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2. Syndrome of inappropriate antidiuretic hormone secretion following bipolar transurethral resection of the prostate

Author

Richard Brough, Sean Rezvani, and Samih Taktak

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, 030232 urology & nephrology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Prostate, 030220 oncology & carcinogenesis, Invasive surgery, Syndrome of inappropriate antidiuretic hormone secretion, medicine, Surgery, business, Transurethral resection of the prostate
Abstract

Syndrome of inappropriate antidiuretic hormone secretion following minimally invasive surgery is extremely rare, having only been reported in a handful of cases. We present the second documented case of syndrome of inappropriate antidiuretic hormone secretion following transurethral resection in an 80-year-old male undergoing bipolar transurethral resection of the prostate for bladder outflow obstruction. Level of evidence: 5

Published
2020

3. Tuberculosis epididymo-orchitis following intravesical bacillus Calmette-Guérin immunotherapy

Author

Sean Rezvani and Gerald Collins

Subjects
Mycobacterium bovis, medicine.medical_specialty, Tuberculosis, biology, business.industry, medicine.medical_treatment, Case Report, Immunotherapy, medicine.disease, biology.organism_classification, Dermatology, 030218 nuclear medicine & medical imaging, Sepsis, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Medicine, Epididymo orchitis, Intravesical bacillus Calmette-Guerin, Surgery, Epididymitis, business, Complication
Abstract

BCG is a well-established treatment for superficial bladder cancer. Although usually well-tolerated, side effects can range from mild cystitis to life-threatening sepsis. Epididymitis is a rare complication of BCG, with only a handful of cases proven to be caused directly by Mycobacterium bovis. We describe one such case, along with radiological findings for this rare complication.

Published
2019

4. A rare case of paratesticular leiomyosarcoma

Author

Ann A. Crump, Sean Rezvani, and James Bolton

Subjects
Leiomyosarcoma, medicine.medical_specialty, High ligation, Scrotal mass, business.industry, 030232 urology & nephrology, Case Report, medicine.disease, Spermatic cord, Surgery, Resection, body regions, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Rare case, Medicine, Orchiectomy, Ligation, business
Abstract

Paratesticular leiomyosarcoma is a rare tumour. It is seldom diagnosed pre-operatively and subsequent secondary resection is often required. Current treatment consensus comprises inguinal radical orchidectomy with high ligation of the spermatic cord. We present a case of a 74-year-old male with a 3-year history of a painless right-sided scrotal mass which following excision was found to be an epididymal leiomyosarcoma. A review of literature and treatment is presented in this article.

Published
2018

5. PD17-08 THE EFFECTS OF MEDICALLY EXPULSIVE THERAPY (MET) ON SPONTANEOUS STONE PASSAGE (SSP) IN PATIENTS PRESENTING WITH ACUTE URETERIC COLIC

Author

Taimur T Shah, Chuanyu Gao, Aidan O' Keefe, Todd Manning, Anthony Peacocke, Sophia Cashman, Arjun Nambiar, Ben Lamb, Marcus Cumberbatch, Nicholas Ivin, Jonathan Maw, Cissy Ali Abdaal, Sami Al Hayek, Daniel Christidis, Damien Bolton, Nathan Lawrentschuk, Shahid Khan, Sibel Demirel, Stuart Graham, Jonathan Chuo Min Lee, Simon Evans, Samantha Koschel, Henry Badgery, Janelle Brennan, Luke Wang, Tatenda Nzenza, Paul Ruljancich, Ruzi Begum, Shazia Hamad, Aarti Shetty, Daniel Swallow, Morrow Jessica S, David Curry, Michael Young, Hamid Abboudi, Rozh Jalil, Ranan Dasgupta, Fraser Cameron, Connie Shingles, Cherrie Ho, Iram Parwaiz, John Henderson, Kenneth R Mackenzie, Kyle Reid, Nkemi Umeni-Eronini, Nazrin Assaf, Adekinte Oyekan, Seshadri Sriprasad, Zara Hayat, Victoria Morrison-Jones, Christopher Steen, Matthew Alberto, Paul Rujancich, Alex Laird, Abhishek Sharma, Simon Phipps, Andrew Harris, Alistair Rogers, Simeon Ngweso, Munyaradzi Nyandoro, Dickon Hayne, Jane Hendry, Lynne Kerr, Craig Mcilhenny, Flora Rodger, Emma Docherty, Alicia Ng, Lisette Seaward, David Eldred-Evans, Matthew Bultitude, Haitham Abdelmoteleb, Amr Hawary, Rebecca Tregunna, Husam Ibrahim, Shannon Mc Grath, Jonathan O’ Brien, Angus Campbell, Peter Cronbach, Amar Paget, Lokesh Suraparaj, James O' Brien, Suresh K Gupta, Campbell Tait, Ashok Sakthivel, Rahul Pankhania, Zubair Al-Qassim, Monika Rezacova, Eric Edison, Sarbjinder Sandhu, Robert Foley, Abisoye Akintimehin, Azhar Khan, Nkwam Nkwam, Peter Grice, Masood Khan, Florence Kashora, David Manson-Bahr, Nadine Mc Cauley, Osayuki Nehikhare, John Bycroft, Kishan Tailor, Asad Saleemi, Wesam Al-Dhahir, Mohamed Abu Yousif, John O' Rourke, Angus On Luk Chin, Ian Pearce, James Olivier, Joel Tay, Andrea Cannon, James Akman, Zahid Hussain, Jack Coode-Bate, Madhavi Natarajan, Stuart Irving, Kevin Murtagh, Anne Carrie, Marek Miller, Manar Malki, Frances Burge, Harry Ratan, Nishant Bedi, Raj Kavia, Thomas Stonier, Nick Simson, Harpreet Singh, Emer Hatem, Manit Arya, Iannish Sadien, Iqbal Miakhil, Sunil Sharma, Patrick Olaniyi, Roelof Stammeijer, Hannah Mason, Andrew Symes, Lisa Lavan, Carl Rowbotham, Carol Wong, Sarah Al-Shakhshir, Mohammed Belal, Alastair Crawford Mc Kay, John Graham, Lucy Simmons, Sinan Khadouri, John Withington, Leye Ajayi, Li June Tay, Alex Ward, Bo Parys, Matthew Liew, Richard Simpson, David Ross, Robert Adams, Asfand Baig Mirza, Pete Acher, Michael Gallagher, Yaamini Premakumar, Michael Ager, Benjamin Ayres, Karl Pang, Jake Patterson, Andrei Adrian Kozan, Ata Jaffer, Waqas Din, Chandra Shekhar Biyani, Johnson Pok-Him Tam, Edward Tudor, John Llewellyn Probert, Mudit Matanhelia, Mohammed Hegazy, David Quinlan, Daniel Ness, Bharat Gowardhan, Kellie Bateman, Slawomir Wozniak, Gidon Ellis, Daron Smith, Laura Derbyshire, Karyee Chow, Rebecca Mosey, Banan Osman, Howard Kynaston, Joshua Clements, Gemma Hann, Sam Gray, Omid Yassaie, George Weeratunga, Cristian Udovicich, James Mbuvi, Heather Stewart, Azizan Samsudin, Archie Hughes-Hallet, Francesca Kum, Rebecca Symes, Rob Frymann, Barnaby Chappell, Sean Rezvani, Issam Ahmed, Iqbal Shergill, Su-Min Lee, Ali Hussain, Robert Pickard, Paul Erotocritou, and Veeru Kasivisvanathan

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Urology, Medicine, 030208 emergency & critical care medicine, Ureteric colic, In patient, business, Surgery
Published
2018

6. Early years postgraduate surgical training programmes in the UK are failing to meet national quality standards: An analysis from the ASiT/BOTA Lost Tribe prospective cohort study of 2,569 surgical trainees

Author

James C. Glasbey, Rhiannon L. Harries, Andrew J. Beamish, Vimal J. Gokani, Helen Mohan, Adam P. Williams, Simon Fleming, Aaron Chai, Abhinav Singh, Adam C.S. Stoneham, Adam J. Lunt, Adeeb H. Rehman, Adeel A. Dhahri, Adrien R.A. Yvon, Agneish Dutta, Ahmad K. Abou-Foul, Ahmed Abdelrahman, Ahmed Daoub, Ahmed Sanalla, Aitor de Gea Rico, Alastair Konarski, Alex E. Ward, Alex J. Wilkin, Alexandra K. Winter, Ali Arnaout, Ali Bakhsh, Alireza Esfandiari, Alistair W. Hardy, Amad N. Khan, Amitabh Thacoor, Ana D. Gavrila, Anca-Mihaela Nedea, Andreas Fontalis, Andrew J. Hall, Andrew J. Williamson, Angeliki Kosti, Anna Harlinska, Anthony Adimonye, Anthony Egglestone, Anthony J. Thaventhiran, Antonia Myatt, Anuhya Vusirikala, Arab S. Rawashdeh, Arjun C. Paramasivan, Arthur E. Cotton, Ashley B. Scrimshire, Ashwanth C. Ramesh, Ashwin K. Krishnamoorthy, Asif Ahmed, Ayeshah Abdul-Hamid, Ayushah Khan, Babatunde Oremule, Beatrice Ho, Ben Barkham, Ben Collard, Ben F. Edgar, Benjamin Drake, Bethan E. John, Catherine R. Gordon, Catherine Rossborough, Chang Y. Park, Charalampos Seretis, Charles H.N. Johnson, Charn Gill, Chiara Serino, Chinomso I. Ogbuokiri, Chloe Swords, Chong Y. Kang, Chris McKinnon, Christopher E. Brown, Christopher J. Manning, Christopher J. Marusza, Christopher P. Jones, Cillian T. Forde, Claire L. Wilson, Claudia Koh, Conal Horgan, Daniel J. Lin, Daniel L. Ashmore, Daniel Ness, Daniel O. Akhtar, Daniel T. Doherty, Daniel W. Scholfield, David C. Ensor, David G. Bratt, David J.R. Spence, David R. Thomson, David W. Ferguson, Denish Apparau, Devaraj M. Navaratnam, Dinh Mai, Duncan G. Rutherford, Edward Karam, Eiling Wu, Eleanor F. Zimmermann, Eleftheria Douka, Elinor Flatt, Elizabeth G. Kane, Elizabeth L. Thornhill, Emanuele Gammeri, Emma G. Littlehales, Epaminondas M. Valsamis, Erin J. Hankin, Erin R.M. Meenan, Etienne N. Botha, Farhan Khalid, Fatema Patel, Fiachra R. Power, Fiona M. Rutherford, Fozia Saeed, Francesca L. Guest, Francisco J. Barbosa, Fraser G. Cameron, Furqan R. Raja, Gajendiran Thiruchandran, Gavish Munbauhal, Gemma E. Dovey, Gemma E. Hogg, George E. Dovell, George Matheron, George T. Hill, Georgia R. Layton, Georgiana G.S. Jong, Georgina Hicks, Graham J. Millward, Grahame A. Shaw, Gregory F.W. Stamp, Hammad Parwaiz, Han Hong Chong, Hannah C. Copley, Hannah C. Lennox-Warburton, Hannah M. Emerson, Harry F. Dean, Hazim Eltyeb, Howard O. Chu, Iannish Sadien, Imran M. Mohamed, Iram Parwaiz, Isabella M.H. Drummond, Jack C.H. Pearce, Jacob J. Ahmed, Jacob Koris, Jaideep S. Rait, James A. Bailey, James A. Cohen, James A. Kennedy, James B. Olivier, James Bailey, James E. Archer, James J. Stewart, James N.J.Monteiro de Barros, James R. Allen, James W. O'Brien, null James, T. McGhee, Jared N. Quarcoopome, Jasmine C. Winyard, Jason L. Roberts, Jennifer S. Barwell, Jeremy Rodrigues, Jessica A.R. Chapman, Jessica Y. Fairbanks, Jessika Voll, Jie Q. Lim, Jin H. Chang, Joanna L. Bovis, John Ferns, Johnson Pok Him Tam, Jonathan B.T. Herron, Jonathan D.R. Macdonald, Jonathan R. Ducey, Joseph W. DIxon, Joshua T. Luck, Kalon Hewage, Kamal M. Yakoub, Kamran F. Bhopal, Karen A. Vejsbjerg, Karim Aboelmagd, Katarzyna D. Bera, Katharine E. Hamlett, Katherine E. Fok, Katherine V. Hurst, Kathryn L. Gillams, Katie L. Siggens, Katie Young, Kenneth M. Burns, Kerry A. Burke, Kevin Seebah, Khalid A. Shah, Kieran R. Bentick, Kiran Majid, Kirsty L. Davies, Krystal Tan, Kwaku W. Baryeh, Laura A.F. Phillips, Laura N. Ellerton, Leeying J. Giet, Liam Monaghan, Lok Ka Cheung, Louise L. Shen, Louise Paramore, Lucy J. Arrowsmith, Lukas A. Attwell, Luke Thornton, Luting Xu, Madeline L. Leadon, Madhavi Natarajan, Maria C.R. Houlihan, Marisa Cheah, Markus L. Sagmeister, Maryam Abubakar, Matthew F. Flynn, Matthew Harris, Matthew J. Stone, Matthew J. Young, Matthew P. Gray, Matthew P. Horner, Matthew Schembri, Matthew Trail, Melvin Joy, Michael J. Rice, Michael P. Thomas, Michael T.C. Poon, Michael T. Stoddart, Michelle L. Fong, Mitchell T. Foster, Mohamed F. Mohamud, Mohammed N. Hoque, Mohammedabbas Remtulla, Mohsin Javed Karim, Monika Rezacova, Muhammad B. Siddiqui, Muhammad R. Iqbal, Mussa Mensa, Nadine McCauley, Natasha J. Bauer, Nathan Walker, Navid A. Hakim, Ngonidzashe Knight, Niall O'Hara, Nicholas A. Fawcett, Nicholas Wong, Nicola F.D. Allen, Nilofer Husnoo, Nimisha Vallabh, Nisaharan Srikandarajah, Nnaemeka Chidumije, Obaiy Elamin, Odunayo O. Akinlaja, Olga Griffiths, Oliver D. Brown, Oliver Shastri, Olivia J. Cameron, Olivia Kenyon, Omar A. Javed, Opeyemi O. Sogaolu, Panagiota Birmpili, Patricia Haylock-Vize, Patrick A. Green, Patrick J. Carroll, Peiming Yang, Philip Beak, Pia Persson, Pok Him Johnson Tam, Rabia Waqar, Rachael L. Morley, Rachel Clare Bowden, Rachel L. Eyre, Rahul M. Pankhania, Rajpreet S. Sahemey, Rakan Kabariti, M. Rawashdeh, Rawashdeh S. Arab, Rebecca A. Rollett, Rebecca S. Nicholas, Rebecca V. Morgan, Richard Limb, Richard Mark Robinson, Richard S. Hayes, Ridwan Daureeawoo, Robert A. Cooke, Robert A.J. Espey, Robert Chessman, Robert D.J. Whitham, Robert E. Payne, Robert Staruch, Roberto J.R. Alho, Robin Gordon, Rory Cuthbert, Roseanna B. Harrison, Rupert A. Scott, Ruth M. Parks, Ryan C.T. Cheong, Ryan L. Hillier-Smith, Ryan Moffatt, Saad Rehman, Sabah Ambren, Sabria Abdulal, Sagar Kulkarni, Sam Hopwood, Samantha H. Greenfield, Samir K. Mehta, Samuel Haines, Sarah A. AlSaati, Sarah A. Williams, Sarah El-Badawy, Sarah L. Barlow, Sarah Pywell, Sarah-jayne Pollock, Savvas Lampridis, Scarlet Nazarian, Sean Rezvani, Sean Scattergood, Sebastian M. Toescu, Sesi Hotonu, Shafaque Shaikh, Shamil Rupani, Shumaila Hasan, Shwetha Pradeep, Simon J. Cole, Siona A. Growcott, Sofia E. Bedoya, Sonia I. Ike, Stefan V. Bodnarescu, Stella C. Seppings, Stephanie A. Poyntz, Stevan J. Jordan, Sundas Iqbal, Suparna Das, Suravi Chatterjee-Woolman, Syed Shumon, Tamsin E.M. Morrison, Tara Sibartie, Tariq Aboelmagd, Thomas B. Russell, Thomas C. Seddon, Thomas D. Stringfellow, Thomas Goldsmith, Thomas H.F. Banks, Thomas Tolley, Tobenna J. Oputa, Todd T. Kanzara, Tom Challoner, Tomas Urbonas, Tomos B. Richards, Victoria J. Morrison-Jones, Vivek Garikapati, Waheeb A.K. Al-Azzani, Wajiha Zahra, Weiguang Ho, Wesam Al-Dhahir, William G.W. Gibson, Yasmin Grant, Yasser Hijazi, Yayganeh Chiang, Zobia K. Gundkalli, Zoe M. Seymour, and Zoe Panayi

Subjects
medicine.medical_specialty, media_common.quotation_subject, education, Specialties, Surgical, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Nursing, medicine, Tribe, Humans, Quality (business), 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Societies, Medical, media_common, Quality Indicators, Health Care, Descriptive statistics, business.industry, General Medicine, Surgical training, United Kingdom, Education, Medical, Graduate, 030220 oncology & carcinogenesis, Family medicine, Workforce, Cohort, Surgery, Observational study, Clinical Competence, Guideline Adherence, business
Abstract

Introduction This study aimed to assess training of Senior House Officer-grade equivalent doctors in postgraduate surgical training or service (SHO-DIPST) in surgical specialties across the United Kingdom (UK), against nationally agreed Joint Committee on Surgical Training Quality Indicators (JCST QIs). Specific recommendations are made, with a view to improving quality of training, workforce retention and recruitment to Higher Surgical Training. Method Prospective, observational, multicentre study conducted by the Association of Surgeons in Training, using the UK National Research Collaborative model. Any centres in the UK providing acute surgical services were eligible. SHO-DIPST with a permanent contract, on out-of-hours ‘on-call rota' were included across four, one-week data capture periods (September to October 2016, February to March 2017). Adherence to five quality indicators was reported using descriptive statistics. P-values were calculated using Student's t-test for continuous data, with a 5% level of significance. Results 2569 SHO-DIPST were included from all ten surgical specialties in 141 NHS trusts across all 16 Local Education and Training Boards in the UK. 960 SHO-DIPST were in registered ‘training' posts (37.3%). The median number of SHO-DIPST per rota was 7.0 (IQR 5.0–9.0). Adherence to the five included JCST QIs ranged from 6.0 to 53.1%. Only four SHO-DIPST posts across the study population met all five JCST QIs (0.3%). The total number of training sessions was higher for those in registered training posts (p Conclusions Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training.

Published
2017

7. Incidence, predictors and clinical characteristics of orolingual angio-oedema complicating thrombolysis with tissue plasminogen activator for ischaemic stroke

Author

Chris Douglass, Robert Hurford, Mohammad Kreimei, Jane Molloy, Andy Vail, Sean Rezvani, Adrian R Parry-Jones, Craig J. Smith, Hana Alachkar, Pippa J. Tyrrell, and Annie Herbert

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Angiotensin-Converting Enzyme Inhibitors, Tissue plasminogen activator, Fibrinolytic Agents, Tongue, Risk Factors, Internal medicine, medicine, Humans, Thrombolytic Therapy, Angioedema, Stroke, Aged, Retrospective Studies, Mouth, business.industry, Incidence, Incidence (epidemiology), Retrospective cohort study, Thrombolysis, Odds ratio, medicine.disease, Surgery, Psychiatry and Mental health, England, Tissue Plasminogen Activator, ACE inhibitor, Female, Neurology (clinical), Complication, business, medicine.drug
Abstract

Background Orolingual angio-oedema is a recognised complication of tissue plasminogen activator (tPA) for ischaemic stroke. We investigated its incidence, clinical characteristics and relationship with other factors in patients receiving tPA at a UK centre. Methods 530 consecutive patients (median age 70 years) receiving tPA treatment for confirmed ischaemic stroke were included. Cases were defined as those developing angio-oedema within 24 h of initiation of tPA. Angio-oedema was retrospectively classified as mild, moderate or severe using predefined criteria. The primary analysis was the association between prior ACE inhibitor (ACE-I) treatment and angio-oedema. Results Orolingual angio-oedema was observed in 42 patients (7.9%; 95% CI 5.5% to 10.6%), ranging from 5 to 189 min after initiation of tPA (median 65 min). 12% of the angio-oedema cases were severe (1% of all patients treated with tPA), requiring urgent advanced airway management. 172 patients (33%) were taking ACE-I. In multifactorial analyses, only prior ACE-I treatment remained a significant independent predictor of angio-oedema (odds ratio (OR) 2.3; 95% CI 1.1 to 4.7). Conclusions Angio-oedema occurs more frequently than previously reported and is associated with preceding ACE-I treatment. Angio-oedema may be delayed and progress to life-threatening airway compromise, which has implications for the assessment and delivery of thrombolysis.

Published
2014

8. Dissolution of extensive urolithiasis: extending the utility of rasburicase can avoid the need for surgical intervention and renal replacement therapy

Author

Sean Rezvani, Alastair J. Hutchison, Bachar Zelhof, M. Picton, Ben R. Grey, and Peter Selby

Subjects
030203 arthritis & rheumatology, medicine.medical_specialty, Pathology, business.industry, medicine.medical_treatment, Case Reports, medicine.disease, Renal stone disease, urologic and male genital diseases, Myelomonocytic leukaemia, Surgery, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), medicine, Rasburicase, Journal Article, 030211 gastroenterology & hepatology, Renal replacement therapy, Hyperuricemia, business, medicine.drug
Abstract

A 79-year-old male with chronic myelomonocytic leukaemia and extensive bilateral renal stone disease was treated with intravenous rasburicase for persistent hyperuricaemia. Subsequent imaging revealed a complete dissolution of stone burden, avoiding the need for complex, invasive stone surgery and further renal replacement therapy.

Published
2016

9. O3 Is point of care testing ‘unsafe in the city’?

Author

Alma Hatley, Sean Rezvani, Susanna Currie, Debbie Thomas, and Orla McQuillan

Subjects
medicine.medical_specialty, Pathology, business.industry, Point-of-care testing, Human immunodeficiency virus (HIV), Dermatology, medicine.disease_cause, medicine.disease, Predictive value, Serology, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Emergency medicine, medicine, False positive paradox, Health education, business, Hiv transmission
Abstract

Background Point of care testing (POCT) for HIV is acknowledged in UK Guidelines as useful outside clinic settings, but is it safe? Our 10 year POCT programme has experienced false positives and negatives which resulted in our use of back up serology samples as standard; this differs from practice within POCT elsewhere. We had a televised false positive POCT result on “Unsafe Sex in the City” and 4 false positives in a year which caused a temporary shutdown of our POCT programme and an MRHA investigation. Aim To review the need for back-up serology with POCT. Method A retrospective review of all Alere Determine™ HIV-1/2 Ag/Ab Combo tests at a City Centre outreach service in 2013. Results were compared with concomitant serology. Results POCT was provided for 382 patients. Three patients declined POCT; 2 POCT results were not documented; 10 did not have serology in parallel. Of the remaining 367 patients: 3 true positives (0.8%); 2 false positives (0.6%); and 3 false negatives (0.8%). Negative predictive value 99.2%; Positive predictive value 60%; Sensitivity 50%; Specificity 99.4%. Discussion This is data providing statistics for POCT in real time. Compared to advertised values Alere is underperforming. The negative predictive value is reassuring; however, the sensitivity of the test is unacceptable. Had 3 of our patients not had back up serology, they would have been unaware of their diagnosis, receiving false reassurance and potentially causing unintentional HIV transmission. Do we take this risk on board and perform POCT without back up serology?

Published
2015

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