Scottish Medical Journal最新文献

{"title":"Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis.","authors":"Haiyan Xiong, Linlin Shi","doi":"10.1177/00369330231189887","DOIUrl":"10.1177/00369330231189887","url":null,"abstract":"<p><strong>Background: </strong>There is an ongoing debate if weekend admissions of critically ill patients are associated with higher mortality rates. The current review aimed to specifically assess this effect in sepsis and septic shock patients by comparing mortality rates with weekend versus weekday admissions.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 20th February 2023 with an additional search of Google Scholar for gray literature.</p><p><strong>Results: </strong>Nine studies were eligible. Meta-analysis of all nine studies with data from 1,134,417 patients demonstrated that sepsis or septic shock patients admitted on weekends don't have higher mortality as compared to those admitted on weekdays (OR: 1.04; 95% CI: 1.00, 1.09; p = 0.05; I²= 93%). On subgroup analysis based on sample size (>2000 or <2000 patients) and timing of mortality, we noted no difference in the significance of the results. However, there was a small significant increased risk of mortality with weekend admission noted in studies on the Asian population and including septic shock patients.</p><p><strong>Conclusion: </strong>Weekend admission does not have an adverse impact on mortality rates of sepsis and septic shock patients. Results must be interpreted with caution owing to high interstudy heterogeneity and variation in confounders adjusted by individual studies.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"91-100"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout and patient safety perceptions among surgeons in the United Kingdom during the early phases of the coronavirus disease 2019 pandemic: A two-wave survey.","authors":"Tmam Al-Ghunaim,&nbsp;Judith Johnson,&nbsp;Chandra S Biyani,&nbsp;Marina Yiasemidou,&nbsp;Daryl B O'Connor","doi":"10.1177/00369330231163378","DOIUrl":"https://doi.org/10.1177/00369330231163378","url":null,"abstract":"<p><strong>Background: </strong>Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time.</p><p><strong>Purpose: </strong>The main aim was to examine the relationships between surgeon burnout and surgeons' perceptions of patient safety cross-sectionally and longitudinally. The secondary aim was to test whether surgeons' burnout levels varied over the first six months of the coronavirus disease 2019 pandemic.</p><p><strong>Methods: </strong>This paper reports data from a two-wave survey (first wave from 5 May and 30 June 2020, the second wave 5 January to 30 February 2021). The dataset was divided into a longitudinal group (for surgeons who responded at both the time points) and two cross-sectional groups (for surgeons who responded at a one-time point, but not the other).</p><p><strong>Results: </strong>The first key finding was that burnout was associated with patient safety outcomes measured at the same time point (Group 1 = 108, <i>r =</i> 0.309<i>,</i> <i>p</i> < 0.05 and Group 2 = 84, <i>r = </i>0.238, <i>p</i> < 0.05). Second, burnout predicted poor patients' safety perceptions over time, and poor patient safety predicted burnout over time (Group 3 = 39, <i>p</i> < 0.05). Third, burnout increased between the first and second surveys (<i>t</i> = -4.034, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Burnout in surgeons may have serious implications for patient safety. Interventions to support surgeons should be prioritised, and healthcare organisations, surgeons and psychological specialists should collaborate on their development.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"41-48"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative feedback: A survey of surgical trainees' perspective.","authors":"Mohammed Gadoora Fadelalla,&nbsp;Sabreen Elbakri,&nbsp;Michael Poon","doi":"10.1177/00369330231163375","DOIUrl":"https://doi.org/10.1177/00369330231163375","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative feedback can be associated with improved surgical performance. Quality feedback can reduce the time required by trainees to achieve proficiency in psychomotor skills. Operative training time has become increasingly limited, and it has become imperative to use surgical training time effectively.</p><p><strong>Aim: </strong>In this survey, we assessed trainees' perspectives of intraoperative feedback. We included several aspects of feedback including its occurrence, quality, and potential barriers.</p><p><strong>Methods: </strong>All surgical trainees in a single centre were invited to complete an electronic questionnaire. Participants were anonymised. We summarised data using descriptive statistics.</p><p><strong>Results: </strong>Most trainees (85%) reported they had the opportunity to share their training goals with trainers. Just under three-quarters of trainees felt they always or sometimes got timely feedback. Only half of the trainees were signposted to feedback and 23% felt feedback was not part of their department's culture. Half of the trainees did not always feel comfortable asking for feedback from their trainers stating their reasons as fear of criticism, lack of time and competing clinical commitments.</p><p><strong>Conclusion: </strong>There is no denying the importance of feedback on operative performance, however, this survey shows that many of the pillars of quality feedback are poorly adhered to.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"58-62"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can automated CT body composition analysis predict high-grade Clavien-Dindo complications in patients with RCC undergoing partial and radical nephrectomy?","authors":"Emin Demirel,&nbsp;Okan Dilek","doi":"10.1177/00369330231166122","DOIUrl":"https://doi.org/10.1177/00369330231166122","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the relationship between body tissue composition analysis and complications according to the Clavien-Dindo classification in patients with renal cell carcinoma (RCC) who underwent partial (PN) or radical nephrectomies (RN).</p><p><strong>Methods: </strong>We obtained all data of 210 patients with RCC from the 2019 Kidney and Kidney Tumor Segmentation Challenge (C4KC-KiTS) dataset and obtained radiological images from the cancer image archive. Body composition was assessed with automated artificial intelligence software using the convolutional network segmentation technique from abdominal computed tomography images. We included 125 PN and 63 RN in the study. The relationship between body fat and muscle tissue distribution and complications according to the Clavien-Dindo classification was evaluated between these two groups.</p><p><strong>Results: </strong>Clavien-Dindo 3A and higher (high grade) complications were developed in 9 of 125 patients who underwent PN and 7 of 63 patients who underwent RN. There was no significant difference between all body composition values between patients with and without high-grade complications.</p><p><strong>Conclusion: </strong>This study showed that body muscle-fat tissue distribution did not affect patients with 3A and above complications according to the Clavien-Dindo classification in patients who underwent nephrectomy due to RCC.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"63-67"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABSTRACTS 2022.","authors":"","doi":"10.1177/00369330221164244","DOIUrl":"10.1177/00369330221164244","url":null,"abstract":"S 2022","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"NP14-NP45"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9555978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for a course to complete urological education for consultant practice using a simulated 'boot camp' structure at the end of specialist training: A survey-based study.","authors":"Karl H Pang,&nbsp;Sunjay Jain,&nbsp;Chandra Shekhar Biyani,&nbsp;Stephen R Payne","doi":"10.1177/00369330231163376","DOIUrl":"https://doi.org/10.1177/00369330231163376","url":null,"abstract":"<p><strong>Background and aims: </strong>To obtain opinions from urology trainees and consultants regarding the need for, and structure of, a post-specialty training Urology Simulation Boot Camp (USBC) for consultant practice.</p><p><strong>Methods and results: </strong>A survey-based study was conducted, and 'Google Forms' were distributed electronically via social media. Urology specialist trainees (ST) in years 5-7 (ST5-ST7), post-certification of completion of training (CCT) fellows and ST3 boot camp faculty consultants in practice for ≤5 years and >5 years were included. One hundred and seven responses were received. 97.2% of responders thought a pre-consultant USBC was worthwhile; 55.1% selected the course duration to be 2 days. 47.7% felt that the USBC should be delivered post-exam in ST7. 91.6%, 43.9%, 73.8%, 87.9% and 74.8% considered that modules in emergency operative procedures, novel uro-technologies, delivering multidisciplinary team (MDT) meetings, non-clinical consultant roles and responsibilities, stress and burnout to be important, respectively. 62.6% and 31.8% felt that the course should be wholly or part-funded by Health Education England (HEE).</p><p><strong>Conclusions: </strong>A post-specialty training, pre-consultant, USBC delivered post-exam in ST7, is worthwhile and should include modules on emergency operative procedures, leading MDTs, non-clinical roles and responsibilities and managing stress and burnout in consultant careers. Ideally, it should be fully/part-funded by HEE.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"49-57"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digitalization of healthcare in India: Have we jumped on the campaign yet?","authors":"Anna Javed","doi":"10.1177/00369330231166121","DOIUrl":"https://doi.org/10.1177/00369330231166121","url":null,"abstract":"India is a vast country with a population of 1.4 billion. With billions of lives on the line, access to healthcare and support systems should be the number one priority. Digitalization is a key to implementing decision making in a country of the size of India. Its implementation is expected to improve the overall efficiency, effectiveness, and transparency in Indian Healthcare and encourage the seamless delivery of personalized solutions making healthcare more patient-centric in India. As a result, advanced digital and data-enabled technologies increasingly diffuse the healthcare market, which undergoes a costly and massive digital transformation. According to a report, the Indian hospital industry accounts for 80% of the total healthcare market which is expected to touch US$132 billion by 2023. The digital health concept was first introduced in 2000 by Frank. Digital Health refers to “Integrating information Technology into Health care services and encompasses an array of components.” It uses information and communication technologies to facilitate understanding of health problems and challenges faced by people receiving medical treatment and social prescribing in more personalized and precise ways. The definitions of digital health and its remits overlap in many ways with those of health and medical informatics. Not just modern healthcare, but, in fact, our whole routine life is difficult to imagine without the use of technology. This has been acutely realized during the COVID-19 pandemic recently forcing the entire globe to adopt digital health and health technologies on a large scale.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"39-40"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10155177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scottish Cardiac Society: 31st Annual General Meeting, 16-17 September 2022.","authors":"","doi":"10.1177/00369330231152988","DOIUrl":"https://doi.org/10.1177/00369330231152988","url":null,"abstract":"Introduction: Inherited Long QT syndrome (iLQTS) car-ries a risk of arrhythmic sudden cardiac death (SCD) and accurate diagnosis is important to allow preventative therapy. Clinical assessment is complicated as (i) QTc prolonga-tion may be acquired and (ii) QTc ranges in iLQTS patients overlap with the normal population. Use of a clinical risk score (Schwartz score, SS 1 ) >3.5 is recommended prior to genetic testing. 2 We audited SS of patients undergoing genetic testing for suspected iLQTS in the West of Scotland (WoS). Methods: Caldicott Guardian approval for the audit was granted by NHS GGC. Genetic test samples sent for diagnostic LQTS testing from the WoS between 2013 and 2021 were included. Demographic data were summarised. Test rates were expressed per 1000 population using publicly available estimates of population by health board. In a subgroup of patients from GGC (n = 81), health records were reviewed to determine SS. Receiver operating curves were used for sensitivity analysis. Results: LQTS testing results from 508 patients were included (62% female, mean age 38 years). Test rates per 100,000 population ranged from 7 (D&G) to 26 (GGC). Ninety-two tests (18%) were positive, 34 (7%) identi fi ed a VUS and 382 (75%) were negative. There were no signi fi - cant differences in results by age or gender. VUS result was more frequent with NGS versus Sanger sequencing (20/ 209 vs. 14/299, p < 0.05). Of positive tests, 63% were KCNQ1 (LQT1), 21% KCNH2 (LQT2) and 16% SCN5A (LQT3","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"NP1-NP11"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning, artificial intelligence, and digitalisation of healthcare: Convergence of science and technology.","authors":"Ghulam Nabi","doi":"10.1177/00369330231173302","DOIUrl":"https://doi.org/10.1177/00369330231173302","url":null,"abstract":"In this May, 2023 issue of Scottish Medical Journaloldest medical journal in the British medical journalism, you will come across a number of exciting papers looking at education of trainees, improving training opportunities through creating a culture of training and burnout in medical profession. But an article which has been invited as editorial from India, summarises opportunities and challenges of digitalisation of healthcare in India. Dr Javed provides us a glimpse of issues related to making healthcare universal in India and the way country is grappling with modernising data collection through the use of power of digital technology. Digital technology could push boundaries of learning and education through sharing and co-creation of innovations. Machine learning and artificial intelligence could be built around data mining to transform healthcare universally. Digital technology could unleash its power in decision-making particularly in the allocation of resources where these are required most. Digital inclusion through improvement of literacy should address long-standing issues of healthcare in marginalised groups such as ethnic minority population. One of the major areas of digitalisation of data is imaging. Images of any part of body carry a wealth of information and tell us more than what can be seen by unaided eyes. Digitalisation improves knowledge exchange and innovations. When encountered with a rare case or a rare image (Figure 1), one can immediately connect with colleagues across the globe and learn from experience of others. Accumulation of data can then be used for machine learning through various algorithms and technologies to create new therapeutic models (Figure 2). The delivery and follow-up can be delivered close to patient chosen place without any issues. Similarly, feedback and suggestions following delivery of services can be gathered through use of smart phones and other devices. The convergence of science and technology is taking place around us. This has potential to improve our precision in managing our patients through easy and better characterisation of disease and health. Neural networks (Figure 2) remain key to machine learning in imaging and are certainly a step towards recreating higher functions of brain through use of advanced computers. Just like human brain, neural networks contain multiple layers with input layer receiving data and hidden layers extract imaging features relevant to answer a particular diagnostic/research question. These layers assign a particular classification to the extracted features and provide relevant information to the operators. Training these networks with superior quality data is key to the entire process. Larger the data, better the prediction models. Later cannot be possible without large international collaborations in particularly for rare disease manifestation such as perirenal lymphoma.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"37-38"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9690944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteroscopic biopsy for upper tract urothelial cancers: A valuable double-edged tool in the era of a risk-stratified approach.","authors":"Morgan Rouprêt,&nbsp;Giorgio Calleris","doi":"10.1177/00369330221130763","DOIUrl":"https://doi.org/10.1177/00369330221130763","url":null,"abstract":"A large multicentre retrospective cohort study investigating the impact of a ureteroscopic biopsy (URS-Bx) on urinary bladder recurrences (UBR) rates after radical nephroureterectomy (RNU) is presented by Anbarasan, Nabi and coll. on the current issue of the Scottish Medical Journal, addressing a “ hot topic ” in upper urinary tract urothelial carcinoma (UTUC) management.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 1","pages":"2-3"},"PeriodicalIF":2.7,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9104760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}