The SCARE Statement: Consensus-based surgical case report guidelines

AbstractIntroductionCase reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines.MethodsThe CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group.ResultsIn round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7–9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist.ConclusionWe present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports

The SCARE Statement: Consensus-based surgical case report guidelines

Introduction: Case reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines.Methods: The CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group.Results: In round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7–9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist.Conclusion: We present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports.</p

The clinical effectiveness of permissive hypotension in blunt abdominal trauma with hemorrhagic shock but without head or spine injuries or burns: a systematic review

Abdulrahman AlsawadiColchester Hospital University NHS Foundation Trust, Colchester, Essex, United KingdomBackground: Trauma is a major cause of death and disability. The current trend in trauma management is the rapid administration of fluid as per the Advanced Trauma Life Support guidelines, although there is no evidence to support this and even some to suggest it might be harmful. Some guidelines, protocols, and recommendations have been established for the use of permissive hypotension although there is reluctance concerning its application in blunt injuries.Objectives: The aim of this review is to determine whether there is evidence of the use of permissive hypotension in the management of hemorrhagic shock in blunt trauma patients. This review also aims to search for any reason for the reluctance to apply permissive hypotension in blunt injuries.Methods: This systematic review has followed the steps recommended in the Cochrane Handbook for Systematic Reviews of Interventions. It is also being reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement and checklist. Database searches of MEDLINE, EMBASE, the Centre for Reviews and Dissemination databases and the Cochrane Library were made for eligible studies as well as journal searches. Inclusion criteria included systematic reviews that have similar primary questions to this review and randomized controlled trials where patients with blunt torso injuries and hemorrhagic shock were not excluded. Rapid or early fluid administration was compared with controlled or delayed fluid resuscitation and a significant outcome was obtained.Results: No systematic reviews attempting to answer similar questions were found. Two randomized controlled trials with mixed types of injuries in the included patients found no significant difference between the groups used in each study. Data concerning the question of this review was sought after these papers were appraised.Conclusion: The limited available data are not conclusive. However, the supportive theoretical concept and laboratory evidence do not show any reason for treating blunt injuries differently from other traumatic injuries. Moreover, permissive hypotension is being used for some nontraumatic causes of hemorrhagic shock and in theater. Therefore, this should encourage interested researchers to continue clinical work in this important field.Keywords: trauma management, fluid administration, ATLS, permissive hypotension, hypotensive resuscitatio

Analysis of Scheimpflug Tomography Parameters for Detecting Subclinical Keratoconus in the Fellow Eyes of Patients with Unilateral Keratoconus in the Eastern Province of Saudi Arabia

Abdulaziz Al Somali,1 Hatim Najmi,2 Hend Alsawadi,2 Hassan Alsawadi,3 Assaf AlMalki,2 Mustafa Alhamoud,2 Hatlan Alhatlan,4 Nada Alwohaibi5 1Department of Ophthalmology, King Faisal University, Alahsa, Saudi Arabia; 2Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia; 3Department of Electrical and Computer Engineering, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Ophthalmology, King Fahad Hospital, Hofuf, Saudi Arabia; 5Cornea, External Diseases, and Refractive Surgery Fellow, Dhahran Eye Specialist Hospital, Dhahran, Saudi ArabiaCorrespondence: Hatim Najmi, Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Al Ameen 6927, Khobar, Eastern Province, 34446, Saudi Arabia, Tel +966533677784, Fax +966133583898, Email [email protected]: We compared the characteristics of subtle morphological changes in subclinical keratoconus (KC) and normal corneas using Scheimpflug tomography (Pentacam®) and assessed the efficacy of these parameters for distinguishing KC or subclinical KC from normal eyes.Patients and Methods: In this multicenter comparative study at Dhahran Eye Specialist Hospital and Al Kahhal Medical Complex in the Eastern Province of Saudi Arabia, we analyzed the Scheimpflug tomography charts of patients with topographically normal eyes and those with unilateral KC. Patients were divided into the normal (NL: patients considered for refractive surgery and with normal topographic/tomographic features, 129 eyes), KC (30 patients with manifest KC in one eye based on biomicroscopy and topographical findings), and forme fruste KC (FFKC: fellow eyes of patients in the KC group that met the NL group criteria) groups. Corneal morphological parameters were analyzed using the area under the receiver operating characteristic (ROC) curves (AUCs).Results: For distinguishing NL and KC groups, all measured corneal morphological parameters, except for flat keratometry, maximum Ambrósio relational thickness index, and minimum sagittal curvature, had AUCs > 0.75. The surface variance index yielded the largest AUC (0.999). For distinguishing NL and FFKC groups, all corneal morphological parameters had AUCs < 0.8. Total higher-order aberrations (RMS HOA) yielded the highest AUC, followed by Belin/Ambrỏsio Enhanced Ectasia total deviation (BAD-D), back elevation at the thinnest location, average pachymetric progression index (PPIave), and deviation of Ambrỏsio relational thickness (Da) (AUC 0.74– 0.78).Conclusion: The diagnostic performance of all tested topographic and tomographic parameters measured using Scheimpflug tomography for discriminating subclinical KC was fair at best, with the top parameters being RMS HOA, BAD-D, back elevation at the thinnest location, PPIave, and Da. Distinguishing between subclinical KC and healthy eyes remains challenging. Multimodal imaging techniques may be required for optimal early detection of subtle morphological changes.Plain language summary: Normal fellow eyes in patients with unilateral keratoconus were found to exhibit the mildest form of subclinical keratoconus. The parameters of these eyes were compared with those of normal eyes in the Saudi population using Scheimpflug tomography to detect early, subtle morphological changes. Most of the evaluated parameters were unsatisfactory in terms of their ability to discriminate between subclinical keratoconus and normal eyes, implying the need for multimodal imaging techniques for the optimal early detection of subclinical keratoconus.Keywords: ectatic corneal disease, forme fruste keratoconus, keratoconu

Low affinity binding site clusters confer HOX specificity and regulatory robustness

SummaryIn animals, Hox transcription factors define regional identity in distinct anatomical domains. How Hox genes encode this specificity is a paradox, because different Hox proteins bind with high affinity in vitro to similar DNA sequences. Here, we demonstrate that the Hox protein Ultrabithorax (Ubx) in complex with its cofactor Extradenticle (Exd) bound specifically to clusters of very low affinity sites in enhancers of the shavenbaby gene of Drosophila. These low affinity sites conferred specificity for Ubx binding in vivo, but multiple clustered sites were required for robust expression when embryos developed in variable environments. Although most individual Ubx binding sites are not evolutionarily conserved, the overall enhancer architecture—clusters of low affinity binding sites—is maintained and required for enhancer function. Natural selection therefore works at the level of the enhancer, requiring a particular density of low affinity Ubx sites to confer both specific and robust expression

Knowledge, perceptions, and readiness of telepharmacy among community pharmacists

Telepharmacy is a practical part of telemedicine that refers to providing pharmaceutical services within the scope of the pharmacist's obligations while maintaining a temporal and spatial distance between patients, users of health services, and healthcare professionals. The present study was a cross-sectional study conducted among community pharmacists in Saudi Arabia between March and May 2022 to assess their knowledge, perceptions, and readiness for telepharmacy. The survey was filled out by 404 respondents. The majority of respondents were male (59.90%) and the age of more than half of them was between 30 and 39 years old (54.46%). Most participants worked in urban areas (83.66%), and 42.57% had less than five years of experience in a pharmacy. Most participants agreed that telepharmacy is available in Saudi Arabia (82.67%). Approximately 70% of pharmacists felt that telepharmacy promotes patient medication adherence, and 77.72% agreed that telepharmacy increases patient access to pharmaceuticals in rural areas. More than 72% of pharmacists said they would work on telepharmacy initiatives in rural areas for free, and 74.26% said they would work outside of usual working hours if necessary. In the future, this research could aid in adopting full-fledged telepharmacy pharmaceutical care services in Saudi Arabia. It could also help academic initiatives by allowing telepharmacy practice models to be included as a topic course in the curriculum to prepare future pharmacists to deliver telepharmacy services

Erratum to “Erratum to “The SCARE guidelines: Consensus-based surgical case report guidelines” [Int. J. Surg. 34 (2016) 180–186]” [Int. J. Surg. 36 (2016) 396], (S1743919116310305), (10.1016/j.ijsu.2016.11.021))

The publisher regrets that the title in the original erratum was incorrect. The correct title of the item referred to is: The SCARE Statement: Consensus-based surgical case report guidelines The author name and affiliation for SCARE group member Mangesh A. Thorat has also been updated. The publisher would like to apologise for any inconvenience caused

Preferred reporting of case series in surgery; the PROCESS guidelines

Introduction Case series have been a long held tradition within the surgical literature and are still frequently published. Reporting guidelines can improve transparency and reporting quality. No guideline exists for reporting case series, and our recent systematic review highlights the fact that key data are being missed from such reports. Our objective was to develop reporting guidelines for surgical case series. Methods A Delphi consensus exercise was conducted to determine items to include in the reporting guideline. Items included those identified from a previous systematic review on case series and those included in the SCARE Guidelines for case reports. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. Surgeons and others with expertise in the reporting of case series were invited to participate. In round one, participants voted to define case series and also what elements should be included in them. In round two, participants voted on what items to include in the PROCESS guideline using a nine-point Likert scale to assess agreement as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group. Results In round one, there was a 49% (29/59) response rate. Following adjustment of the guideline with incorporation of recommended changes, round two commenced and there was an 81% (48/59) response rate. All but one of the items were approved by the participants and Likert scores 7-9 were awarded by >70% of respondents. The final guideline consists of an eight item checklist. Conclusion We present the PROCESS Guideline, consisting of an eight item checklist that will improve the reporting quality of surgical case series. We encourage authors, reviewers, editors, journals, publishers and the wider surgical and scholarly community to adopt these

The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines

Introduction: The SCARE Guidelines were published in 2016 to provide a structure for reporting surgical case reports. Since their publication, SCARE guidelines have been widely endorsed by authors, journal editors, and reviewers, and have helped to improve reporting transparency of case reports across a range of surgical specialties. In order to encourage further progress in reporting quality, the SCARE guidelines must themselves be kept up to date. We completed a Delphi consensus exercise to update the SCARE guidelines. Methods: A Delphi consensus exercise was undertaken. All members of the previous Delphi group were invited to participate, in addition to researchers who have previously studied case reports, and editors from the International Journal of Surgery Case Reports. The expert group was sent an online questionnaire where they were asked to rate their agreement with proposed changes to each of the 24 items. Results: 56 people agreed to participate and 45 (80%) invitees completed the survey which put forward modifications to the original guideline. The collated responses resulted in modifications. There was high agreement amongst the expert group. Conclusion: A modified and improved SCARE checklist is presented, after a Delphi consensus exercise was completed. The SCARE 2018 Statement: Updating Consensus Surgical CAse REport (SCARE) Guidelines

“The SCARE guidelines: Consensus-based surgical case report guidelines” [Int. J. Surg. 34 (2016) 180–186]((2016) 34 (180–186)(S174391911630303X)(10.1016/j.ijsu.2016.08.014))

The publisher regrets that there was an error in the author list of this paper. The members of the SCARE Group were not tagged as a collaborator group. This has now been corrected. The names of the collaborator group are as follows: Raafat Afifi, Cairo University Raha Al-Ahmadi, King Faisal Specialist Hospital and Research Centre Joerg Albrecht, John H. Stroger Jr. Hospital of Cook County Abdulrahman Alsawadi, Colchester Hospital University NHS Foundation Trust Jeffrey Aronson, Radcliffe Infirmary, Oxford M. Hammad Ather, Aga Khan University Mohammad Bashashati, Texas Tech University Health Sciences Center Somprakas Basu, Banarus Hindu University Patrick Bradley, Nottingham University Hospitals Mushtaq Chalkoo, Hyderpora Ben Challacombe, Guy's and St Thomas’ NHS Foundation Trust Trent Cross, James Cook University Laura Derbyshire, North West Deanery Naheed Farooq, Central Manchester University Hospital Foundation Trust Jerome Hoffman, University of California Los Angeles Huseyin Kadioglu, Bezmialem Vakif University Veeru Kasivisvanathan, University College London Boris Kirshtein, Soroka University Medical Center Roberto Klappenbach, Simplemente Evita Hospital Daniel Laskin, Virginia Commonwealth University Diana Miguel, University Hospital Jena James Milburn, Queens Medical Centre Seyed Reza Mousavi, Shohada Medical Center Tajrish Oliver Muensterer, University Medicine Mainz James Ngu, Changi General Hospital Iain Nixon, East Kent University Hospitals Ashraf Noureldin, Cumberland Royal Infirmary Benjamin Perakath, Dr. Gray's Hospital Nicholas Raison, King's College London Kandiah Raveendran, Fatimah Hospital Timothy Sullivan, Minneapolis Heart Institute Achilleas Thoma, McMaster University Mangesh Thorat, Wolfson Institue of Preventative Medicine, Queen Mary University of London Michele Valmasoni, Università di Padova Samuele Massarut, Centro di Riferimento Oncologico Aviano, Italy Anil D'cruz, Tata Memorial Hospital Baskaran Vasudevan, MIOT Hospitals Salvatore Giordano, Turku University Hospital Gaurav Roy, Medanta-The Medicity Donagh Healy, University Hospital Waterford David Machado-Aranda, University of Michigan Bryan Carroll, Eastern Virginia Medical School David Rosin, University of West IndiesThe publisher would like to apologise for any inconvenience caused