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Article ; Online: Pharmacological interventions for early-stage frozen shoulder: a systematic review and network meta-analysis.

Berner, Juan Enrique / Nicolaides, Marios / Ali, Stephen / Pafitanis, Georgios / Preece, Jane / Hopewell, Sally / Nanchahal, Jagdeep

Rheumatology (Oxford, England)

2024

Abstract: Objectives: To evaluate the efficacy of pharmacological interventions for treating early-stage, pain predominant, adhesive capsulitis, also known as frozen shoulder.: Methods: We performed a systematic review in accordance with PRSIMA guidelines. ... ...

Abstract	Objectives: To evaluate the efficacy of pharmacological interventions for treating early-stage, pain predominant, adhesive capsulitis, also known as frozen shoulder. Methods: We performed a systematic review in accordance with PRSIMA guidelines. Searches were conducted on PUBMED, EMBASE and Cochrane Central Register of Controlled Trials on the 24th of February 2022. Outcomes were shoulder pain, shoulder function and range of movement. Synthesis involved both qualitative analysis for all studies and pairwise meta-analyses followed by a network meta-analysis for randomised controlled trials (RCTs). Results: A total of 3,252 articles were found, of which 31 met inclusion criteria, and 22 of these were RCTs. Intraarticular (IA) injection of corticosteroids (8 RCTS, 340 participants) and IA injection of platelet-rich plasma (PRP) (3 RCTs, 177 participants) showed benefit at 12 weeks compared with physical therapy in terms of shoulder pain and function, while oral non-steroidal anti-inflammatories (NSAIDs) (2 RCTs, 44 participants) and IA injection of hyaluronate (2 RCTs, 42 participants) did not show a benefit. Only IA PRP showed benefit over physical therapy for shoulder range of movement. Conclusion: These results shows that IA corticosteroids IA PRP injections are beneficial for early-stage frozen shoulder. These findings should be appraised with care considering the risk of bias, heterogeneity, and inconsistency of the included studies. We believe that research focused on early interventions for frozen shoulder could improve patient outcomes and lead to cost-savings derived from avoiding long-term disability. Further well-designed studies comparing with standardised physical therapy or placebo are required to improve evidence to guide management.
Language	English
Publishing date	2024-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keae176
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Article: Open tibial fractures: An overview.

Nicolaides, Marios / Pafitanis, Georgios / Vris, Alexandros

Journal of clinical orthopaedics and trauma

2021 Volume 20, Page(s) 101483

Abstract: Open tibial fractures are complex injuries with multifactorial outcomes and variable prognosis. The close proximity of the tibia to the skin makes it prone to extensive soft tissue damage and subsequent detrimental complications, such as infection and ... ...

Abstract	Open tibial fractures are complex injuries with multifactorial outcomes and variable prognosis. The close proximity of the tibia to the skin makes it prone to extensive soft tissue damage and subsequent detrimental complications, such as infection and non-union. Thus, they were historically associated with high rates of amputation, sepsis, or even death. The advancement of surgical instruments and techniques, along the emergence of evidence-based guidance, have resulted in a significant reduction in complications. Peculiarly though, modern management strategies have a strong foundation in practices described in the ancient times. Nevertheless, post-operative complications are still a challenge in the management of open tibial fractures. Efforts are actively being made to refine the surgical approaches used, while noteworthy is the emergence of the Orthoplastic approach. The aim of this review is to summarise and discuss the historical perspective of the management of open tibial fractures, their epidemiology and classification, up-to-date principles of surgical management and outcomes following injury.
Language	English
Publishing date	2021-06-24
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2021.101483
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Article: The Effect of Delayed Surgical Debridement in the Management of Open Tibial Fractures: A Systematic Review and Meta-Analysis.

Nicolaides, Marios / Vris, Alexandros / Heidari, Nima / Bates, Peter / Pafitanis, Georgios

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 6

Abstract: Introduction: Open tibial fractures are complex injuries with variable outcomes that significantly impact patients' lives. Surgical debridement is paramount in preventing detrimental complications such as infection and non-union; however, the exact ... ...

Abstract	Introduction: Open tibial fractures are complex injuries with variable outcomes that significantly impact patients' lives. Surgical debridement is paramount in preventing detrimental complications such as infection and non-union; however, the exact timing of debridement remains a topic of great controversy. The aim of this study is to evaluate the association between timing of surgical debridement and outcomes such as infection and non-union in open tibial fractures. Materials and methods: We performed a systematic review and meta-analysis of the literature to capture studies evaluating the association between timing of initial surgical debridement and infection or non-union, or other reported outcomes. We searched the MEDLINE, PubMed Central, EMBASE, SCOPUS, Cochrane Central and Web of Science electronic databases. Our methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane handbook for systematic reviews of interventions. Results: The systematic review included 20 studies with 10,032 open tibial fractures. The overall infection rate was 14.3% (314 out of 2193) and the overall non-union rate 14.2% (116 out of 817). We did not find any statistically significant association between delayed debridement and infection rate (OR = 0.87; 95% CI, 0.68 to 1.11; Conclusion: The findings of this meta-analysis support that delayed surgical debridement does not increase the infection or non-union rates in open tibial fracture injuries. Consequently, we propose that a reasonable delay in the initial debridement is acceptable to ensure that optimal management conditions are in place, such that the availability of surgical expertise, skilled staff and equipment are prioritised over getting to surgery rapidly. We recommend changing the standard guidance around timing for performing surgical debridement to 'as soon as reasonably possible, once appropriate personnel and equipment are available; ideally within 24-h'.
Language	English
Publishing date	2021-06-02
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11061017
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Article: The UEMS experience in continuous medical education accreditation process: a 'quo vadis' analysis of our global database.

Sideris, Michail / Rallis, Kathrine S / Nicolaides, Marios / Kuri, Ashvin / Schottler, Nadine / Paulus, Nathalie / Haas, Orthmar / Krajewski, Romuald / Grenho, Joao / Papalois, Vassilios

Annals of medicine and surgery (2012)

2024 Volume 86, Issue 2, Page(s) 689–696

Abstract: Background: The authors systematically appraise a large database of continuous professional development (CPD) and continuous medical education (CME) events against the European Accreditation Council for Continuous Medical Education (EACCME) framework.!## ...

Abstract	Background: The authors systematically appraise a large database of continuous professional development (CPD) and continuous medical education (CME) events against the European Accreditation Council for Continuous Medical Education (EACCME) framework. Methods: The authors performed a retrospective observational study of all CPD or CME events within the European Union of Medical Specialists (UEMS) database between 2017 and 2019, including 91 countries and 6034 events. Assessment of event design, quality and outcomes was evaluated against a validated, expert-derived accreditation framework, using thematic analysis to extract distinct themes, and subsequent quantitative analysis. Results: The authors included 5649 live educational events (LEEs) and 385 e-learning materials (ELMs). Three thousand seven hundred sixty-two [3762 (62.3%)] of the events did not report clear justification in their needs assessment process. Most accreditation applications claimed covering a single educational need [1603/2277 (70.3%)]. Needs assessments were reported to be similar across conferences, courses and other types of events ( Conclusions: Despite EACCME providing a robust framework for the CPD/CME accreditation process, reporting quality can still be improved, as more than 1 in 2 events fail to provide a clear description of their needs assessment. To the authors' knowledge, this is the largest educational LEE/ELM database, which can be a starting to revisit the CME/CPD accreditation process.
Language	English
Publishing date	2024-01-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000001583
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Article ; Online: Suturing Skills for Medical Students: A Systematic Review.

Emmanuel, Thanos / Nicolaides, Marios / Theodoulou, Iakovos / Yoong, Wai / Lymperopoulos, Nikolaos / Sideris, Michail

In vivo (Athens, Greece)

2020 Volume 35, Issue 1, Page(s) 1–12

Abstract: Aim: This systematic review aimed to identify all published evidence on teaching suturing skills for medical students. We aimed to outline significant positive teaching outcomes and devise a comprehensive framework for the optimal teaching of suturing ... ...

Abstract	Aim: This systematic review aimed to identify all published evidence on teaching suturing skills for medical students. We aimed to outline significant positive teaching outcomes and devise a comprehensive framework for the optimal teaching of suturing skills for medical students. Materials and methods: We searched MEDLINE Results: Our search yielded a total of 2,562 articles, out of which 25 were included in the final data synthesis. We provide a structured breakdown of educational interventions including participants, instructors and nature of teaching intervention. We also describe discrete means for assessment of performance and retention of suturing skills. Based on those we propose a standardised framework on teaching suturing skills for novices. Conclusion: To our knowledge this is the first systematic review investigating teaching interventions used to teach suturing skills in medical students. After extraction of individual positive teaching outcomes and utilising widely known learning theories and principles, we devised a comprehensive framework for more efficient and cost-effective teaching of suturing skills to medical students in the future.
MeSH term(s)	Humans ; Students, Medical
Language	English
Publishing date	2020-12-24
Publishing country	Greece
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.12226
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Article ; Online: The early response of plastic and reconstructive surgery services to the COVID-19 pandemic: A systematic review.

Boyce, Louis / Nicolaides, Marios / Hanrahan, John Gerrard / Sideris, Michail / Pafitanis, Georgios

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2020 Volume 73, Issue 11, Page(s) 2063–2071

Abstract: The World Health Organisation characterised the spread of coronavirus disease-19 (COVID-19) as a pandemic in March 2020, signalling medical governance and professional organisations worldwide to make urgent changes in their service. We have performed a ... ...

Abstract	The World Health Organisation characterised the spread of coronavirus disease-19 (COVID-19) as a pandemic in March 2020, signalling medical governance and professional organisations worldwide to make urgent changes in their service. We have performed a systematic review of the literature to identify all published literature on plastic surgery and COVID-19, in an effort to summarise the evidence for future reference. Our search identified 1207 articles from electronic databases and 17 from manual search, out of which 20 were included in the final data synthesis. Out of the included studies, most originated from the United States (n = 12), five from Europe, two from China and one from Australia. Strategies described to limit the spread and impact of the virus could be divided into nine distinct categories, including the suspension of non-essential services, use of telemedicine, use of personal protective equipment, screening patients for COVID-19, restructuring the healthcare team, adapting standard management practices, using distance-learning for trainees, promoting public education and initiatives, and minimising intra-hospital viral transmission. The ever-changing nature of the COVID-19 may prompt plastic surgeons to adapt special strategies as pandemic progresses and subsequently declines. The findings of this review can prove beneficial to other plastic surgery departments in informing their response strategies to the pandemic and in a second wave of the disease.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Cross Infection/prevention & control ; Delivery of Health Care/organization & administration ; Education, Distance ; Health Education ; Hospital Departments/organization & administration ; Humans ; Pandemics/prevention & control ; Patient Care Team/organization & administration ; Personal Protective Equipment ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Plastic Surgery Procedures/education ; SARS-CoV-2 ; Telemedicine ; Triage
Keywords	covid19
Language	English
Publishing date	2020-09-07
Publishing country	Netherlands
Document type	Journal Article ; Systematic Review
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2020.08.088
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Article ; Online: Simulation-Based Learning Strategies to Teach Undergraduate Students Basic Surgical Skills: A Systematic Review.

Theodoulou, Iakovos / Nicolaides, Marios / Athanasiou, Thanos / Papalois, Apostolos / Sideris, Michail

Journal of surgical education

2018 Volume 75, Issue 5, Page(s) 1374–1388

Abstract: Objective: We aimed to identify and critically appraise all literature surrounding simulation-based learning (SBL) courses, to assess their relevance as tools for undergraduate surgical education, and create a design framework targeted at standardizing ... ...

Abstract	Objective: We aimed to identify and critically appraise all literature surrounding simulation-based learning (SBL) courses, to assess their relevance as tools for undergraduate surgical education, and create a design framework targeted at standardizing future SBL. Methods: We performed a systematic review of the literature using a specific keyword strategy to search at MEDLINE database. Results: Of the 2371 potentially eligible titles, 472 were shortlisted and only 40 explored active interventions in undergraduate medical education. Of those, 20 were conducted in the United States, 9 in Europe and 11 in the rest of the world. Nineteen studies assessed the effectiveness of SBL by comparing students' attributes before and after interventions, 1 study assessed a new tool of surgical assessment and 16 studies evaluated SBL courses from the students' perspectives. Of those 40 studies, 12 used dry laboratory, 7 wet laboratory, 12 mixed, and 9 cadaveric SBL interventions. The extent to which positive results were obtained from dry, wet, mixed, and cadaveric laboratories were 75%, 57%, 92%, and 100%, respectively. Consequently, the SBL design framework was devised, providing a foundation upon which future SBL interventions can be designed such that learning outcomes are optimized. Conclusions: SBL is an important step in surgical education, investing in a safer and more efficient generation of surgeons. Standardization of these efforts can be accelerated with SBL design framework, a comprehensive guide to designing future interventions for basic surgical training at the undergraduate level.
MeSH term(s)	Education, Medical, Undergraduate/methods ; Educational Measurement ; Female ; General Surgery/education ; Humans ; Internationality ; Male ; Simulation Training ; Young Adult
Language	English
Publishing date	2018-02-17
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2018.01.013
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Article ; Online: Inspiring the future generation of oncologists: a UK-wide study of medical students' views towards oncology.

Rallis, Kathrine S / Wozniak, Anna Maria / Hui, Sara / Nicolaides, Marios / Shah, Neha / Subba, Beena / Papalois, Apostolos / Sideris, Michail

BMC medical education

2021 Volume 21, Issue 1, Page(s) 82

Abstract: Background: One in 2 people born in the UK after 1960 are expected to require oncology input in their lifetime. However, only 36% of UK medical schools provide dedicated oncology placements and teaching indicating a discordance between public health ... ...

Abstract	Background: One in 2 people born in the UK after 1960 are expected to require oncology input in their lifetime. However, only 36% of UK medical schools provide dedicated oncology placements and teaching indicating a discordance between public health impact and training. We designed a UK-wide survey to capture medical students' views on current oncology teaching and the potential role of a national undergraduate oncology symposium as an educational, networking and motivational tool. Methods: We undertook a national cross-sectional survey of UK medical students' views in oncology and satisfaction with teaching using pre-designed questionnaires. We also distributed a dedicated survey (pre and post-conference) to compare medical students' motivation towards a career in oncology after attending the national symposium. This study was prospectively approved by QMUL Ethics Committee (Reference number QMREC2348). Statistical analysis included univariate inferential tests on SPSS and GraphPad software. Results: The national survey was completed by 166 students representing 22 UK medical schools. Students reported limited interest, knowledge and exposure to oncology, lack of confidence in skills, and teaching dissatisfaction. Oncology was perceived as a challenging specialty (mean 4.5/5 ± 0.7), yet most students estimate receiving only 1-2 weeks of dedicated oncology teaching. The national symposium generated a statically significant increase in students' interest, knowledge, and confidence in skills surrounding oncology, improving students' perceived ability to cope with the emotional challenges in this field. Conclusion: Students' views towards oncology alongside their teaching dissatisfaction underpin the need to revisit and strive to improve current undergraduate oncology curricula. Increasing medical student oncology exposure by proposing outcome-based guidelines and adopting a standardised undergraduate oncology curriculum should be the foremost priority in inspiring future oncologists to ensure excellent cancer patient care.
MeSH term(s)	Cross-Sectional Studies ; Curriculum ; Education, Medical, Undergraduate ; Humans ; Oncologists ; Social Responsibility ; Students, Medical ; Surveys and Questionnaires ; United Kingdom
Language	English
Publishing date	2021-02-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-021-02506-0
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Article ; Online: Microvascular anastomotic arterial coupling: A systematic review.

Pafitanis, Georgios / Nicolaides, Marios / O'Connor, Edmund Fitzgerald / Raveendran, Maria / Ermogenous, Panagiotis / Psaras, George / Rose, Victoria / Myers, Simon

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2021 Volume 74, Issue 6, Page(s) 1286–1302

Abstract: Introduction: There are several reasons microsurgeons may not use a coupler device in arterial anastomosis: may be thick-walled, non-pliable due to atherosclerotic calcification or present vessel geometrical discrepancies. This review summarises the ... ...

Abstract	Introduction: There are several reasons microsurgeons may not use a coupler device in arterial anastomosis: may be thick-walled, non-pliable due to atherosclerotic calcification or present vessel geometrical discrepancies. This review summarises the current applications, efficacy and troubleshooting of microvascular coupler devices in arterial end-to-end anastomosis. Methods: A systematic review of the literature was performed in November 2020 across 4 electronic databases and in accordance with the PRISMA guidelines. All studies comprised the data synthesis that reported the use of a microvascular coupler device for arterial end-to-end anastomosis. Data were extracted and collected in three groups of standardised variables: study, anastomosis-related and technical characteristics. Results: Out of the 7,690 articles identified, 20 were included in the final data synthesis. Included studies involved a total of 1639 patients, who underwent 670 arterial and 1,124 venous anastomoses. Out of all arterial anastomoses, 351 were performed in free tissue transfers in head and neck, 117 in breast, 4 in upper extremity and 5 in lower extremity reconstruction, whereas the remaining were not specified. The total arterial coupler anastomosis success rate reported was 92.1% (617/670). Fifty-three (8%) arterial anastomoses were reported to result in either troubleshooting events or intra- or post-operative failures, most being reported in extremity reconstructions. Conclusions: Arterial coupling is not widespread with predominant use in head and neck and chest reconstructions, and total reported efficacy of 92.1%. Microsurgeons are reluctant to routinely use current widespread coupler devices as a result of inherent arterial characteristics. This study delivered collective recommendations, 'do's and don'ts' of microvascular arterial coupling.
MeSH term(s)	Anastomosis, Surgical/instrumentation ; Anastomosis, Surgical/methods ; Arteries/surgery ; Free Tissue Flaps ; Humans ; Microvessels/surgery ; Procedures and Techniques Utilization/statistics & numerical data ; Reconstructive Surgical Procedures/adverse effects ; Reconstructive Surgical Procedures/instrumentation ; Reconstructive Surgical Procedures/methods ; Vascular Surgical Procedures/adverse effects ; Vascular Surgical Procedures/instrumentation ; Vascular Surgical Procedures/methods
Language	English
Publishing date	2021-01-12
Publishing country	Netherlands
Document type	Journal Article ; Systematic Review
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2020.12.090
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Article ; Online: A prospective study integrating a curriculum of interventional radiology in undergraduate education: a tetra-core simulation model.

Theodoulou, Iakovos / Louca, Christina / Sideris, Michail / Nicolaides, Marios / Agrawal, Deepsha / Halapas, Antonios / Diamantopoulos, Athanasios / Papalois, Apostolos

CVIR endovascular

2020 Volume 3, Issue 1, Page(s) 12

Abstract: Background: Interventional radiology (IR) is underrepresented in undergraduate medical curricula across Europe. By continuing to challenge the boundaries of IR, a rise in the demand for radiologists has been inevitable - a trend not met by a ... ...

Abstract	Background: Interventional radiology (IR) is underrepresented in undergraduate medical curricula across Europe. By continuing to challenge the boundaries of IR, a rise in the demand for radiologists has been inevitable - a trend not met by a corresponding rise in the supply of radiologists. On tracing the roots of this shortage, lack of awareness of the specialty within medical trainees coupled with a global lack of IR teaching in undergraduate education seem to constitute major exacerbating factors. The purpose of this study was to identify gaps in the field of IR education and address these by implementing an international IR simulation-based course for undergraduates. Results: Implementation of a multi-modality simulation-based course consisted of seven modules incorporating technical and non-technical skills, basic science and applied clinical science modules. Of all participants, 90.7% (N = 68) never had previous IR teaching experience and only 28% (N = 21) had a previous placement in an IR department. Following the course, confidence improvement was statistically significant both in IR skills (1/5, p < 0.01) and knowledge (1/5, p < 0.01)]. The majority (90.7%) said they would benefit with more exposure to IR. In terms of the students' motivation for a career in IR, 32% (N = 24) reported that they would more likely consider a career in IR after completing the course. Conclusion: Delivery of a tetra-core simulation course with the aim to address the gaps in undergraduate IR education has had a positive impact on students' skills, confidence levels as well as motivation. We propose reviewing the curricula across medical schools in Europe to identify gaps and address any inadequacies; for this, we consider our simulation course an excellent starting point.
Language	English
Publishing date	2020-03-09
Publishing country	Switzerland
Document type	Journal Article
ISSN	2520-8934
ISSN (online)	2520-8934
DOI	10.1186/s42155-020-0104-y
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