Citation: Lupus. 2023 Jan 23, Online ahead of print
Author: Smriti Ramakrishnan, Azhar Abbas, Natasha Jordan
Thursday 2 February 2023
WUTH publication: Neonatal IVC thrombosis in a baby born to an aPL positive mother - a case report
WUTH publication: Prevalence of Potentially Clinically Significant Drug-Drug Interactions With Antiretrovirals Against HIV Over Three Decades: A Systematic Review of the Literature
Citation: Journal of acquired immune deficiency syndromes. 2023, 92(2), 97-105
Author: Daryl Hodge, Eva Maria Hodel, Elen Hughes, Phoebe Hazenberg, Sandra Grañana Castillo, Sara Gibbons, Duolao Wang, Fiona Marra, Catia Marzolini, David Back, Saye Khoo
Abstract: Background: Contemporary first-line antiretrovirals have considerably reduced liability for clinically significant drug-drug interactions (DDI). This systematic review evaluates the prevalence of DDI among people receiving antiretrovirals across 3 decades.
Methods: We searched 3 databases for studies reporting the prevalence of clinically significant DDIs in patients receiving antiretrovirals published between January 1987 and July 2022. Clinically significant DDIs were graded by severity. All data extractions were undertaken by 2 independent reviewers, adjudicated by a third.
Results: Of 21,665 records returned, 13,474 were duplicates. After screening the remaining 13,596 abstracts against inclusion criteria, 122 articles were included for full-text analysis, from which a final list of 34 articles were included for data synthesis. The proportion of patients experiencing a clinically significant DDI did not change over time (P = 0.072). The most frequently reported classes of antiretrovirals involved in DDIs were protease inhibitors and non-nucleoside reverse transcriptase inhibitors; of note, integrase use in the most recent studies was highly variable and ranged between 0% and 89%.
Conclusions: The absolute risk of DDIs has not decreased over the period covered. This is likely related to continued use of older regimens and an ageing cohort of patients. A greater reduction in DDI prevalence can be anticipated with broader uptake of regimens containing unboosted integrase inhibitors or non-nucleoside reverse transcriptase inhibitors.
WUTH publication: Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis
Citation: Cureus. 2022, 14(11), e32018
Author: Abduelraheim Abu, Ali Yasen Mohamedahmed, Amin Alamin, Mazin Mohamed, Mohamed Osman, Mohammed Jibreel Mohammed, Hiba Abdalla, Hazim A Eltyeb, Omer Ali, Rifat Mohamad, Safaa Hamid, Shaza Faycal Mirghani, Yousif Hamad, Hussam Khougali Mohamed
Abstract: This meta-analysis aims to evaluate the comparative outcomes of drain insertion versus no drain after appendicectomy for complicated appendicitis. A systematic search of PubMed, Cochrane Library and Scopus was conducted, and all studies comparing drain versus no drain after appendicectomy for complicated appendicitis were included. Abdominal collection, surgical site infection (SSI), bowel obstruction, faecal fistula, paralytic ileus, length of hospital stay (LOS) and mortality were the evaluated outcome parameters for the meta-analysis. Seventeen studies reporting a total number of 4,255 patients who underwent appendicectomy for complicated appendicitis with (n=1,580) or without (n=2,657) drain were included. There was no significant difference between the two groups regarding abdominal collection (odds ratio (OR)=1.41, P=0.13). No-drain group was superior to the drain group regarding SSI (OR=1.93, P=0.0001), faecal fistula (OR=4.76, P=0.03), intestinal obstruction (OR=2.40, P=0.04) and paralytic ileus (OR=2.07, P=0.01). There was a difference regarding mortality rate between the two groups (3.4% in the drain group vs 0.5% in the no-drain group, risk difference (RD)=0.01, 95% CI (-0.01, 0.04), P=0.36). In conclusion, this meta-analysis has shown that drains have no effect on the development of intra-abdominal collections in complicated appendicitis, but it can significantly increase the risk of postoperative complications such as fistula, surgical site infection (SSI), bowel obstruction, ileus and length of hospital stay.
Keywords: drain insertion; intra-abdominal abscess; intra-abdominal collection; postoperative ileus; ruptured appendicitis.
WUTH publication: The Validation of Surgical Simulators: A Technical Report on Current Validation Terminology as a Reference for Future Research
Citation: Cureus. 2022, 14(11), e31881
Author: Thomas Hughes, Joseph T Fennelly, Rakesh Patel, Jonathan Baxter
Abstract: In recent years, surgical trainees have been exposed to a lower volume of operative procedures. In part, this is due to the reduction in working hours and further disruption by the coronavirus disease 2019 pandemic. Much has been done to develop the techniques of surgical skill training outside of the operating theatre. Simulation-based interventions must undergo a process of validation to assess their appropriateness and effectiveness for use in training. The terminology of validation within current literature, however, has not evolved in line with the education community, resulting in varying definitions for the same phrase across domains. This can result in confusion and misinterpretation among researchers and surgeons working within this domain. This technical report describes the "types of validity" definitions used in the traditional framework of surgical simulation literature and the contemporary, unitary framework of validity adopted by educationalist theorists. There is a clear overlap between the traditional "types of validity" and the contemporary, unitary framework. The divergence in the use of those definitions seems, at least partly, influenced by the context of the investigations being conducted. By utilising the contemporary definitions, authors may have struggled to provide the evidence required to justify the use of the multitude of surgical skill simulators developed in the recent past. This report has provided an overview of the current terminology within the validation frameworks and can be used as a reference for future surgical simulation research.
Keywords: simulation education; simulation in medical education; surgical training; terminology; validation.
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