Objective This study aimed to report the changes made to ENT placements across the UK in response to the pandemic and their impact on student experience. Methods A questionnaire eliciting how ENT placements were provided before and after coronavirus disease 2019 was disseminated amongst Student and Foundation Doctors in Otolaryngology representatives. Results Thirty-eight respondents from 27 medical schools across the UK completed the survey (response rate of 90 per cent). Twenty-nine of the 38 respondents (76 per cent) reported a change in ENT placements in response to the pandemic. Six of the 38 students (16 per cent) remained satisfied with their ENT placements, as compared to 12 students prior to the pandemic (32 per cent). Conclusion There is considerable variability in how medical schools responded to the pandemic. Most medical schools placed students into smaller groups, with less direct contact in the hospital. These changes resulted in lower student satisfaction. The increased emphasis on e-learning underscores the need for high quality e-learning materials to promote learning throughout the pandemic and in the future.

To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. Subjects and MethodsThe uroLogical tEAching in bRitish medical schools Nationally (LEARN) study was a national multicentre cross-sectional evaluation. Year 2 to Year 5 medical students and Foundation Year (FY) 1 doctors were invited to complete a survey between 3 October and 20 December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). ResultsIn all, 7063/8346 (84.6%) responses from all 39 UK medical schools were included; 1127/7063 (16.0%) were from FY1 doctors who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory-based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and

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Introduction This collaborative European Academy of Plastic Surgery (EAFPS) study aimed to provide an overview of rhinoplasty practices, informing clinician and patient decision making. Methods Study design: Multicentre cross-sectional study, reported as per STROBE guidelines. Participants: All EAFPS members were contacted via email, inviting them to participate. Members expressing an interest to participate were asked to anonymously complete a questionnaire, related to rhinoplasties that they performed as first/supervising surgeon over period 1st January 2019 to 1st January 2022. A descriptive analysis was performed. Results One hundred and fifteen surgeons submitted data on 41,259 rhinoplasties from 33 countries. 80% of rhinoplasties were primary, and 20% were secondary. Thirty five percent of primary rhinoplasties were closed and 65% were open. Thirty one percent of primary rhinoplasties were for cosmetic indications, 11% functional and 58% were for both. Of the 8147 secondary rhinoplasties, 44% were closed and 56% were open. Thirty percent were for cosmetic indications, 11% functional and 59% for both cosmetic and functional. Ninety-one percent of rhinoplasties were performed by ENT surgeons, 3% by Plastic surgeons, 5% by Maxillo-facial surgeons, and 1% were dual (Maxillofacial and ENT) trained. 1730 primary rhinoplasties underwent revision surgery (5%) and 102 secondary rhinoplasties underwent revision surgery (1%). The most commonly reported indications for revision surgery were dorsal asymmetry, nasal blockage and dissatisfaction with nasal tip. Three percent of rhinoplasties underwent pre-operative psychological assessment. Discussion To the authors knowledge this the largest published rhinoplasty dataset. This study provides an overview of rhinoplasty practices that can be used for benchmarking and to guide clinician and patient decision making. Psychological assessment pre-rhinoplasty appears insufficient with higher levels recommended to minimise unsuccessful outcomes. This study showcases the power of collaborative research and may serve as a catalyst for future collaborative facial plastic surgery research.

We would like to comment on the article entitled “Association between cytokine profiles and lung injury in COVID-19 pneumonia” by Li-Da Chen and colleagues, with respect to emerging data regarding the immunopathogenesis of COVID-19. Chen et al. demonstrated the relevance of IL-2R, IL-6 and TNF-α in the cytokine storm and IL-6 as an independent predictor for COVID-19 severity. Del Valle et al. corroborated these findings with regard to IL-6 and disease severity, however, they also showed IL-8 to be of significance. This may be explained by the varying techniques used by the two studies to determine severity. Further studies including critically ill patients and the analysis of mortality rates in this patient cohort would greatly enhance the clinical relevance of these findings. As speculated by Chen et al., early studies on the use of tocilizumab in COVID-19 patients were promising, however, full results from ongoing trials are required to confirm a survival benefit in patients treated with tocilizumab. Moreover, investigating the roles of other pro-inflammatory cytokines and their impact on disease severity could potentially inform novel therapeutic targets.

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