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Curtis F, Li L, Kolanko M, Lai H, Daniels S, True J, Del Giovane M, Golemme M, Lyall R, Raza S, Hassim N, Patel A, Beal E, Walsh C, Purnell M, Whitethread N, Nilforooshan R, Norman C, Wingfield D, Barnaghi P, Sharp D, Dani M, Fertleman M, Parkinson M. 1362 ANTICHOLINERGIC PRESCRIBING HABITS AND ITS ASSOCIATIONS IN A COMMUNITY POPULATION OF PEOPLE LIVING WITH DEMENTIA. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Many commonly prescribed medications have inadvertent anticholinergic effects. People with Dementia (PwD) are more vulnerable to these effects and at risk of adverse outcomes, the risk being higher with a greater degree of anticholinergic exposure. We investigated prescribing patterns and Anticholinergic burden (ACB) in a cohort of community-dwelling older adults with dementia and aimed to explore the effect of ACB on cognition, mood, and quality of life(QoL).
Method
The medication and demographic information for 87 (39 female) community-dwelling PwD were obtained from Electronic Care Summaries. We used the German Anticholinergic Burden Scale (GABS) to measure ACB. Additionally, we investigated associations between ACB and cognitive (ADAS-Cog), functional (BADL) and QoL (DemQoL) assessments.
Results
28.7% of participants had a clinically significant score (ACB> 2). The most commonly prescribed medications with ACB were Lansoprazole(18.3%), Mirtazapine(12.6%) and Codeine(12.6%). ACB was higher in males and negatively correlated with age, r(87)=-.21,p=.03. There was no association between ACB and cognition, QoL, functional independence, and neuropsychiatric symptoms. Over six months, PLWD with no ACB had a greater negative change in neuropsychiatric symptoms[t(18)=2.27,p=.04] and functional independence[t(23)=-3.8,p=.001], indicating greater dependence and worsening neuropsychiatric symptoms.
Conclusion
A third of PLWD in the community had clinically significant ACB. No ACB was associated with worsening neuropsychiatric symptoms and functional dependence over a six-month period. Community prescribers should consider regular medication reviews with PLWD and carers to ensure medications are prescribed safely and appropriately.
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Oh GY, Gibson M, Khanom S, Jaiswal P, Patel A. Validating low-fidelity arthroscopic simulation in medical students: a feasibility trial. Ann R Coll Surg Engl 2023; 105:28-34. [PMID: 35446721 PMCID: PMC9773295 DOI: 10.1308/rcsann.2022.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION With surgical opportunities becoming increasingly restricted for orthopaedic trainees, simulation training is a valuable alternative at providing sufficient practice. This pilot study aims to assess the potential effectiveness of low-fidelity simulation in teaching medical students basic arthroscopic skills and the feasibility of its incorporation into formal student training programmes. METHODS Twenty-two medical students completed pre- and post-training tests on the Probing (Task 1) and Maze (Task 2) exercises from the Sawbones 'Fundamentals of Arthroscopy Surgery Training' (FAST) programme. Training consisted of practising horizon control, deliberate linear motion and probing within 25min over a period of days. Completion time and error frequency were measured. The difference in performance was assessed using a paired two-tailed t-test. Qualitative data were collected. RESULTS Test completion time decreased significantly by a mean of 83s (±46s, 95% confidence intervals [CI] 37 to 129) for Task 1 (p=0.001) and 105s (±55s, 95% CI 50 to 160) for Task 2 (p=0.0007). Frequency of direct visualisation errors decreased significantly by a mean of 1.0 errors (±1.0 errors, 95% CI 0.1 to 2.0) for Task 1 (p = 0.04) and 0.8 errors (±0.8 errors, 95% CI 0.1 to 1.6) for Task 2 (p = 0.04). At post-training, 82% of participants were willing to incorporate FAST into formal training. CONCLUSIONS Low-fidelity simulators such as FAST can potentially teach basic arthroscopic skills to medical students and are feasible for incorporation into formal training. They also give students a cost-effective and safe basic surgical training experience.
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Patel A. Metal nanoparticles produced by plants with antibacterial properties against Staphylococcus aureus. BRAZ J BIOL 2023; 82:e268052. [PMID: 36888798 DOI: 10.1590/1519-6984.268052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/15/2022] [Indexed: 03/08/2023] Open
Abstract
Staphylococcus aureus (S. aureus) is a pathogenic bacteria that causes a variety of potentially fatal infections. The emergence of antibiotic-resistant strains of S. aureus has made treatment even more difficult. In recent years, nanoparticles have been used as an alternative therapeutic agent for S. aureus infections. Among various methods for the synthesis of nanoparticles, the method utilizing plant extracts from different parts of a plant, such as root, stem, leaf, flower, seeds, etc. is gaining widespread usage. Phytochemicals present in plant extract are an inexpensive, eco-friendly, natural material that act as reducing and stabilization agent for the nanoparticle synthesis. The utilization of plant-fabricated nanoparticles against S. aureus is currently in trend. The current review discusses recent findings in the therapeutic application of phytofabricated metal-based nanoparticles against Staphylococcus aureus.
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Molero-Senosiain M, Tiew S, Patel A, Houben I, Dhillon N. Impact of face mask wear on bacterial keratitis. J Fr Ophtalmol 2023; 46:e37-e39. [PMID: 36443112 PMCID: PMC9698048 DOI: 10.1016/j.jfo.2022.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/27/2022]
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Oaks Z, Patel A, Huang N, Choudhary G, Winans T, Faludi T, Krakko D, Duarte M, Lewis J, Beckford M, Blair S, Kelly R, Landas SK, Middleton FA, Asara JM, Chung SK, Fernandez DR, Banki K, Perl A. Cytosolic aldose metabolism contributes to progression from cirrhosis to hepatocarcinogenesis. Nat Metab 2023; 5:41-60. [PMID: 36658399 PMCID: PMC9892301 DOI: 10.1038/s42255-022-00711-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/11/2022] [Indexed: 01/21/2023]
Abstract
Oxidative stress modulates carcinogenesis in the liver; however, direct evidence for metabolic control of oxidative stress during pathogenesis, particularly, of progression from cirrhosis to hepatocellular carcinoma (HCC), has been lacking. Deficiency of transaldolase (TAL), a rate-limiting enzyme of the non-oxidative branch of the pentose phosphate pathway (PPP), restricts growth and predisposes to cirrhosis and HCC in mice and humans. Here, we show that mitochondrial oxidative stress and progression from cirrhosis to HCC and acetaminophen-induced liver necrosis are critically dependent on NADPH depletion and polyol buildup by aldose reductase (AR), while this enzyme protects from carbon trapping in the PPP and growth restriction in TAL deficiency. Both TAL and AR are confined to the cytosol; however, their inactivation distorts mitochondrial redox homeostasis in opposite directions. The results suggest that AR acts as a rheostat of carbon recycling and NADPH output of the PPP with broad implications for disease progression from cirrhosis to HCC.
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Linn YL, Choke ETC, Yap CJQ, Tan RY, Patel A, Tang TY. Utility of sirolimus coated balloons in the peripheral vasculature – a review of the current literature. CVIR Endovasc 2022; 5:29. [PMID: 35748962 PMCID: PMC9232675 DOI: 10.1186/s42155-022-00308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 12/24/2022] Open
Abstract
AbstractSirolimus-coated balloons (SCB) have demonstrated much promise as an alternative drug eluting device to the existing paclitaxel coated balloon platforms for the treatment of peripheral arterial disease (PAD). They have been well tested pre-clinically and have demonstrated anti-restenotic effects as well as clinical safety in its use for treatment of coronary artery disease. The existing approved SCBs have thus far demonstrated good short-term patency (12-months) and did not exhibit any major adverse events or device related shortcomings in its use for treatment of PAD. There are several studies ongoing which aim to further investigate the efficacy of existing SCBs and establish a direct comparison of its outcomes compared with plain balloon angioplasty. Also, SCB utility to salvage failing arteriovenous fistulas for haemodialysis patients has also been explored. We review the current progress made in the establishment of SCB in the treatment of PAD as well as highlight ongoing studies investigating the role of SCB in various settings.
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Tregidgo L, Hammond R, Bramley A, Davis M, Morshed A, Patel A, Pradhan A, D'Cruz R, Lipman M. Delayed-onset disseminated BCG disease causing a multi-system illness with fatal mycotic aortic aneurysm. CLINICAL INFECTION IN PRACTICE 2022. [DOI: 10.1016/j.clinpr.2022.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Meshram S, Gupta S, Alexander A, Agrawal S, Lanjewar N, Meshram K, Patel A, More A, Yadav R, Muley S, Shamkuwar C, Singh A. Sleep quality in COVID-19 patients and its association with severity of COVID. Sleep Med 2022. [PMCID: PMC9300259 DOI: 10.1016/j.sleep.2022.05.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Patel A, Kars MS, Duggan LV, Mariano ER. How to engage in social media to get your work published. Anaesthesia 2022. [DOI: 10.1111/anae.15919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/26/2022]
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Patel A, Melkonian E, Joshi S, Bussineau T, Patel P. PAINLESS HERPES ZOSTER IN THE SETTING OF EOSINOPHILIA AND MARKEDLY ELEVATED IGE LEVELS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chang S, Parvathaneni U, Laramore G, Humphreys I, Moe K, Patel A, Ferreira M, Rodriguez C, Cranmer L, Futran N, Barber B, Houlton J, Abuzeid W, Jafari A, Rizvi Z, Cash H, Liao J. Surgical Resection and Intensity Modulated Proton Therapy for Esthesioneuroblastoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Patel A, Jain R, Li R, Sim A, Welsh E, Eschrich S, Ahmed K, Grass D. Evaluation of Patient and Tumor Features to Optimize Urothelial Metastasis Treatment. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Patel A, Heintz J, Olson P, Nance A, Haas B, Whitney A, Kuehn J, McCoy K. 230 Increasing the number of completed colonoscopies among eligible adults with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00920-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pons A, De Sousa P, Proli C, Booth S, Palmares A, Leung M, Alshammari A, Vlastos D, Raubenheimer H, Devbhandari M, Patel A, Lim E. EP02.03-002 Impact of Society and National Guidelines on Patient Selection for Lung Cancer Surgery in the UK from 2008 to 2013. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gordan L, Diaz M, Patel A, Fink M, Wenk D, Roos A, Jiang J, Tam J, Sathyan P, Febbo P. 1162P Tissue and liquid biopsy utilization in advanced NSCLC in a large community US practice. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kong A, Chiu G, Shah S, Bolodeoku J, Casey C, Massey O, Patel A, Black C. 682P Patient characteristics and treatment patterns of newly diagnosed locally advanced head and neck squamous cell carcinoma (LA HNSCC): A retrospective cohort analysis of real-world data in England. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Johnson M, Rodon J, Aljumaily R, Villalona-Calero M, Borazanci E, Pishvaian M, Turk A, Carvajal R, Mantia C, Giaccone G, Mounir Z, Patel A, Maurer M, Neilan C, Rajendran D, Ganesan U, Hinkle J, Tolcher A. 492TiP A phase I study of synthetic lethal, IDE397 (MAT2A inhibitor) as a monotherapy and in combination with chemotherapy in advanced solid tumors harboring MTAP deletion. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Fladung L, Homburg S, Kruse O, Patel A. A novel method to measure diffusion of dissolved CO
2
in hydrogels. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Patel A, Ally M, Venkatachalam V, Hearn M, Mochloulis G. The learning curve and safety of continuous intraoperative vagus nerve monitoring in thyroid surgery. Ann R Coll Surg Engl 2022; 104:618-623. [PMID: 35133210 PMCID: PMC9433176 DOI: 10.1308/rcsann.2021.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION Continuous intraoperative nerve monitoring allows for continuous feedback on the integrity of the recurrent laryngeal nerve (RLN) and the quality of its induced myogenic potential. The aims of this study were to assess the time requirements and risks associated with vagus nerve electrode placement when learning the technique. METHODS This is a prospective observational study carried out in a single otolaryngology department at the start of a trainee's placement. A total of 40 vagus nerve dissections in 31 consecutive operations (22 hemithyroidectomies, 9 total thyroidectomies) using automatic periodic stimulation (APS, Medtronic) are included. Of the electrode placements, 10 were performed by the trainer and 30 by the trainee. The time required for each surgical step and complications relating to vagus nerve dissection were recorded. RESULTS The average (median+IQR) total additional time attributable to vagus nerve dissection, electrode placement and baseline electromyogenic assessment was 3.1mins (2.5-3.3) for the trainer and 4.8mins (4.1-5.3) for the trainee (p<0.0001). There was a downward trend in time requirement for the trainee (not statistically significant, p=0.080). Total operative time was 38min (35-45) for hemithyroidectomy and 56min (53-62) for total thyroidectomy. There was a mix of benign (74%) and malignant (26%) histology, no intraoperative complications relating to autonomic dysfunction and one (2.5%) transient nerve palsy. CONCLUSIONS Operative time attributable to vagus nerve electrode placement is short and the procedure is easy to learn. Appropriate surgical technique and careful anaesthetic considerations allow monitoring to be performed safely, and may reduce the rate of RLN palsy.
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Fladung L, Homburg S, Kruse O, Patel A. Development of novel silica hydrogels with improved structure properties to support growth of entrapped microalgae. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ashraf M, AlShammari A, De Sousa P, Naruka V, Tincknell L, Booth S, Proli C, Patel A, Docherty C, Murray J, Wagner T, Mhizha N, Lim E. EP01.07-006 Incidence and Resource Burden for the Management of CT Detected Ground Glass Opacities at a Tertiary Lung Cancer Service in the UK. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nocente M, Kiptily V, Tardocchi M, Bonofiglo PJ, Craciunescu T, Molin AD, De La Luna E, Eriksson J, Garcia J, Ghani Z, Gorini G, Hägg L, Kazakov Y, Lerche E, Maggi CF, Mantica P, Marcer G, Maslov M, Putignano O, Rigamonti D, Salewski M, Sharapov S, Siren P, Stancar Z, Zohar A, Beaumont P, Crombe K, Ericsson G, Garcia-Munoz M, Keeling D, King D, Kirov K, Nave MFF, Ongena J, Patel A, Perez von Thun C. Fusion product measurements by nuclear diagnostics in the Joint European Torus deuterium-tritium 2 campaign (invited). THE REVIEW OF SCIENTIFIC INSTRUMENTS 2022; 93:093520. [PMID: 36182523 DOI: 10.1063/5.0101767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
A new deuterium-tritium experimental, DTE2, campaign has been conducted at the Joint European Torus (JET) between August 2021 and late December 2021. Motivated by significant enhancements in the past decade at JET, such as the ITER-like wall and enhanced auxiliary heating power, the campaign achieved a new fusion energy world record and performed a broad range of fundamental experiments to inform ITER physics scenarios and operations. New capabilities in the area of fusion product measurements by nuclear diagnostics were available as a result of a decade long enhancement program. These have been tested for the first time in DTE2 and a concise overview is provided here. Confined alpha particle measurements by gamma-ray spectroscopy were successfully demonstrated, albeit with limitations at neutron rates higher than some 1017 n/s. High resolution neutron spectroscopy measurements with the magnetic proton recoil instrument were complemented by novel data from a set of synthetic diamond detectors, which enabled studies of the supra-thermal contributions to the neutron emission. In the area of escaping fast ion diagnostics, a lost fast ion detector and a set of Faraday cups made it possible to determine information on the velocity space and poloidal distribution of the lost alpha particles for the first time. This extensive set of data provides unique information for fundamental physics studies and validation of the numerical models, which are key to inform the physics and scenarios of ITER.
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Farah M, Rizvi I, Fernandes R, Patel A. 571 Evaluating the Effectiveness of Extracorporeal Shockwave Lithotripsy (ESWL) for Ureteric Stones During COVID-19 Pandemic - A Single Centre Experience. Br J Surg 2022. [PMCID: PMC9452093 DOI: 10.1093/bjs/znac269.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aim Reliance on ESWL for treating ureteric stone has increased during the COVID-19 pandemic. We examined the outcomes for ureteric stones treated with our on-site lithotripter to assess the success rate and determine the variables that could affect the outcome results. Method A retrospective review using electronic records and images of patients who underwent ESWL for ureteric stones (January to December 2020). Univariate and multivariate analysis used to determine stone-free rate predictors (Stone Free rate/SFR: No residual stones on post-ESWL imagining). Results A total of 36 patients underwent ESWL for ureteric stones. Mean age was 58 years (21–90), and mean stone size was 8 mm (5–20). Stones were located in the proximal (67%) or lower ureter (33%). Overall SFR was 64% (67% proximal, 33% distal). 64% of patients required only one session to be stone free, with 60% stone free after two sessions. Stones <10mm had a SFR of 67%, compared to 58% for stone >10 mm. The only statistically significant predictor was stone size (longest dimension, p=0.04). No statistical significance with stone location (P=0.09), skin-to-stone distance (SSD) (P=0.7), stone density (P=0.3) or stone volume (P=0.3). In treatment failure, time to definitive ureteroscopy was 4 weeks. Conclusion Our overall SFR was slightly lower than expected but comparable to available literature. This data highlights the importance of patient selection for ESWL and would be useful in counselling about local success rate. More than half of the patients required only one session for stone clearance and stone size was the only significant predictor for successful ESWL.
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Patel A, Sarver M, Liu B, Green C, Nicholas M, Chen S. 373 Retrospective algorithmic application of a dermatological complexity tool. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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