Evaluating the SAFE Tool's Impact on Documentation and Patient Safety During Structured Ward Rounds in General Surgery: A Retrospective Study.

Aim  Effective documentation of critical clinical information is vital for patient safety and timely discharges. Ward rounds (WRs) are crucial for multidisciplinary assessments and care planning. Current emergency surgical WR documentation is inconsistent; therefore, this study will implement a structured WR template adapted from the Royal College of Surgeons of Edinburgh's "Surgical Assessment for Emergencies Ward Round Tool" (SAFE) to address these shortcomings.

Harnessing Artificial Intelligence (AI) in Anaesthesiology: Enhancing Patient Outcomes and Clinical Efficiency.

The rapid rise and potential of artificial intelligence (AI) have created growing excitement and much debate on its potential to bring transformative changes across entire industries, including the medical industry. This systematic review aims to investigate the advancements in the AI industry and its potential implementation, specifically in the field of anaesthesiology. AI has already been integrated into different areas of medicine, including diagnostic uses in radiology and pathology and therapeutic and interventional uses in cardiology and surgery.

Paclitaxel- or sirolimus-coated balloons used for ArterioVEnous fistulas-2 (PAVE-2): study protocol for a randomised controlled trial to determine the efficacy of paclitaxel- or sirolimus-coated balloons in arteriovenous fistulas used for haemodialysis.

Background: In view of the conflicting results from previous studies, the benefit of paclitaxel-coated balloons for arteriovenous fistulas is uncertain and equipoise remains. Although an industry-led trial testing the efficacy of sirolimus-coated balloons in AVFs is in progress, the benefit of sirolimus-coated balloons for arteriovenous fistulas is currently unknown. The purpose of this trial is to compare the efficacy of additional paclitaxel-coated or sirolimus-coated balloons on outcomes after a plain balloon fistuloplasty to preserve the patency of arteriovenous fistulae used for haemodialysis.

Sternal haematoma infusion catheter: a novel technique for pain management in manubriosternal fractures in the emergency department.

Sternal fractures are associated with significant morbidity and mortality, with some patients requiring admission for pain management, often through systemic analgesia, which may be ineffective. Regional anaesthetic techniques are more challenging for sternal fractures than rib fractures and require experienced clinicians. Local anaesthetic techniques are becoming recognised as a modality to improve pain control and to reduce complications from opioid use, especially in the elderly.

Sparing piriformis and internus repairing externus vs. other conventional approaches for hip hemiarthroplasty: A report of early outcomes from a single UK trauma unit.

Purpose: Over 30,000 hip hemiarthroplasties for neck of femur fractures are performed annually in the United Kingdom (UK). The national recommendation is via the lateral approach, to reduce the risk of dislocation, with the potential expense of reduced function and mobility post-operatively. Muscle-sparing approaches, such as SPAIRE (sparing piriformis and internus repairing externus), have been invented to address the issue of dislocation.

Efficacy and tolerability of monoamine oxidase inhibitors for the treatment of depressive episodes in mood disorders: A systematic review and network meta-analysis.

Background: Monoamine oxidase inhibitors (MAOIs) are considered third-line treatments for treatment resistant depression; however, they are underused in clinical practice.

Aims: This study aimed to assess the efficacy, tolerability, and acceptability of MAOIs for the treatment of depression in comparison with other antidepressant treatments.

Methods: A systematic review and network meta-analysis of randomised clinical trials was performed to compare the efficacy, tolerability and acceptability between MAOIs and other antidepressant treatments for the treatment of depressive episodes.

Timing of radiotherapy (RT) after radical prostatectomy (RP): long-term outcomes in the RADICALS-RT trial (NCT00541047).

Background: The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for prostate-specific antigen (PSA) failure.

Patients And Methods: RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, preoperative PSA≥10 ng/ml) for recurrence after radical prostatectomy.

Beyond high-risk: analysis of the outcomes of extreme-risk patients in the National Emergency Laparotomy Audit.

Patients who require emergency laparotomy are defined as high risk if their 30-day predicted risk of mortality is ≥ 5%. Despite a large difference in the characteristics of patients with a mortality risk score of between 5% and 50%, these outcomes are aggregated by the National Emergency Laparotomy Audit (NELA). Our aim was to describe the outcomes of the cohort of patients at extreme risk of death, which we defined as having a NELA-predicted 30-day mortality of ≥ 50%.

Cemented uncemented stems for revision total hip replacement: A systematic review and meta-analysis.

Background: The popularity of uncemented stems in revision total hip arthroplasty (THA) has increased in the last decade.

Aim: To assess the outcomes of both cemented and uncemented stems after mid-term follow up.

Methods: This study was performed following both the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement and the Cochrane Handbook for systematic reviews and meta-analysis guidelines.

Slipped Upper Femoral Epiphysis in Adolescents: Evolving Information on Its Mode of Presentation and Management.

Background and objective Slipped upper femoral epiphysis (SUFE) is one of the most common hip pathologies in adolescents and pre-adolescents, the diagnosis of which is often missed due to delayed presentations. In this study, we aimed to conduct a retrospective analysis of SUFE cases treated in the hospital during the 15-year period from 2003 to 2018 and examine its bilateral presentation and the need for prophylactic pinning on the unaffected side. Methods This retrospective cohort study involved cases that were treated from 2003 to 2018.

Automated analysis of intraoperative phase in laparoscopic cholecystectomy: A comparison of one attending surgeon and their residents.

Objective: This study compares the intraoperative phase times in laparoscopic cholecystectomy performed by an attending surgeon and supervised residents over 10-years to assess operative times as a marker of performance and any impact of case severity on times.

Design: Laparoscopic cholecystectomy videos were uploaded to Touch Surgery™ Enterprise, a combined software and hardware solution for securely recording, storing, and analysing surgical videos, which provide analytics of intraoperative phase times. Case severity and visualisation of the critical view of safety (CVS) were manually assessed using modified 10-point intraoperative gallbladder scoring system (mG10) and CVS scores, respectively.

Randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery following open globe trauma: The ASCOT study.

Background/aims: To investigate the clinical effectiveness of adjunctive triamcinolone acetonide (TA) given at the time of vitreoretinal surgery following open globe trauma (OGT).

Methods: A phase 3, multicentre, double-masked randomised controlled trial of patients undergoing vitrectomy following OGT comparing adjunctive TA (intravitreal and subtenons) against standard care (2014-2020). The primary outcome was the proportion of patients with at least 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letter improvement in corrected visual acuity (VA) at 6 months.

Is dementia more likely following traumatic brain injury? A systematic review.

Background: The association between traumatic brain injury (TBI) and dementia is controversial, and of growing importance considering the ageing demography of TBI.

Objective: To review the scope and quality of the existing literature investigating the relationship between TBI and dementia.

Methods: We conducted a systematic review following PRISMA guidelines.

SARS-CoV-2 vaccination and new-onset myasthenia gravis: A report of 7 cases and review of the literature.

Myasthenia gravis (MG) is an antibody-mediated immune disorder of the neuromuscular junction. SARS-CoV-2 is now recognised as a trigger factor for autoimmune diseases and to cause immune-mediated dysregulation, likely due to molecular mimicry induced by viral antigens. SARS-CoV-2 vaccination, similarly, results in exposure to viral antigen.

Validation of a post operative complication risk prediction algorithm in a non-head and neck squamous cell carcinoma cohort.

Risk-adjusted algorithms in surgical audit attempt to adjust for patient case mix and complexity in order that published outcomes fairly reflect surgical performance and quality of care. Such risk-adjustment models have applied to head and neck squamous cell carcinoma (HNSCC). We test one algorithm, currently embedded in the oncology and reconstruction dataset within the Quality and Outcomes in Oral and Maxillofacial (QOMS) Audit, which is an artificial neural network, for its predictive accuracy on a surgical cohort receiving curative surgery for non-HNSCC pathology.

Cochlear implant eligibility in an adult hearing aid population: a multi-perspective service evaluation of a patient referral pathway at a British district general hospital.

Objectives: To quantify patient eligibility for cochlear implantation following National Institute for Health and Care Excellence 2019 guidelines (TA566) over five years at our institution, and identify factors influencing patients' decisions surrounding cochlear implantation referral.

Methods: A multi-perspective service evaluation was conducted at a district general hospital, comprising cochlear implantation eligible patients. The main outcome measures were: eligibility numbers for 2014-2019, comparing application of TA566 versus 2009 (TA166) guidelines; and patient interview transcripts and questionnaires.

Social and Educational Outcomes in Patients With Biliary Atresia: A Systematic Review.

Objectives: To systematically review the social outcomes of patients with biliary atresia (BA), including educational, employment and family outcomes.

Methods: We conducted a systematic review of Medline, EMBASE, Global Health, Maternity and Infant Care Database, supplemented by reference searching. National Heart, Lung and Blood Institute scoring was conducted for quality assessment.

Peer training in surgery: The SSuRF model approach.

Surgical training traditionally has been afforded an apprenticeship model of learning but has since strived to become a structured programme of learning events and progress. Peer led training in an undergraduate course is increasingly utilised but its role in postgraduate/speciality training is not widely published. This paper reviews the historical roots of surgical training and current educational theories which underpin the proposal of a new tool, the SSuRF approach, an innovate aide memoire to assist peer led technical/operative surgical training with the hope that this approach will allow peers, especially those who do not have much formal educational training, to teach those junior using a structured format and document this within their workplace based assessment.

Thirty-day mortality and reliability of Nottingham Hip Fracture Score in patients with COVID19 infection.

Unlabelled: In March 2020 Coronavisus-19 pandemic led to significant changes in operations in healthcare in the United Kingdom with national lockdown measures imposed to help protect the vulnerable and prevent transmission. Those deemed vulnerable fall into the cohort of patients at risk of fragility fractures such as fracture neck of femur (NOF). British Orthopaedic Association released guidelines advising that NOF fractures should continue to be treated urgently.

Should eloquence be taught as part of the undergraduate medical curriculum?

This article was migrated. The article was marked as recommended. The integration of the humanities into the medical curriculum over the past two decades has been widely adopted in the stream of communication usually within the realms of doctor-patient relationship.

Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction.

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction.

The COVID-19 Pandemic: Disproportionate Thrombotic Tendency and Management Recommendations.

COVID-19 is an infectious disease caused by the SARS COV-2 virus. Patients with COVID-19 are susceptible to thrombosis due to excessive inflammation, platelet activation, endothelial dysfunction, and circulatory stasis, resulting in an increased risk of death due to associated coagulopathies. In addition, many patients receiving antithrombotic therapy for pre-existing thrombotic diseases can develop COVID-19, which can further complicate dose adjustment, choice and laboratory monitoring of antithrombotic treatment.

Concordance between a neuroradiologist, a consultant radiologist and trained reporting radiographers interpreting MRI head examinations: An empirical study.

Introduction: This study assessed agreement between MRI reporting radiographers and a consultant radiologist compared with an index neuroradiologist when reporting MRI head (brain/internal auditory meati [IAMs]) examinations. The effect on patient management of any discordant reports was also examined.

Methods: Two trained MRI reporting radiographers (RRs), a consultant radiologist (CR) and an index neuroradiologist (INR) reported on a random sample of 210 MRI examinations.

A safe and comparable alternative to BIPP packing following tympanoplasty for tympanic membrane perforation.

Purpose: To compare two post-operative ear packing methods following tympanoplasty for tympanic membrane perforation.

Methods: A prospective study of patients undergoing tympanoplasty for tympanic membrane perforation over a 2-year period was undertaken across two district general hospitals. Data, including demographics, pre-operative ear state, and graft type used for repair were recorded.