Impact of The New Fast Track Kidney Allocation Scheme For Declined Kidneys in The UK.

Abstract:The introduction of “highly sensitive” cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision. Firstly, the guideline drafters have to reconsider the available evidence that does not permit to assign the same class and level of evidence to the very well-validated 0–3 h algorithm and to the 0–1 h algorithm. In agreement with the validity of available data, the limitations of fast track protocols, in particular of the 0–1 h algorithm for NSTEMI rule-in, calls for caution. Secondly, as the current diagnostics guidance by the UK National Institute for Health and Care Excellence recommends, rapid diagnostic protocols should be performed only using well-validated hsTn; recommending the use of an assay before being commercially available is not fair and scientifically sound.

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14-P: HLA matching in the 2006 UK national kidney allocation scheme: Patients benefit from a revised approach

Human Immunology ◽

10.1016/j.humimm.2009.09.047 ◽

2009 ◽

Vol 70 ◽

pp. S18

Author(s):

Susan Fuggle ◽

Rachel Johnson ◽

Lisa Mumford ◽

John Forsythe ◽

Andrew Bradley ◽

...

Keyword(s):

Allocation Scheme ◽

Hla Matching ◽

Kidney Allocation

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Increased number of cases of giant cell arteritis and higher rates of ophthalmic involvement during the era of COVID-19

Rheumatology Advances in Practice ◽

10.1093/rap/rkaa067 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Rosamond Luther ◽

Sarah Skeoch ◽

John D Pauling ◽

Christopher Curd ◽

Felicity Woodgate ◽

...

Keyword(s):

Medical Records ◽

Fast Track ◽

Temporal Artery ◽

Temporal Artery Biopsy ◽

Duration Of Symptoms ◽

Time Period ◽

Number Of Patients ◽

Male Patients ◽

The Uk ◽

Made In

Abstract Objectives Our centre offers a fast-track assessment service for patients with suspected GCA and this service continued to operate during the coronavirus disease 2019 (COVID-19) pandemic. During and immediately following the peak of the COVID-19 pandemic in the UK we observed an increase in the number of patients diagnosed with GCA as well as an increased number of patients with visual complications. Our aim was to investigate this further. Methods The electronic medical records of all patients referred for GCA fast-track assessment from January 2019 were reviewed. A complete list of patients undergoing temporal artery ultrasound and temporal artery biopsy for investigation of GCA dating back to 2015 was also available. Results In the 12 week period between April and June 2020, 24 patients were diagnosed with GCA. Six (25%) had associated visual impairment. In contrast, during 2019, 28 new diagnoses of GCA were made in total and just 10% of patients suffered visual involvement. The number of patients diagnosed with GCA in April–June 2020 was nearly 5-fold that of the same time period the previous year. GCA diagnoses between April and June 2020 were supported by imaging (temporal artery ultrasound or CT-PET) in 72% of cases. We noted a higher proportion of male patients and a lower median age but no clear difference in the duration of symptoms prior to assessment. Conclusions The reasons behind our observations remain unclear. However, our findings support the viral aetiopathogenesis hypothesis for GCA and demonstrate the importance of maintaining access to urgent rheumatology services during periods of healthcare disruption.

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The mental health of nurses in the UK

Advances in Psychiatric Treatment ◽

10.1192/apt.9.5.374 ◽

2003 ◽

Vol 9 (5) ◽

pp. 374-379 ◽

Cited By ~ 10

Author(s):

Peter Nolan ◽

Maureen Smojkis

Keyword(s):

Health Care ◽

Interpersonal Relationships ◽

Working Conditions ◽

Workplace Violence ◽

Care Management ◽

Fast Track ◽

High Technology ◽

Health Policies ◽

Track System ◽

The Uk

The recruitment and retention crisis in UK nursing puts many reforms outlined in recent health policies at risk. Increasing bureaucratisation of health care, unattractive working conditions, poor pay and the emotionally exhausting nature of the work are associated with high rates of burnout and workplace violence. Some nurses prefer agency work, some leave because they cannot reconcile a caring role with working in the NHS. It seems that health care has become emotionally distant and the profession's longstanding attachment to caring through interpersonal relationships has been overridden by a high-technology, fast-track system of care management. To retain the principles and ethos of nursing at the centre of health developments, attention must be given to the micro-environments in which nurses work.

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