MedWorm: Royal College of Surgeons

Identifying co-morbidity in surgical patients using administrative data with the Royal College of Surgeons Charlson Score

British Journal of Surgery — Fri, 19 Mar 2010 00:00:00 +0100

Surgical outcomes are influenced by co-morbidity. The Royal College of Surgeons (RCS) Co-morbidity Consensus Group was convened to improve existing instruments that identify co-morbidity in International Classification of Diseases tenth revision administrative data.The RCS Charlson Score was developed using a coding philosophy that enhances international transferability and avoids misclassifying complications as co-morbidity. The score was validated in English Hospital Episode Statistics data for abdominal aortic aneurysm (AAA) repair, aortic valve replacement, total hip replacement and transurethral prostate resection.With exception of AAA, patients with co-morbidity were older and more likely to be admitted as an emergency than those without. All patients with co-morbidity stayed longer ...

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Bursaries

Wed, 17 Mar 2010 15:48:00 +0100

for undergraduate elective or vacation studies 2010. The Royal College of Surgeons of Edinburgh is offering a number of bursaries to undergraduate students of medicine or dentistry to enable them to work for elective or vacation periods in universities, medical schools, NHS laboratories or research institutes in the United Kingdom. Proposals for work on research projects in any branch of surgery are eligible for consideration. The bursary will be up to £150 per week for a maximum of 8 weeks. Up to £300 is also available for consumables. Comments: The closing date for applications is 31st March 2010. Applications must be submitted on the official Royal College of Surgeons of Edinburgh application form. An electronic version of Part A must be sent to the Awards and Grants Secretary, ...

Synergistic interaction between trastuzumab and EGFR/HER-2 tyrosine kinase inhibitors in HER-2 positive breast cancer cells

Investigational New Drugs — Mon, 15 Mar 2010 05:32:53 +0100

Summary Overexpression of HER-2 in breast cancer is frequently associated with expression of EGFR, and EGFR expression influences response to HER-2 inhibition. The aim of this study was to examine the effects of combining dual inhibition of EGFR and HER-2, using trastuzumab, gefitinib and lapatinib, in HER-2 overexpressing breast cancer cells. Combination proliferation assays were performed in two HER-2 positive breast cancer cell lines, SKBR-3 and BT-474. Trastuzumab combined with lapatinib was also tested in BT-474 xenografts. In proliferation assays, dual targeting with trastuzumab and gefitinib or lapatinib showed synergy or additivity in both SKBR-3 and BT-474 cells. Trastuzumab (10 nM) or gefitinib (5 µM) alone did not induce significant apoptosis, whereas lapatinib...

Understanding of intra operative tourniquetsamongst orthopaedic surgeons and theatre staff a questionnaire study.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS Most surgeons are taught how to use pneumatic tourniquets by their senior colleagues as no formal teaching is given. Most of the complications are infrequent and preventable. However their consequences can be devastating to the patient with medico legal implications. Our results show suboptimal knowledge of tourniquets and their use among SpRs and ODAs. This study highlights the need for amendments in training to improve the knowledge and awareness of medical practitioners on the application and use of tourniquets to prevent adverse events and improve patient safety. PMID: 20223078 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

Prospective evaluation of a selective approach to cholangiography for suspected common bile duct stones.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS A selective policy for intra operative cholangiography yields acceptably high positive results. Pre operatively asymptomatic bile duct stones rarely present following LC; thus routine imaging of the biliary tree for occult calculi can safely be avoided. Therefore a rationing approach to the use of intra operative imaging based on the pre operative indicators presented in this paper successfully identifies those patients with bile duct stones requiring exploration. Laparoscopic bile duct exploration performed by an experienced laparoscopic surgeon is a safe and effective method of clearing the bile duct of calculi with minimal complications avoiding the necessity for an additional intervention and prolonged hospital stay. PMID: 20223077 [PubMed - as supplied by publisher] (S...

The use and abuse of abbreviations in orthopaedic literature.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS Guidelines regarding the use of abbreviations are not being adhered to by authors or editors. The poor understanding of abbreviations underlines the importance of minimising their use and defining abbreviations when they are used. PMID: 20223075 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

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Optimal surgical technique, use of intra-operativecholangiography and management of acute gallbladder disease: the results of a nationwide survey in the UK and Ireland.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS A wide dissection of Calot's triangle to provide a critical view of safety is the technique most commonly recommended by AUGIS surgeons (83 percent) to minimise risk of bile duct injury, in contrast to 24 percent that recommend routine IOC. The majority (88 percent) of AUGIS surgeons advise index admission cholecystectomy for acute gallbladder disease. PMID: 20223074 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

Immediate breast reconstruction after mastectomy: what are the long-term prospects?

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS Long term, large studies of immediate reconstruction are required to assess adequately the impact of type of reconstruction on re operation rates. The National Mastectomy and Breast Reconstruction Audit is ideally placed to provide answers to remaining questions about longevity of immediate breast reconstruction and the effect that late failure has on patient satisfaction. PMID: 20223055 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

Temporal trends in primary total hip and knee arthroplasty :surgery results from a UK regional joint register 1991 to 2004.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS The prevalence of primary TKR increased significantly over time whereas THR remained steady in the Trent region between 1991 and 2004. PMID: 20223054 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

Legal implications of tissue.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

Authors: Lucassen A, Wheeler R This paper reviews the legal rules that govern the way surgeons deal with human tissues during the course of diagnosing and treating their patients. The topic is dominated by the Human Tissue Act 2004 which was enacted in September 2006 thus the article applies specifically only to England Wales and Northern Ireland since Scotland has separate legislation [Human Tissue [Scotland] Act 2006]. Although the Human Tissue Act 2004 was built largely upon a plethora of legal principles that were developed throughout the Commonwealth and in the US some of the principles underlying it will be equally familiar and applicable to surgeons across the world. Much everyday clinical activity falls outside the remit of the Act and depends both upon other statutes and on co...

Evaluation of the introduction of a standardised protocol for the staging and follow up of colorectal cancer on resection rates for liver metastases.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS Introduction of a referral protocol standardised resection rates from the four district hospitals, but these remain lower compared to the specialist centre. The wide spread adoption of a policy to discuss all patients with liver metastases at an advanced disease multidisciplinary team meeting, in the presence of hepatobiliary specialists, may further increase resection rates across the UK. PMID: 20223052 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

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Treating the boxer's fracture in Wales a postal survey.

Annals of the Royal College of Surgeons of England — Wed, 10 Mar 2010 00:00:00 +0100

CONCLUSIONS The treatment being offered for this common fracture in Wales is inconsistent. There is a need to develop evidence based best practice guidelines which should standardise the treatment of this common injury. Perhaps, a large multicentre outcome study may enable this to be drawn up in the future. PMID: 20223051 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)

A novel collagen scaffold supports human osteogenesis—applications for bone tissue engineering

Cell and Tissue Research — Wed, 03 Mar 2010 08:50:45 +0100

Abstract Collagen glycosaminoglycan (CG) scaffolds have been clinically approved as an application for skin regeneration. The goal of this study has been to examine whether a CG scaffold is a suitable biomaterial for generating human bone tissue. Specifically, we have asked the following questions: (1) can the scaffold support human osteoblast growth and differentiation and (2) how might recombinant human transforming growth factor-beta (TGF-β1) enhance long-term in vitro bone formation? We show human osteoblast attachment, infiltration and uniform distribution throughout the construct, reaching the centre within 14 days of seeding. We have identified the fully differentiated osteoblast phenotype categorised by the temporal expression of alkaline phosphatase, collagen...

An audit of intra-oral digital radiographs for endodontics

International Endodontic Journal — Tue, 02 Mar 2010 00:00:00 +0100

Conclusions This study was carried out in order to minimise the ionising radiation dose to patients and to maximise the clinical and administrative benefits of using a digital system. It demonstrated an improvement in the quality of radiographs across all criteria measured up to and beyond the desired standard, from 55% of radiographs scoring excellent in the first phase to 80% in the third phase. As a result of the study it was decided to install the Schick CDR system because of the speed it produced images even though the first phase of this study demonstrated inferior image quality. The audit had clear, measurable standards with explicit targets. The audits have been through the entire audit cycle, data collection, change and a further data collection to provide evidence of the benefit ...

Validating population-based registers for ALS: how accurate is death certification?

Journal of Neurology — Fri, 12 Feb 2010 07:08:14 +0100

Abstract The purpose of this study was to determine the accuracy of death certification for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) as recorded by the Central Statistics Office in the Republic of Ireland, and to examine its utility in capture-recapture analysis. The database of the Irish Central Statistics Office (CSO) was searched for death certificates of individuals over 15 years of age for whom ALS/MND (ICD9) was listed as a primary, secondary or tertiary cause of death from 2002 to 2006. This dataset was compared with mortality data from the Irish Register for ALS/MND for the same period. Three hundred ninety-eight cases with a diagnosis of ALS were identified through the CSO. The cause of death as identified by the CSO was 318 out of 398 (...

Anaesthesia for the bleeding tonsil.

British Journal of Hospital Medicine — Wed, 10 Feb 2010 00:00:00 +0100

Authors: Pushpanathan E, Sultan N, Sultan P Tonsillectomy is a common procedure, with over 50 000 operations performed annually in the UK (Royal College of Surgeons of England, 2005). Just over half of these patients are under 15 years of age. Postoperative complications of a tonsillectomy include dysphagia, nausea and vomiting, pain, infection and bleeding. PMID: 20220706 [PubMed - as supplied by publisher] (Source: British Journal of Hospital Medicine)

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"Would you have ever thought such a thing possible?" Alexander Fleming and FRS

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 14:42:37 +0100

Today Alexander Fleming is famous for the discovery of penicillin, but Kevin Brown, curator of the Alexander Fleming Laboratory Museum, exposes the professional rivalries that threatened the career of one of the greatest medical microbiologists of all time. Organised as part of the 350th anniversary of the "Royal Society":http://seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Wed, 12 May 2010 13:00:00 +0100 End date: Wed, 12 May 2010 14:00:00 +0100 (Source: Nature Network London - Upcoming Events)

Blood under the microscope: William Hewson, an 18th-century anatomist

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 14:24:55 +0100

Join Tania Kausmally, historian and archaeologist, as she lays bare the history of the 18th-century anatomist and microscopist William Hewson, the father of modern haematology. Organised as part of the 350th anniversary of the "Royal Society":http://seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Tue, 20 Apr 2010 13:00:00 +0100 End date: Tue, 20 Apr 2010 14:00:00 +0100 (Source: Nature Network London - Upcoming Events)

Keeping it in the family: the Dollonds and microscopy

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 14:14:12 +0100

As their name disappears from the British high street forever, Neil Handley uncovers the remarkable history of the Dollond family of opticians and their contributions to the science of microscopy. Organised as part of the 350th anniversary of the "Royal Society":http://seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Thu, 25 Mar 2010 13:00:00 +0000 End date: Thu, 25 Mar 2010 14:00:00 +0000 (Source: Nature Network London - Upcoming Events)

Microscopes: a key role in transplant surgery

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 12:49:39 +0100

In the last 40 years microscopy has been crucial to advances in surgery that has transformed our ability to treat disease. Sir Peter Morris, Nuffield Professor of Surgery Emeritus at the University of Oxford, draws on his own experience to explore the role of the microscope in transplant surgery. Organised as part of the 350th anniversary of the "Royal Society":http://seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Tue, 11 May 2010 19:00:00 +0100 End date: Tue, 11 May 2010 20:30:00 +0100 (Source: Nature Network London - Upcoming Events)

Joseph Lister, surgeon and microscopist

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 11:57:18 +0100

Emeritus Professor of Surgery and medical historian Professor Harold Ellis charts the story of Joseph Lister FRS, who followed in the footsteps of his father, a wine merchant and amateur microscopist, to develop the skills that led to a new understanding of wound infection and to the introduction of antiseptic surgery. Treasures from the Royal College of Surgeons archive and rare book collection will be on show in the Library prior to the event. Organised as part of the 350th anniversary of the "Royal Society":http://www.seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Wed, 28 Apr 2010 19:00:00 +0100 End date: Wed, 28 Apr 2010 20:30:00 +0100 (Source: Nature Network London - Upcoming Events)

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Robert Hooke, Micrographia and experimental physiology in the early Royal Society

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 11:37:29 +0100

Noted historian Dr Allan Chapman, brings to life the work of one of the Royal Society’s great figures, Robert Hooke and explores his ground breaking investigations into plant and animal physiology that were detailed in his famous work Micrographia. The book will be on display in the Library prior to the lecture, together with other rare material related to the history of microscopy from the Royal College of Surgeons archives and rare book collections. Organised as part of the 350th anniversary of the "Royal Society":http://seefurther.org Venue: Hunterian Museum at the Royal College of Surgeons Start date: Wed, 10 Mar 2010 19:00:00 +0000 End date: Wed, 10 Mar 2010 20:30:00 +0000 (Source: Nature Network London - Upcoming Events)

Curious: the craft of microscopy

Nature Network London - Upcoming Events — Mon, 08 Feb 2010 11:20:24 +0100

Several years ago artist Susanna Edwards happened upon a collection of Victorian microscope slides in a second-hand shop. Intrigued by the creativity and dexterity involved in making these delicate objects, she began to research the history of microscopy. Her exhibition explores microscopy as craft and technology, art and science. Through stunning photography, her exhibition reveals the way in which developments in microscopy have changed the way we see the world. Supported by the Royal Microscopical Society, the Arts Council, London and the Calouste Gulbenkian Foundation. Venue: Hunterian Museum at the Royal College of Surgeons Start date: Tue, 16 Feb 2010 10:00:00 +0000 End date: Sat, 03 Jul 2010 17:00:00 +0100 (Source: Nature Network London - Upcoming Events)

College seeks 'vetting passports'

BMA daily feed — Mon, 25 Jan 2010 16:48:16 +0100

Royal College of Surgeons echoes BMA calls (Source: BMA daily feed)

New Blood Screening Test For Colon Cancer

About.com Colon Cancer — Mon, 25 Jan 2010 11:28:09 +0100

Researchers from the Royal College of Surgeons in Ireland have discovered a pattern of antibodies present in the blood of individuals with colon cancer. This pattern is not found in the blood of most people who do not have the disease. Antibodies are proteins produced by a type of immune system cell called a B-cell. "Antibody Signature" For Colon Cancer As published in the new study, the authors describe a "12-antibody signature" that can identify patients with and without colorectal cancer with 83.7% sensitivity and 80% specificity. Sensitivity is the ability of a test to correctly identify those with a disease, as actually having the disease. Specificity is the ability of a test to correctly identify people without the disease as not having the disease. The "antibody signature" test co...

CT Network Comments On NHS Access To Weight-Loss Surgery

Health News from Medical News Today — Fri, 22 Jan 2010 18:00:00 +0100

David Stout, director of the NHS Confederation's PCT Network, comments on claims by the Royal College of Surgeons that patients are not being given appropriate access to weight-loss surgery on the NHS. "All PCTs are working with local NHS services to deal with the increasing rates of obesity in England and have arrangements in place to treat those patients who will require surgery... (Source: Health News from Medical News Today)

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CT Network Comments On NHS Access To Weight-Loss Surgery

Obesity / Weight Loss / Fitness News From Medical News Today — Fri, 22 Jan 2010 18:00:00 +0100

NHS obesity operation access inconsistent, surgeons say (BBC News Online, 21 January 2010)

Society for Endocrinology — Fri, 22 Jan 2010 12:00:00 +0100

The Royal College of Surgeons has expressed concerns that the NHS is failing to meet NICE guidelines when referring obese patients for gastric-band surgery.Full article (Source: Society for Endocrinology)

Obese patients being made to eat MORE to get weight-loss surgery on the NHS

the Mail online | Health — Thu, 21 Jan 2010 13:36:55 +0100

The Royal College of Surgeons said lack of NHS funding meant some patients who already qualify for operations are being forced to wait until they are more obese. (Source: the Mail online | Health)

NHS 'inconsistent' on obesity ops

BBC News | Health | UK Edition — Thu, 21 Jan 2010 01:56:45 +0100

Access to weight loss operations on the NHS is "inconsistent and unethical", the Royal College of Surgeons says. (Source: BBC News | Health | UK Edition)

Thursday 21 January

Royal College of Nursing News Alert — Thu, 21 Jan 2010 00:00:00 +0100

Hospitals 'encourage the overweight to eat more to get operation': Patients requiring life-saving weight loss surgery are being refused treatment because of "inconsistent and unethical" hospital policies, according to the Royal College of Surgeons. Bariatric surgeons have warned that some patients are being forced to wait until they become more obese or until they develop life-threatening illnesses such as diabetes or stroke before they are deemed eligible for surgery. (Source: Royal College of Nursing News Alert)

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Too Many Private Hospitals Failing Patients When It Comes To Weight Loss Surgery, Warns Leading Surgeon, UK

Health News from Medical News Today — Wed, 20 Jan 2010 08:00:00 +0100

One of the UK's leading bariatric surgeons has expressed serious concern about the extremely poor levels of aftercare being provided to many weight loss surgery patients by private hospitals who offer 'cut-price' surgery both here and abroad. Consultant laparoscopic and bariatric* surgeon David Kerrigan, the Royal College of Surgeons' representative who advised the government on the NICE obesity guidelines in use today, said the lack of follow up care provided by some hospitals was 'shocking' and could put patients' lives at risk... (Source: Health News from Medical News Today)

Curious: the craft of microscopy An exhibition by Susanna Edwards

Nature Network London - Upcoming Events — Tue, 19 Jan 2010 20:25:31 +0100

Six years ago artist Susanna Edwards happened upon a collection of Victorian microscopic slides in a second-hand shop. Intrigued by the creativity and dexterity involved in making these delicate objects, she began to research the history of microscopy. Her exhibition traces her project, exploring microscopy as craft and technology, art and science. Through stunning photography, her exhibition reveals the way in which developments in microscopy have changed the way we see the world. Supported by the Royal Microscopical Society, the Arts Council, London, and the Calouste Gulbenkian Foundation. Venue: Hunterian Museum at the Royal College of Surgeons Start date: Tue, 16 Feb 2010 10:00:00 +0000 End date: Sat, 03 Jul 2010 17:00:00 +0100 (Source: Nature Network London - Upcoming Events)

UCSF Pediatric Surgeon to be Inducted into Royal College of Surgeons

UCSF Medical Center — Tue, 12 Jan 2010 00:00:00 +0100

UCSF Children's Hospital Surgeon-in-Chief Dr. Diana Farmer will be inducted as a fellow into the Royal College of Surgeons of England (RCSE) on Jan. 20, 2010 — becoming only the second U.S. female surgeon to be bestowed this prestigious honor. (Source: UCSF Medical Center)

A simple aid to wire localisation procedure in breast surgery: 'covering the hook-wire with a needle'.