Citation: The British Journal of Ophthalmology. 2017, 101(12), 1673-1678
Author: Denniston AK, Chakravarthy U, Zhu H, Lee AY, Crabb DP, Tufail A, Bailey C, Akerele T, Al-Husainy S, Brand C, Downey L, Fitt A, Khan R, Kumar V, Lobo A, Mahmood S, Mandal K, Mckibbin M, Menon G, Natha S, Ong JM, Tsaloumas MD, Varma A, Wilkinson E, Johnston RL, Egan CA, UK DR EMR Users Group
Abstract: AIM: To assess the rate of 'treatment-requiring diabetic macular oedema (DMO)' in eyes for the two years before and after cataract surgery.
METHODS: Multicentre national diabetic retinopathy (DR) database study with anonymised data extraction across 19 centres from an electronic medical record system.
INCLUSION CRITERIA: eyes undergoing cataract surgery in patients with diabetes with no history of DMO prior to study start. The minimum dataset included: age, visual acuity (all time-points), injection episodes, timing of cataract surgery and ETDRS grading of retinopathy and maculopathy.
MAIN OUTCOME MEASURE: rate of developing first episode of treatment-requiring DMO in relation to timing of cataract surgery in the same eye.
RESULTS: 4850 eyes met the inclusion criteria. The rate of developing treatment-requiring DMO in this cohort was 2.9% in the year prior to surgery versus 5.3% in the year after surgery (p<0.01). The risk of 'treatment-requiring DMO' increased sharply after surgery, peaking in the 3-6 months' period (annualised rates of 5.2%, 6.8%, 5.6% and 4.0% for the 0-3, 3-6, 6-9 and 9-12 months' post-operative time periods respectively). Risk was associated with pre-operative grade of retinopathy: risk of DMO in the first year post-operatively being 1.0% (no DR pre-operatively), 5.4% (mild non-proliferative diabetic retinopathy; NPDR), 10.0% (moderate NPDR), 13.1% (severe NPDR) and 4.9% (PDR) (p<0.01).
CONCLUSIONS: This large real-world study demonstrates that the rate of developing treatment-requiring DMO increases sharply in the year after cataract surgery for all grades of retinopathy, peaking in the 3-6 months' postoperative period. Patients with moderate and severe NPDR are at particularly high risk.
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
KEYWORDS: Cataract; Diabetic macular oedema; Diabetic retinopathy; Electronic medical record; Intravitreal therapy
Link to PubMed record
Thursday 27 July 2017
Monday 24 July 2017
WUTH publication: Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons
Citation: Obesity Surgery. 2018, 28(1), 204-211
Author: Mahawar KK, Kular KS, Parmar C, Van den Bossche M, Graham Y, Carr WRJ, Madhok B, Magee C, Purkayastha S, Small PK
Abstract: BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB.
METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included.
RESULTS: Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation.
CONCLUSION: This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.
KEYWORDS: Cancer; Mini gastric bypass; Objections; Omega loop gastric bypass; One anastomosis gastric bypass; Perioperative practices; Single anastomosis gastric bypass
Link to PubMed record
Author: Mahawar KK, Kular KS, Parmar C, Van den Bossche M, Graham Y, Carr WRJ, Madhok B, Magee C, Purkayastha S, Small PK
Abstract: BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB.
METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included.
RESULTS: Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation.
CONCLUSION: This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.
KEYWORDS: Cancer; Mini gastric bypass; Objections; Omega loop gastric bypass; One anastomosis gastric bypass; Perioperative practices; Single anastomosis gastric bypass
Link to PubMed record
Friday 21 July 2017
Wirral Postgraduate Medical Centre closure
The Trustees of Wirral Postgraduate Medical Centre have confirmed that they can no longer fulfil their charitable objectives and therefore has made the decision to relinquish their lease on the Postgraduate Centre at Clatterbridge and from 1 August 2017 the Centre will be closed.
Wirral University Teaching Hospital has had a long established and valued relationship with the Trustees of the Charity and has endeavoured to support Education and Library facilities within the Postgraduate Centre.
Support for existing users at the Postgrad Centre Clatterbridge will continue until the end of July 2017 and where requested, users have been offered alternative venues for education meetings, study days, support groups etc at both Clatterbridge and Arrowe Park sites. Throughout this process the Medical Education team has been in discussions with the Multi-disciplinary Team (MDT) Co-ordinator to ensure patient safety remains a priority.
For any future meeting requirements please contact the Education Centre Reception, Telephone No.0151 604 7365 (internal Ext 8600) or the Clinical Skills Centre 0151 604 7721 (internal ext 8644) at Arrowe Park. Meeting room information for the Arrowe Park site can also be found here. For rooms bookings at Elm House, Clatterbridge please contact the Learning & Development Team on 0151 482 7981.
From the 1st August the J. Aitken Library Resource Room will be relocating to a new interim home in the ‘Holly’ room in Radiotherapy at Clatterbridge Cancer Centre (CCC), before being re-housed in a more permanent location. As a result of this move, CCC staff will have more convenient access to library space and resources. WUTH and Wirral Community Trust (WCT) staff should access the McArdle Library at Arrowe Park and visit our webpages for all library needs. If you’re based at the Clatterbridge site and need access to books, journals or computers please contact the Library & Knowledge Service and they will be able to provide advice and support. If there are any further questions or comments please contact Library & Knowledge Service at lks.wuth@nhs.net or via ext. 8610. Staff can also like the Library & Knowledge Service Facebook page for updates.
WUTH and the Trustees thank all Wirral Postgraduate Centre Users for their loyal support over the years.
Monday 17 July 2017
Friday 14 July 2017
Oxford Medicine Online - new edition added!
The 2017 edition of the Oxford Handbook of Operative Surgery has now been added to the Oxford Medicines Online collection.
The Oxford Medicine Online collection gives you quick and easy access to the contents of over 200 books on a variety of clinical subjects.
Why should I use Oxford Medicine Online?
* Saves you time
If you waiting for a book to become available or can’t make it to the Library, you can access this book from wherever you normally access the internet.
* Easy-to-use functionality
The contents of the books are set out just like a web page. You can search for specific sections of the subject and filter your results.
* Images and videos
Included in the contents are over 40000 images and 750 videos which can help with your research, academic study or personal development.
How do I access Oxford medicine Online?
6 simple steps to access the collection
All you need is an Open Athens account (link here to helpsheet)
1. Go to http://www.evidence.nhs.uk
2. Select Journals and Database
3. Select ‘Login to OpenAthens’
4. Login with your Open Athens account user name and password
5. Select ‘Oxford Medicine Online’
6. Select ‘Browse all titles in your subscription
Friday 7 July 2017
International Group B Strep Awareness Month
This month, Group B Strep Support website are providing downloadable materials and resources for parents, medical professionals, and students from their website at http://www.gbss.org.uk #GBSaware
If you need further information on Group B Strep, the Library & Knoweldge Service can help you access a range of resources.
Browse the LKS catalogue, register for an Open Athens account or visit the LKS for more details!
Monday 3 July 2017
WUTH publication: Practices in antenatal counseling for extremely premature infants amongst European trainees
Citation: The Journal of maternal-fetal & neonatal medicine. 2016, 29(24), 3956-9
Author: Geurtzen R, van Heijst AF, Babarao S, Molloy E, Draaisma JM, Hogeveen M
Abstract: There is no international consensus on content and process regarding antenatal counseling in extreme prematurity. The need for adequate training is increasingly recognized. This descriptive study evaluates current practice in antenatal counseling amongst European trainees using an online survey. Focusing on the process, the majority of respondents did not have a medical consensus guideline. Seven percent of the trainees received some formal training. Focusing on the content, about half of the subjects did not mention any statistics about mortality.
CONCLUSION: We observed wide variation in actual content and organization in antenatal counseling in Europe amongst European trainees in neonatology.
KEYWORDS: Antenatal counseling; limits of viability; prematurity
Link to PubMed record
Author: Geurtzen R, van Heijst AF, Babarao S, Molloy E, Draaisma JM, Hogeveen M
Abstract: There is no international consensus on content and process regarding antenatal counseling in extreme prematurity. The need for adequate training is increasingly recognized. This descriptive study evaluates current practice in antenatal counseling amongst European trainees using an online survey. Focusing on the process, the majority of respondents did not have a medical consensus guideline. Seven percent of the trainees received some formal training. Focusing on the content, about half of the subjects did not mention any statistics about mortality.
CONCLUSION: We observed wide variation in actual content and organization in antenatal counseling in Europe amongst European trainees in neonatology.
KEYWORDS: Antenatal counseling; limits of viability; prematurity
Link to PubMed record
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