Improving Weekend Out Of hours Surgical Handover (WOOSH).

An effective surgical handover is imperative to optimise patient care and safety, whilst ensuring progression of clinical management and the delivery of an efficient service. The introduction of full-shift working, as a response to progressive implementation of the European Working Time Directive (EWTD), has placed the spotlight on patient and doctor safety. Effective handover between shifts is vital to protect patient safety and assist doctors with clinical governance.

Using whole disease modeling to inform resource allocation decisions: economic evaluation of a clinical guideline for colorectal cancer using a single model.

Objective: To assess the feasibility and value of simulating whole disease and treatment pathways within a single model to provide a common economic basis for informing resource allocation decisions.

Methods: A patient-level simulation model was developed with the intention of being capable of evaluating multiple topics within National Institute for Health and Clinical Excellence's colorectal cancer clinical guideline. The model simulates disease and treatment pathways from preclinical disease through to detection, diagnosis, adjuvant/neoadjuvant treatments, follow-up, curative/palliative treatments for metastases, supportive care, and eventual death.

Obstructive uropathy secondary to incisional herniation of a transplant ureter - case report and review of literature.

Background: Herniation of transplant ureter into an incisional hernia is an uncommon and unreported cause of ureteric obstruction, which can lead to transplant dysfunction and diagnostic dilemmas. A report of our case and review of pertinent literature is presented.

Case Report: We report a 61-year-old lady, who presented with transplant dysfunction and hydronephrosis due to obstruction of the transplant ureter in an incisional hernia 8 years post-transplantation.

Support expectations of cancer patients.

Patients' satisfaction is a paramount in the delivery of health care provisions, particularly in patients with poor prognosis. Effective communication with such patients helps in achieving a better satisfaction score. A survey was conducted on upper gastrointestinal cancer patients to assess their perceived satisfaction regarding the healthcare received.

Estimating the direct costs of bowel cancer services provided by the National Health Service in England.

Objectives: Bowel cancer is the second most common cancer in England and Wales, accounting for approximately 13,000 deaths per year. Economic evaluations and national guidance have been produced for individual treatments for bowel cancer. However, it has been suggested that Primary Care Trusts develop program budgeting or equivalent methodology demonstrating a whole system approach to investment and disinvestment.

Cholesterol crystal embolism leading to perforation of the gallbladder.

Background: Cholesterol crystal embolism (CCE) from atherosclerotic arterial disease leading to perforation of the gallbladder is rare. We describe our experience of managing a patient with perforation of gallbladder caused by CCE.

Methods: A 64-year-old man was admitted to this hospital because of acute abdominal pain with clinical features suggestive of peritonitis.