Reducing the risk of venous thromboembolism following superficial endovenous treatment: A UK and Republic of Ireland consensus study.

OBJECTIVES: Venous thromboembolism is a potentially fatal complication of superficial endovenous treatment. Proper risk assessment and thromboprophylaxis could mitigate this hazard; however, there are currently no evidence-based or consensus guidelines. This study surveyed UK and Republic of Ireland vascular consultants to determine areas of consensus. METHODS: A 32-item survey was sent to vascular consultants via the Vascular and Endovascular Research Network (phase 1). These results generated 10 consensus statements which were redistributed (phase 2). 'Good' and 'very good' consensus were defined as endorsement/rejection of statements by >67% and >85% of respondents, respectively. RESULTS: Forty-two consultants completed phase 1. This generated seven statements regarding risk factors mandating peri-procedural pharmacoprophylaxis and three statements regarding specific pharmacoprophylaxis regimes. Forty-seven consultants completed phase 2. Regarding venous thromboembolism risk factors mandating pharmacoprophylaxis, 'good' and 'very good' consensus was achieved for 5/7 and 2/7 statements, respectively. Regarding specific regimens, 'very good' consensus was achieved for 3/3 statements. CONCLUSIONS: The main findings from this study were that there was 'good' or 'very good' consensus that patients with any of the seven surveyed risk factors should be given pharmacoprophylaxis with low-molecular-weight heparin. High-risk patients should receive one to two weeks of pharmacoprophylaxis rather than a single dose.

Wellbeing and burnout amongst medical students in England.

The wellbeing of doctors in training is currently under the spotlight. The British Medical Association (BMA) has committed to understanding issues of wellbeing amongst medical students. Medical students from England were asked to complete an online survey pertaining to wellbeing. 84 students responded. Results show 29% of respondents were given a mental health diagnosis whilst at medical school, and 82% could be classified as 'disengaged' and 85% 'exhausted' using the Oldenburg Burnout Scale. This demonstrates the need for further surveys with an increased number of respondents in order to gather more evidence surrounding these high rates of mental health issues. Support and preventative measures for medical students are required.

A descriptive study of mental health and wellbeing of doctors and medical students in the UK.

Doctors and medical students are working in a system which is affecting their mental wellbeing and their ability to provide the best possible care for patients. The British Medical Association conducted an online survey of doctors and medical students in October 2018. In total, 4347 responses were received and analysed. Doctors working the longest hours appear to be most vulnerable to psychological and emotional disturbance. Older and more senior doctors are most likely to report that their working environment has impacted on their condition. Medical students and junior doctors report the highest rate of having a formally diagnosed mental health condition in the last 12 months. This may be because they are in the vulnerable age group when psychiatric disorders start. Junior doctors were least likely to be aware of how to access help or support. Older doctors, those working as SAS (Staff, Associate Specialists and Specialty) doctors and overseas qualified doctors are most likely to say they have asked for support in managing a problem from their employer but that no support was provided. It is important to recognize that doctors, in spite of stress and poor wellbeing, continue to work hard, which has both advantages and disadvantages. These findings highlight that the environment in which doctors work, train, and study affects their mental health, and for this reason careful consideration needs to be given to the type and level of support provision available to them, as well as the ease of access and awareness of such support.

Serum Copper, Ceruloplasmin and Non Ceruloplasmin Copper Levels in Hyperpigmentary Disorders.

In 50 controls and 50 patients with hyperpigmentation serum copper, ceruloplasmin and non-ceruloplasmin copper have been estimated. Significantly higher levels of serum copper and non-ceruloplasmin copper have been detected in hyperpigmentary disorders. In toxic melanodenna and in females with melasma the main rise had been in non-ceruloplasmin copper, importance of which has been high-lighted.