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  1. Article ; Online: Oncological outcomes of patients with oligometastatic oesophagogastric cancer.

    Down, Billy / Lakunina, Svetlana / Maynard, Nick / Markar, Sheraz R / Gordon-Weeks, Alex

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2024  Volume 50, Issue 4, Page(s) 108231

    Abstract: Oligometastatic oesophagogastric cancer was recently defined by consensus as the presence of no more than two metastases and an 18-week period of oncological stability during chemotherapy. The number of patients who fit this criterion and whether their ... ...

    Abstract Oligometastatic oesophagogastric cancer was recently defined by consensus as the presence of no more than two metastases and an 18-week period of oncological stability during chemotherapy. The number of patients who fit this criterion and whether their oncological outcome differs from those with multi-metastatic disease is unknown. We analysed a database of 497 patients from 2017 to 2021 with metastatic oesophageal cancer. In total, 36 (7.2%) had oligometastatic disease and significantly improved median overall survival (mOS) versus multi-metastatic disease. In synchronous OMD, mOS was 26.8 months versus 7.3 months and in metachronous OMD, 38.6 months versus 6.1 months (both p < 0.0001). A subset of oligometastatic patients who underwent surgical management of their oligometastases after primary tumour resection demonstrated significantly increased mOS compared with systemic treatment alone (60 months versus 24.4 months; p < 0.038). Oligometastatic oesophagogastric cancer is associated with improved oncological outcome when compared to multi-metastatic disease. Further work is needed to identify patients who will benefit from aggressive treatment of metastatic oesophagogastric cancer.
    MeSH term(s) Humans ; Esophageal Neoplasms/surgery
    Language English
    Publishing date 2024-03-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2024.108231
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1149: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Zs.MO 549: Show issues

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  2. Article: Patient Outcomes Related to In-Hospital Delays in Appendicectomy for Appendicitis: A Retrospective Study.

    Claydon, Oliver / Down, Billy / Kumar, Sidharth

    Cureus

    2022  Volume 14, Issue 3, Page(s) e23034

    Abstract: Background and objective In many hospitals, the availability of operating theatres and access to senior surgical and anaesthetic support diminish during night hours. Therefore, urgent surgery is sometimes postponed until the following morning rather than ...

    Abstract Background and objective In many hospitals, the availability of operating theatres and access to senior surgical and anaesthetic support diminish during night hours. Therefore, urgent surgery is sometimes postponed until the following morning rather than performed overnight, if it is judged to be safe. In this study, we aimed to determine if a delay in laparoscopic appendicectomy in cases of acute appendicitis of over 12 hours, analogous to an overnight delay, correlated with worse patient outcomes. Our primary outcome was delayed discharge from the hospital. Our secondary outcomes were appendicitis severity, conversions, and postoperative complications. Methods We undertook a retrospective review of the medical records of patients who underwent laparoscopic appendicectomy for appendicitis at a UK district general hospital between 01/01/2018 and 30/08/2019. For each patient, clinical and demographic information, and time of hospital admission, surgery, and discharge were collected. Delayed discharge was defined as "time to discharge" >24 hours after surgery. Results A total of 446 patients were included in the study. In 137 patients (30.7%), "time to surgery" was under 12 hours; in 309 patients (69.3%) "time to surgery" was over 12 hours. Of note, 319 patients (71.5%) had a delayed discharge; 303 patients (67.9%) had complicated appendicitis, and 143 patients had severe appendicitis (32.1%). No statistically significant association between "time to surgery" and delayed discharge, appendicitis severity, conversion, or 30-day re-presentations was observed. Conclusion Time from admission to the start of appendicectomy did not affect patient outcomes. Short in-hospital delays in appendicectomy, such as an overnight delay, may be safe in certain patients and should be determined based on clinical judgement.
    Language English
    Publishing date 2022-03-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.23034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Long-Term Follow-up of Complex Calcaneal Osteomyelitis Treated With Modified Gaenslen Approach.

    Kendal, Adrian / Loizou, Constantinos / Down, Billy / McNally, Martin

    Foot & ankle orthopaedics

    2022  Volume 7, Issue 4, Page(s) 24730114221133391

    Abstract: Background: The treatment of chronic calcaneal osteomyelitis is a challenging and increasing problem because of the high prevalence of diabetes mellitus and operative fixation of heel fractures. In 1931, Gaenslen reported treatment of hematogenous ... ...

    Abstract Background: The treatment of chronic calcaneal osteomyelitis is a challenging and increasing problem because of the high prevalence of diabetes mellitus and operative fixation of heel fractures. In 1931, Gaenslen reported treatment of hematogenous calcaneal osteomyelitis by surgical excision through a midline, sagittal plantar incision. We have refined this approach to allow successful healing and early mobilization in a modern series of complex patients with hematogenous, diabetic, and postsurgical osteomyelitis.
    Methods: Twenty-eight patients (mean age 54.6 years, range 20-94) with Cierny-Mader stage IIIB chronic calcaneal osteomyelitis were treated with sagittal incision and calcaneal osteotomy, excision of infected bone, and wound closure. All patients received antibiotics for at least 6 weeks, and bone defects were filled with an antibiotic carrier in 20 patients. Patients were followed for a mean of 31 months (SD 25.4). Primary outcome measures were recurrence of calcaneal osteomyelitis and below-knee amputation. Secondary outcome measures included 30-day postoperative mortality and complications, duration of postoperative inpatient stay, footwear adaptions, mobility, and use of walking aids.
    Results: All 28 patients had failed previous medical and surgical treatment. Eighteen patients (64%) had significant comorbidities. The commonest causes of infection were diabetes ± ulceration (11 patients), fracture-related infection (4 patients), pressure ulceration, hematogenous spread, and penetrating soft tissue trauma. The overall recurrence rate of calcaneal osteomyelitis was 18% (5 patients) over the follow-up period, of which 2 patients (7%) required a below-knee amputation. Eighteen patients (64%) had a foot that comfortably fitted into a normal shoe with a custom insole. A further 6 patients (21%) required a custom-made shoe, and only 3 patients required a custom-made boot.
    Conclusion: Our results show that a repurposed Gaenslen calcanectomy is simple, safe, and effective in treating this difficult condition in a patient group with significant local and systemic comorbidities.
    Level of evidence: Level III, case series.
    Language English
    Publishing date 2022-10-30
    Publishing country United States
    Document type Journal Article
    ISSN 2473-0114
    ISSN (online) 2473-0114
    DOI 10.1177/24730114221133391
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Effectiveness of a multi-session combined near-peer and faculty-led surgical skills course on self-perceived ability to perform basic surgical skills.

    Down, Billy / Morris, Simon / Kulkarni, Sagar / Mohiuddin, Kamran

    Annals of medicine and surgery (2012)

    2020  Volume 57, Page(s) 153–156

    Abstract: Background: Newly qualified UK doctors report feeling unprepared to perform basic practical procedures. The Royal College of Surgeons of England (RCSEng) responded to this concern by developing a national surgical curriculum, however, a national survey ... ...

    Abstract Background: Newly qualified UK doctors report feeling unprepared to perform basic practical procedures. The Royal College of Surgeons of England (RCSEng) responded to this concern by developing a national surgical curriculum, however, a national survey of UK medical schools identified that surgical skills teaching is inconsistent throughout the UK.Peer assisted teaching sessions are delivered by senior students to junior peers and have been demonstrated to be effective in a number of settings. We aimed to develop a peer-led surgical skills course for medical students and assess its efficacy in teaching surgical skills.
    Methods: Combined near-peer and faculty-led teaching sessions were delivered to medical students (N = 14). We assessed for confidence in these skills using pre- and post-course Likert scale questionnaires to determine self-perceived benefit.
    Results: Overall, student confidence in all skills improved by +1.254 (p < 0.0001). Individually, confidence in every skill increased significantly, including continuous suturing, knot tying and excision and closure, which improved by +1.45 (p < 0.001), +1.22 (p < 0.05) and +1.59 (p < 0.0001), respectively.
    Discussion: This study demonstrates that teaching provided through near-peer faculty improves medical student confidence in basic surgical skills. A similar course design could be implemented in other UK medical schools to improve the surgical skills of newly graduated doctors.
    Language English
    Publishing date 2020-07-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.07.045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The Mental Treatment Bill.

    Langdon-Down, R

    Mental welfare

    2017  Volume 11, Issue 1, Page(s) 15–19

    Language English
    Publishing date 2017-09-14
    Publishing country England
    Document type Journal Article
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Novel coronavirus (COVID-19) infection: What a doctor on the frontline needs to know.

    Down, Billy / Kulkarni, Sagar / Khan, Ameer Hamid Ahmed / Barker, Benjamin / Tang, Ivan

    Annals of medicine and surgery (2012)

    2020  Volume 55, Page(s) 24–29

    Abstract: Coronavirus disease 2019 (COVID-19) is a zoonotic respiratory infection originating from Wuhan, China. Rapidly spreading from Wuhan to all inhabited continents of the world, the World Health Organisation declared COVID-19 a pandemic on March 11, 2019. ... ...

    Abstract Coronavirus disease 2019 (COVID-19) is a zoonotic respiratory infection originating from Wuhan, China. Rapidly spreading from Wuhan to all inhabited continents of the world, the World Health Organisation declared COVID-19 a pandemic on March 11, 2019. Infected patients present with fever and cough; radiological features include bilateral infiltrates on chest x-ray and computed tomography scanning. Management is supportive with oxygen supplementation, broad-spectrum antibiotics as well as careful fluid balancing. A number of drugs, both new and old, are currently in clinical trials and being used on an experimental basis in clinical practice. The COVID-19 pandemic is the greatest worldwide public health crisis of a generation, and has led to seismic political, economic and social changes. This review provides an overview of COVID-19 for junior doctors who find themselves on a new frontline of healthcare.
    Keywords covid19
    Language English
    Publishing date 2020-05-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.05.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Novel coronavirus (COVID-19) infection

    Down, Billy / Kulkarni, Sagar / Khan, Ameer Hamid Ahmed / Barker, Benjamin / Tang, Ivan

    Annals of Medicine and Surgery

    What a doctor on the frontline needs to know

    2020  Volume 55, Page(s) 24–29

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.05.014
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: A local experience of non-operative management for an appendicitis cohort during COVID-19.

    Mai, Dinh Van Chi / Sagar, Alex / Menon, Nainika Suresh / Claydon, Oliver / Park, Ji Young / Down, Billy / Keeler, Barrie David

    Annals of medicine and surgery (2012)

    2021  Volume 63, Page(s) 102160

    Abstract: Background: During the first United Kingdom COVID-19 wave, the Royal Colleges of Surgeons initially recommended conservative management with antibiotics instead of surgery for appendicitis. This study compared local outcomes of appendicitis during this ... ...

    Abstract Background: During the first United Kingdom COVID-19 wave, the Royal Colleges of Surgeons initially recommended conservative management with antibiotics instead of surgery for appendicitis. This study compared local outcomes of appendicitis during this period with a pre-COVID-19 cohort.
    Methods: An observational study was conducted in a district general hospital. All episodes of appendicitis were prospectively studied from 25
    Results: Over nine weeks, there were 39 cases of appendicitis during COVID-19 and 50 cases pre-COVID-19. Twenty-six and 50 cases underwent appendicectomy during and pre-COVID-19 respectively. There was no difference in 30-day postoperative complication rates and nor were there any peri-operative COVID-19 infections.Twelve cases of simple appendicitis underwent conservative management during COVID-19 and were compared with 23 operatively managed simple cases pre-pandemic. There was a higher failure rate in the conservative versus operative group (33.3 vs 0% OR = 24.88, 95% CI 1.21 to 512.9,
    Discussion: Locally, conservative management was more likely to fail than initial appendicectomy. We suggest that surgery should remain first line for appendicitis, with conservative management reserved for those with suspected or proven COVID-19 infection.
    Language English
    Publishing date 2021-02-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2021.02.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Novel coronavirus (COVID-19) infection: What a doctor on the frontline needs to know

    Down, Billy / Kulkarni, Sagar / Ahmed Khan, Ameer Hamid / Barker, Benjamin / Tang, Ivan

    Abstract: Coronavirus disease 2019 (COVID-19) is a zoonotic respiratory infection originating from Wuhan, China. Rapidly spreading from Wuhan to all inhabited continents of the world, the World Health Organisation declared COVID-19 a pandemic on March 11, 2019. ... ...

    Abstract Coronavirus disease 2019 (COVID-19) is a zoonotic respiratory infection originating from Wuhan, China. Rapidly spreading from Wuhan to all inhabited continents of the world, the World Health Organisation declared COVID-19 a pandemic on March 11, 2019. Infected patients present with fever and cough; radiological features include bilateral infiltrates on chest x-ray and computed tomography scanning. Management is supportive with oxygen supplementation, broad-spectrum antibiotics as well as careful fluid balancing. A number of drugs, both new and old, are currently in clinical trials and being used on an experimental basis in clinical practice. The COVID-19 pandemic is the greatest worldwide public health crisis of a generation, and has led to seismic political, economic and social changes. This review provides an overview of COVID-19 for junior doctors who find themselves on a new frontline of healthcare.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #245314
    Database COVID19

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  10. Article: The matrimonial causes bill.

    Down, C F

    The Eugenics review

    2010  Volume 10, Issue 1, Page(s) 44

    Language English
    Publishing date 2010-11-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 281960-0
    ISSN 0374-7573
    ISSN 0374-7573
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 47: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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