Author: Jason Curtis

Patient's Understanding of Follow-Up Post Curative Primary Lung Cancer Surgery (2025)

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Type of publication:

Conference abstract

Author(s):

Barton P.W.J.; King M.; *Wassell E.; *McAdam J.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S872), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Follow up is an important part of patient care post primary lung cancer resection due to the possibility of cancer recurrence or the development of a new primary lung cancer. We aim to explore post operative patient's with a lung cancer understanding of follow-up and how we can implement and support this practice. Method(s): Between 01/08/2023 and 31/08/2023 every curative intent surgical patient was given a questionnaire to complete whilst attending follow-up clinics. This was rolled out over three UK thoracic surgical centers/Diagnostic centers and targeted patients with lung cancer undergoing follow-up post curative primary lung cancer surgery (excluding carcinoids, recurrence). 148/155 questionnaires were returned, collecting information on demographics, smoking status, operation performed, follow-up period post-surgery and patient understanding of follow-up. The responses were collated, compared and interpreted by the authors. Result(s): 148/155 (96%) patients responded. 62% female, 36% male. 80% Ex-smokers, Lobectomy most common operation 64%. 97% of patients' aware follow-up was required, and 72% identified that this would be for 5 years. 68% knew their diagnosis prior to surgery and 58% their final staging, 9% understood TNM. 58% knew their lung cancer nurse specialist (LCNS) and 54% when radiological investigations would be performed. 57% recall being given advice on improving their health and wellbeing, from (LCNS) 30%. 45% recalled a healthcare professional discussing recurrence. 34% knew the potential signs and symptoms of recurrence. Conclusion(s): This study has identified a gap in patients' knowledge and understanding of follow-up: The necessity of followup; TNM stage relevant to individuals; Schedule and frequency of radiological tests; Signs and symptoms suggestive of lung cancer recurrence. The development of a information leaflet patients with lung cancer by LCNS aims to address this need.

DOI: 10.1016/j.jtho.2025.09.1691

Incidence Trends and Survival Outcomes of Pulmonary Langerhans Cell Histiocytosis: A National Cancer Study Using SEER (2025)

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Type of publication:

Conference abstract

Author(s):

Carpo B.; *Arunachalam J.; Gunturu K.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S864), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, smoking-related neoplastic lung disease arising from clonal proliferation of dendritic cells. Initially considered a reactive disorder, the discovery of recurrent BRAF V600E mutations has led to its reclassification as a neoplasm. PLCH typically presents with nonspecific respiratory symptoms or may be incidentally detected on imaging. Diagnosis is based on high-resolution computed tomography, with histologic confirmation via biopsy. Smoking cessation remains the cornerstone of treatment, although glucocorticoids and BRAF-targeted therapies are used in selected cases. This study aims to characterize the incidence trends and survival outcomes of PLCH using a large population-based dataset in the U.S. Method(s): We performed a retrospective analysis using SEER (Surveillance, Epidemiology, and End Results) Research Plus (17 registries, 2010-2021). Patients with histologically confirmed Langerhans cell histiocytosis (ICD code 9751/ 3) with a primary site in the lung (C34) were included. Demographic and clinical data collected included age at diagnosis, sex, race/ ethnicity, stage at presentation, treatment modality, and county of residence (metropolitan vs. non-metropolitan). Incidence rates (IRs) per 100,000 were calculated using SEER*Stat and age-adjusted to the 2000 U.S. standard population. Kaplan-Meier survival analysis was performed using GraphPad Prism to evaluate overall survival (OS) and cancer-specific survival (CSS). Result(s): A total of 253 patients with PLCH were identified. The cohort was 57% female and 43% male, with 73% White, 15% Black, 6% Hispanic, 3.5% Asian/Pacific Islander, and 1% American Indian/Alaska Native. At diagnosis, 73% had localized disease and 20% presented with metastases. The overall age-adjusted IR was 0.0132 per 100,000, with the highest annual IR observed in 2016 (0.0493), followed by a decline. Females had a 33% higher IR than males (0.01509 vs. 0.01138; p = 0.028). While Black patients had a higher incidence (0.0190) compared to White patients (0.0160), the difference was not statistically significant (p = 0.37). The highest IR was observed in the 55-59 age group (IR = 0.03840), which was significantly higher than in the 40-44 (IR = 0.01419; p = 0.0004) and 35-39 (IR = 0.01261; p = 0.0001) groups, though not significantly different from those aged 45-54. Nonmetropolitan counties had a significantly higher IR (0.02507) compared to metropolitan counties (0.01185; p = 0.0004). The 5- and 10-year OS rates were 84.38% and 60.08%, respectively, while CSS rates were 96.25% and 93.39%. Adults aged >=60 years had a significantly shorter median OS (mOS) of 81 months compared to younger patients (p < 0.0001; HR 4.19, 95% CI 2.20-7.99). Conclusion(s): PLCH is an extremely rare pulmonary neoplasm with excellent cancer-specific survival but modest overall outcomes, likely reflecting comorbidities or delayed diagnosis. Incidence was highest in females, adults aged 55-59, and residents of nonmetropolitan areas, suggesting demographic and geographic disparities. These findings highlight the importance of early diagnosis and smoking cessation. The potential for disease stabilization or regression following smoking cessation differentiates PLCH from other lung neoplasms and underscores the need for timely recognition and intervention. Further investigation is warranted into the molecular framework and development of targeted therapies for this rare disease.

DOI: 10.1016/j.jtho.2025.09.1675

Correlation Between Cycle Threshold Value and CT Severity Score During COVID-19 Pandemic (2026)

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Type of publication:

Journal article

Author(s):

Udayakumar C.; M V.; Kumar K.; *Jayaram A.

Citation:

International Journal of Pharmacy Research and Technology. 16(1) (pp 391-397), 2026. Date of Publication: 01 Jan 2026.

Abstract:

Introduction: The novel SARS CoV-2 was declared as a public health emergency in January 2020. Patients infected with this virus show different severity of disease symptoms ranging from mild disease to that requiring intensive care and death. Therefore, it is important to have a test with the ability to predict the prognosis of patients at diagnosis and can aid in management decisions. Material(s) and Method(s): This study is a hospital based prospective observational study. The study includes the patients who are tested RTPCR positive within 72 hours of onset of symptoms. Patient who underwent Chest CT between 5th-7th day after the onset of symptoms were included in the study. Patients with RTPCR negative, RTPCR positive without Chest CT, asymptomatic RTPCR positive patients were excluded from the study. Viral RNA will be extracted by using extraction kits, and RTPCR performed in VRDL laboratory, SIMS, Shimoga. Using primers and probes targeting the RNA-dependent RNA polymerase (RdRp) gene fragment will be detected in the sample. A positive and a negative control were included in each run to generate a valid result. A Ct value of 15-35 was defined as a positive result. Computed tomography images of the chest will be obtained using 64 Slice Phillips CT machine. CT severity score will be calculated by looking for the presence of inflammatory abnormalities (like ground-glassopacities, mixed ground-glass opacities, or consolidation) in each lobe. Each lobe will then be awarded 0 to 4 points, depending on the percentage of involvement in each lobe: 0 (0%), 1 (1-25%), 2 (26-50%), 3 (51-75%), or 4 (76-100%. Total severity score will then be calculated with cut off being 7 for mild disease. Result(s): The mean age in the mild COVID-19 group was 49.52 years and in the moderate COVID-19 group was 51.84 years. The gender distribution showed that 68% (68/100) of the subjects were males while 32% (32/100) of them were females. On comparison of the haematological parameters, there was a statistically significant difference in the mean platelet count between the mild and moderate COVID-19 group (3.04 L versus 2.19 L, respectively, p-value=0.01). Among the biochemical parameters, a statistically significant difference between the mild and moderate COVID-19 groups were found in the following parameters- mean AST, mean ALT, mean D-dimer and mean serum ferritin. Conclusion(s): Viral load can be used as an early prognostic marker to assess severity. The utility of CT severity score, RT-PCR Ct value and other various clinical, radiological and immunological indices for supplementing the clinical diagnosis of COVID-19 cannot be overemphasized especially in a pandemic situation. CT chest severity score correlates with cycle threshold values in assessing severity of disease. However since the sample size is small further studies are required to prove the same.

DOI: 10.48047/ijprt/16.01.43

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National multi-specialty robotic surgery training curriculum and implementation for UK surgical residents: a delphi consensus (2026)

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Type of publication:

Journal article

Author(s):

Francis N; Shakir T; McLarty E; Haddad F; *Farquharson A; Garnham A; Siddiq S; Bannon A; Collins J; Yassin N

Citation:

Journal of Robotic Surgery. 20(1), 2026 Aug 29.

Abstract:

Robotic-assisted surgery is now established across multiple surgical specialties in the United Kingdom, yet training for surgical residents remains variable, resource-dependent, and insufficiently standardised at national level. This study sought multispecialty expert consensus on the essential components of a national robotic surgery training curriculum for UK surgical residents. A four-round modified Delphi study was conducted between September and December 2025 under the RaDaR network of the Royal College of Surgeons of England. Round 1 used open-ended questionnaires with independent dual-coder thematic analysis; Round 2 was a hybrid face-to-face and online meeting with live anonymous electronic voting; Rounds 3 and 4 were online questionnaires addressing statements not yet reaching the pre-defined consensus threshold of 70% agreement or greater. The panel comprised consultant surgeons, surgical trainees, curriculum and training authorities, and industry representatives with deliberately bounded, non-clinical input. 25 participants completed the final round. Of 26 statements, 22 (84%) reached consensus. A three-tier framework of device, basic skills, and procedural training was endorsed, with device training introduced during Phase 1 (76%) and basic skills and procedural training introduced after Phase 1 (96% and 88% respectively). Competency assessment integrated within the Annual Review of Competence Progression was supported (84%), alongside multi-source funding; trainee self-funding was not endorsed. This consensus offers a pragmatic foundation for standardising robotic surgery training for UK residents, contingent on coordinated investment in platform access, simulation infrastructure, and faculty development.

DOI: 10.1007/s11701-026-03864-x

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Unscheduled PMB and HRT-An analysis of urgent unscheduled bleeding referrals in accordance with BMS 2024 guidelines (2026)

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Type of publication:

Conference abstract

Author(s):

Chopra S.; Kaur H.; *Chai A.; *Sahu B.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S25), 2026. Date of Publication: 01 Jun 2026.

Abstract:

Background: Management of unscheduled bleeding on HRT is an integral part of investigating endometrial cancer, due to the increasing referrals to the Urgent Suspicion of Cancer Pathway (USCP). Objective(s): We aimed to retrospectively assess the impact that this pathway will have on our clinical practice. Method(s): Patients referred to the gynaecology cancer services at Shrewsbury and Telford Hospitals (SaTH) between March and October 2024 were retrospectively included. Under the BMS 2024 guidelines, data was extracted, including but not limited to demographics, time since menopause, HRT duration, parity, cancer risk factors, and amendment status during primary care. The recorded biopsy results served as the outcome. Result(s): Of the 1308 referrals identified, 627 (47.9%) were referred while actively using HRT. The rate of endometrial cancer diagnosis was significantly lower in the HRT cohort (0.15% (1/627)) when compared to the non-HRT cohort (4.55% (31/681)). Age was not included as a major risk factor, despite higher predictive value for uterine cancer in women over 55. The BMS pathway, although designed primarily for use in primary care, was complex and difficult to apply within a standard 10-min GP consultation when identifying patients requiring secondary care referral. Conclusion(s): We developed a simplified modified pathway to support our GP colleagues. We incorporated age as an additional risk factor and tailored the pathway to reflect best practice and the needs of our local population. The success of this initiative may support the development and adoption of similar pathways in other services.

DOI: 10.1111/1471-0528.70281

Obstetric Bleeding Study UK (OBS UK): protocol for a stepped wedge cluster randomised trial investigating the clinical and cost-effectiveness of a maternity quality improvement programme to reduce excess bleeding and need for transfusion after childbirth (2026)

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Type of publication:

Journal article

Author(s):

Kotecha S.J.; Potter C.; Hope-Bell J.; Riddell N.S.; Munnery K.; Onyimadu O.; Liberty C.; Taylor H.; Dop C.; De Lloyd L.; *Parry-Smith W.; Townson J.; Pallmann P.; Moody G.; Moriarty Y.; Deere R.; Barlow C.; Dhadda A.; *Elsmore A.; Willson S.; *Millward H.; *Siddall K.; Sanders J.; Stanworth S.J.; Black M.; Petrou S.; Rai T.; Slade P.; Hinton L.; Fye H.; Gur Geden A.; Collis R.E.; Collins P.; Bell S.

Citation:

BMJ open. 16(8) (pp e118723), 2026. Date of Publication: 20 Aug 2026.

Abstract:

INTRODUCTION: Bleeding during and after childbirth (postpartum haemorrhage, PPH) is the leading cause of severe maternal morbidity in the UK. Between 2017 and 2018, a PPH care bundle termed the Obstetric Bleeding Strategy (OBS) was implemented as a quality improvement project across all Welsh maternity units and improvements in maternal outcomes were observed. The OBS PPH care bundle incorporates assessment of bleeding risk, real-time cumulative quantification of blood loss, escalation of multiprofessional care including more senior staff at defined volumes of blood loss and point-of-care testing of coagulation at 1 L blood loss (or earlier if clinical concern) with targeted blood product transfusion in cases of haemostatic impairment. The Obstetric Bleeding Study UK (OBS UK) will evaluate this intervention in a larger number of maternity units across the UK. METHODS AND ANALYSIS: OBS UK is a stepped wedge cluster randomised trial designed to test the effectiveness of the OBS intervention compared with usual care on clinical and psychological PPH outcomes after childbirth, evaluate its cost-effectiveness and perform a process evaluation. The study will be capturing data from over 270 000 women and birthing people giving birth in the care of 36 participating maternity units during the 30-month study period. All maternity units will undertake a control period (lasting 3-18 months) during which usual PPH care will be provided, followed by a 9-month implementation period during which the OBS PPH care bundle will be introduced using quality improvement methods and then an OBS UK intervention period (lasting 3-18 months) during which OBS PPH care will be delivered.The primary outcome is the number of women receiving allogeneic red blood cell transfusion for PPH per 1000 maternities. Secondary outcomes are informed by the core PPH outcome set, psychological and cost-effectiveness measures for women and their partners and a mixed methods process evaluation exploring how the intervention was deployed and possible improvements to inform wider implementation. ETHICS AND DISSEMINATION: OBS UK will establish whether (and how) the OBS UK PPH care bundle improves outcomes and experiences of women and their partners. Published results will provide evidence to inform PPH maternity care across the UK and internationally. Dissemination of the findings will be made available to members of the public and participants. TRIAL REGISTRATION NUMBER: ISRCTN17679951

DOI: 10.1136/bmjopen-2026-118723

Link to full-text [open access - no password required]

The volume-outcome relationship for incisional hernia repair: analysis of an administrative dataset for England (2026)

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Type of publication:

Journal article

Author(s):

Monaghan M.; *Cheetham M.; Thomas R.; Parker S.; Briggs T.W.R.; Gray W.K.

Citation:

Hernia. 30(1) (no pagination), 2026. Article Number: 322. Date of Publication: 01 Dec 2026 [epub ahead of print]

Abstract:

Purpose: Incisional hernia is a common complication following abdominal surgery and repair can be complex. We aimed to use an administrative dataset for England to investigate the relationship between surgeon and provider volumes and outcomes. Method(s): We used data from the Hospital Episodes Statistics database for adult incisional hernia repair conducted in England from 1st April 2013 to 31st March 2025. The exposure variables were annual surgeon and provider volume defined as the number of procedures conducted in the 12 months prior to the index procedure. The primary outcome was reintervention surgery within two-years. Secondary outcomes were reintervention surgery at one and five years, length of stay greater than the median, 30-day all-cause emergency readmission and post-surgery complications. The relationship was modelled using multilevel, multivariable logistic regression with adjustment for prespecified covariates. Result(s): Data were available for 75,664 incisional hernia repairs conducted by 4355 surgeons within 165 providers. There was a significant relationship between greater surgeon annual volume and lower rates of reintervention surgery at two years (OR 0.995 (95% CI 0.992 to 0.998), p = 0.002) and five years (OR 0.994 (95% CI 0.991 to 0.997), p < 0.001) and between greater hospital provider volume and stay greater than the median (OR 1.001 (95% CI 1.000 to 1.002), p = 0.004). There was no relationship between volume and other short-term surgical outcomes. Conclusion(s): A relationship exists between lower surgeon volume and higher rates of reintervention surgery for incisional hernia repair. There was no relationship between lower surgeon or provider volume and poorer peri-surgical complications. Setting minimum surgeon annual volume thresholds may help to improve repair rates.

DOI: 10.1007/s10029-026-03827-z

A systematic review of clinical outcome reporting in randomised controlled trials evaluating remote obstetric antenatal monitoring (2026)

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Type of publication:

Conference abstract

Author(s):

Le Vance J.; Man R.; *Adeoye A.; Amaranathan S.; Massey S.; Gurney L.; Morton V.H.; Morris R.K.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BMFMS Abstracts 2026. Leeds United Kingdom. 133(Supplement 1) (pp S29), 2026. Date of Publication: 01 Aug 2026.

Abstract:

Objective: Technological innovations in remote antenatal care have expanded rapidly, aiming to shift aspects of care outside the hospital setting. However, current research objectively heralds variable outcome reporting, currently limiting meaningful comparison. This review systematically examined the heterogeneity of outcome reporting in remote obstetric monitoring trials and determined the need for a core outcome set (COS). Method(s): Five databases were searched from January 2015 to November 2025. Randomised controlled trials (RCTs), RCT protocols and randomised pilot studies evaluating any remote antenatal monitoring device with an appropriate comparator were included. Outcomes and their timing were extracted verbatim by two reviewers. Duplicate and similarly worded outcomes were removed, and outcome variability was assessed by the number of unique outcomes reported. Outcomes were categorised into domains. Result(s): Forty studies were included: 24 (60%) RCTs, 10 (25%) RCT protocols and 6 (15%) pilot RCTs. Blood pressure (17, 42.5%) and blood glucose monitoring (16, 40.0%) were the most frequently used technologies, with 19 studies (47.5%) employing multiple monitoring devices. Across all studies, 1,004 verbatim outcomes were reported, of which 11% (113) were primary outcomes. No single outcome was reported in all studies. After de-duplication, 361 unique outcomes remained, grouped into 73 domains. Glycaemic monitoring demonstrated the greatest definitional variation, with 29 distinct definitions. When stratified by measurement time-points, outcomes increased to 1,210, with fewer than 6% assessed beyond three months postpartum. Conclusion(s): This review demonstrated the current variability in consistent outcome reporting for remote antenatal monitoring trials. A COS is recommended for standardising outcome reporting.

DOI: 10.1111/1471-0528.70283

Coeliac Pneumococcal Vaccination (2025)

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Type of publication:

Service improvement case study

Author(s):

*Riddhika Chakravartty, *Rebekah Tudor

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

To identify all patients in the practice with a diagnosis of coeliac disease who did not have a recorded pneumococcal vaccination, and to improve vaccination uptake over a one-month period.

Link to PDF poster