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Norman Briffa
Works at Northern General Hospital, University of Sheffield,
Attended St. Aloysius' College in Malta
Lives in Sheffield, UK
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Norman Briffa

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Great articles in this month's Bulletin of the Royal College of Surgeons of England on reporting of Surgeon Specific Mortality Data (SSMD). 
The Bulletin of the Annals of the Royal College of England (RCSEng)is this month dedicated to the thorny issue of surgical outcomes reporting. The editorial team should be commended for publishing 2 very opposing views of the...
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Norman Briffa

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Chestcracker's Dictum #1 Everyone takes a hit!
Heart surgery used to be a high stakes game for the patient. It is now a high stakes game for the patient, the commissioner and the surgeon. Long Live Equity.
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Apt and excellent piece in the @HSJnews considering recent news on the deteriorating mental health of NHS staff. *http://www.bbc.co.uk/news/uk-england-32022114
*
The NHS needs a more skilful approach to managing performance | Opinion | Health Service Journal
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Paradigm shift in the planning of #drug trials is required to prevent the demise of what has goine before. Good read
#pharmaceutical #clinicaltrials
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Norman Briffa

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Looking good on the slopes
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JAMA Network | JAMA | Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in China: The CSPPT Randomized Clinical Trial

Whether applicable to the rest of the world is not certain. Iyis possible the chinese diet is folate deficient. It is nonethless a ground breaking trial. Any trial showing that a devastating complication such as stroke can be prevented by  simple lowcost intervention is gorund breaking #hypertension #stroke
This randomized, double-blind clinical trial found that among adults with hypertension in China without a history of stroke or myocardial infarction, the combined use of enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke.
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Norman Briffa

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The Stick and Bigger Stick Approach to Health Outcomes Publication
The Bulletin of the Annals of the Royal College of England  (RCSEng)is this month dedicated to the thorny issue of surgical outcomes reporting. The editorial team should be commended for publishing 2 very opposing views of the reporting of surgeon specific ...
The Bulletin of the Annals of the Royal College of England (RCSEng)is this month dedicated to the thorny issue of surgical outcomes reporting. The editorial team should be commended for publishing 2 very opposing views of the...
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The Human Cost of Scrutiny?
This story appears in the health section of BBC news online today. The BBC are wee bit late onto this story. There was an excellent article on the subject of the mental health of NHS staff published 2 weeks ago in the Lancet. The ever excellent and compassi...
This story appears in the health section of BBC news online today. The BBC are wee bit late onto this story. There was an excellent article on the subject of the mental health of NHS staff published 2 weeks ago in the Lancet...
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BBC are late to this story. Hospital staff absences for mental health reasons double - BBC *News
* Excellent recent article in the Lancet *http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60470-6/fulltext
Claire* gerada, @clairercgp, hits the nail on the head with her assessment *

*
Staff absences for mental health problems have doubled at hospital trusts across England in the last four years, new figures show.
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 #UK
 
My take on the new National Licensing exam planned for the UK. 
In 2008, a locum GP doctor injected David Gray, a patient with typical excruciatingly painful kidney stones, with a fatal (10 times normal) dose of morphine. This act was not intentional but a tragic mistake and it occurred b...
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The New England Journal of Medicine: Research & Review Articles on Disease & Clinical Practice

The NEJM today publishes the results of some every important cardiovascular intervention trials.  This publication is in conjunction with the presentation of the findings from these trials at the annual conference of the American College of Cardiology  #ACC2015.   All the major cardiovascular conferences,  the 2 American ones - +American Heart Association  and @americancollegeofcardiology  and the European , @europeansocietyofcardiology  are now huge exciting events associated with the publication of all that matters in the cardiovascular world  - abit like an #Apple keynote in fact.  In summary these are the conclusions of the three interventional trials 
1. ablation for AF during mitral surgery is not as good as previously advertised, does not have to be applied to both atria and after one year offers no advantages as far as the clinical state of the patient is concerned.  I have yet to see a study that convinces me that ablation decreases the most feared consequence of  #atrialfibrillation i.e. stroke. 
2. Coronary surgery beats coronary stents AGAIN!!! To paraphrase the late great Norman Shumway - the future of effective coronary intervention is stenting and always will be! 
3. If you manually suck clot out of a coronary surgery (into the aorta!!) during primary PCI, the patient ends up getting a stroke - what can I say but 2 things - NOT ROCKET SCIENCE, & DON'T MESS WITH CLOT!
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Contemporary Bloodletting in Cardiac Surgical Care - The Annals of Thoracic Surgery


This is a great audit (sorry service review as I suppose there is no Gold Standard) of blood letting and blood tests in a cardiac surgery mega unit. As the concept of 7 day working becomes entrenched into every day practice and the availability of tests improves, it is no surprise to see that excessive testing is done. This is undoubtedly compounded by the fact that as individuals or institutions, we are all watched closely by regulators. We are far too scared of getting it wrong.

But crikey - half a litre of blood per patient per episode of care ?!!!? Looks to me like a good subject for a recurring review in most units.
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Have him in circles
82 people
Marcel Dalli's profile photo
masum haque's profile photo
Österreichisches Freilichtmuseum Stübing's profile photo
Fatima Mullen's profile photo
Linh Thùy's profile photo
Kirsty Bylett GIVETORECEIVE's profile photo
Mary Rose A's profile photo
armah malik's profile photo
Joseph Farrugia's profile photo
Education
  • St. Aloysius' College in Malta
    1970 - 1978
  • University of Sheffield
    Medicine, 1978 - 1983
  • Stanford University School of Medicine
    Postdoc, 1996 - 1997
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Cardiac Surgeon
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I am a Cardiac Surgeon living and working in Sheffield, UK. I am originally from Malta where I attended St. Aloysius' College. I came to the UK and went to  med school at the University of Sheffield.  I have worked in Newcastle, Manchester and trained in cardiothoracic surgery in the West Midlands and at Papworth Hospital in Cambridge. I did my post grad research at Stanford in California, USA.  
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Have worked wit the great Norman Shumway
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Cardiac Surgeon
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  • Northern General Hospital, University of Sheffield,
    Cardiac Surgeon, Honorary Senior Lecturer, 2005 - present
    I am a consultant cardiac surgeon at Northern General Hospital and Honorary Senior Lecturer at the University of Sheffield
  • University Hospitals Coventry & Warwickshire
    Consultant Cardiac Surgeon, 1998 - 2005
  • Sheffield Teaching Hospitals NHS Trust
    Consultant Cardiac Surgeon, 2005 - present
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Sheffield, UK
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Malta - Berkswell Warwickshire, UK , Palo Alto, Ca, USA - Palo Alto, Ca
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