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1. 543 Improving the Management of Acute Ureteric Colic in A Multi-Centre District General Hospital: A Closed-Loop Audit

Author

U Otite, S Ahmad, C Desai, S A Ehsanullah, and A Bruce

Subjects
medicine.medical_specialty, business.industry, General surgery, Medicine, Surgery, Ureteric colic, Audit, Multi centre, General hospital, business, Closed loop
Abstract

Introduction The British Association of Urological Surgeons (BAUS) released guidance in 2018 regarding the optimum management of acute ureteric colic: a condition which can present as a surgical emergency. Our aim was to review the current practice at our hospital in diagnosing and managing acute ureteric colic and ultimately, implement sustainable change to address any areas of limitations. Method The following data was retrospectively collected for of all patients admitted with acute ureteric colic: investigations performed, medications administered, details of surgical intervention and follow-up. 1st Cycle: March 2017 to February 2018. Intervention: Teaching sessions delivered to staff (including doctors and nurses) in the A&E and urology department. 2nd Cycle: January 2019 to December 2019. Results 268 patients presented to A&E with ureteric colic – 18% increase from previous year. On admission: 60.4% of patients had serum calcium checked, 97.7% had a CT KUB performed within 24 hours and 67.2% were given NSAIDs; this is a 20.4%, 0.4% and 5.2% increase from the previous year, respectively. Only 31.3% of patients had an acute surgical intervention. The average wait time for clinic follow-up was reduced to 41 days following departmental education, but only 26.4% of patients were seen within the BAUS advised 4-week timeframe. Conclusions Re-audit showed distinct improvement in the management of acute ureteric colic. Thus, departmental education strategies have had a positive impact. It is recommended that the reservation of one daily elective theatre slot for an emergency operation and a computerised clinic booking system will further optimise our management in line with BAUS guidance.

Published
2021
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2. Contents Vol. 38, 2000

Author

Kazuki Kawabe, Alexandre R. Zlotta, J. Köllermann, J. Steffens, B. Kosharskyy, Ugur Mungan, Frieder Bauss, Denis Chautard, Çetin Harmankaya, Yutaka Ono, Thomas Ebert, Andrew J. G. Simpson, Murat Sade, K.E. Giercksky, Akihiko Okuyama, A.K. Nigam, R. Hiebl, Claude Schulman, O. Naňka, B. Helpap, André T. Guay, G. Dipaola, Shiro Takahara, E.W. Hauck, A. Stenzl, Satoru Takahashi, B. Schönberger, M. Grim, M. Ludwig, Peter J. Goebell, Manfred Wiesel, Murat Dayanc, I. Schroeder-Printzen, U. Otite, U. Kaulfuss, Yasunori Harada, G. Moutzouris, Norio Nonomura, G. Lüdecke, D. Brkovic, Murat Sevinç, C. Arens, Özgür Tan, Véronique Verriele, Claudia M. Carvalho, Yukio Homma, Philippe Colls, Ch. Theodorou, Riyadh F. Talic, W. Weidner, Ziya Kirkali, Markus J. Seibel, A. Katsoulis, W. Månsson, Kazuo Nishimura, Francesco Saverio Camoglio, Gerd Staehler, P. Röttger, Natsuki Takaha, Ch. Katsifotis, S.D. Fosså, Gérard Bertrand, Elaine Darini, S. Loening, A Daver, D. Floratos, K.D. Jacobsen, Jesús B. Perez, Masahiro Nozawa, Tadaichi Kitamura, H. Müller, B.M. Altinkilic, Joachim Dörsam, P. Stournaras, M.W. Köllermann, Yves Fradet, Bernd J. Schmitz-Dräger, Lüfti Tahmaz, Francesco P. Selvaggi, K.-Horst Bichler, Gerhard Forster, Walter Ludwig Strohmaier, Tatsunari Fukui, U. Oehler, Christian Kissling, Luca Giacomello, Ernesto Velásquez, Michele Spalletta, Carlos Dzik, Sven Lahme, Johannes Schmidt, Frans M.J. Debruyne, Kutsal Yorukoglu, S.M. Pecher, S. Bianchi, Wim P.J. Witjes, Katia R. M. Leite, Luciano Nesralhah, Bernardo Garicochea, L. Jarolím, Robert A. Newton, Miguel Srougi, Vincent Bocquillon, Jerilynn P. Jacobson, M. Janský, U.E. Studer, D.F. Badenoch, Alberto Ottolenghi, M. Babjuk, C. Nord, Mete Kilciler, Jean-Yves Soret, T. Hanuš, Ricardo P. Moura, M. Tichý, R. Mills, Luiz H. Camara-Lopes, F.H. Comhaire, U. Feek, T. Balducci, and Yasushi Kondo

Subjects
medicine.medical_specialty, business.industry, Urology, General surgery, medicine, business
Published
2000
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4. Detection of human chorionic gonadotrophin-beta in serum or urine of prostate cancer patients is of no clinical significance

Author

F. Chinegwundoh, Ray K. Iles, Vinod H. Nargund, Suhail Baithun, and U. Otite

Subjects
PCA3, Male, endocrine system, medicine.medical_specialty, Chorionic gonadotrophin, Urinary system, Urology, Urine, Newly diagnosed, Prostate cancer, medicine, Humans, Clinical significance, Chorionic Gonadotropin, beta Subunit, Human, reproductive and urinary physiology, Neoplasm Staging, Gynecology, business.industry, Prostatic Neoplasms, Reproducibility of Results, General Medicine, medicine.disease, Survival Analysis, Prostate-specific antigen, Treatment Outcome, Disease Progression, business
Abstract

The aim of this study was to prospectively evaluate the potential role of elevated urinary/serum human chorionic gonadotrophin-beta (hCGbeta) in prostate cancer prognosis. 104 patients with newly diagnosed prostate cancers were included; 68 patients had organ-confined, 18 had locally advanced and 18 had metastatic disease. A control group consisted of 115 patients presenting with benign prostatic disease. Serum and urinary total hCGbeta was measured prior to treatment and serum PSA was measured at diagnosis. The patients were treated along conventional lines and progression-free survival was assessed. Four patients had elevated serum and 10 had elevated urinary, total hCGbeta. There were no significant correlations between serum/urinary levels of hCGbeta and tumour stage, Gleason score or PSA. In contrast, serum PSA had significant linear correlations with both clinical tumour stage and Gleason score (p = 0.0001). At a median follow-up of 36 months, 22 (21.2%) patients had died while 17 (16.3%) others had progressed. Kaplan-Meier plots and log-rank test revealed no significant difference in progression-free survival between patients with elevated or normal levels of serum and/or urinary total hCGbeta. Clinical tumour stage, grade and PSA were statistically significant prognostic variables. Immunoassay measurement of serum or urinary hCGbeta has no significant role in the clinical management of prostate cancer.

Published
2005

5. Subject Index Vol. 38, 2000

Author

Çetin Harmankaya, Yutaka Ono, B.M. Altinkilic, Christian Kissling, Alberto Ottolenghi, Michele Spalletta, Carlos Dzik, Ernesto Velásquez, Riyadh F. Talic, A Daver, S.M. Pecher, D. Floratos, Johannes Schmidt, H. Müller, Sanzio Bianchi, D. Brkovic, Gerd Staehler, K.-Horst Bichler, Elaine Darini, Tatsunari Fukui, Gerhard Forster, C. Nord, Jesús B. Perez, Tadaichi Kitamura, A.K. Nigam, K.E. Giercksky, B. Schönberger, S. Loening, G. Dipaola, W. Månsson, B. Helpap, Akihiko Okuyama, R. Hiebl, O. Naňka, P. Stournaras, Thomas Ebert, U. Otite, Ziya Kirkali, I. Schroeder-Printzen, U. Kaulfuss, André T. Guay, Shiro Takahara, M. Janský, Claude Schulman, T. Balducci, R. Mills, Luiz H. Camara-Lopes, Norio Nonomura, Kazuki Kawabe, Claudia M. Carvalho, Alexandre R. Zlotta, J. Köllermann, Murat Sade, U. Oehler, A. Katsoulis, Natsuki Takaha, J. Steffens, Andrew J. G. Simpson, Satoru Takahashi, Frieder Bauss, Peter J. Goebell, E.W. Hauck, Philippe Colls, F.H. Comhaire, Ch. Theodorou, Yasushi Kondo, A. Stenzl, B. Kosharskyy, Murat Sevinç, U.E. Studer, Vincent Bocquillon, Ugur Mungan, Denis Chautard, Yves Fradet, Véronique Verriele, Yukio Homma, M. Ludwig, Markus J. Seibel, Bernd J. Schmitz-Dräger, K.D. Jacobsen, M. Grim, Ch. Katsifotis, Kazuo Nishimura, Gérard Bertrand, Francesco Saverio Camoglio, Manfred Wiesel, Murat Dayanc, Luciano Nesralhah, Robert A. Newton, S.D. Fosså, Özgür Tan, U. Feek, Yasunori Harada, M. Babjuk, G. Lüdecke, Miguel Srougi, Wim P.J. Witjes, Bernardo Garicochea, L. Jarolím, M.W. Köllermann, Francesco P. Selvaggi, Katia R. M. Leite, Masahiro Nozawa, Joachim Dörsam, G. Moutzouris, D.F. Badenoch, Sven Lahme, Frans M.J. Debruyne, T. Hanuš, Kutsal Yorukoglu, Jerilynn P. Jacobson, C. Arens, Mete Kilciler, Ricardo P. Moura, M. Tichý, W. Weidner, Luca Giacomello, Jean-Yves Soret, P. Röttger, Lüfti Tahmaz, and Walter Ludwig Strohmaier

Subjects
Gynecology, medicine.medical_specialty, Index (economics), business.industry, Urology, medicine, Medical physics, Subject (documents), business
Published
2000
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6. Acknowledgement to the Reviewers

Author

Wim P.J. Witjes, Bernardo Garicochea, L. Jarolím, T. Balducci, Yves Fradet, Bernd J. Schmitz-Dräger, Jerilynn P. Jacobson, Ugur Mungan, Denis Chautard, U. Kaulfuss, M.W. Köllermann, Jesús B. Perez, Tadaichi Kitamura, D. Brkovic, Francesco P. Selvaggi, C. Arens, Philippe Colls, B. Kosharskyy, P. Stournaras, A.K. Nigam, A Daver, D. Floratos, Ch. Theodorou, Luca Giacomello, Vincent Bocquillon, Elaine Darini, Yasushi Kondo, A. Stenzl, C. Nord, Manfred Wiesel, D.F. Badenoch, S. Bianchi, Kazuo Nishimura, U. Oehler, W. Månsson, Katia R. M. Leite, I. Schroeder-Printzen, B. Schönberger, Christian Kissling, K.D. Jacobsen, Ziya Kirkali, Tatsunari Fukui, Ernesto Velásquez, K.E. Giercksky, M. Janský, Johannes Schmidt, Lüfti Tahmaz, T. Hanuš, M. Grim, U. Otite, G. Dipaola, Walter Ludwig Strohmaier, Akihiko Okuyama, Özgür Tan, R. Hiebl, Andrew J. G. Simpson, Claude Schulman, E.W. Hauck, G. Moutzouris, B.M. Altinkilic, Gérard Bertrand, Murat Sade, U.E. Studer, Natsuki Takaha, Miguel Srougi, Mete Kilciler, Francesco Saverio Camoglio, H. Müller, M. Ludwig, Michele Spalletta, Carlos Dzik, Yutaka Ono, Peter J. Goebell, K.-Horst Bichler, Gerhard Forster, S.M. Pecher, Ricardo P. Moura, M. Tichý, Claudia M. Carvalho, A. Katsoulis, Markus J. Seibel, Yasunori Harada, Thomas Ebert, Alberto Ottolenghi, G. Lüdecke, Luciano Nesralhah, Robert A. Newton, R. Mills, Luiz H. Camara-Lopes, Jean-Yves Soret, F.H. Comhaire, U. Feek, Murat Dayanc, Masahiro Nozawa, Joachim Dörsam, Sven Lahme, Gerd Staehler, S. Loening, Riyadh F. Talic, Satoru Takahashi, M. Babjuk, O. Naňka, Véronique Verriele, Yukio Homma, Ch. Katsifotis, Norio Nonomura, Murat Sevinç, S.D. Fosså, Çetin Harmankaya, Frans M.J. Debruyne, Kutsal Yorukoglu, Kazuki Kawabe, Alexandre R. Zlotta, J. Köllermann, J. Steffens, W. Weidner, Frieder Bauss, P. Röttger, B. Helpap, André T. Guay, and Shiro Takahara

Subjects
medicine.medical_specialty, business.industry, Urology, Family medicine, Acknowledgement, Medicine, business
Published
1998
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