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  1. Article: A quality improvement project: Reducing the number of unnecessary plain abdominal radiographs performed in the emergency department of a London district general hospital.

    Kyriakides, Jonathon / Khamar, Rahul / Khani, Aria / Khatkar, Harman

    Journal of family medicine and primary care

    2022  Volume 11, Issue 1, Page(s) 190–193

    Abstract: Background: Inappropriate completion of abdominal radiographs results in unnecessary exposure to ionizing radiation. This quality improvement project aimed to reduce the number of inappropriate abdominal radiographs performed in the emergency department. ...

    Abstract Background: Inappropriate completion of abdominal radiographs results in unnecessary exposure to ionizing radiation. This quality improvement project aimed to reduce the number of inappropriate abdominal radiographs performed in the emergency department.
    Materials and methods: Abdominal radiograph request forms were analyzed with reference to the Royal College of Radiologists (RCR) iRefer guidance. A teaching session was then delivered to ED clinicians and posters were disseminated within the department. Post-intervention data collection followed.
    Results: Following the intervention, there was an increase in the proportion of abdominal radiographs meeting iRefer guidance, which was accompanied by an increased diagnostic yield of these investigations. There was a reduction in the number of requests post-intervention.
    Conclusions: Our interventions helped increase awareness of both the guidelines and radiation dose associated with each study. Routine education of the iRefer guidelines will help reduce inappropriate requests. This in turn will reduce unnecessary radiation exposure, whilst also reducing the financial burden.
    Language English
    Publishing date 2022-01-31
    Publishing country India
    Document type Journal Article
    ZDB-ID 2735275-4
    ISSN 2278-7135 ; 2249-4863
    ISSN (online) 2278-7135
    ISSN 2249-4863
    DOI 10.4103/jfmpc.jfmpc_1193_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Analysis of an Ambulatory Care Pathway for Patients With COVID-19 Utilising Remote Pulse Oximetry at a London District General Hospital.

    Kyriakides, Jonathon / Khani, Aria / Coleman, Reginald / Kelly, Charlotte

    Cureus

    2021  Volume 13, Issue 1, Page(s) e12979

    Abstract: The identification of coronavirus disease 2019 (COVID-19) patients with oxygen saturations between 90-94% who can be safely discharged from the emergency department (ED) is challenging due to the difficulty of community monitoring. A pathway consisting ... ...

    Abstract The identification of coronavirus disease 2019 (COVID-19) patients with oxygen saturations between 90-94% who can be safely discharged from the emergency department (ED) is challenging due to the difficulty of community monitoring. A pathway consisting of home pulse oximetry with telephone follow-up was devised and implemented at a London District General Hospital to facilitate the safe discharge of these patients from the ED. Twenty patients with confirmed or suspected COVID-19 with oxygen saturations between 90%-94% were discharged on this novel ambulatory care pathway. Eighty-five percent of patients successfully avoided hospitalisation, whilst 15% were re-assessed and subsequently admitted to hospital. Home pulse oximetry monitoring was utilised to aid discharge from the ED and therefore prevent hospital admission. Telephone follow-up identified patients requiring further assessment. This study demonstrates the potential for safe ambulation of a subgroup of patients with COVID-19.
    Language English
    Publishing date 2021-01-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.12979
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Analysis of an ambulatory care pathway for patients with COVID-19 utilising remote pulse oximetry.

    Kyriakides, Jonathon / Khani, Aria / Kelly, Charlotte / Coleman, Reginald

    Clinical medicine (London, England)

    2021  Volume 21, Issue Suppl 2, Page(s) 48–49

    MeSH term(s) Ambulatory Care ; COVID-19 ; Humans ; Oximetry ; Oxygen ; SARS-CoV-2
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2021-01-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.21-2-s48
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5439: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Hospital Trainees Worries, Perceived Sufficiency of Information and Reported Psychological Health During The COVID-19 Pandemic

    Aziminia, Nikoo / Khani, Aria / Smith, Colette / Bakhai, Ameet / Lisk, Clifford

    medRxiv

    Abstract: Introduction: The COVID-19 pandemic has been unsurpassed in clinical severity or infectivity since the 1918 Spanish influenza pandemic and continues to impact the world. During the A/H1N1 influenza pandemic, healthcare workers presented frequent concerns ...

    Abstract Introduction: The COVID-19 pandemic has been unsurpassed in clinical severity or infectivity since the 1918 Spanish influenza pandemic and continues to impact the world. During the A/H1N1 influenza pandemic, healthcare workers presented frequent concerns regarding their ownand their families health, as well as high levels of psychological distress. Objectives: To assess hospital trainees concerns, perceived sufficiency of information, behaviour and reported psychological health during the COVID-19 pandemic in the NHS Design: Cross-sectional 39-point questionnaire study conducted in May 2020 Setting: A large NHS foundation trust in London Participants: 204 hospital trainee doctors Outcome measures: Quantitative analysis of trainees worries and concerns while working during the COVID-19 pandemic were assessed across 8 domains: trainee demographics; concerns and worries regarding COVID-19; perceived sufficiency of information about the COVID-19 pandemic; social distancing; use of personal protective equipment (PPE) and training in PPE; COVID-19 acquisition and risk; reported psychological health; and medical education. Results: 91.7% looked after COVID-19 patients. 91.6% were worried about COVID-19; the most frequent concern was that of family and friends dying from COVID-19 (74.6%). 22.2% reported being infected with COVID-19. 6.8% of trainees were so concerned about COVID-19 infection that they would avoid going to work. Perceived sufficiency of information about COVID-19 was moderately high. 25.9% reported that they were able to socially distance at work compared to 94.4% able to socially distance outside work. 98.2% reported using PPE and 24.7% were confident the provided PPE protected them against infection with COVID-19. 41.9% reported that their psychological health had been affected by their work with the commonest being anxiety (56.6%), emotional distress (50.9%) and burnout (37.7%). 95.6% felt it is important to have a service that provides psychological support during this pandemic and 62.5% reported they would consider using this at work. Conclusions: A significant proportion of hospital trainees are worried about the COVID-19 pandemic with high levels of reported psychological distress. Given that almost a third would not use psychological support services at work, hospital leaders and liaison psychiatry need to explore the reasons for not wanting to use services at work and highlight the provision of psychological services provided outside work such that provided by the London deaneries professional support unit (PSU). Seeking solutions to support trainee wellbeing in addition to this, such as larger offices, adequate rest facilities and alternative methods of teaching, with their input would enable empowerment of trainees and improve their health and morale while working in a pandemic.
    Keywords covid19
    Language English
    Publishing date 2020-07-25
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.07.22.20158311
    Database COVID19

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  5. Article ; Online: PERcutaneous transhepatic CHOLangioscopy using a new single-operator short cholangioscope (PERCHOL): European feasibility study.

    Pérez-Cuadrado-Robles, Enrique / Phillpotts, Simon / Bronswijk, Michiel / Conrad, Claudio Cim / Binda, Cecilia / Monino, Laurent / Basiliya, Kirill / Hollenbach, Marcus / Papaefthymiou, Apostolis / Alric, Hadrien / Quénéhervé, Lucille / Di Gaeta, Alessandro / Pioche, Mathieu / Khani, Aria / Lorenzo, Diane / Moreels, Tom G / Rahmi, Gabriel / Boeken, Tom / Fabbri, Carlo /
    Prat, Frédéric / Laleman, Wim / Cellier, Christophe / Van der Merwe, Schalk / Webster, George / Ellrichmann, Mark

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

    2023  

    Abstract: Objectives: A new short device for percutaneous endoscopic cholangioscopy was recently developed. However, feasibility and safety has not yet been evaluated. The aim of this study was to assess clinical success, technical success, and adverse events ( ... ...

    Abstract Objectives: A new short device for percutaneous endoscopic cholangioscopy was recently developed. However, feasibility and safety has not yet been evaluated. The aim of this study was to assess clinical success, technical success, and adverse events (AEs).
    Methods: This observational multicenter retrospective study included all patients who underwent percutaneous cholangioscopy using a short cholangioscope between 2020 and 2022. The clinical success, defined as the complete duct clearance or obtaining at least one cholangioscopy-guided biopsy, was assessed. The histopathological accuracy, technical success, and the AE rate were also evaluated.
    Results: Fifty-one patients (60 ± 15 years, 45.1% male) were included. The majority of patients had altered anatomy (n = 40, 78.4%), and biliary stones (n = 34, 66.7%) was the commonest indication. The technique was predominantly wire-guided (n = 44, 86.3%) through a percutaneous sheath (n = 36, 70.6%) following a median interval of 8.5 days from percutaneous drainage. Cholangioscopy-guided electrohydraulic lithotripsy was performed in 29 cases (56.9%), combined with a retrieval basket in eight cases (27.6%). The clinical success was 96.6%, requiring a median of one session (range 1-3). Seventeen patients (33.3%) underwent cholangioscopy-guided biopsies. There were four (7.8%) cholangioscopy-related AEs (cholangitis and peritonitis). Overall, the technical success and AE rates were 100% and 19.6%, respectively, in a median follow-up of 7 months.
    Conclusion: Percutaneous endoscopic cholangioscopy with a new short device is effective and safe, requiring a low number of sessions to achieve duct clearance or accurate histopathological diagnosis.
    Language English
    Publishing date 2023-09-29
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1171589-3
    ISSN 1443-1661 ; 0915-5635
    ISSN (online) 1443-1661
    ISSN 0915-5635
    DOI 10.1111/den.14697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3854: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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