2 questions: can anal acoustic reflectometry be used alongside manometry (order study) and can anal acoustic reflectometry be performed faster (filling study).

The short-term effects of posterior tibial nerve stimulation on anorectal physiology in patients with faecal incontinence: a single centre experience.

Background: Posterior tibial nerve stimulation (PTNS) is a novel treatment for patients with faecal incontinence (FI) and may be effective in selected patients; however, its mechanism of action is unknown. We sought to determine the effects of PTNS on anorectal physiological parameters.

Methods: Fifty patients with FI underwent 30 min of PTNS treatment, weekly for 12 weeks.

Systematic review of surgical interventions for Crohn's anal fistula.

Background: Anal fistula occurs in approximately one in three patients with Crohn's disease and is typically managed through a multimodal approach. The optimal surgical therapy is not yet clear. The aim of this systematic review was to identify and assess the literature on surgical treatments of Crohn's anal fistula.

Developing a core outcome set for fistulising perianal Crohn's disease.

Objective: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD.

Association of Coloproctology of Great Britain and Ireland consensus exercise on surgical management of fistulating perianal Crohn's disease.

Aim: Management of fistulating perianal Crohn's disease (fpCD) is a significant challenge for a colorectal surgeon. A recent survey of surgical practice in this condition showed variation in management approaches. As a result we set out to devise recommendations for practice for UK colorectal surgeons.

A national patient and public colorectal research agenda: integration of consumer perspectives in bowel disease through early consultation.

Aim: There is a recognized need to include the views of patients and the public in prioritizing health research. This study aimed: (i) to explore patients' views on colorectal research; and (ii) to prioritize research topics with patients and the public.

Method: In phase 1, 12 charitable organizations and patient groups with an interest in bowel disease were invited to attend a consultation exercise.

Improving accuracy of clinical coding in surgery: collaboration is key.

Background: Clinical coding data provide the basis for Hospital Episode Statistics and Healthcare Resource Group codes. High accuracy of this information is required for payment by results, allocation of health and research resources, and public health data and planning. We sought to identify the level of accuracy of clinical coding in general surgical admissions across hospitals in the Northwest of England.

Surgical management of fistulating perianal Crohn's disease: a UK survey.

Aim: Around one-third of patients with Crohn's disease are affected by Crohn's fistula-in-ano (pCD). It typically follows a chronic course and patients undergo long-term medical and surgical therapy. We set out to describe current surgical practice in the management of pCD in the UK.

Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy.

Purpose. Surgical site infections (SSIs) remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI.

A quality improvement programme to reduce pressure ulcers.

This article outlines an innovative way of preventing pressure ulcers in the acute hospital setting. A programme using Rapid Spread Methodology was undertaken to reduce hospital-acquired pressure ulcers over a short period of time. Results demonstrated a reduction to zero in the prevalence of hospital-acquired pressure ulcers and an 80% reduction in their incidence, in a six-month period.

Recording pressure ulcer risk assessment and incidence.

This article reports on the introduction of an innovative computer-based system developed to record and report pressure ulcer risk and incidence at an acute NHS trust. The system was introduced to ensure that all patients have an early pressure ulcer risk assessment, which prompts staff to initiate appropriate management if a pressure ulcer is detected, thereby preventing further patient harm. Initial findings suggest that this electronic process has helped to improve the timeliness and accuracy of data on pressure ulcer risk and incidence.

MRSA screening in orthopaedic surgery: clinically valuable and cost effective? A prospective analysis of 8,867 patients.

This study aimed at assessing the prevalence of MRSA colonisation in Trauma and Orthopaedics. Risk factors, decolonisation, and subsequent infection rates were investigated. Cost-analysis of the MRSA screening program was performed.

Beware the syndrome in neonatal hip instability: follow up assessment is required after apparent resolution.

Developmental dysplasia of the hip is one of the most common congenital musculoskeletal disorders of childhood, affecting 1-3% of newborns. An early diagnosis and prompt treatment is essential to avoid complex treatments and achieve improved results. Since 1992, we have undertaken a screening programme for clinical instability and at risk patients.

Generic immunosuppression in solid organ transplantation: a Canadian perspective.

The introduction of generic immunosuppressant medications may present an opportunity for cost savings in solid organ transplantation if equivalent clinical outcomes to the branded counterparts can be achieved. An interprofessional working group of the Canadian Society of Transplantation was established to develop recommendations on the use of generic immunosuppression in solid organ transplant recipients (SOTR) based on a review of the available data. Under current Health Canada licensing requirements, a demonstration of bioequivalence with the branded formulation in healthy volunteers allows for bridging of clinical data.