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Strict infection control procedures can control MRSA infection and keep the prevalence low in CF clinics. Eradication is achievable in the majority of patients even when significant time has lapsed from initial isolation. In some instances, up to 3 courses of antibiotics were required to achieve eradication.

The records of 114 patients (51 adult, 63 paediatric) circumcised in a year were retrospectively reviewed. Indications for circumcision were phimosis, recurrent balanoposthitis and suspected squamous cell carcinoma (SCC). Data were collected on the following areas: patient age, indication, pre-operative and histological diagnosis. Pre-operative diagnosis was compared with histological diagnosis to determine whether histology differed from the clinical impression. Results: A total of 31 patients had histologically confirmed lichen sclerosus (22 adult, 9 paediatric). Of these patients, 26 (84%) were predicted pre-operatively. There were three adult patients diagnosed with squamous cell carcinoma and all of these cases were predicted pre-operatively. There were no cases of SCC or lichen sclerosus diagnosed in patients clinically thought to have normal foreskin. Conclusions:The data indicate that routine histology is not necessary in adult and paediatric circumcision and should be reserved for patients with suspected lichen sclerosus or carcinoma.

Introduction Frailty is prevalent in elderly patients in acute medical wards. It is recognised that length of stay (LOS), inpatient mortality and readmission rates rise with increasing frailty. (Reference: Specialised Clinical Frailty Network: Clinical frailty Scale. 2018. https://www.scfn.org.uk/clinical-frailty-scale) The Rockwood clinical frailty scale (CFS) is a well-recognised and validated tool, which can be easily incorporated into the comprehensive geriatric assessment to identify the frailest patients and aid in clinical decision making. We collected data on elderly patients in a non-acute community setting to assess the relationship between degree of frailty and outcomes, in this subset of inpatients. Methods Data was collected on 200 patients admitted to a geriatrician led community hospital over an 8 month period. Patients were all transferred from the affiliated acute hospital site (both medical and surgical wards).Commonest acute diagnoses were: falls, fractures, infections, delirium and heart failure. Premorbid CFS was recorded and patients were divided into 2 groups: CFS ≤ 4: versus CFS ≥5, and outcomes compared to degree of frailty. Results Of 200 patients, aged ≥65 years, admitted from the acute hospital setting to the community hospital,28.5% had premorbid CFS ≤4,and 71.5% had premorbid CFS ≥5. Median LOS in the community hospital was 10 days in the less frail group compared to 13 days in the frailer group. One year emergency readmission rate was 58.5% in those with CFS ≤4,and 67% in those with CFS ≥5. Conclusion(s) Accurate recording of premorbid CFS in the non-acute hospital setting can be used to help predict patient outcomes. Used in conjunction with the CGA it is a tool that can aid decision making and prompt discussions with patients and/or families re advance care planning, specifically re suitability of transfer back to the acute hospital setting in the event of a decline in health.

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