Scottish Medical Journal最新文献

{"title":"Scottish Paediatric Society Summer Meeting 2021.","authors":"","doi":"10.1177/00369330211068776","DOIUrl":"10.1177/00369330211068776","url":null,"abstract":"","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"71-74"},"PeriodicalIF":2.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43802260","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":"A clinical trial comparing BiVap (Richard Wolf®) saline vaporization of the prostate vs. Twister^TM Diode Laser System in the treatment of benign prostatic obstruction between prostate volume 90 to 150 ml.","authors":"Ayhan Karakose,&nbsp;Yasin Yitgin","doi":"10.1177/00369330211072262","DOIUrl":"https://doi.org/10.1177/00369330211072262","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the efficacy, safety and postoperative outcomes of the BiVap and Twister systems with benign prostatic obstruction (BPO) in prostate volüm between 90-150 ml.</p><p><strong>Methods: </strong>In total, we included 131 patients treated with BiVap system (n = 68) and Twister system (n = 63). Postoperative complications including urinary tract infection, transient hematuria, severe dysuria and fever >38° C, urinary incontinence and urethral stricture were also noted. All patients were evaluated at the postoperative 1st, 3rd, 6th and 12th month and preoperative and postoperative values of IPSS score, QoL score, total PSA, IIEF 15, PVR, Qmax and Qave were compared.</p><p><strong>Results: </strong>Preoperative demographic characteristics were similar in the 2 groups. There was observed significant improvement for IPSS, Qmax, Qave, PVR, and QoL score by the postoperative first month compared to the preoperative values in both groups. Maximum improvement in the IPSS, Qmax, Qave, QoL score and PVR were achieved at postoperative 6, 3, 12, 3 and 12th months respectively in group 1. In group 2 maximum improvement in the same parameters were achieved at postoperative 6, 3, 6, 6 and 12th months, respectively.</p><p><strong>Conclusions: </strong>BiVap and Twister systems are safe, effective, and useful technique, which can be used in the surgical treatment of BPO between 90-150 ml.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"38-45"},"PeriodicalIF":2.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39652081","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":"Learning from the report of the independent medicines and medical devices safety review: \"first do no harm\".","authors":"Priyanka H Krishnaswamy,&nbsp;Marie-Anne Ledingham,&nbsp;Veenu Tyagi,&nbsp;Karen Lesley Guerrero","doi":"10.1177/00369330211058467","DOIUrl":"https://doi.org/10.1177/00369330211058467","url":null,"abstract":"<p><p>This is a review of the learning points from the Independent Medicines and Medical Devices Safety Review,¹ chaired by Baroness Julia Cumberlege CBE DL. This system-wide review was initiated by the then Secretary of State for Health and Social Care, following patient-led campaigns. It looked at how the \"healthcare system reacted as a whole, and how that response can be made more robust, speedy and appropriate\".We aim to highlight the learning points for doctors in Obstetrics and Gynaecology as these are relevant to our current practice and future changes in our healthcare system. These are: Aims of the review: why it was initiated and how it was conductedOverarching themes and missed opportunities to prevent avoidable harmThree clinical scenarios: their histories, issues and adverse events associated with their use and the current response in Scotland The hormone pregnancy test - PrimodosThe anti-epileptic drug - sodium valproateSurgical mesh for prolapse & incontinenceThe recommendations made by the review and implementation guidanceResponses to the review, such as apologies issued by BSUG²/BAUS³/RCOG,⁴ and compensations schemes such as the Scottish scheme as recommended by the review.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"2-6"},"PeriodicalIF":2.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39795358","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":"Devices and Procedures Regulation in Medical Practice: Is There a Need for More transparency?","authors":"Ghulam Nabi","doi":"10.1177/00369330221080789","DOIUrl":"10.1177/00369330221080789","url":null,"abstract":"","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45570998","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 for Research & Audit Presentation - 12th November 2021.","authors":"","doi":"10.1177/00369330211068775","DOIUrl":"10.1177/00369330211068775","url":null,"abstract":"","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"66-70"},"PeriodicalIF":2.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43654362","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":"Waist circumference, hip circumference, arm span, and waist-to-hip ratio high risk of polycystic ovarian syndrome.","authors":"Tazkia Mawaddatina,&nbsp;Uki Retno Budihastuti,&nbsp;Dwi Rahayu","doi":"10.1177/00369330211043206","DOIUrl":"https://doi.org/10.1177/00369330211043206","url":null,"abstract":"<p><strong>Background and aims: </strong>Polycystic ovarian syndrome is a reproductive problem of women with high prevalence cases accompanied by obesity conditions. Obesity condition can be seen from the size of waist circumference, hip circumference, arm span, and waist-to-hip ratio. This study aims to find out the risk factors between waist circumference size, hip circumference, arm span, and waist-to-hip ratio with polycystic ovarian syndrome.</p><p><strong>Methods: </strong>This research is an analytical observation using a case-control approach conducted at Sekar Fertility Clinic and Poly Obgyn Dr Moewardi General Hospital Surakarta. Subjects were 150 consisting of 75 polycystic ovarian syndrome women and 75 normal fertile women. Sampling techniques used in this study are purposive sampling, researchers doing anthropometric measurements in the form of waist circumference, hip circumference, arm span, and waist-to-hip ratio simultaneously. The results were analyzed using Statistic Product and Service Solution 25.</p><p><strong>Results: </strong>The results of the study obtained waist circumference with polycystic ovarian syndrome (<i>b</i> = 3.002; CI 95% = 3.41-123.5; <i>p</i> = 0.001), hip circumference (<i>b</i> = -2.671; CI 95% = 0.01-0.37; <i>p</i> = 0.002), arm span (<i>b</i> = 5.318; CI 95% = 32.23-129.58; <i>p</i> < 0.001) and waist-to-hip ratio (<i>b</i> = 1.761; CI 95% = 1.02-33.01; <i>p</i> = 0.047).</p><p><strong>Conclusion: </strong>Waist circumference size, hip circumference, arm span, and waist-to-hip ratio correlate to a high risk of polycystic ovarian syndrome. Arm span is more dominant as an indicator of high risk to polycystic ovarian syndrome compared to waist circumference, hip circumference, and waist-to-hip ratio.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"66 4","pages":"186-190"},"PeriodicalIF":2.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39553220","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":"National trends and cost of litigation in UK National Health Service (NHS): a specialty-specific analysis from the past decade.","authors":"Jenni Lane,&nbsp;Rahul Bhome,&nbsp;Bhaskar Somani","doi":"10.1177/00369330211052627","DOIUrl":"https://doi.org/10.1177/00369330211052627","url":null,"abstract":"<p><strong>Background and aims: </strong>Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19.</p><p><strong>Methods: </strong>Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009-2019 (2009/2010 to 2018/2019 financial years).</p><p><strong>Results: </strong>The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010.</p><p><strong>Conclusions: </strong>Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"66 4","pages":"168-174"},"PeriodicalIF":2.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39849685","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":"Relationship between Lp-PLA2 and in-stent restenosis after coronary stenting: a 3-year follow-up study.","authors":"Guohua Sheng,&nbsp;Juan Zhou,&nbsp;Chi Zhang,&nbsp;Caijuan Wu,&nbsp;Kairong Huang,&nbsp;Xiaotong Qin,&nbsp;Jie Wu","doi":"10.1177/00369330211034809","DOIUrl":"https://doi.org/10.1177/00369330211034809","url":null,"abstract":"<p><strong>Background and aims: </strong>Coronary in-stent restenosis (ISR) is an important complication of percutaneous coronary intervention (PCI). However, the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) level and ISR after PCI is rarely reported. This study aims to explore the relationship between Lp-PLA2 and the occurrence of ISR at post-PCI and its predictive value for ISR.</p><p><strong>Methods and results: </strong>Plasma Lp-PLA2 mass were measured in 847 patients planting 1262 stents and evaluated along with known risk indicators. One-year angiographic follow-up showed that baseline elevated Lp-PLA2 mass was strongly associated with early restenosis (95% CI = 1.062-3.050, P < 0.05). Beyond the first year, the occurrence of late restenosis (95% CI = 1.043-3.214, P < 0.05) was significantly larger in the elevated Lp-PLA2 group. Kaplan-Meier analysis after three-year clinical follow up suggested that Lp-PLA2 mass did add the positive effect on the occurrence of major adverse cardiovascular events (MACEs).</p><p><strong>Conclusion: </strong>In conclusion, increased baseline plasma Lp-PLA2 predicts increased risks of re-stenosis and MACEs, which may be a novel biomarker for predicting ISR and MACEs.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"66 4","pages":"178-185"},"PeriodicalIF":2.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00369330211034809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39226540","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":"Editorial - Medical litigation in the 21st century.","authors":"Robyn Webber","doi":"10.1177/00369330211055810","DOIUrl":"https://doi.org/10.1177/00369330211055810","url":null,"abstract":"<p><p>The possibility of a medical negligence claim lies at the back of many doctors' minds. But which specialties see the greatest and fewest claims, and what are the potential costs to the NHS of a successful claim? In their article, Dr Lane et al. analyse 10 years' NHS litigation data, broken down by specialty, number of claims, and the attendant cost of those claims which were successful. Litigation in the 'post Montgomery' era is considered along with some of the common factors which may lead to a patient or their family taking legal action.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"66 4","pages":"166-167"},"PeriodicalIF":2.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39849686","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":"Medicolegal issues in healthcare: Corporatisation of healthcare.","authors":"Ghuam Nabi","doi":"10.1177/00369330211058808","DOIUrl":"https://doi.org/10.1177/00369330211058808","url":null,"abstract":"A career in Medicine is often rewarding and profession is regarded as one of the noble professions. In a professional relationship between patient and doctor, due care is rendered based on principles of sincerity, trust and mutual understanding that outcome may not be predictable in certain circumstances and things can and will go wrong. however, axiom such as “you learn from your mistakes” is not considered as learning opportunity anymore and law is brought in by the patients to decide level of negligence by the doctors, in cases where perceived errors are witnessed. The judges with no knowledge of medical science decide degree of negligence and compensation based on medical expert opinions. In Cambridge dictionary, negligence is defined as “the fact of not giving enough care or attention to someone or something”. The parameters to categorise degree of negligence are often subjective and varied between; lata culpa, gross neglect; levis culpa’ ordinary neglect and levissima culpa, slight neglect (1). The decision on the level of negligence is further dependant on the context, circumstances of individuals and systems. In a medical error, it is often assumed that things have gone wrong and somebody needs to be punished and medical practitioners are often held responsible without observing any cautions that matters are invariably complex. The decisions to pursue cases of medicolegal negligence are often based on notions that what the best practice should have been rather than exhibiting deeper understanding of real-life practices. No distinction is made between a case of occupational negligence and professional negligence. A case of negligence should not be made on the basis that better alternatives or more skilled approach was likely to adopted in a case than the one under consideration. Rather Bolam test should be applied to the matters of negligence (2). The Bolam test is “The test is the standard of the ordinary skilled man exercising and professing to have that special skill” A practitioner is not negligent as long as he has acted in accordance with practice approved by a body of other responsible doctors. There is a less recognised side effect of negligence cases pursued by litigants against doctors. The impact of “fear of failure” by medical practitioners on society need to be realised and this may be counterproductive with potential for more harm than good. A dangling fear in the mind of surgeon of failure and subsequent prosecution would prevent him from acting in the best interest of patient. Similarly, a seriously sick patient with 10% chances of survival may not get resuscitated as failure to achieve a satisfactory outcome may land a medical practitioner into a court case and the fear may prevent him from acting in the best interest of patient. In contrast to spending resources on pursuing matters of perceived negligence by society, we should be spending on prevention. Use of apology, clinical guidelines and proper documentation are some","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"66 4","pages":"165"},"PeriodicalIF":2.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39849692","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}