Psychiatric liaison service referral patterns during the UK COVID-19 pandemic: An observational study

Genital warts (GW) are mucosal or skin lesions caused by sexual transmission of human papillomavirus (HPV). This study estimates the frequency of GW cases in physicians’ clinics and physicians’ usual practices of GW referral and diagnosis in Peru. Participants in this study were a convenience sample of 100 physicians in five specialties: primary care (17), gynecology (37), urology (10), dermatology (31), and infectious diseases (5). Physicians completed a survey and daily log of all patients aged 18–60 years seen over ten days in their offices located in Peru. The survey recorded GW referral patterns and the daily log recorded patient demographic information and GW diagnosis. Among 12,058 patients, the annual GW prevalence (95% confidence interval [CI]) was 2.28% (2.02–2.56) and cumulative incidence (95% CI) was 1.60% (1.38–1.84). Physicians reported that most GW patients were direct consult (73.5% of male and 67.9% of females) and physicians treated most GW patients themselves (73.4% of males and 76.7% of females). As reported, the most common reasons for referring were ‘serious cases requiring more specialized treatment’ (73.2% of male and 72.2% of female) and ‘lack of resources to treat’ (26.8% of male and 27.8% of female). We conclude that GW cases are commonly seen by physicians in Peru.

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Thrombotic and haemorrhagic complications in critically ill patients with COVID-19: a multicentre observational study

Critical Care ◽

10.1186/s13054-020-03260-3 ◽

2020 ◽

Vol 24 (1) ◽

Cited By ~ 8

Author(s):

Akshay Shah ◽

Killian Donovan ◽

Anna McHugh ◽

Manish Pandey ◽

Louise Aaron ◽

...

Keyword(s):

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

White Cell Count ◽

Laboratory Data ◽

Outcome Data ◽

Icu Length Of Stay ◽

Tertiary Hospitals ◽

Thrombotic Complications ◽

The Uk

Abstract Background Optimal prophylactic and therapeutic management of thromboembolic disease in patients with COVID-19 remains a major challenge for clinicians. The aim of this study was to define the incidence of thrombotic and haemorrhagic complications in critically ill patients with COVID-19. In addition, we sought to characterise coagulation profiles using thromboelastography and explore possible biological differences between patients with and without thrombotic complications. Methods We conducted a multicentre retrospective observational study evaluating all the COVID-19 patients received in four intensive care units (ICUs) of four tertiary hospitals in the UK between March 15, 2020, and May 05, 2020. Clinical characteristics, laboratory data, thromboelastography profiles and clinical outcome data were evaluated between patients with and without thrombotic complications. Results A total of 187 patients were included. Their median (interquartile (IQR)) age was 57 (49–64) years and 124 (66.3%) patients were male. Eighty-one (43.3%) patients experienced one or more clinically relevant thrombotic complications, which were mainly pulmonary emboli (n = 42 (22.5%)). Arterial embolic complications were reported in 25 (13.3%) patients. ICU length of stay was longer in patients with thrombotic complications when compared with those without. Fifteen (8.0%) patients experienced haemorrhagic complications, of which nine (4.8%) were classified as major bleeding. Thromboelastography demonstrated a hypercoagulable profile in patients tested but lacked discriminatory value between those with and without thrombotic complications. Patients who experienced thrombotic complications had higher D-dimer, ferritin, troponin and white cell count levels at ICU admission compared with those that did not. Conclusion Critically ill patients with COVID-19 experience high rates of venous and arterial thrombotic complications. The rates of bleeding may be higher than previously reported and re-iterate the need for randomised trials to better understand the risk-benefit ratio of different anticoagulation strategies. Graphical abstract

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Efficacy of palliative treatments in renal cancer: A retrospective observational study in a district general hospital in the UK

Annals of Oncology ◽

10.1093/annonc/mdx661.002 ◽

2017 ◽

Vol 28 ◽

pp. x81

Author(s):

N. O'Connell ◽

H. Iftikhar ◽

G. Srinivasan ◽

J. Radhakrishnan

Keyword(s):

Observational Study ◽

General Hospital ◽

Renal Cancer ◽

District General Hospital ◽

Retrospective Observational Study ◽

The Uk

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Bend it like Beckham or fix them like Florence—proportional representation of healthcare in New Year honours: an observational study

BMJ ◽

10.1136/bmj.l6721 ◽

2019 ◽

pp. l6721

Author(s):

John A Emelifeonwu ◽

James E Hazelwood ◽

Oscar Nolan ◽

Emma Sharland ◽

Anna O’Donald ◽

...

Keyword(s):

Observational Study ◽

Absolute Risk ◽

Proportional Representation ◽

Relative Risks ◽

The Arts ◽

Gender Biases ◽

Significant Difference ◽

And Gender ◽

The Uk ◽

To Receive

AbstractObjectivesTo compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases.DesignObservational study of the UK honours system with a comparative analysis of proportional representation of the UK workforce and subgroup analyses of gender and geographical representations.ParticipantsRecipients of NYHs from 2009 to 2018.Main outcome measuresAbsolute risk of receiving an NYH based on industry, gender, or region of the UK. Relative risk of receiving an NYH for services to healthcare compared with other industries.Results10 989 NYHs were bestowed from 2009 to 2018, 47% of which were awarded to women. 832 awards (7.6%) were for services to healthcare. People working in sport and in the arts and media were more likely to receive NYHs than those working in healthcare (relative risks of 22.01 (95% confidence interval 19.91 to 24.34) and 5.84 (5.31 to 6.44), respectively). There was no significant difference between the rate of receiving honours for healthcare and for science and technology (P=0.22). 34% (3741) of awards were issued to people living in London and in the southeast of England, and only 496 of 1447 (34%) higher order awards (knighthoods, damehoods, companions of honour, and commanders of the order of the British empire) were received by women.ConclusionsIn relation to the size of its workforce, a career in healthcare is not as “honourable” as careers in certain other industries. Geographical and gender biases might exist in the honours system.

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Real-world outcomes with pembrolizumab in patients with treatment-naive advanced/metastatic NSCLC in the UK: multicentre retrospective observational study

Lung Cancer ◽

10.1016/s0169-5002(19)30124-2 ◽

2019 ◽

Vol 127 ◽

pp. S33-S34

Author(s):

N. Tokaca ◽

F. Gomes ◽

S. Lau ◽

A. Jackson ◽

M. Gradwell ◽

...

Keyword(s):

Observational Study ◽

Real World ◽

Retrospective Observational Study ◽

Metastatic Nsclc ◽

Treatment Naïve ◽

The Uk

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Investigating Wilms’ Tumours Worldwide: A Report of the OxPLORE Collaboration—A Cross-Sectional Observational Study

World Journal of Surgery ◽

10.1007/s00268-019-05213-6 ◽

2019 ◽

Vol 44 (1) ◽

pp. 295-302 ◽

Cited By ~ 2

Author(s):

K. Ford ◽

S. Gunawardana ◽

E. Manirambona ◽

G. S. Philipoh ◽

B. Mukama ◽

...

Keyword(s):

Medical Students ◽

Observational Study ◽

Research Collaboration ◽

Multidisciplinary Treatment ◽

High Income ◽

Junior Doctors ◽

Paediatric Surgery ◽

Cross Sectional ◽

Oncology Research ◽

The Uk

Abstract Background Childhood cancer is neglected within global health. Oxford Pediatrics Linking Oncology Research with Electives describes early outcomes following collaboration between low- and high-income paediatric surgery and oncology centres. The aim of this paper is twofold: to describe the development of a medical student-led research collaboration; and to report on the experience of Wilms’ tumour (WT). Methods This cross-sectional observational study is reported as per STROBE guidelines. Collaborating centres included three tertiary hospitals in Tanzania, Rwanda and the UK. Data were submitted by medical students following retrospective patient note review of 2 years using a standardised data collection tool. Primary outcome was survival (point of discharge/death). Results There were 104 patients with WT reported across all centres over the study period (Tanzania n = 71, Rwanda n = 26, UK n = 7). Survival was higher in the high-income institution [87% in Tanzania, 92% in Rwanda, 100% in the UK (X2 36.19, p < 0.0001)]. Given the short-term follow-up and retrospective study design, this likely underestimates the true discrepancy. Age at presentation was comparable at the two African sites but lower in the UK (one-way ANOVA, F = 0.2997, p = 0.74). Disease was more advanced in Tanzania at presentation (84% stage III–IV cf. 60% and 57% in Rwanda and UK, respectively, X2 7.57, p = 0.02). All patients had pre-operative chemotherapy, and a majority had nephrectomy. Post-operative morbidity was higher in lower resourced settings (X2 33.72, p < 0.0001). Methodology involving medical students and junior doctors proved time- and cost-effective. This collaboration was a valuable learning experience for students about global research networks. Conclusions This study demonstrates novel research methodology involving medical students collaborating across the global south and global north. The comparison of outcomes advocates, on an institutional level, for development in access to services and multidisciplinary treatment of WT.

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