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Article ; Online: A Paper-Based Simulation Model for Teaching Inguinal Hernia Anatomy.

Kong, Chia Yew / Iddles, Emma / Glen, Paul

2023 Volume 47, Issue 8, Page(s) 1842–1849

Abstract: Background: Inguinal hernias remain a challenging area of learning for medical students due to its relatively complex anatomy. Modern curriculum delivery methods are conventionally limited to didactic lectures and demonstration of anatomy ... ...

Abstract	Background: Inguinal hernias remain a challenging area of learning for medical students due to its relatively complex anatomy. Modern curriculum delivery methods are conventionally limited to didactic lectures and demonstration of anatomy intraoperatively. These strategies have limitations; lectures are inherently descriptive and based on 2-dimensional models, while intraoperative teaching is often unstructured and opportunistic. Methods: A paper-based model was developed comprising three overlapping paper panels simulating the anatomical layers of the inguinal canal which can be modified readily to further simulate various hernia pathologies and their surgical repair. These models were incorporated into a timetabled structured learning session for 3 Findings: A total of 45 students participated in these sessions over a period of 6 months. Pre-learning session mean ratings for the learners' confidence in their understanding of the layers of the inguinal canal, identifying indirect and direct inguinal hernias and in naming the contents of the inguinal canal were 2.5, 3.3 and 2.9, while post-learning session mean ratings were 8.0, 9.4 and 8.2, respectively. Paired samples Student's t-tests for all three questions were statistically significant (p < 0.001). The mean rating for usefulness of the session was 9.6/10. Free comments from students emphasised the models' usefulness as a visual learning aid. Discussion and conclusion: Our novel, low-cost paper model was associated with an improvement in learners' perceived knowledge and understanding of inguinal canal anatomy and pathology.
MeSH term(s)	Humans ; Hernia, Inguinal/surgery ; Learning ; Curriculum ; Computer Simulation ; Educational Measurement ; Teaching ; Anatomy/education ; Students, Medical
Language	English
Publishing date	2023-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-023-07018-0
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Article ; Online: The role of stents in the palliation of oesophageal cancer.

Glen, Paul

BMJ supportive & palliative care

2016 Volume 6, Issue 1, Page(s) 135–139

Abstract: Oesophageal cancer is the 13th most common cancer in the UK and very few patients are suitable for radical treatment. Almost all of the remaining patients suitable for palliative treatment only have some degree of dysphagia requiring treatment. Self- ... ...

Abstract	Oesophageal cancer is the 13th most common cancer in the UK and very few patients are suitable for radical treatment. Almost all of the remaining patients suitable for palliative treatment only have some degree of dysphagia requiring treatment. Self-expanding metal stents are currently the most common means of improving swallowing. This review discusses when we should stent patients, what type of stent we should use and how it can be carried out as well as illustrating the problems that can occur immediately after stent insertion and longer term problems.
MeSH term(s)	Deglutition Disorders/etiology ; Deglutition Disorders/prevention & control ; Esophageal Neoplasms/complications ; Female ; Humans ; Male ; Palliative Care/methods ; Self Expandable Metallic Stents ; United Kingdom
Language	English
Publishing date	2016-03
Publishing country	England
Document type	Journal Article ; Review
ISSN	2045-4368
ISSN (online)	2045-4368
DOI	10.1136/bmjspcare-2014-000802
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: National adoption of an esophageal cell collection device for Barrett's esophagus surveillance: impact on delay to investigation and pathological findings.

Chien, Siobhan / Glen, Paul / Penman, Ian / Bryce, Gavin / Cruickshank, Neil / Miller, Michael / Crumley, Andrew / Fletcher, Jonathan / Phull, Perminder / Gunjaca, Ivan / Robertson, Kevin / Apollos, Jeyakumar / Fullarton, Grant

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

2024

Abstract: High quality Barrett's esophagus surveillance is crucial to detect early neoplastic changes. An esophageal cell collection device (OCCD) was introduced as a triage tool for Barrett's surveillance. This study aims to evaluate whether the Scottish OCCD ... ...

Abstract	High quality Barrett's esophagus surveillance is crucial to detect early neoplastic changes. An esophageal cell collection device (OCCD) was introduced as a triage tool for Barrett's surveillance. This study aims to evaluate whether the Scottish OCCD program (CytoSCOT) has reduced delays to Barrett's surveillance, and whether delayed surveillance negatively impacts endoscopic pathology. All patients undergoing OCCD testing for Barrett's surveillance across 11 Scottish health boards between 14/9/2020 and 13/9/2022 were identified. Patients were dichotomised into two groups (Year 1 vs. Year 2), with individual records interrogated to record demographics, recommended surveillance interval, time from last endoscopy to OCCD test, and OCCD result. Patients were deemed high-risk if the OCCD demonstrated atypia and/or p53 positivity. Further analysis was performed on patients who underwent endoscopy within 12 months of OCCD testing. A total of 3223 OCCD tests were included in the analysis (1478 in Year 1; 1745 in Year 2). In Year 1 versus Year 2, there was a longer median delay to surveillance (9 vs. 5 months; P < 0.001), increased proportion of patients with delayed surveillance (72.6% vs. 57.0%; P < 0.001), and more high-risk patients (12.0% vs. 5.3%; P < 0.001). 425/3223 patients (13.2%) were further investigated with upper gastrointestinal endoscopy, 57.9% of which were high-risk. As surveillance delay increased beyond 24 months, high-risk patients were significantly more likely to develop dysplasia or malignancy (P = 0.004). Delayed Barrett's esophagus surveillance beyond 24 months is associated with increased risk of pre-cancerous pathology. The CytoSCOT program has reduced delays in surveillance, promoting earlier detection of dysplasia and reducing burden on endoscopy services.
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	639470-x
ISSN	1442-2050 ; 1120-8694
ISSN (online)	1442-2050
ISSN	1120-8694
DOI	10.1093/dote/doae002
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Article ; Online: Choledocholithiasis: Long-term follow-up in patients without stone clearance at first endoscopic retrograde cholangiopancreatography.

Kourounis, Georgios / Gall, Lewis S / McArthur, Donald / Gibson, Simon / Glen, Paul

Journal of digestive diseases

2021 Volume 22, Issue 9, Page(s) 551–556

Abstract: Objectives: Complete clearance during endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis is not always successful and biliary stenting is commonplace. Strategies vary between temporary stent placement (TSP) with interval ERCP ... ...

Abstract	Objectives: Complete clearance during endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis is not always successful and biliary stenting is commonplace. Strategies vary between temporary stent placement (TSP) with interval ERCP or permanent stent placement (PSP) and watchful waiting for recurrent biliary obstruction (RBO). This study aimed to describe outcomes in these two groups and stent patency rates in PSP. Methods: Patients with incomplete clearance at first ERCP for choledocholithiasis between May 2015 and December 2018 were identified. Clinical outcomes were obtained by retrospective interrogation of the case notes. Median follow-up duration was 41 months (interquartile range 29-51 mo). Results: Of 1263 index ERCP, 199 (15.8%) had no stone clearance, with 53.3% receiving PSP and 46.7% undergoing TSP. The TSP group had repeat ERCP after a median of 8 weeks; 75.3% had clearance on a repeat ERCP. The PSP group was elder than the TSP group (82 y vs 72 y, P < 0.001). The rates of RBO (32.1% vs 16.1%) and emergency readmissions (32.1% vs 19.4%) were higher in the PSP group (both P < 0.05). More patients died without further biliary disease in the PSP group (39.6% vs 12.9%, P = 0.001). PSP stent patency rates at 6, 12, 24, 36, and 61 months were 87.7%, 82.1%, 75.5%, 69.8% and 67.9%, respectively. Conclusions: Though PSP had higher RBO and emergency readmissions, two-thirds of patients either died or survived without recurrent biliary disease. Stent patency decreased fastest in the first 12 months. Criteria to guide decision-making for biliary stenting remain unclear.
MeSH term(s)	Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis/diagnostic imaging ; Choledocholithiasis/surgery ; Cholestasis ; Follow-Up Studies ; Humans ; Retrospective Studies ; Stents ; Treatment Outcome
Language	English
Publishing date	2021-09-16
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2317117-0
ISSN	1751-2980 ; 1751-2972
ISSN (online)	1751-2980
ISSN	1751-2972
DOI	10.1111/1751-2980.13043
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Article ; Online: Palliative stenting for oesophagogastric cancer: tumour and host factors and prognosis.

Park, James Hugh / Woodley, Niall / McMillan, Donald C / Glen, Paul

BMJ supportive & palliative care

2018 Volume 9, Issue 3, Page(s) 332–339

Abstract: Objectives: Palliative self-expandable metallic stent (SEMS) insertion is common in patients not suitable for resection of oesophagogastric (OG) cancer. Factors which may determine survival, however, are not clear. The present study examined the ... ...

Abstract	Objectives: Palliative self-expandable metallic stent (SEMS) insertion is common in patients not suitable for resection of oesophagogastric (OG) cancer. Factors which may determine survival, however, are not clear. The present study examined the relationship between tumour and host factors, including the systemic inflammatory response and survival of patients undergoing palliative SEMS insertion. Methods: Patients with a diagnosis of OG cancer who were considered suitable for palliative SEMS only without systemic therapy were identified. Patient characteristics including Eastern Cooperative Oncology Group performance status, radiological stage and modified Glasgow Prognostic Score (mGPS: 0-C-reactive protein (CRP) ≤10 mg/L; 1-CRP >10 mg/L; 2-CRP >10 mg/L; albumin <35 g/L) were recorded prospectively. The relationship between such characteristics and 3-month survival was examined. Results: 203 patients were included in the final analysis. All patients died during follow-up, with median survival from diagnosis 75 days (IQR 47-157). 78% of patients were systemically inflamed (mGPS >1). On multivariate analysis, only poor performance status (HR 1.23, p=0.025), metastatic disease (HR 2.27, p<0.001) and mGPS (HR 1.25, p=0.021) were associated with shorter survival. The combination of performance status and mGPS stratified 3-month survival of patients without metastatic disease from 88% to 20% (p<0.001) and patients with metastases from 43% to 6% (p=0.059). Similar results were observed when analysis was restricted to patients with oesophageal and junctional cancer (M0: 83%-20%, p=0.008; M1: 33%-8%, p=0.082). Conclusion: Performance status, metastatic disease and mGPS are independent predictors of survival in patients with OG cancer undergoing palliative SEMS insertion. These routinely available markers provide a rational system on which to base decisions regarding prognosis and treatment.
MeSH term(s)	Aged ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/surgery ; Female ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Palliative Care/methods ; Prognosis ; Self Expandable Metallic Stents ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery ; Survival Analysis
Language	English
Publishing date	2018-03-23
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ISSN	2045-4368
ISSN (online)	2045-4368
DOI	10.1136/bmjspcare-2017-001490
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Leeding geeks

Glen, Paul

Business leadership : a Jossey-Bass reader , p. 244-254

technology and leadership

2008 , Page(s) 244–254

Author's details	Paul Glen
Keywords	Management ; Führungsstil ; Hochqualifizierte Arbeitskräfte
Language	English
Size	graph. Darst.
Publisher	Jossey-Bass
Publishing place	San Francisco, Calif.
Document type	Article
ISBN	978-078-798-819-7 ; 078-798-819-7
Database	ECONomics Information System

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Article ; Online: Iron-induced gastric ulceration with radiological and endoscopic appearance of carcinoma.

Smith, Iain M / Bryson, Gareth / Glen, Paul

BMJ case reports

2015 Volume 2015

Abstract: Erosive injury of the upper gastrointestinal tract resulting from therapeutic oral iron supplements is an uncommon phenomenon. We present a case of a large gastric ulcer with clinical, endoscopic and radiological features suggestive of malignancy, which ... ...

Abstract	Erosive injury of the upper gastrointestinal tract resulting from therapeutic oral iron supplements is an uncommon phenomenon. We present a case of a large gastric ulcer with clinical, endoscopic and radiological features suggestive of malignancy, which resolved completely on cessation of iron therapy.
MeSH term(s)	Carcinoma/pathology ; Dietary Supplements/adverse effects ; Endoscopy ; Humans ; Iron/adverse effects ; Iron, Dietary/adverse effects ; Male ; Middle Aged ; Stomach/pathology ; Stomach Ulcer/etiology ; Stomach Ulcer/pathology
Chemical Substances	Iron, Dietary ; Iron (E1UOL152H7)
Language	English
Publishing date	2015-10-06
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2015-211997
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A simple technique for fenestration of an hepatic cyst.

Glen, Paul / Horgan, Paul G

Annals of the Royal College of Surgeons of England

2003 Volume 85, Issue 3, Page(s) 209

MeSH term(s)	Cysts/surgery ; Drainage/methods ; Humans ; Liver Diseases/surgery
Language	English
Publishing date	2003-06-11
Publishing country	England
Document type	Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/003588403321661497
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Article: Chronic inflammation and pancreatic cancer.

McKay, Colin J / Glen, Paul / McMillan, Donald C

Best practice & research. Clinical gastroenterology

2008 Volume 22, Issue 1, Page(s) 65–73

Abstract: There is a proven association between carcinoma of the pancreas and both the sporadic and hereditary forms of chronic pancreatitis. In chronic pancreatitis the standardised incidence ratio for development of pancreatic cancer is 14-18 and is further ... ...

Abstract	There is a proven association between carcinoma of the pancreas and both the sporadic and hereditary forms of chronic pancreatitis. In chronic pancreatitis the standardised incidence ratio for development of pancreatic cancer is 14-18 and is further increased by cigarette smoking. Underlying mechanisms are unclear but current theories point to the progressive accumulation of genetic mutations as a consequence of repeated DNA damage and cell regeneration in an environment favouring proliferation and neovascularisation. In patients who develop pancreatic cancer, there is interest in the role of the inflammatory response in the development of cancer cachexia and in determining prognosis. Furthermore, markers of a systemic inflammatory response have prognostic significance in both advanced, inoperable pancreatic cancer and in patients undergoing resection. Further understanding of the details of the relationship between inflammation, carcinogenesis and cancer prognosis may lead to new therapeutic possibilities as part of multi-modality management of this difficult disease.
MeSH term(s)	Biomarkers ; C-Reactive Protein ; Cachexia ; Humans ; Pancreatic Neoplasms/etiology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatitis, Chronic/genetics ; Pancreatitis, Chronic/physiopathology ; Prognosis ; Risk Factors
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2008
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2048181-0
ISSN	1521-6918
ISSN	1521-6918
DOI	10.1016/j.bpg.2007.11.007
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Article: Pneumomediastinum following Ecstasy (methylenedioxymetamphetamine, MDMA) ingestion in two people at the same 'rave'.

Rejali, Darius / Glen, Paul / Odom, Nicholas

The Journal of laryngology and otology

2002 Volume 116, Issue 1, Page(s) 75–76

Abstract: Ecstasy is a class A controlled drug often consumed by the young population for recreational purposes. Documented complications of its use include hyperpyrexia, disseminated intravascular coagulation (DIC), renal failure and rhabdomyolysis. We report on ... ...

Abstract	Ecstasy is a class A controlled drug often consumed by the young population for recreational purposes. Documented complications of its use include hyperpyrexia, disseminated intravascular coagulation (DIC), renal failure and rhabdomyolysis. We report on two patients who developed pneumomediastinum after Ecstasy abuse. Both patients obtained and consumed the drug at the same establishment and presented to the same hospital within half an hour. The possible pathogenesis of this complication are discussed and the literature reviewed. Pneumomediastinum should be recognized as a possible complication of Ecstasy use. Conservative management is appropriate.
MeSH term(s)	Adult ; Amphetamine-Related Disorders/complications ; Female ; Hallucinogens/adverse effects ; Humans ; Male ; Mediastinal Emphysema/chemically induced ; N-Methyl-3,4-methylenedioxyamphetamine/adverse effects
Chemical Substances	Hallucinogens ; N-Methyl-3,4-methylenedioxyamphetamine (KE1SEN21RM)
Language	English
Publishing date	2002-01
Publishing country	England
Document type	Journal Article
ZDB-ID	218299-3
ISSN	1748-5460 ; 0022-2151
ISSN (online)	1748-5460
ISSN	0022-2151
DOI	10.1258/0022215021910230
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