Citation: Current Urology. 2021, 15(3), 148-52. Epub 2021 Aug 17
Author: Ibraheem Alrishan Alzouebi, Sanad Saad, Tom Farmer, Sophie Green
Abstract: Background: Google Glass is an optical head-mounted display that has been used in multiple medical and surgical settings to enhance delivery of education and training. This systematic review focuses solely on the use of this technology in urology operating theaters for the purpose of surgical education.
Materials and methods: A systematic search strategy was employed using EMBASE (1996-2019), Medline (1946-2019) and PubMed. Search terms included optical head-mounted displays, Google Glass and urological surgical training. Use of this technology in a nonurological setting, nonteaching sessions, case reports, reviews, editorials, abstracts, and articles not in English were rejected. Three studies were identified following the exclusion criteria.
Results: All 3 studies received positive feedback from trainees regarding this technology in relation to enhanced surgical education. In addition, in all studies the trainees felt the technology had a place for educational training in the future. All studies described disadvantages to the technology as well including battery life, comfort, and cost.
Conclusions: Studies describe a big potential for Google Glass and similar head-mounted devices for the role of surgical training in urology, however, larger studies looking at more varied operations can help reinforce this viewpoint.
Keywords: Augmented reality; Education; Google glass; Head mounted display; Surgical training; Urology.
Friday 24 September 2021
WUTH publication: Is the use of augmented reality-assisted surgery beneficial in urological education? A systematic review
Thursday 16 September 2021
WUTH publication: Establishing the phenotypic spectrum of ZTTK syndrome by analysis of 52 individuals with variants in SON
Author: Alexander J M Dingemans, Kim M G Truijen, Jung-Hyun Kim, Zahide Alaçam, Laurence Faivre, Kathleen M Collins, Erica H Gerkes, Mieke van Haelst, Ingrid M B H van de Laar, Kristin Lindstrom, Mathilde Nizon, James Pauling, Edyta Heropolitańska-Pliszka, Astrid S Plomp, Caroline Racine, Rani Sachdev, Margje Sinnema, Jon Skranes, Hermine E Veenstra-Knol, Eline A Verberne, Anneke T Vulto-van Silfhout, Marlon E F Wilsterman, Eun-Young Erin Ahn, Bert B A de Vries, Lisenka E L M Vissers
Abstract: Zhu-Tokita-Takenouchi-Kim (ZTTK) syndrome, an intellectual disability syndrome first described in 2016, is caused by heterozygous loss-of-function variants in SON. Its encoded protein promotes pre-mRNA splicing of many genes essential for development. Whereas individual phenotypic traits have previously been linked to erroneous splicing of SON target genes, the phenotypic spectrum and the pathogenicity of missense variants have not been further evaluated. We present the phenotypic abnormalities in 52 individuals, including 17 individuals who have not been reported before. In total, loss-of-function variants were detected in 49 individuals (de novo in 47, inheritance unknown in 2), and in 3, a missense variant was observed (2 de novo, 1 inheritance unknown). Phenotypic abnormalities, systematically collected and analyzed in Human Phenotype Ontology, were found in all organ systems. Significant inter-individual phenotypic variability was observed, even in individuals with the same recurrent variant (n = 13). SON haploinsufficiency was previously shown to lead to downregulation of downstream genes, contributing to specific phenotypic features. Similar functional analysis for one missense variant, however, suggests a different mechanism than for heterozygous loss-of-function. Although small in numbers and while pathogenicity of these variants is not certain, these data allow for speculation whether de novo missense variants cause ZTTK syndrome via another mechanism, or a separate overlapping syndrome. In conclusion, heterozygous loss-of-function variants in SON define a recognizable syndrome, ZTTK, associated with a broad, severe phenotypic spectrum, characterized by a large inter-individual variability. These observations provide essential information for affected individuals, parents, and healthcare professionals to ensure appropriate clinical management.
Tuesday 7 September 2021
WUTH publication: Never events in orthopaedics: A nationwide data analysis and guidance on preventative measures
Citation: The International Journal of Risk & Safety in Medicine. 2021 Aug 23. Online ahead of print.
Author: Ahmed T Hafez, Islam Omar, Balaji Purushothaman, Yusuf Michla, Kamal Mahawar
Abstract: Background: Never Events (NE) are serious clinical incidents that are wholly preventable if appropriate institutional safeguards are in place and followed. They are often used as a surrogate of the quality of healthcare delivered by an institution. Most NEs are surgical and orthopaedic surgery is one of the most involved specialties.
Objective: The aim of this study was to identify common NE themes associated with orthopaedics within the National Health Service (NHS) of England.
Method: We conducted an observational study analysing the annual NE data published by the NHS England from 2012 to 2020 to collate all orthopaedic surgery-related NE and construct relevant recurring themes.
Results: We identified 460 orthopaedic NE out of a total of 3247 (14.16%) reported NE to NHS England. There were 206 Wrong implants/prostheses under 8 different themes. Wrong hip and knee prosthesis were the commonest "wrong implants" (n = 94; 45.63% and n = 91; 44.17% respectively). There were 197 "Wrong-site surgery" incidents in 22 different themes. The commonest of these was the laterality problems accounting for 64 (32.48%) incidents followed by 63 (31.97%) incidents of wrong spinal level interventions. There were 18 (9.13%) incidents of intervention on the wrong patients and 17 (8.62%) wrong incisions. Retained pieces of instruments were the commonest retained foreign body with 15 (26.13%) incidents. The next categories were retained drill parts and retained instruments with 13 (22.80%) incidents each.
Conclusion: We identified 47 different themes of NE specific to orthopaedic surgery. Awareness of these themes would help in their prevention. Site marking can be challenging in the presence of cast and on operating on the digits and spine. Addition of a Real-time intra-operative implant scan to the National Joint Registry can avoid wrong implant selection while Fiducial markers, intraoperative imaging, O-arm navigation, and second time-out could help prevent wrong level spinal surgery.
Keywords: Orthopaedic surgery; medical claims; medical errors; never events; patient safety.
Thursday 2 September 2021
WUTH publication: Prevalence of Falls in Patients Presenting to an Ophthalmic Outpatients Department- A Surveillance Study
Citation: The Biritsh and Irish Orthoptic Journal. 2021, 17(1), 134-41
Author: Jignasa Mehta, Karen Knowles, Erin Wilson
Abstract: Introduction: Approximately 1 in 3 adults aged 65 and over experience a fall each year. Poor vision is an identified risk factor. The aim of this cross-sectional public health surveillance audit was to determine the prevalence of falls experienced in the previous 12 months by adult patients presenting to an ophthalmology department.
Methods: A short questionnaire was given to consecutive patients attending an ophthalmology department at two trusts in the North West to determine whether they had experienced a fall in the previous 12 months, whether they had suffered a fracture, their eye condition and the type of glasses worn.
Results: Data was collected for 585 patients (mean age: 69 years, SD: 13.8). Falls in the previous 12 months were reported by 96 (16.4%) patients, and a significant proportion of these were aged 60 years and over (82%, p < 0.0001, one-sample binomial test). Half of the respondents were unaware of their eye health condition for which they were attending the department. Glaucoma was the most prevalent condition in those who had experienced a fall (43%). A significant proportion of the individuals who reported a fall wore single-vision glasses (43%, p < 0.0001, one-sample chi-square test).
Conclusion: In an ophthalmology outpatient department, the proportion of older adults who experienced a fall in the previous 12 months was lower than the reported prevalence in the general population. There is a need for health literacy to educate patients about their eye condition, the potential effects on their visual function and, consequently, managing falls risk.
Keywords: Falls; Ophthalmic conditions; Vision.