Urology never events in the United Kingdom: A retrospective 10-year review.

Objectives: The aim was to assess the prevalence of never events (NEs) specific to urology in the United Kingdom and identify commonly occurring themes. Methods: Data from the National Health Service (NHS) NEs website were obtained and all NEs from 2012 to 2022 were reviewed. Urology-specific NEs were identified and further analysed in their respective categories. Data regarding the total number of surgical procedures performed in the NHS specific to each specialty were obtained via the NHS Hospital Episode Statistics website. Results: There were 3972 NEs recorded over the 10-year period with 95 (2.4%) of these as a result of urology surgery. The most common surgical intervention associated with a urological NE was ureteric stenting, which comprised 45/95 (47.4%) of all analysed NEs. These consisted of wrong site ureteric stent insertion (n = 29), wrong site ureteric stent removal (n = 9), wrong stent type (n = 5) and retained guidewires (n = 2). There were 7.14 million urology surgeries performed in the 10-year period, and prevalence was 0.0013%. Conclusion: NEs are fully preventable serious incidents in the NHS. This is the first study to investigate the prevalence of NEs in urology in the United Kingdom. This study demonstrates that in the last 10 years the prevalence of urology NEs is low at 0.0013%, with ureteric stent procedures accounting for more than half of the NEs. Urologists should be mindful of the potential for wrong site surgery in urologic stenting procedures.

Treatment of Cachexia in Gastric Cancer: Exploring the Use of Anti-Inflammatory Natural Products and Their Derivatives.

(1) Background: Gastric cancer is a significant cause of cancer-related mortality worldwide. Weight loss and malnutrition associated with cancer are linked with increased mortality rates and reduced quality of life. Cancer cachexia, characterised by the loss of skeletal muscle, is associated with approximately 20% of cancer-related deaths and differs from malnutrition in that it cannot be fully reversed by nutritional support alone. It is now recognised that the primary pathophysiological process underlying cancer cachexia is chronic inflammation leading to increased calorie consumption. Current treatments that focus on nutritional supplementation, psychological counselling, appetite stimulation and reducing inflammation are lacking in efficacy. This review focuses on the evidence supporting the potential roles of natural anti-inflammatory products and their derivatives including fatty acids, probiotics, amino acids, curcumin, fucoidan, epigallocatechin-3-gallate, ginger, resveratrol and Boswellia serrata in the management of gastric cancer cachexia. (2) Results: While natural anti-inflammatory products show promise in a number of in vitro and in vivo studies, there are only a small number of human studies available. Where present, the evidence base is heterogeneous, with varying study methodologies and outcomes. (3) Conclusions: Natural anti-inflammatory products represent a potential adjunctive therapy for gastric cancer cachexia. Further research, particularly well-designed clinical trials, is needed to elucidate their optimal role, dosing and safety profiles in the management of gastric cancer cachexia.

Assessing the preparedness of foundation year 1 (FY1) doctors during the transition from medical school to the foundation training programme.

BACKGROUND: To assess how ready current FY1 doctors felt when starting their first posting as newly qualified doctors. METHODS: We created an online survey where 45 FY1 doctors in South Yorkshire rated how confident they were across different domains (Induction and Assistantship, Hospital Systems, and Skills) using a scale ranging from 0 (no confidence performing task) to 5 (highly confident). RESULTS: The ICE system and observations had a mean rating of 3.645 (95% CI 3.446 to 3.844), and 4.425 (95% CI 4.248 to 4.602) with a standard deviation (SD) of 1.10 and 0.83 respectively. The radiological platform, referral system, telephone system, and hospital notes had a mean score of 3.149 (95% CI 2.876 to 3.422), 2.340 (95% CI 2.096 to 2.584), 3.573 (95% CI 3.407 to 3.739) and 4.061 (95% CI 3.931 to 4.191), with a SD of 1.281, 1.153, 0.961 and 0.752 respectively. Patient needs and diagnostic procedures had a mean score of 3.933 (95% CI 3.749 to 4.117) and 4.250 (95% CI 4.140 to 4.360) with a SD of 1.190 and 0.944 respectively. Patient care, prescribing, and therapeutic procedures gave a mean score of 3.634 (95% CI 3.432 to 3.836), 4.130 (95% CI 3.959 to 4.301), 3.386 (95% CI 3.228 to 3.544) with a SD of 1.133, 0.958 and 1.256 respectively. No statistically significant difference in the overall mean score was found between respondents who attended medical schools in Yorkshire, and those who had not. CONCLUSION: Overall, confidence differs across different domains and categories. A larger sample size across a wider geographical area would allow us to compare and contrast results across the different regions in the UK.