Introduction: Ring chromosomes arise from breakage and fusion at distal regions of short and long arms of the chromosomes. The effect of the ring chromosome on the phenotype may vary widely depending on the amount of the deletion in the chromosomal areas and genes implicated in these regions.
Case presentation: We present a 35-year-old male patient with infertility and mild intellectual disability (MID) who has de novo ring 13 (r(13)) chromosomes. To determine chromosomal abnormality, we performed karyotype analysis, Y chromosome microdeletion analysis, FISH, and aCGH techniques.
Conclusion: The patient's karyotype analysis result was mos46,XY,r(13)(p13q34)[75]/45,XY,-13[14]/46,XY,dic (13;13)[8]/47,XY,r(13), + r(13)[2]/46,XY,tetrac r(13;13;13;13)[1]. FISH analysis supported the findings of the cytogenetic analysis. Y microdeletion analysis showed that the AZF region was intact. On aCGH analysis, we detected a 1.5 megabase deletion at the end of chromosome 13, including the CHAMP1 gene. The loss of the CHAMP1 gene, in particular, may explain our patient's MID, and the other deleted genes at 13q34 may explain our patient's infertility.
{"title":"Cytogenetic and molecular characterization of a patient having infertility and mild intellectual disability with a very rare unstable ring chromosome 13.","authors":"Murat Kaya, Ilknur Suer, Tugba Kalayci, Birsen Karaman, Sukru Ozturk, Sukru Palanduz","doi":"10.1177/00369330221114426","DOIUrl":"https://doi.org/10.1177/00369330221114426","url":null,"abstract":"<p><strong>Introduction: </strong>Ring chromosomes arise from breakage and fusion at distal regions of short and long arms of the chromosomes. The effect of the ring chromosome on the phenotype may vary widely depending on the amount of the deletion in the chromosomal areas and genes implicated in these regions.</p><p><strong>Case presentation: </strong>We present a 35-year-old male patient with infertility and mild intellectual disability (MID) who has de novo ring 13 (r(13)) chromosomes. To determine chromosomal abnormality, we performed karyotype analysis, Y chromosome microdeletion analysis, FISH, and aCGH techniques.</p><p><strong>Conclusion: </strong>The patient's karyotype analysis result was mos46,XY,r(13)(p13q34)[75]/45,XY,-13[14]/46,XY,dic (13;13)[8]/47,XY,r(13), + r(13)[2]/46,XY,tetrac r(13;13;13;13)[1]. FISH analysis supported the findings of the cytogenetic analysis. Y microdeletion analysis showed that the AZF region was intact. On aCGH analysis, we detected a 1.5 megabase deletion at the end of chromosome 13, including the <i>CHAMP1</i> gene. The loss of the <i>CHAMP1</i> gene, in particular, may explain our patient's MID, and the other deleted genes at 13q34 may explain our patient's infertility.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"173-177"},"PeriodicalIF":2.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1177/00369330221112128
Ghulam Nabi
Welcome to September 2022 issue of Scottish Medical Journal. The issue highlights advancements in medical education and researcha basic ambitions of journal since its inception more than 100 years back. Hassan et al. bring in new knowledge on methods of teaching in neuroanatomy. Khatkar and colleagues discuss virtual reality simulation questionnaire survey and reminds us importance of snap-shot assessment. Domenic G et al. report relationship of body composition and BMI with colorectal cancer. In another common cancer in young men, Alifrangis et al. provide a glimpse of current practise perspective of testicular cancer (Seminoma). Clinicians are exposed to risk of radiation injuries and in particularly those working in orthopaedics surgery. Snowden et al. provide an assessment of knowledge amongst orthopaedic surgeons about radiation safety. Li et al. in a meta-analysis describe an interesting association of polycystic ovarian syndrome with various cancers. Finally, Yitgin et al. share their knowledge about optimal duration of surgical procedure for renal stones. They report a lower postoperative complications rate following retrograde intrarenal surgery in patients where procedural time is more than 60 min. There are several implications of these findings: First, it will improve delivery of information to urological surgeons so that careful planning is considered in reducing complications; second, it will help in better patient counselling and may be discuss alternate therapeutic approaches. Collins TC et al. in a previous study reported intraoperative blood transfusion, operative time, return to the operating room, and the number of complications as strong predictors of length of stay in hospital for patients following surgery. These events are inter-related and hence quality assurance of intra-operative events should be focus of quality assurance in the future. I trust the issue will be an enjoyable reading and generate discussion amongst colleagues and the future generations.
{"title":"Surgical procedure time and postoperative complications: Quality assurance of intraoperative events.","authors":"Ghulam Nabi","doi":"10.1177/00369330221112128","DOIUrl":"https://doi.org/10.1177/00369330221112128","url":null,"abstract":"Welcome to September 2022 issue of Scottish Medical Journal. The issue highlights advancements in medical education and researcha basic ambitions of journal since its inception more than 100 years back. Hassan et al. bring in new knowledge on methods of teaching in neuroanatomy. Khatkar and colleagues discuss virtual reality simulation questionnaire survey and reminds us importance of snap-shot assessment. Domenic G et al. report relationship of body composition and BMI with colorectal cancer. In another common cancer in young men, Alifrangis et al. provide a glimpse of current practise perspective of testicular cancer (Seminoma). Clinicians are exposed to risk of radiation injuries and in particularly those working in orthopaedics surgery. Snowden et al. provide an assessment of knowledge amongst orthopaedic surgeons about radiation safety. Li et al. in a meta-analysis describe an interesting association of polycystic ovarian syndrome with various cancers. Finally, Yitgin et al. share their knowledge about optimal duration of surgical procedure for renal stones. They report a lower postoperative complications rate following retrograde intrarenal surgery in patients where procedural time is more than 60 min. There are several implications of these findings: First, it will improve delivery of information to urological surgeons so that careful planning is considered in reducing complications; second, it will help in better patient counselling and may be discuss alternate therapeutic approaches. Collins TC et al. in a previous study reported intraoperative blood transfusion, operative time, return to the operating room, and the number of complications as strong predictors of length of stay in hospital for patients following surgery. These events are inter-related and hence quality assurance of intra-operative events should be focus of quality assurance in the future. I trust the issue will be an enjoyable reading and generate discussion amongst colleagues and the future generations.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":" ","pages":"79"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40672803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-12DOI: 10.1177/00369330221107101
Sherif S. Hassan, Fauzia Nausheen, Frank Scali, Hina Mohsin, Charity Thomann
Background A recent trend in medical education is developing a more dynamic and integrated curriculum. Team-based learning (TBL) increases students’ engagement and the active construction of anatomical knowledge. This initial study aimed to empirically observe medical students’ perceptions of their achievement of learning outcomes and the construction of their neuroanatomy knowledge, critical thinking, and problem-solving using an interactive whiteboard (IWB) as a teaching strategy. Methods An independent neuroanatomy lab survey collected students’ perceptions and comments about their learning experiences using the IWB on a questionnaire using a 5-point Likert scale. Results Student participants felt that using the IWB has facilitated their learning experience. 94.2% of student participants endorsed feelings that new technology has helped them achieve their learning outcomes, helped them integrate both their basic science and clinical science/skills knowledge (90.4%), enhanced their problem-solving skills (92.3%), facilitated their interaction with the neuroanatomy faculty (96.2%) and increase their critical thinking (88.4%). Conclusion Collecting such empirical data about students’ perceptions and their learning environment should help neurosciences faculty in medical schools better outline their activities to faculty at other medical institutions. Applying these methods may enhance the learning process, save time during neuroanatomy lab, and it could also help overcome the shortage of qualified neuroanatomy educators.
{"title":"A constructivist approach to teach neuroanatomy lab: Students’ perceptions of an active learning environment","authors":"Sherif S. Hassan, Fauzia Nausheen, Frank Scali, Hina Mohsin, Charity Thomann","doi":"10.1177/00369330221107101","DOIUrl":"https://doi.org/10.1177/00369330221107101","url":null,"abstract":"Background A recent trend in medical education is developing a more dynamic and integrated curriculum. Team-based learning (TBL) increases students’ engagement and the active construction of anatomical knowledge. This initial study aimed to empirically observe medical students’ perceptions of their achievement of learning outcomes and the construction of their neuroanatomy knowledge, critical thinking, and problem-solving using an interactive whiteboard (IWB) as a teaching strategy. Methods An independent neuroanatomy lab survey collected students’ perceptions and comments about their learning experiences using the IWB on a questionnaire using a 5-point Likert scale. Results Student participants felt that using the IWB has facilitated their learning experience. 94.2% of student participants endorsed feelings that new technology has helped them achieve their learning outcomes, helped them integrate both their basic science and clinical science/skills knowledge (90.4%), enhanced their problem-solving skills (92.3%), facilitated their interaction with the neuroanatomy faculty (96.2%) and increase their critical thinking (88.4%). Conclusion Collecting such empirical data about students’ perceptions and their learning environment should help neurosciences faculty in medical schools better outline their activities to faculty at other medical institutions. Applying these methods may enhance the learning process, save time during neuroanatomy lab, and it could also help overcome the shortage of qualified neuroanatomy educators.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"80 - 86"},"PeriodicalIF":2.7,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42309423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-09DOI: 10.1177/00369330221107099
Zhen Li, Yuhua Wang, Linlin Wang, Dingtao Hu, Ying Teng, Tingyu Zhang, Ziye Yan, Fang Wang, Y. Zou
Background and Aims This updated meta-analysis aimed to further quantify the risk of endometrial, ovarian, and breast cancer in patients with polycystic ovary syndrome (PCOS), thus providing updated and more reliable estimates. Methods and Results We identified relevant articles by searching electronic databases of PubMed, Embase, Web of Science, and Chinese Biological Medical Literature (CBM) published up to March 20, 2021. The pooled effect estimates and their 95% confidence intervals (CIs) were calculated using the random-effect model or the fixed-effect model. A total of 26 eligible studies were included. We found that PCOS was significantly associated with endometrial cancer (odds ratios [OR]: 3.66, 95%CI: 2.05–6.54, P < 0.001), but not with ovarian or breast cancer (OR: 1.23, 95%CI: 0.99–1.53, P = 0.059; OR: 0.94, 95%CI: 0.78–1.14, P = 0.551, respectively). However, in subgroups of high-quality studies, cohort studies, younger women (54 years or less or premenopausal), and studies with unadjusted body mass index (BMI), PCOS patients had a significantly higher risk of ovarian cancer. Conclusion These results indicated that PCOS is a significant risk factor for endometrial cancer independent of BMI, but not for breast cancer. PCOS may increase the risk of ovarian cancer in younger women.
背景和目的这项更新的荟萃分析旨在进一步量化多囊卵巢综合征（PCOS）患者患子宫内膜癌、卵巢癌和乳腺癌的风险，从而提供更新的、更可靠的估计。方法和结果我们通过检索截至2021年3月20日发表的PubMed、Embase、Web of Science和中国生物医学文献（CBM）的电子数据库来识别相关文章。使用随机效应模型或固定效应模型计算合并效应估计值及其95%置信区间（CI）。共纳入26项符合条件的研究。我们发现PCOS与子宫内膜癌症显著相关（比值比[OR]：3.66，95%CI:2.05–6.54，P < 0.001），但与卵巢或乳腺癌症无关（or:1.23，95%CI:0.99–1.53，P = 0.059；或：0.94，95%置信区间：0.78–1.14，P = 分别为0.551）。然而，在高质量研究、队列研究、年轻女性（54岁或54岁以下或绝经前）和未调整体重指数（BMI）的研究的亚组中，PCOS患者患卵巢癌症的风险显著较高。结论PCOS是癌症的重要危险因素，与BMI无关，但与癌症无关。PCOS可能会增加年轻女性患卵巢癌症的风险。
{"title":"Polycystic ovary syndrome and the risk of endometrial, ovarian and breast cancer: An updated meta-analysis","authors":"Zhen Li, Yuhua Wang, Linlin Wang, Dingtao Hu, Ying Teng, Tingyu Zhang, Ziye Yan, Fang Wang, Y. Zou","doi":"10.1177/00369330221107099","DOIUrl":"https://doi.org/10.1177/00369330221107099","url":null,"abstract":"Background and Aims This updated meta-analysis aimed to further quantify the risk of endometrial, ovarian, and breast cancer in patients with polycystic ovary syndrome (PCOS), thus providing updated and more reliable estimates. Methods and Results We identified relevant articles by searching electronic databases of PubMed, Embase, Web of Science, and Chinese Biological Medical Literature (CBM) published up to March 20, 2021. The pooled effect estimates and their 95% confidence intervals (CIs) were calculated using the random-effect model or the fixed-effect model. A total of 26 eligible studies were included. We found that PCOS was significantly associated with endometrial cancer (odds ratios [OR]: 3.66, 95%CI: 2.05–6.54, P < 0.001), but not with ovarian or breast cancer (OR: 1.23, 95%CI: 0.99–1.53, P = 0.059; OR: 0.94, 95%CI: 0.78–1.14, P = 0.551, respectively). However, in subgroups of high-quality studies, cohort studies, younger women (54 years or less or premenopausal), and studies with unadjusted body mass index (BMI), PCOS patients had a significantly higher risk of ovarian cancer. Conclusion These results indicated that PCOS is a significant risk factor for endometrial cancer independent of BMI, but not for breast cancer. PCOS may increase the risk of ovarian cancer in younger women.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"109 - 120"},"PeriodicalIF":2.7,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41717379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-30DOI: 10.1177/00369330221103279
Harman Khatkar, Ashley Ferro, Sanjeev Kotecha, M. Prokopenko, A. Evans, J. Kyriakides, Jonathan Botterill, Miljyot Singh Sangha, Abbas See, Ryan Kerstein
Background We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms. Methods The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities. Results VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons. Conclusion Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.
{"title":"Assessing the attitude of surgical trainees towards virtual reality simulation: A national cross-sectional questionnaire study","authors":"Harman Khatkar, Ashley Ferro, Sanjeev Kotecha, M. Prokopenko, A. Evans, J. Kyriakides, Jonathan Botterill, Miljyot Singh Sangha, Abbas See, Ryan Kerstein","doi":"10.1177/00369330221103279","DOIUrl":"https://doi.org/10.1177/00369330221103279","url":null,"abstract":"Background We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms. Methods The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities. Results VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons. Conclusion Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"87 - 92"},"PeriodicalIF":2.7,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43851591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-22DOI: 10.1177/00369330221102237
Domenic Di Rollo, J. McGovern, Christopher Morton, Gillian Miller, R. Dolan, P. Horgan, D. McMillan, D. Mansouri
Introduction Obesity is associated with an increased risk of colorectal cancer (CRC). Unlike the indirect measures such as BMI, CT-Body composition (CT-BC) allows for the assessment of both volume and distribution of adipose tissue. Therefore, the aim of this study was to examine the relationship between host characteristics, BMI, CT-BC measurements and the incidence of colorectal neoplasia. Methods Patients undergoing CT Colonography (CTC) as part of the Scottish Bowel Screening Programme, between July 2009 and February 2016, were eligible for inclusion. Data were collected including demographic data, clinicopathological variables and CT-BC measurements including skeletal muscle index (SMI), subcutaneous fat index (SFI) and visceral fat area (VFA). CTC, colonoscopy, and pathology reports were used to identify CRC incidence. Associations between demographic data, clinicopathological variables, CT-BC measurements, colorectal neoplasia and advanced colorectal neoplasia were analysed using univariate and multivariate binary logistics regression. Results 286 patients met the inclusion criteria. Neoplasia was detected in 105 (37%) of the patients with advanced neoplasia being detected in 72 (69%) of patients. On multivariate analysis sex (p < 0.05) and high VFA (p < 0.001) remained independently associated with colorectal neoplasia. On multivariate analysis a high SFI (p < 0.01) remained independently associated with advanced colorectal neoplasia. BMI was not associated with either colorectal neoplasia or advanced colorectal neoplasia. Conclusion When directly compared to BMI, CT derived fat measurements were more closely associated with the degree of neoplasia in patients undergoing colorectal cancer screening. In patients investigated with CT colonography, CT adipose measures may stratify the risk and grade of neoplasia.
{"title":"Relationship between BMI, CT-derived body composition and colorectal neoplasia in a bowel screening population","authors":"Domenic Di Rollo, J. McGovern, Christopher Morton, Gillian Miller, R. Dolan, P. Horgan, D. McMillan, D. Mansouri","doi":"10.1177/00369330221102237","DOIUrl":"https://doi.org/10.1177/00369330221102237","url":null,"abstract":"Introduction Obesity is associated with an increased risk of colorectal cancer (CRC). Unlike the indirect measures such as BMI, CT-Body composition (CT-BC) allows for the assessment of both volume and distribution of adipose tissue. Therefore, the aim of this study was to examine the relationship between host characteristics, BMI, CT-BC measurements and the incidence of colorectal neoplasia. Methods Patients undergoing CT Colonography (CTC) as part of the Scottish Bowel Screening Programme, between July 2009 and February 2016, were eligible for inclusion. Data were collected including demographic data, clinicopathological variables and CT-BC measurements including skeletal muscle index (SMI), subcutaneous fat index (SFI) and visceral fat area (VFA). CTC, colonoscopy, and pathology reports were used to identify CRC incidence. Associations between demographic data, clinicopathological variables, CT-BC measurements, colorectal neoplasia and advanced colorectal neoplasia were analysed using univariate and multivariate binary logistics regression. Results 286 patients met the inclusion criteria. Neoplasia was detected in 105 (37%) of the patients with advanced neoplasia being detected in 72 (69%) of patients. On multivariate analysis sex (p < 0.05) and high VFA (p < 0.001) remained independently associated with colorectal neoplasia. On multivariate analysis a high SFI (p < 0.01) remained independently associated with advanced colorectal neoplasia. BMI was not associated with either colorectal neoplasia or advanced colorectal neoplasia. Conclusion When directly compared to BMI, CT derived fat measurements were more closely associated with the degree of neoplasia in patients undergoing colorectal cancer screening. In patients investigated with CT colonography, CT adipose measures may stratify the risk and grade of neoplasia.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"93 - 102"},"PeriodicalIF":2.7,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44860727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.1177/00369330221099620
Gordon T Snowden, M. Jabbal, A. Akhtar
As orthopaedic surgeons we use x-rays every day; not only when diagnosing pathology but often to assist in operative management of said pathology or ensure satisfactory outcomes for our patients in clinic. An awareness of the correct use of ionising radiation in the form of fluoroscopic imaging is therefore of great importance to reduce intraoperative exposure and has led to the development of the As Little As Reasonably Achievable (ALARA) principle. The primary aim of this study is to determine the knowledge and practises of radiation safety amongst orthopaedic surgeons in Scotland. Secondary aim is to assess the prevalence of back pain and relation to lead gowns. A google forms survey containing 20 questions about both an individual's radiation practises, and knowledge and departmental practises were distributed to all 4 deaneries in Scotland. In total 72 responses were received from 20 hospitals across all 4 Scottish deaneries. This included 28 Consultants, 23 Senior trainees and 21 Junior trainees. We found that the level of radiation training and knowledge varied considerably across seniority and the nation. Of those surveyed 100% reported always wear lead aprons/gowns however only 46.2% (n = 34) frequently or always wear thyroid protection when using X-rays. Only 55% (n = 40) of those surveyed had completed a radiation safety course with this being far less likely amongst junior trainees (29%, n = 6) than amongst Consultants (82%, n = 23) and senior trainees (48%, n = 11) (p < 0.0001). To our knowledge this is the most extensive survey into the radiation practises of Orthopaedic Surgeons in the literature and shows the need for increased education and awareness of radiation safety practises, particularly amongst junior trainees.
{"title":"Radiation safety awareness and practices amongst orthopaedic surgeons in Scotland","authors":"Gordon T Snowden, M. Jabbal, A. Akhtar","doi":"10.1177/00369330221099620","DOIUrl":"https://doi.org/10.1177/00369330221099620","url":null,"abstract":"As orthopaedic surgeons we use x-rays every day; not only when diagnosing pathology but often to assist in operative management of said pathology or ensure satisfactory outcomes for our patients in clinic. An awareness of the correct use of ionising radiation in the form of fluoroscopic imaging is therefore of great importance to reduce intraoperative exposure and has led to the development of the As Little As Reasonably Achievable (ALARA) principle. The primary aim of this study is to determine the knowledge and practises of radiation safety amongst orthopaedic surgeons in Scotland. Secondary aim is to assess the prevalence of back pain and relation to lead gowns. A google forms survey containing 20 questions about both an individual's radiation practises, and knowledge and departmental practises were distributed to all 4 deaneries in Scotland. In total 72 responses were received from 20 hospitals across all 4 Scottish deaneries. This included 28 Consultants, 23 Senior trainees and 21 Junior trainees. We found that the level of radiation training and knowledge varied considerably across seniority and the nation. Of those surveyed 100% reported always wear lead aprons/gowns however only 46.2% (n = 34) frequently or always wear thyroid protection when using X-rays. Only 55% (n = 40) of those surveyed had completed a radiation safety course with this being far less likely amongst junior trainees (29%, n = 6) than amongst Consultants (82%, n = 23) and senior trainees (48%, n = 11) (p < 0.0001). To our knowledge this is the most extensive survey into the radiation practises of Orthopaedic Surgeons in the literature and shows the need for increased education and awareness of radiation safety practises, particularly amongst junior trainees.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"103 - 108"},"PeriodicalIF":2.7,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48565073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1177/00369330221099619
C. Alifrangis, D. Nicol, J. Shamash, P. Rajan
Background and Aims Testicular Germ Cell Tumours (TGCTs) are the commonest young adult male cancer, with excellent survival outcomes even with metastatic disease. Chemotherapy, radiotherapy, and surgery are international guideline-dictated standard of care (SOC) treatments for International Germ Cell Cancer Collaborative Group (IGCCCG) “good risk” TGCT, but are associated with significant toxicities. Therapy de-escalation aims to reduce treatment morbidity whilst preserving cure rates, and has been adopted by some centres for stage IIA/B seminoma. Here, we report on the contemporary UK treatment landscape for stage IIA/B seminoma. Methods A questionnaire-based survey of NHS England-designated specialist cancer centres hosting supra-regional specialist multi-disciplinary team (sMDT) services (n = 13) as well those within NHS Scotland, NHS Wales and Health and Social Care Northern Ireland. Respondents were asked to order preferences of SOC and therapy de-escalation treatments for stage IIA/B seminoma. Results We identified significant geographical heterogeneity in treatment preferences. Whilst up to a third of centres have adopted a treatment de-escalation regimen, the majority deliver combination chemotherapy or radiotherapy. Conclusion A wider recognition of UK treatment heterogeneity and consideration of therapy de-escalation strategies at supra-regional sMDTs will increase stage IIA/B seminoma treatment options as part of clinical trials with oncological and quality of life endpoints.
背景和目的睾丸生殖细胞肿瘤（TGCT）是最常见的年轻成年男性癌症，即使有转移性疾病，也有良好的生存结果。化疗、放射治疗和手术是国际生殖细胞癌症合作小组（IGCCCG）“良好风险”TGCT的国际指导方针指定的护理标准（SOC）治疗，但与显著的毒性相关。降级治疗旨在降低治疗发病率，同时保持治愈率，并已被一些IIA/B期精原细胞瘤中心采用。在这里，我们报道了当代英国IIA/B期精原细胞瘤的治疗情况。方法对英国国家医疗服务体系（NHS）指定的癌症专科中心提供跨区域专家多学科团队（sMDT）服务（n = 13） 以及苏格兰国家医疗服务体系（NHS Scotland）、威尔士国家医疗服务系统（NHS Wales）和北爱尔兰卫生和社会护理机构（Health and Social Care Northern Ireland）内部的人员。受访者被要求对IIA/B期精原细胞瘤的SOC和治疗降级治疗进行排序。结果我们发现治疗偏好存在显著的地理异质性。虽然多达三分之一的中心采用了治疗降级方案，但大多数中心提供联合化疗或放疗。结论更广泛地认识到英国治疗的异质性，并考虑超区域sMDT的治疗降级策略，将增加IIA/B期精原细胞瘤治疗的选择，作为肿瘤学和生活质量终点临床试验的一部分。
{"title":"Management of stage II seminoma: a contemporary UK perspective","authors":"C. Alifrangis, D. Nicol, J. Shamash, P. Rajan","doi":"10.1177/00369330221099619","DOIUrl":"https://doi.org/10.1177/00369330221099619","url":null,"abstract":"Background and Aims Testicular Germ Cell Tumours (TGCTs) are the commonest young adult male cancer, with excellent survival outcomes even with metastatic disease. Chemotherapy, radiotherapy, and surgery are international guideline-dictated standard of care (SOC) treatments for International Germ Cell Cancer Collaborative Group (IGCCCG) “good risk” TGCT, but are associated with significant toxicities. Therapy de-escalation aims to reduce treatment morbidity whilst preserving cure rates, and has been adopted by some centres for stage IIA/B seminoma. Here, we report on the contemporary UK treatment landscape for stage IIA/B seminoma. Methods A questionnaire-based survey of NHS England-designated specialist cancer centres hosting supra-regional specialist multi-disciplinary team (sMDT) services (n = 13) as well those within NHS Scotland, NHS Wales and Health and Social Care Northern Ireland. Respondents were asked to order preferences of SOC and therapy de-escalation treatments for stage IIA/B seminoma. Results We identified significant geographical heterogeneity in treatment preferences. Whilst up to a third of centres have adopted a treatment de-escalation regimen, the majority deliver combination chemotherapy or radiotherapy. Conclusion A wider recognition of UK treatment heterogeneity and consideration of therapy de-escalation strategies at supra-regional sMDTs will increase stage IIA/B seminoma treatment options as part of clinical trials with oncological and quality of life endpoints.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 1","pages":"126 - 128"},"PeriodicalIF":2.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47785319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2022-01-05DOI: 10.1177/00369330211072247
Fatma Özcan, Zuhal Özişler
Background: Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state.
Aim: To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status.
Method: 77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings.
Result: The mean CLSS of men was significantly higher than women (P = 0.017). A significant positive correlation was found between age and CLSS (P = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (P = 0.001 r = -0.467).
Conclusion: LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.
背景:下尿路功能障碍(LUTD)是脑卒中患者的常见病，影响患者的生活质量和心理状态。目的:探讨影响脑卒中患者LUTD严重程度的因素及其与功能状态的关系。方法:选取77例脑卒中患者进行研究。记录所有患者的人口学特征和脑卒中特征。采用功能行走量表(FAS)、功能独立性量表(FIM)、核心下尿路症状评分问卷(CLSS)、贝克抑郁量表。77例患者中有33例进行了尿动力学研究，这些患者构成了研究的亚组。根据尿动力学研究结果，将患者按障碍类型、逼尿肌类型和逼尿肌括约肌协同障碍(DSD)进行分组。结果:男性的平均CLSS显著高于女性(P = 0.017)。年龄与CLSS呈显著正相关(P = 0.035 r = 0.24)，总FIM与所有子参数得分和CLSS平均值呈负相关(P = 0.001 r = -0.467)。结论:LUTD在脑卒中患者中很常见，泌尿系统症状的出现与功能状态不佳有关。除最大流量与CLSS外，尿动力学数据之间无显著关系。
{"title":"The Relationship Between Urinary Symptom Severity And Functional Status İn Patients With Stroke.","authors":"Fatma Özcan, Zuhal Özişler","doi":"10.1177/00369330211072247","DOIUrl":"https://doi.org/10.1177/00369330211072247","url":null,"abstract":"<p><strong>Background: </strong>Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state.</p><p><strong>Aim: </strong>To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status.</p><p><strong>Method: </strong>77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings.</p><p><strong>Result: </strong>The mean CLSS of men was significantly higher than women (<i>P</i> = 0.017). A significant positive correlation was found between age and CLSS (<i>P</i> = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (<i>P</i> = 0.001 r = -0.467).</p><p><strong>Conclusion: </strong>LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 2","pages":"64-70"},"PeriodicalIF":2.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2022-02-01DOI: 10.1177/00369330211072264
Stephen Rankin, Jacqueline McGuire, Mohamed Chekroud, Likhith Alakandy, Babu Mukhopadhyay
Aim: Cerebrospinal fluid (CSF) analysis for xanthochromia is routinely used to exclude subarachnoid haemorrhage (SAH). In this study, we evaluated the sensitivity and specificity of xanthochromia (by NEQAS-spectrophotometry) in routine clinical practice in three acute hospitals, in patients with suspected SAH. We explored whether including CSF red cell count (RCC) with xanthochromia improved diagnostic accuracy.
Methods: In this retrospective analysis, all xanthochromia results were assessed over three consecutive years. Clinical information and Registry data were analysed to find all patients diagnosed with SAH. We correlated xanthochromia data with clinical and radiological findings.
Results: There were 1761 xanthochromia performed. Of these, 26 (1.5%) were positive, 1624 (92%) negative and 72 (4.1%) were inconclusive. Of the 26 tests that were positive, 9 (35%) had confirmed SAH, 17 (65%) were falsely positive, with no false negative tests in our series. Xanthochromia identified 6% of all SAH diagnosed in the study. Incorporating RCC <1000 with xanthochromia, reducing false positive tests by 38% and inconclusive test by 85%.
Conclusion: The positive yield of xanthochromia is low but identified 6% of SAH. NEQAS-spectrophotometry is an excellent diagnostic method with 100% sensitivity, 99% specificity. Incorporating RCC markedly reduces false positive and inconclusive tests reducing need for further imaging.
{"title":"Evaluating xanthochromia in the diagnosis of subarachnoid haemorrhage in Scotland in the Era of modern computed tomography.","authors":"Stephen Rankin, Jacqueline McGuire, Mohamed Chekroud, Likhith Alakandy, Babu Mukhopadhyay","doi":"10.1177/00369330211072264","DOIUrl":"https://doi.org/10.1177/00369330211072264","url":null,"abstract":"<p><strong>Aim: </strong>Cerebrospinal fluid (CSF) analysis for xanthochromia is routinely used to exclude subarachnoid haemorrhage (SAH). In this study, we evaluated the sensitivity and specificity of xanthochromia (by NEQAS-spectrophotometry) in routine clinical practice in three acute hospitals, in patients with suspected SAH. We explored whether including CSF red cell count (RCC) with xanthochromia improved diagnostic accuracy.</p><p><strong>Methods: </strong>In this retrospective analysis, all xanthochromia results were assessed over three consecutive years. Clinical information and Registry data were analysed to find all patients diagnosed with SAH. We correlated xanthochromia data with clinical and radiological findings.</p><p><strong>Results: </strong>There were 1761 xanthochromia performed. Of these, 26 (1.5%) were positive, 1624 (92%) negative and 72 (4.1%) were inconclusive. Of the 26 tests that were positive, 9 (35%) had confirmed SAH, 17 (65%) were falsely positive, with no false negative tests in our series. Xanthochromia identified 6% of all SAH diagnosed in the study. Incorporating RCC <1000 with xanthochromia, reducing false positive tests by 38% and inconclusive test by 85%.</p><p><strong>Conclusion: </strong>The positive yield of xanthochromia is low but identified 6% of SAH. NEQAS-spectrophotometry is an excellent diagnostic method with 100% sensitivity, 99% specificity. Incorporating RCC markedly reduces false positive and inconclusive tests reducing need for further imaging.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"67 2","pages":"71-77"},"PeriodicalIF":2.7,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39741059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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