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Watch and wait for Rectal Cancer: A 9 year Experience. 观察和等待直肠癌:一个9年的经验。
Ulster Medical Journal Pub Date : 2022-09-01
C Cosgrove, Raj Spence, L Convie, D Beattie, K McCallion, I McAllister
{"title":"Watch and wait for Rectal Cancer: A 9 year Experience.","authors":"C Cosgrove,&nbsp;Raj Spence,&nbsp;L Convie,&nbsp;D Beattie,&nbsp;K McCallion,&nbsp;I McAllister","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant long course chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. It can reduce tumour bulk, downstage, reduce the risk of local recurrence, and increase the possibility of clear resection margins. The aim of our study is to evaluate all patients over a 9 year period who underwent neoadjuvant chemoradiotherapy for rectal cancer and entered our watch and wait programme.</p><p><strong>Methods: </strong>Data were analysed from a prospective database for all patients diagnosed with rectal cancer over a 9 year period (2011-2019 inclusive).</p><p><strong>Findings: </strong>Over a 9 year period, 532 patients were treated for rectal cancer, with 180 patients receiving long course chemoradiotherapy. 61 (11%) patients entered a watch and programme as they had a complete clinical and radiological response following chemoradiotherapy. Within this programme, 40 patients (65%) remain disease free over the follow-up period (mean 38 months); 12 (20%) patients had regrowth and proceeded to surgery; and 9 (15%) proceeded to palliation due to being unfit for surgery or had distant metastatic disease. Overall (all cause) mortality was 18% during follow-up period in the watch and wait group.</p><p><strong>Conclusions: </strong>Neoadjuvant long course chemoradiotherapy is the standard treatment for locally advanced rectal cancer. 34% of our patient group who received long course chemoradiotherapy entered a watch and wait programme with the majority avoiding major rectal surgery.</p>","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/d6/umj-91-03-130.PMC9720580.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Could the Emergency Department Facilitate the Start of a Holistic Follow-Up Pathway for Patients Recovering from COVID-19? 急诊科能否为COVID-19康复患者提供全面的随访途径?
Ulster Medical Journal Pub Date : 2022-09-01
Patrick Cook, Emma Allde, Flynn Griffith, Reza Khorasanee, Calum Luke, Benjamin Ridley, Thomas Simpson
{"title":"Could the Emergency Department Facilitate the Start of a Holistic Follow-Up Pathway for Patients Recovering from COVID-19?","authors":"Patrick Cook,&nbsp;Emma Allde,&nbsp;Flynn Griffith,&nbsp;Reza Khorasanee,&nbsp;Calum Luke,&nbsp;Benjamin Ridley,&nbsp;Thomas Simpson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>For many patients suffering from COVID-19, Emergency Departments (ED) facilitate the first contact with clinicians. There is a high rate of psychiatric symptoms in COVID-19 survivors, including anxiety, depression, fatigue and sleep disturbance, which persist months after the acute phase.</p><p><strong>Aims: </strong>To investigate if COVID-19 patients discharged from ED have a higher prevalence of mental health symptoms than those admitted.In addition, this study will investigate if discharged ED patients who now require COVID-19 follow-up with the respiratory team had a higher prevalence of mental health symptoms than admitted patients requiring follow-up.</p><p><strong>Methods: </strong>This was a retrospective cohort study (n = 472) with the PHQ2 and GAD-2 scoring systems to quantify current anxiety and depression symptoms via a telephone consultation.</p><p><strong>Results: </strong>The PHQ-2 and GAD-2 scores were significantly higher for discharged ED patients than the admitted patients. There was a higher proportion of females with a positive PHQ2 or GAD-2 score. Of the patients requiring respiratory follow-up, discharged ED patients were more likely to have a positive PHQ-2 or GAD-2 score than those admitted.</p><p><strong>Conclusions: </strong>Clinicians should maintain a low threshold for referring patients with psychiatric complaints post-COVID alongside respiratory symptoms irrespective of admission. It is imperative that available psychological services, crisis lines and other avenues of support post-COVID-19 are signposted to patients before discharge to facilitate earlier intervention.</p>","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/56/umj-91-03-135.PMC9720589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
RESPONSE TIMES FOR ACUTE NON-INVASIVE VENTILATION SET-UPS. 急性无创通气装置的反应时间。
Ulster Medical Journal Pub Date : 2022-09-01
A Watson, H Barnard, A Shanmugarajah, P Antoine-Pitterson, R Mukherjee
{"title":"RESPONSE TIMES FOR ACUTE NON-INVASIVE VENTILATION SET-UPS.","authors":"A Watson,&nbsp;H Barnard,&nbsp;A Shanmugarajah,&nbsp;P Antoine-Pitterson,&nbsp;R Mukherjee","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/c1/umj-91-03-169.PMC9720591.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Straight to test reduces time to investigation and treatment. 直接检测减少了调查和治疗的时间。
Ulster Medical Journal Pub Date : 2022-09-01
R S Wilson, D B Johnston, D McKay, D Mark
{"title":"Straight to test reduces time to investigation and treatment.","authors":"R S Wilson,&nbsp;D B Johnston,&nbsp;D McKay,&nbsp;D Mark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Straight to test (STT) is a recognised pathway for improving the waiting time for red flag referrals. Electronic patient care records (ECR) provide clinicians with a greater volume of clinical information allowing virtual triage and STT. We aimed to assess if using ECR and STT can reduce delays in diagnosis and treatment. A review of 300 colorectal referrals between 2018-2019 was performed. Patients awaiting an appointment were reviewed electronically, by a single colorectal surgeon and re-triaged STT if appropriate. The delay in time from referral to initial review was removed, creating a second group for statistical comparison to demonstrate time saved if the strategy was adopted at the point of original triage. 91.3% (n= 274) were red flag referrals. 94% (n=282) were sent STT. Patients processed via traditional referral and clinic had a median time to scope of 36 days compared with 22.5 days, p < 0.001 if triaged STT via virtual clinic. Median time to management was 59 days for traditional and 35 days for STT, p < 0.001.</p>","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/f5/umj-91-03-139.PMC9720590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pestilence, Plague and Pandemics: A Troubled History. 瘟疫、瘟疫和流行病:一段混乱的历史。
Ulster Medical Journal Pub Date : 2022-09-01
Mwd Wren, D Petts, G Guthrie, S Clarke, B R Nation, L Peters, S Mortlock, I Sturdgess, M Wright, C Burt
{"title":"Pestilence, Plague and Pandemics: A Troubled History.","authors":"Mwd Wren,&nbsp;D Petts,&nbsp;G Guthrie,&nbsp;S Clarke,&nbsp;B R Nation,&nbsp;L Peters,&nbsp;S Mortlock,&nbsp;I Sturdgess,&nbsp;M Wright,&nbsp;C Burt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Humankind has lived with the danger of endemic, epidemic and pandemic disease for thousands of years. The effects of these outbreaks have often devastated human populations. Sixteen pandemic events causing an estimated 147 million deaths have occurred since the eighth century, The Black Death and the influenza pandemic of 1918-1920 probably having the greatest impact. Animal populations, both wild and domestic, have similarly suffered devastating outbreaks of disease which, on occasions, have translated into serious effects on human health. The deliberate or accidental introduction of animals into virgin areas has given rise to unforeseen disease events occasionally leading to extinction. Similarly, human intent or negligence and the vagaries of nature itself has resulted in ill health and loss of life. This paper describes the history of pandemics, epidemics and disasters, and the attempts to bring them under control.</p>","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/b3/umj-91-03-143.PMC9720592.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ulster Medical Society Lecture Programme 2022-2023. 阿尔斯特医学会2022-2023年讲座计划。
Ulster Medical Journal Pub Date : 2022-09-01
Nigel Hart
{"title":"Ulster Medical Society Lecture Programme 2022-2023.","authors":"Nigel Hart","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/de/umj-91-03-123.PMC9720587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HAART, THE HEART AND THE POTENTIAL FOR INTERACTION. 心脏和潜在的相互作用。
Ulster Medical Journal Pub Date : 2022-09-01
Liam Coyle, Niall Herity
{"title":"HAART, THE HEART AND THE POTENTIAL FOR INTERACTION.","authors":"Liam Coyle,&nbsp;Niall Herity","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/9c/umj-91-03-166.PMC9720585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A secular age. 一个世俗的时代。
Ulster Medical Journal Pub Date : 2022-09-01
Michael Trimble
{"title":"A secular age.","authors":"Michael Trimble","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/be/umj-91-03-121.PMC9720586.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Launch of William Whitla's Medical Institute: Concept and Commissioning. 威廉·惠特拉医学研究所的启动:概念和调试。
Ulster Medical Journal Pub Date : 2022-09-01
Alun Evans
{"title":"The Launch of William Whitla's Medical Institute: Concept and Commissioning.","authors":"Alun Evans","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/69/umj-91-03-152.PMC9720578.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
REACTIVE NON-REGIONAL LYMPHADENOPATHY FROM THE COVID-19 mRNA VACCINE: A NOVEL SIDE-EFFECT. COVID-19 mRNA 疫苗引起的反应性非区域性淋巴腺病变：一种新的副作用。
Ulster Medical Journal Pub Date : 2022-09-01 Epub Date: 2022-12-05
Rithvik Gidwani, Salman Siddiqui, Siddhesh Prabhavalkar
{"title":"REACTIVE NON-REGIONAL LYMPHADENOPATHY FROM THE COVID-19 mRNA VACCINE: A NOVEL SIDE-EFFECT.","authors":"Rithvik Gidwani, Salman Siddiqui, Siddhesh Prabhavalkar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/bd/umj-91-03-166a.PMC9720588.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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