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How can we be SMART with virtual consultations?
At the beginning of 2020, video conferencing and phone consultations accounted for less than 1% of all consultations. Now it is probably 70%. Whilst there are many remote consultation solutions available, Tina Marshall describes what the ideal solution should look...Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer
Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...Guide to gaining approval for a clinical study
This article focuses on gaining approval for clinical research involving NHS patients, although the principles can be applied to other types of research. It can be quite a daunting process for the uninitiated applicant. Often it can be made less...My experience of addiction
In this incredibly honest and thought-provoking article, we hear from an anonymous doctor who has struggled with addiction. The nature of addiction is a subject of interest to a broad range of scientific disciplines, from medicine to psychology, psychotherapy and...
Transfer to tertiary paediatric hospitals for patients with testicular torsion
Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...
Is AS in SRM more convincing than in prostate cancer?
This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...
Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus
Thiazide diuretics have been used to reduce calcium nephrolithiasis recurrence as it is tolerated well, inexpensive and reduces calcium excretion in urine. It has been linked with increased risk of diabetes mellitus (DM) in the presence of hypertension (ALLHAT study),...
Fluoroquinolone resistant rectal colonisation predicts risk of infectious complications after TRPB
Transrectal prostate biopsy (TRPB) has been associated with increased risk of infection between 3.6-5% and sepsis rates of 0.3-3.1% mainly due to fluoroquinolone resistance (FQR). At present, FQ antibiotic prophylaxis is utilised commonly across North America and Europe but due...
Prostatic artery embolisation – an option for select BPO patients
Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...
Curing pure CIS with radical surgery: lessons learned
As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...
Can antibiotics reduce ‘unnecessary’ prostate biopsies?
With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...
