688 Cancellation Rate of Prostate Template Biopsy: Are There Any Merits to Implementing Pre-Operative Bowel Preparations?

Introduction The aim of this quality improvement project was to analyse the cancellation rates of the template biopsy done at the George Eliot Hospital. The focus was mainly on those due to poor bowel prep whereby manual evacuations have failed. Locally we have sometimes noted the failure rate of transperineal prostate biopsy as a result of the poor quality of the ultrasound due to inadequately evacuated rectum. Unfortunately, there are very limited studies which have looked into this issue hence the significance of this problem is not universally acknowledged. Method Retrospective review of all the template biopsies that were planned from April 2019 to April 2020 using the operation notes and local theatre management software. Results There was a total of 105 planned template biopsies from April 2019 to April 2020. 72 cases were attempted and within this, 7 of these cases required manual evacuations in which 3 resulted in abandonment of procedure. There were 33 cases which were cancelled due various other reasons. Conclusions The results showed that the failure rates due to poor bowel prep were not significant (4%). Based on these findings we have decided not to proceed with the implementation of pre-operative bowel prep with phosphate enema as we felt that the potential benefits were not enough for it be initiated as a routine practice. We aim to address the other reasons identified for cancellations.

The Victorian Period

This chapter has five sections: 1. General and Prose, including Dickens; 2. The Novel; 3. Poetry; 4. Periodicals, Publishing History, and Drama; 5. Miscellaneous. Section 1 is by Ana Alicia Garza; section 2 is by Lois Burke; section 3 is by Sally Blackburn-Daniels; sections 4 and 5 are by William Baker. In somewhat of a departure from previous accounts, this chapter concludes with a mixed-genre section that covers Samuel Butler Thomas and Jane Welsh Carlyle, Wilkie Collins, George Eliot and George Henry Lewes, George Gissing, Richard Jefferies, William Makepeace Thackeray, and Anthony Trollope. This is followed by a section containing additional materials that came too late to be included elsewhere. These sections have been contributed by William Baker, who thanks for their assistance Dominic Edwards, Olaf Berwald, Beth Palmer, Sophie Ratcliffe, and Caroline Radcliffe.

Finding Hoards

In literature, folklore, and popular culture, coins have a powerful association with buried treasure. That association often includes, of course, a colorful array of dragons, elves, leprechauns, and pirates. This chapter examines coin hoards as they appear in the works of Aristophanes, Plautus, Sir Walter Scott, George Eliot, J.R.R. Tolkien, and others. Among historical hoards are those reported by Cicero, Samuel Pepys, and a curious testimonial involving a witch in a medieval manuscript from 1366. Modern discoveries of ancient and medieval coin hoards number in the tens of thousands; this chapter examines some notable examples from Pompeii, Herculaneum, Britain, and Afghanistan.

The Pace of Fiction

We talk about pace, often: the pace of history, modern life, everyday movement. And, really, we have talked about pace for centuries. But we hardly know what it means or how one might analyze it. The Pace of Fiction starts from the notion that all pace is, essentially, a product of narrative, and narrative fiction is what produces pace most elaborately. It moves forward as a history of transformations in narrative movement, from Fielding and Goethe and Austen to George Eliot, Flaubert, Henry James, James Joyce, Hemingway, Woolf, and Mann. Pace reveals narrative in its most elaborate effects. And the way pace changes in fiction expresses much of what we refer to as the pace of modernity.