Type and crossmatch tests in urologic elective surgery: our practice and thoughts for the future

2016 ◽  
Author(s):  
Patricia Martins
Keyword(s):  
Elective Surgery ◽  
The Future

scholarly journals Survey of General Paediatric Surgery Provision in England, Wales and Northern Ireland

2008 ◽  
Vol 90 (3) ◽  
pp. 193-197 ◽  
Author(s):  
JK Pye
Keyword(s):  
Northern Ireland ◽  
Elective Surgery ◽  
High Volume ◽  
District General Hospital ◽  
Paediatric Surgery ◽  
Subtle Change ◽  
Tertiary Centre ◽  
The Future ◽  
Tertiary Hospitals ◽  
Current Provision

INTRODUCTION A survey was carried out to ascertain the current provision of general paediatric surgery (GPS) in all hospitals in England, Wales and Northern Ireland with 100% return rate. The provision of GPS is at a crossroads with a drift of these cases to the overstretched, tertiary referral hospitals. METHODS The regional representatives on the council of the Association of Surgeons of Great Britain and Ireland (ASGBI) obtained data from their regions. Any gaps in the data were completed by the author telephoning the remaining hospitals to ascertain their current provision. RESULTS A total of 325 acute hospitals are potentially available to admit elective and/or emergency paediatric patients, of which 25 hospitals provide a tertiary paediatric surgical service. Of the remaining ‘non-tertiary’ hospitals, 138 provide elective GPS and 147 provide emergency GPS. The ages at which GPS is carried out varies considerably, but 76% of non-tertiary hospitals provide elective GPS to those over the age of 2 years. The ages of emergency cases are 24% over the age of 2 years and 51.5% over the age of 5 years. The age at which surgery is carried out is dependent on the anaesthetic provision. Subspecialisation within each hospital has taken place with a limited number of surgeons providing the elective surgery. ‘Huband-spoke’ provision of GPS to a district general hospital (DGH) from a tertiary centre is embryonic with only 11 surgeons currently in post. An estimate of the annual elective case load of GPS based on the average number of cases done on an operation list works out at 23,000 cases done outwith the tertiary centres. DISCUSSION Almost 10 years ago, a change in the training of young surgeons took place. An increase in training posts in Tertiary centres was made available following advice from the British Association of Paediatric Surgeons (BAPS) but these posts were often not taken up. Many DGH surgeons became uncertain whether they should continue GPS training. A subtle change in the wording of the general guidance by the Royal College of Anaesthetists altered the emphasis on the age at which it was appropriate to anaesthetise children. Change in clinical practice, reducing need, and a drift towards tertiary centres has reduced DGH operations by 30% over a decade. Young surgeons are now seldom exposed to this surgery, and are not being trained in it. The large volume of these low-risk operations in well children cannot be absorbed into the current tertiary centres due to pressure on beds. The future provision of this surgery is at risk unless action is taken now. This survey was carried out to inform the debate, and to make recommendations for the future. The principal recommendations are that: (i) GPS should continue to be provided as at present in those DGHs equipped to do so; (ii) GPS training should be carried out in the DGHs where a high volume of cases is carried out; (iii) management of these cases should use a network approach in each region; (iv) hospital trusts should actively advertise for an interest in GPS as a second subspecialty; and (v) the SAC in general surgery develop a strategy to make GPS relevant to trainee surgeons.

Impact of Covid-19 on Surgical Training in a Tertiary Care Centre in Tirupati, Andhra Pradesh, India

2021 ◽  
Vol 8 (18) ◽  
pp. 1212-1216
Author(s):  
Roja Ramani Kumbha ◽  
Venkata Prakash Gandikota ◽  
Venkata Ramanaiah Nannam ◽  
Ganesh Reddy Elluru
Keyword(s):  
Surgical Training ◽  
Elective Surgery ◽  
Human Life ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Surgical Practice ◽  
The Future ◽  
The Impact

BACKGROUND Covid-19 pandemic has a devastating effect on many aspects of human life. The health care sector is the most affected, and surgical disciplines are no exception. Surgery has an essential role in human life, given its curative potential, and its dearth would cause much morbidity and even mortality in many cases. Surgery cannot wait even for a pandemic. Against this backdrop, it becomes essential to examine the effect of the pandemic on surgical disciplines. Here we study the impact of Covid-19 on the general surgery department in a tertiary care hospital. METHODS A retrospective observational study comparing data of outpatient department (OPD), admissions, and surgical activity in two different periods was done. RESULTS There was a significant impact on the number of surgical outpatients seen, admissions done, and surgeries conducted when compared between the two periods. In 2019 vs. 2020, 19,983 vs. 4481 OPD’s were seen. Similarly, 4274 admissions occurred during 2019 vs. only 506 in the 2020 period. Likewise, the impact on both elective and emergency surgery was also significant, 1102 elective surgeries were conducted in 2019. In contrast, Covid lead to complete cessation of elective surgery in 2020, increasing the risk of complication of various surgical conditions to the patients. Emergency surgeries in 2019, 694 vs. 220 in 2020 signified how the Covid pandemic had led human life to a standstill. Covid-19 pandemic resulted in abrupt cessation of various academic activities conducted in the department, but it also has seen the adoption of newer teaching methods. CONCLUSIONS Surgical care is quintessential in the fact that no other remedy can produce its results. There is no parallel. Lack of surgical care can lead to complications, avoidable morbidity, and mortality and can profoundly impact human life quality. Surgical education, which requires an apprenticeship, direct involvement, also took a hard hit, which has implications for future surgeons and patients alike. In this backdrop, our study highlights the need for more information on the future of surgical practices to make surgery safe in pandemic times. The existing lockdown had a significant impact on routine surgical practice and will require dedicated efforts for the resumption of "New Normal" in the future of all surgical disciplines. KEYWORDS Covid-19, Pandemic, Impact, Surgical Practice, Surgical Training

International determination of the total motion of the pole

1961 ◽  
Vol 13 ◽  
pp. 29-41
Author(s):  
Wm. Markowitz
Keyword(s):  
Secular Motion ◽  
The Future

A symposium on the future of the International Latitude Service (I. L. S.) is to be held in Helsinki in July 1960. My report for the symposium consists of two parts. Part I, denoded (Mk I) was published [1] earlier in 1960 under the title “Latitude and Longitude, and the Secular Motion of the Pole”. Part II is the present paper, denoded (Mk II).

Status of the Lick Proper Motion Program

1978 ◽  
Vol 48 ◽  
pp. 387-388
Author(s):  
A. R. Klemola
Keyword(s):  
Proper Motion ◽  
The Future

Second-epoch photographs have now been obtained for nearly 850 of the 1246 fields of the proper motion program with centers at declination -20° and northwards. For the sky at 0° and northward only 130 fields remain to be taken in the next year or two. The 270 southern fields with centers at -5° to -20° remain for the future.

Some Structural Features of Metaphase Chromosomes of Mice and Men

1967 ◽  
Vol 25 ◽  
pp. 190-191
Author(s):  
Godfrey C. Hoskins ◽  
Betty B. Hoskins
Keyword(s):  
Electron Microscopy ◽  
Electron Micrographs ◽  
Structural Features ◽  
Metaphase Chromosomes ◽  
The Future ◽  
Of Mice And Men ◽  
Mouse Cells ◽  
Human And Mouse

Metaphase chromosomes from human and mouse cells in vitro are isolated by micrurgy, fixed, and placed on grids for electron microscopy. Interpretations of electron micrographs by current methods indicate the following structural features.Chromosomal spindle fibrils about 200Å thick form fascicles about 600Å thick, wrapped by dense spiraling fibrils (DSF) less than 100Å thick as they near the kinomere. Such a fascicle joins the future daughter kinomere of each metaphase chromatid with those of adjacent non-homologous chromatids to either side. Thus, four fascicles (SF, 1-4) attach to each metaphase kinomere (K). It is thought that fascicles extend from the kinomere poleward, fray out to let chromosomal fibrils act as traction fibrils against polar fibrils, then regroup to join the adjacent kinomere.

Freeze-fracture cytochemistry: A goal set by Russell Steere in 1957

1993 ◽  
Vol 51 ◽  
pp. 60-61
Author(s):  
Nicholas J Severs
Keyword(s):  
Chemical Nature ◽  
Biological Systems ◽  
Freeze Fracture ◽  
Structural Components ◽  
Major Goal ◽  
Membrane Biology ◽  
Routine Application ◽  
The Future ◽  
Freeze Etching

In his pioneering demonstration of the potential of freeze-etching in biological systems, Russell Steere assessed the future promise and limitations of the technique with remarkable foresight. Item 2 in his list of inherent difficulties as they then stood stated “The chemical nature of the objects seen in the replica cannot be determined”. This defined a major goal for practitioners of freeze-fracture which, for more than a decade, seemed unattainable. It was not until the introduction of the label-fracture-etch technique in the early 1970s that the mould was broken, and not until the following decade that the full scope of modern freeze-fracture cytochemistry took shape. The culmination of these developments in the 1990s now equips the researcher with a set of effective techniques for routine application in cell and membrane biology.Freeze-fracture cytochemical techniques are all designed to provide information on the chemical nature of structural components revealed by freeze-fracture, but differ in how this is achieved, in precisely what type of information is obtained, and in which types of specimen can be studied.

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