scholarly journals Colonoscopy at a Combined District General Hospital and Specialist Endoscopy Unit: Lessons from 505 Consecutive Examinations

2002 ◽  
Vol 95 (4) ◽  
pp. 194-197 ◽  
Author(s):  
Siwan Thomas-Gibson ◽  
Catherine Thapar ◽  
Syed G Shah ◽  
Brian P Saunders
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
British Society ◽  
Completion Rates ◽  
Endoscopy Unit ◽  
Pain Scores ◽  
Training And Supervision ◽  
Long Term Follow Up

Provisional reports from the Intercollegiate British Society of Gastroenterology National Colonoscopy audit show completion rates of 57–77%for the procedure and poor levels of training and supervision. We prospectively audited all aspects of colonoscopy performed at a combined district general hospital and specialist endoscopy unit. Details of referral, examination, endoscopist, complications and follow-up were recorded and patients were sent questionnaires for long-term follow-up. 505 patients (246 male) underwent colonoscopy by 27 different endoscopists. Their median age was 57 years (range 13–92) and 93%were outpatients. 64% patients were symptomatic and 36%were having surveillance or follow-up colonoscopy. The overall caecal intubation rate was 93%, with little difference between surgeons, physicians and experienced trainees (89%, 92%, 94%) and specialist endoscopists (98%). In only one case was an inexperienced trainee (<100 procedures) unsupervised. Pain scores estimated by the endoscopist were well matched with those given by the patient—medians 29 and 26 (maximum 100) respectively. Median satisfaction score was 96 (maximum 100). Polyp pick-up rate was 26.9%and there were 11 new cancers. 16 (3%) minor immediate complications were recorded—5 oversedation, 6 vasovagal attacks, 3 polypectomy haemorrhages and 2 mucosal injuries (neither requiring treatment). 3 patients died within 6 months of follow-up but no death was colonoscopy related. Completion rates in this setting were adequate for all endoscopists studied. Patient satisfaction with the procedure was high and very few immediate or long-term complications were encountered.

Long-term follow-up of patients who had bronchial carcinoid tumours resected in a district general hospital

Lung Cancer ◽  
2019 ◽  
Vol 127 ◽  
pp. S63-S64
Author(s):  
M. Mccloskey ◽  
C. Yarr ◽  
K. Grant ◽  
M. Doherty ◽  
R. Sharkey ◽  
...  
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Bronchial Carcinoid ◽  
Carcinoid Tumours ◽  
Long Term Follow Up

scholarly journals Latissimus dorsi myocutaneous reconstruction: a study of long-term outcomes in a district general hospital

2016 ◽  
Vol 98 (8) ◽  
pp. 574-577 ◽  
Author(s):  
C Kallaway ◽  
A Humphreys ◽  
N Laurence ◽  
R Sutton
Keyword(s):  
General Hospital ◽  
Latissimus Dorsi ◽  
Capsular Contracture ◽  
District General Hospital ◽  
Latissimus Dorsi Flap ◽  
Protective Mechanism ◽  
Term Outcome ◽  
Long Term Outcome

INTRODUCTIONThe aim of this study was to evaluate the long-term outcome and durability of both autologous and implant-assisted latissimus dorsi reconstruction in a district general hospital over a 10-year follow-up period.METHODSA prospective cohort study was carried out using a detailed database of all latissimus dorsi flap reconstructions performed by a single consultant surgeon between 2003 and 2013 at the Royal United Hospital, Bath. The long-term outcome following reconstruction was assessed by analysing all episodes of ‘reconstruction-specific’ operations required from 6 months after the initial surgery.RESULTSThe study included 110 patients with latissimus dorsi flap reconstructions, 21 autologous and 95 implant-assisted. Radiotherapy was given to 27 patients with reconstructed flaps. Mean follow-up was 69 months. Further reconstruction-specific surgery was needed in 27 (23%) cases, with 5 of these being post-radiotherapy flaps. Implant-related surgery was the most common reason for further surgery. Complications of the implant itself made up 52% of these cases, chronic sepsis being the most common. The rate of symptomatic capsular contracture requiring further surgery was 4.2%. Of these, one of four patients had undergone radiotherapy.DISCUSSIONIn our institution, latissimus dorsi reconstruction is durable and safe over the long term, with limited need for further substantial intervention to maintain a good outcome from the initial reconstruction. Autologous flaps were less likely to require further surgery over the long term compared with implant-based reconstructions. The low rate of symptomatic capsular contracture may be due to the protective mechanism provided by the extended harvest flap used.

Long-term follow-up of schizophrenics admitted to a general hospital psychiatric ward

1969 ◽  
Vol 43 (1-4) ◽  
pp. 525-534 ◽  
Author(s):  
David A. Soskis ◽  
Martin Harrow ◽  
Thomas P. Detre
Keyword(s):  
General Hospital ◽  
Psychiatric Ward ◽  
Long Term Follow Up

Long-term follow-up of borderline patients in a general hospital

1987 ◽  
Vol 28 (6) ◽  
pp. 530-535 ◽  
Author(s):  
J. Paris ◽  
R. Brown ◽  
D. Nowlis
Keyword(s):  
General Hospital ◽  
Long Term Follow Up ◽  
Borderline Patients

scholarly journals Long-term Follow-Up of Individuals with Celiac Disease: An Evaluation of Current Practice Guidelines

2007 ◽  
Vol 21 (9) ◽  
pp. 557-564 ◽  
Author(s):  
Jocelyn A Silvester ◽  
Mohsin Rashid
Keyword(s):  
Primary Care ◽  
Celiac Disease ◽  
Practice Guidelines ◽  
Current Practice ◽  
British Society ◽  
Care Society ◽  
American Gastroenterological Association ◽  
Long Term Follow Up

INTRODUCTION: Celiac disease can be treated by following a strict gluten-free diet for life. If properly followed, the diet resolves symptoms and nutritional deficiencies. It is generally recommended that individuals with celiac disease have careful long-term follow-up. However, it is not clear which elements of disease status evaluation, laboratory investigations and self-management support should be included in follow-up.OBJECTIVES: To examine the current practice guidelines and recommendations regarding follow-up of individuals with celiac disease.METHODS: Guidelines issued by gastroenterological societies and associations, and recommendations by experts were retrieved using MEDLINE and other Internet search engines.RESULTS: Practice guidelines were available from the American Gastroenterological Association; the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition; the National Institutes of Health Consensus Development Conference 2004; the World Gastroenterology Organization; the British Society for Gastroenterology and the United Kingdom-based Primary Care Society for Gastroenterology. Most guidelines recommended a scheduled annual review and regular measurements of body mass index. The British Society for Gastroenterology recommended dietary review only at times of stress, while others recommended dietary review with a nutritionist. All associations recommended serial tissue transglutaminase antibody testing. The American Gastroenterological Association and the Primary Care Society for Gastroenterology recommended annual hemoglobin, ferritin and folate checks. One guideline recommended annual hemoglobin, electrolyte, calcium, albumin, ferritin, folate, fat-soluble vitamin, liver function test, parathyroid hormone and bone density measurements (approximately $400 per patient).CONCLUSIONS: The current practice guidelines regarding the follow-up of patients with celiac disease varied greatly in their recommendations and many were not evidence-based. Prospective studies are required to develop rational, cost-effective and risk-stratified guidelines for long-term follow-up of these patients.

scholarly journals Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital

2003 ◽  
Vol 182 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Keith Hawton ◽  
Daniel Zahl ◽  
Rosamund Weatherall
Keyword(s):  
General Hospital ◽  
Age Groups ◽  
First Year ◽  
Prevention Strategies ◽  
Deliberate Self Harm ◽  
Long Term Follow Up ◽  
Self Harm ◽  
Annual Risk

BackgroundDeliberate self-harm (DSH) is the strongest risk factor for future suicide. Up-to-date information on the extent of risk is lacking.AimsTo investigate the risk of suicide after DSH during a long follow-up period.MethodA mortality follow-up study to 2000 was conducted on 11583 patients who presented to hospital after DSH between 1978 and 1997. Data were obtained from a general hospital DSH register in Oxford and the Office for National Statistics, and from equivalent mortality registers in Scotland and Northern Ireland.ResultsThree hundred patients had died by suicide or probable suicide. The risk in the first year of follow-up was 0.7% (95% CI 0.6–0.9%), which was 66 (95% CI 52–82) times the annual risk of suicide in the general population. The risk after 5 years was 1.7%, at 10 years 2.4% and at 15 years 3.0%. The risk was far higher in men than in women (hazard ratio 2.8, 95% CI 2.2–3.6). In both genders it increased markedly with age at initial presentation.ConclusionsFollowing DSH there is a significant and persistent risk of suicide, which varies markedly between genders and age groups. Reduction in the risk of suicide following DSH must be a key element in national suicide prevention strategies.

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