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Intrépide : Australian women artists in early twentieth-century France / Clem Gorman and Therese Gorman.

104 - Z/SP/W12/99 - Warrane Estate - North Sydney Road - North Shore - French's Rd, Borlaise St, Warrane St, Armstrong St, Government Rd, North Sydney Rd, 1889

060 - Z/SP/W12/56 - 9th subdivision - Northbridge - Harden Avenue Subdivision - Eric St, Bligh St, Tenilba Rd, Harden Ave, Kameruka Rd, Sailors Bay Creek, Tailor St, Euroka Rd, Dalkeith Rd, Bellambi Rd, Kyogly Rd , 1918

137 - Z/SP/W12/132a - The Wireless Subdivision - Sunnyside Estate - No boundaries shown

[Willoughby subdivision plans] [cartographic material]

Purpose
To compare the performance of multiple international guidelines in selecting patients for head CT prior to lumbar puncture (LP) in suspected meningitis, focusing on identification of potential contraindications to immediate LP.
Methods
Retrospective study of 196 patients with suspected meningitis presenting to an emergency department between March 2013 and March 2023 and undergoing head CT prior to LP. UK Joint Specialist Society Guidelines (UK), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Infectious Diseases Society of America (IDSA) guidelines were evaluated by cross-referencing imaging criteria with clinical characteristics present at time of presentation. Sensitivity of each guideline for recommending neuroimaging in cases with brain shift on CT was evaluated, along with the number of normal studies and incidental or spurious findings.
Results
2/196 (1%) patients had abnormal CTs with evidence of brain shift, while 14/196 (7%) had other abnormalities on CT without brain shift. UK, ESCMID and IDSA guidelines recommended imaging in 10%, 14% and 33% of cases respectively. All three guidelines recommended imaging pre-LP in 2/2 (100%) cases with brain shift. IDSA guidelines recommended more CT studies with normal findings (59 vs 16 and 24 for UK and ESCMID guidelines respectively) and CT abnormalities without brain shift (4 vs 1 and 2 respectively) than the other guidelines.
Conclusion
UK, ESCMID and IDSA guidelines are all effective at identifying the small cohort of patients who benefit from a head CT prior to LP. Following the more selective UK/ESCMID guidelines limits the number of normal studies and incidental or spurious CT findings.

Emergency radiology, 2024-06, Vol.31 (3), p.373-379

Comparison of international guidelines for CT prior to lumbar puncture in patients with suspected meningitis

ObjectiveEndoscopy departments have experienced considerable challenges in the provision of endoscopy services since the start of the COVID-19 pandemic. Several studies have reported a reduction of procedures performed by trainee endoscopists during the pandemic. The aim of this study was to assess the impact on colonoscopy training and quality in an academic centre throughout successive waves of the pandemic.MethodsThis was a single-centre, retrospective, observational study comparing colonoscopies performed at a tertiary endoscopy centre in Ireland at different stages of the pandemic with those performed during a similar time frame prepandemic. Data were collected using electronic patient records. Primary outcomes were procedure volumes, adenoma detection rate and mean adenoma per procedure.ResultsIn the prepandemic period, 798 colonoscopies were performed. During the same period in 2020, 172 colonoscopies were performed. In 2021, during the third wave of the pandemic, 538 colonoscopies were performed. Percentages of colonoscopies performed by trainees were 46.0% (n=367) in 2019, 25.6% (n=44) in 2020 and 45.2% (n=243) in 2021. Adenoma detection rate was 21.3% in 2019, 38.6% in 2020 and 23.9% in 2021. Mean adenoma per procedure was 0.45 in 2019, 0.86 in 2020 and 0.49 in 2021. Caecal intubation rate was 90.74% in 2019, 90.9% in 2020 and 95.88% in 2021.ConclusionThe COVID-19 pandemic initially had a negative impact on overall colonoscopy volumes and training. Despite a reduction in procedural volume, key performance standards were maintained by trainees. Maintenance of hands-on training is essential to allow trainees achieve and retain competency in endoscopy.

Frontline gastroenterology, 2023-01, Vol.14 (1), p.38-44

Endoscopy training through the COVID-19 pandemic: maintaining procedural volumes and key performance standards

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Intrépide : Australian women artists in early twentieth-century France / Clem Gorman and Therese Gorman.

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[Willoughby subdivision plans] [cartographic material]

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Comparison of international guidelines for CT prior to lumbar puncture in patients with suspected meningitis

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Endoscopy training through the COVID-19 pandemic: maintaining procedural volumes and key performance standards

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