Pub Date : 2024-06-01DOI: 10.1136/flgastro-2024-102772
R. Beattie, Philip J Smith
{"title":"Climate change—so what should we do about it?","authors":"R. Beattie, Philip J Smith","doi":"10.1136/flgastro-2024-102772","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102772","url":null,"abstract":"","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1136/flgastro-2023-102473
Robin Baddeley, Nikolaos Voulvoulis, Siwan Thomas-Gibson, Bu'Hussain Hayee
Concern regarding the environmental impact of healthcare provision is now accompanied by a legal commitment for the NHS to align itself with national emissions targets. Meanwhile, the academic literature increasingly features environmental impact assessments focused on healthcare products, processes and systems. However, the current evidence base contains significant methodological heterogeneity, and the healthcare context demands that particular considerations are made when interpreting the findings from these studies. In this article, we consider the role environmental accounting methodologies can play in the effort to achieve environmental sustainability in healthcare; their utility and limitations.
{"title":"Environmental impact assessment in healthcare: utility and limitations","authors":"Robin Baddeley, Nikolaos Voulvoulis, Siwan Thomas-Gibson, Bu'Hussain Hayee","doi":"10.1136/flgastro-2023-102473","DOIUrl":"https://doi.org/10.1136/flgastro-2023-102473","url":null,"abstract":"Concern regarding the environmental impact of healthcare provision is now accompanied by a legal commitment for the NHS to align itself with national emissions targets. Meanwhile, the academic literature increasingly features environmental impact assessments focused on healthcare products, processes and systems. However, the current evidence base contains significant methodological heterogeneity, and the healthcare context demands that particular considerations are made when interpreting the findings from these studies. In this article, we consider the role environmental accounting methodologies can play in the effort to achieve environmental sustainability in healthcare; their utility and limitations.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141191774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-29DOI: 10.1136/flgastro-2024-102673
Rory James McCluskey, Jessie Elliott, Jan Leyden, John Conneely, Gerry McEntee, Suzanne O'Mahony, Niall McInerney
A previously well 43-year-old men was admitted with right upper quadrant and epigastric pain, fever and vomiting. His medical history included asymptomatic cholestatic liver function tests for which serial ultrasound (US), magnetic resonance cholangiopancreatography, fibroscan and a US-guided liver biopsy had proved unremarkable several years prior to this presentation. Physical examination revealed diffuse abdominal tenderness worst in the right upper quadrant and epigastric region. Laboratory investigations demonstrated raised inflammatory markers and deranged liver function but were otherwise unremarkable. CT of the abdomen and pelvis showed extensive pancreatic stranding and fluid most prominent around the tail and body of the pancreas. The patient had no history of gallstones, alcohol misuse, new medications, family history or hypercholesterolemia. The patient was managed conservatively but subsequently deteriorated with features of abdominal sepsis. Serial …
一名 43 岁的男性因右上腹和上腹痛、发烧和呕吐入院。他的病史包括无症状性胆汁淤积性肝功能检查，在这次就诊前的几年里，连续的超声波（US）、磁共振胆胰造影、纤维扫描和 US 引导下的肝活检均未发现异常。体格检查显示，右上腹和上腹部弥漫性压痛最严重。实验室检查显示炎症标志物升高，肝功能异常，但其他方面无异常。腹部和盆腔CT显示，胰腺尾部和胰体周围有广泛的胰腺绞窄和积液。患者没有胆结石史、酗酒史、新服药史、家族史或高胆固醇血症史。患者接受了保守治疗，但随后病情恶化，出现腹腔败血症特征。连续...
{"title":"Unique cause of acute pancreatitis","authors":"Rory James McCluskey, Jessie Elliott, Jan Leyden, John Conneely, Gerry McEntee, Suzanne O'Mahony, Niall McInerney","doi":"10.1136/flgastro-2024-102673","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102673","url":null,"abstract":"A previously well 43-year-old men was admitted with right upper quadrant and epigastric pain, fever and vomiting. His medical history included asymptomatic cholestatic liver function tests for which serial ultrasound (US), magnetic resonance cholangiopancreatography, fibroscan and a US-guided liver biopsy had proved unremarkable several years prior to this presentation. Physical examination revealed diffuse abdominal tenderness worst in the right upper quadrant and epigastric region. Laboratory investigations demonstrated raised inflammatory markers and deranged liver function but were otherwise unremarkable. CT of the abdomen and pelvis showed extensive pancreatic stranding and fluid most prominent around the tail and body of the pancreas. The patient had no history of gallstones, alcohol misuse, new medications, family history or hypercholesterolemia. The patient was managed conservatively but subsequently deteriorated with features of abdominal sepsis. Serial …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141192019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1136/flgastro-2023-102477
Leigh Donnelly
The current climate crisis is the biggest risk to health in recent years. As a result the National Health Service (NHS) has a commitment to reduce carbon emissions to net zero by 2040. As healthcare professionals in Gastroenterology, we have a responsibility to ensure that our services are sustainable. By making changes to practice and re-examine the way we deliver patient care, we can safeguard a greener NHS for future generations.
{"title":"A greener gastroenterology service in a greener NHS","authors":"Leigh Donnelly","doi":"10.1136/flgastro-2023-102477","DOIUrl":"https://doi.org/10.1136/flgastro-2023-102477","url":null,"abstract":"The current climate crisis is the biggest risk to health in recent years. As a result the National Health Service (NHS) has a commitment to reduce carbon emissions to net zero by 2040. As healthcare professionals in Gastroenterology, we have a responsibility to ensure that our services are sustainable. By making changes to practice and re-examine the way we deliver patient care, we can safeguard a greener NHS for future generations.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141105075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.1136/flgastro-2023-102620
Damien Leith, J. Orpen-Palmer, Adrian J Stanley, S. Siddhi
{"title":"Developing a sustainable endoscopy network in Scotland: in response to Tavabieet al","authors":"Damien Leith, J. Orpen-Palmer, Adrian J Stanley, S. Siddhi","doi":"10.1136/flgastro-2023-102620","DOIUrl":"https://doi.org/10.1136/flgastro-2023-102620","url":null,"abstract":"","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1136/flgastro-2023-102500
Mai Ling Perman
Despite contributing minimally to global greenhouse gas emissions,1 Pacific Island nations are at the frontline of climate change impacts.2 Their heightened vulnerability stems from their geographical dispersal across the expansive Pacific Ocean, which leaves them encircled by vast bodies of water. This unique geological position subjects these island communities to climate-related threats, including rising sea levels, coastline erosion, ocean acidification, loss of biodiversity, food and water insecurities and extreme weather events, jeopardising their existence and way of life. Oceania comprises Australia, New Zealand and the PICs and territories (see figure 1). The three ethnogeographic regions (Melanesia, Micronesia and Polynesia) form the PICs. Of these, 13 are sovereign nations, while others maintain unique political associations with France, New Zealand and the USA. Figure 1 Map of Oceania (Source: map-oceania-05.gif (720×410) (globalsecurity.org). The self-governing nations have almost 13 million people but only about 2.7 million live on the smaller islands.3 They are classified as low-income and middle-income countries.3 These include the Federated States of Micronesia, Fiji, Kiribati, the Republic of the Marshall Islands (RMI), Nauru, Papua New Guinea, Samoa, the Solomon Islands, Tonga, Tuvalu and Vanuatu. Each country boasts a unique blend of culture, tradition, history and political systems. As Earth becomes warmer due to climate change, sea levels rise via two main mechanisms: expanding heated seawater and melting ice sheets and glaciers.2 Because some PICs are low-lying atolls, they face the potential existential threat of vanishing underwater with rising sea levels. The countries with the most significant threat of ‘sinking’ first are Tuvalu, Kiribati and the Republic of the Marshall Islands. Their highest elevations vary from atoll to atoll, but, generally, they are mostly under 5 m above sea level. The only bridge, which is the highest peak (<10 m above sea level) in Majuro, Republic of the …
{"title":"Climate change and gastroenterology: from the frontline","authors":"Mai Ling Perman","doi":"10.1136/flgastro-2023-102500","DOIUrl":"https://doi.org/10.1136/flgastro-2023-102500","url":null,"abstract":"Despite contributing minimally to global greenhouse gas emissions,1 Pacific Island nations are at the frontline of climate change impacts.2 Their heightened vulnerability stems from their geographical dispersal across the expansive Pacific Ocean, which leaves them encircled by vast bodies of water. This unique geological position subjects these island communities to climate-related threats, including rising sea levels, coastline erosion, ocean acidification, loss of biodiversity, food and water insecurities and extreme weather events, jeopardising their existence and way of life. Oceania comprises Australia, New Zealand and the PICs and territories (see figure 1). The three ethnogeographic regions (Melanesia, Micronesia and Polynesia) form the PICs. Of these, 13 are sovereign nations, while others maintain unique political associations with France, New Zealand and the USA. Figure 1 Map of Oceania (Source: map-oceania-05.gif (720×410) (globalsecurity.org). The self-governing nations have almost 13 million people but only about 2.7 million live on the smaller islands.3 They are classified as low-income and middle-income countries.3 These include the Federated States of Micronesia, Fiji, Kiribati, the Republic of the Marshall Islands (RMI), Nauru, Papua New Guinea, Samoa, the Solomon Islands, Tonga, Tuvalu and Vanuatu. Each country boasts a unique blend of culture, tradition, history and political systems. As Earth becomes warmer due to climate change, sea levels rise via two main mechanisms: expanding heated seawater and melting ice sheets and glaciers.2 Because some PICs are low-lying atolls, they face the potential existential threat of vanishing underwater with rising sea levels. The countries with the most significant threat of ‘sinking’ first are Tuvalu, Kiribati and the Republic of the Marshall Islands. Their highest elevations vary from atoll to atoll, but, generally, they are mostly under 5 m above sea level. The only bridge, which is the highest peak (<10 m above sea level) in Majuro, Republic of the …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 43-year-old woman presented with 1 day of epigastric pain and a developing fever. She was tachycardic and febrile. Physical examination showed rebound tenderness on the left upper quadrant with decreased bowel sounds. CT of the abdomen revealed duodenal perforation surrounding a mass of unknown nature (figure 1). An oesophagogastroduodenoscopy showed a phytobezoar unusually located in the fourth duodenal segment (figure 2). A bezoar is a rare cause of small bowel perforation that most frequently occurs in …
{"title":"Perforation of the fourth duodenal segment and peritonitis caused by a bezoar","authors":"Baptiste Massart, Chieh-Wen Lai, Kian-Hwee Chong, Jia-Hui Chen","doi":"10.1136/flgastro-2024-102739","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102739","url":null,"abstract":"A 43-year-old woman presented with 1 day of epigastric pain and a developing fever. She was tachycardic and febrile. Physical examination showed rebound tenderness on the left upper quadrant with decreased bowel sounds. CT of the abdomen revealed duodenal perforation surrounding a mass of unknown nature (figure 1). An oesophagogastroduodenoscopy showed a phytobezoar unusually located in the fourth duodenal segment (figure 2). A bezoar is a rare cause of small bowel perforation that most frequently occurs in …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1136/flgastro-2024-102643
Jian-Wei Liu, Ru-Yuan Li
A 44-year-old man was referred to our hospital with a 2-week history of abdominal distention, nausea and recurrent vomiting. The past medical history disclosed peptic ulcer-related duodenal stenosis at the bulb for 3 years and cholecystolithiasis for 20 years. On examination, the abdomen was distended and soft with no tenderness. Blood laboratory tests showed leucocytosis (12.10×109/L, reference 3.5–9.5), mild hypokalaemia (3.25 mmol/L, reference 3.5–5.3), normal C reactive protein, liver function, renal function and coagulation function. An abdominal CT showed a typical Rigler’s triad: pneumobilia, …
{"title":"Unusual cause of recurrent vomiting in a patient with duodenal stenosis","authors":"Jian-Wei Liu, Ru-Yuan Li","doi":"10.1136/flgastro-2024-102643","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102643","url":null,"abstract":"A 44-year-old man was referred to our hospital with a 2-week history of abdominal distention, nausea and recurrent vomiting. The past medical history disclosed peptic ulcer-related duodenal stenosis at the bulb for 3 years and cholecystolithiasis for 20 years. On examination, the abdomen was distended and soft with no tenderness. Blood laboratory tests showed leucocytosis (12.10×109/L, reference 3.5–9.5), mild hypokalaemia (3.25 mmol/L, reference 3.5–5.3), normal C reactive protein, liver function, renal function and coagulation function. An abdominal CT showed a typical Rigler’s triad: pneumobilia, …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1136/flgastro-2024-102654
Swathi Prabhu, Anuradha Calicut Kini Rao, Vishwanath Basavaraj
A 70-year-old woman presented to the gastroenterology clinic with a 2-month history of acid reflux, heartburn and dysphagia. A clinical diagnosis of gastro-oesophageal reflux disease was made. Upper gastrointestinal (GI) endoscopy (figure 1) revealed a hiatus hernia with a red smooth surfaced lump at the gastro-oesophageal junction (GOJ), measuring 1 cm in diameter. The biopsy in our case threw up an unusual surprise of …
{"title":"Reflux riddle: an unforeseen element at the gastro-oesophageal junction","authors":"Swathi Prabhu, Anuradha Calicut Kini Rao, Vishwanath Basavaraj","doi":"10.1136/flgastro-2024-102654","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102654","url":null,"abstract":"A 70-year-old woman presented to the gastroenterology clinic with a 2-month history of acid reflux, heartburn and dysphagia. A clinical diagnosis of gastro-oesophageal reflux disease was made. Upper gastrointestinal (GI) endoscopy (figure 1) revealed a hiatus hernia with a red smooth surfaced lump at the gastro-oesophageal junction (GOJ), measuring 1 cm in diameter. The biopsy in our case threw up an unusual surprise of …","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1136/flgastro-2024-102642
Michael Dawson, Melissa Rankin, Grahame Smith
The North West Endoscopy Academy is committed to ensuring endoscopy training is of a standardised high quality that is multidisciplinary. It seeks to address the historic lack of admin training by providing a core admin and clerical (A&C) skills in endoscopy course for all A&C staff. The competency framework used for this training is the first developed specifically for A&C staff in endoscopy and the early indications are that it has significantly contributed to the efficacy of a unit’s performance, highlighting that greater focus should be placed on providing these opportunities to A&C staff in the future. This article will explore the aims and methodology of the course and present evaluation data to discuss the successes and future recommendations. We have used a combination of teaching methods, such as small group work, case study analysis and traditional classroom teaching to provide an education programme which seeks to underline existing best practice and introduce new themes and ways of working. Our two-tiered evaluation has shown this approach to be effective, in the future, we intend to implement a further evaluation to establish the long-term added value of the training. In combination, we will begin work on advanced skills modules aimed at supervisory and management staff.
{"title":"Improving endoscopy unit efficacy and retention through the provision of role-specific admin and clerical training","authors":"Michael Dawson, Melissa Rankin, Grahame Smith","doi":"10.1136/flgastro-2024-102642","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102642","url":null,"abstract":"The North West Endoscopy Academy is committed to ensuring endoscopy training is of a standardised high quality that is multidisciplinary. It seeks to address the historic lack of admin training by providing a core admin and clerical (A&C) skills in endoscopy course for all A&C staff. The competency framework used for this training is the first developed specifically for A&C staff in endoscopy and the early indications are that it has significantly contributed to the efficacy of a unit’s performance, highlighting that greater focus should be placed on providing these opportunities to A&C staff in the future. This article will explore the aims and methodology of the course and present evaluation data to discuss the successes and future recommendations. We have used a combination of teaching methods, such as small group work, case study analysis and traditional classroom teaching to provide an education programme which seeks to underline existing best practice and introduce new themes and ways of working. Our two-tiered evaluation has shown this approach to be effective, in the future, we intend to implement a further evaluation to establish the long-term added value of the training. In combination, we will begin work on advanced skills modules aimed at supervisory and management staff.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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