Timely access to specialist outpatient care: can applying systems thinking unblock our waiting lists?

Background: The purpose of this qualitative study was to focus on review and repeat review outpatients and the structural role they play in exacerbating waitlists for Specialist Outpatient (SOP) services in Queensland. Waitlists, which record the number of patients waiting for an initial consultation (new appointment), are an indicator of a health system under strain. Waiting too long to access SOP can have a detrimental effect on people's health outcomes.

Implementation of Alcohol Use Disorder Training Curriculum Improves Perceived Confidence in Treating Alcohol-Related Liver Disorder Amongst Gastroenterology Fellows.

Background: Alcohol use disorder and alcohol-associated liver disease is increasing in the US, with subsequent and expected increases in morbidity and mortality due to these conditions.

Aims: To determine the impact of an educational intervention regarding alcohol use disorder on gastroenterology fellows.

Methods: A before-after survey study was carried out.

Fracture Resistance of Endodontically Treated Teeth Prepared With Biologically Oriented Preparation Technique Versus Horizontal Finish Lines: An In Vitro Study.

Introduction: The biologically oriented preparation technique (BOPT) is a conservative tooth preparation method with no defined finish lines. Studies comparing the fracture resistance of endodontically treated teeth (ETT) prepared using BOPT or horizontal finish lines are lacking. The primary objective of this study was to compare the fracture resistance of ETT prepared using BOPT, chamfer finish line, or shoulder finish line and restored with monolithic zirconia (MZ) crowns.

Modelling the Banni social-ecological system using participatory system dynamics for building insights on invasive species management and stakeholder engagement.

Invasive species are a significant driver of environmental change in social-ecological systems (SES) globally. Given that SES are inherently complex adaptive systems (CAS), they continuously reorganize themselves and adapt to change, including changes in ecological composition, as well as in associated lives and livelihoods. Decision-making on invasive species management in such systems can be contested and fraught with tradeoffs.

Effect of oil pulling on the Streptococcus mutans concentation in plaque around orthodontic brackets -A prospective clinical study.

Introduction: Fixed orthodontic appliances create areas of plaque stagnation leading to an increase in the volume, structure, and composition of plaque. This increases the chances of decalcification and white spot lesions. Oil pulling, an ancient practice involving swishing oil in the mouth, has demonstrated a significant reduction in plaque scores after 45 days, and a reduction in salivary Streptococcus mutans concentration in few studies done in nonorthodontic subjects.

Dental and ENT Evaluation Before Liver Transplantation.

The assessment of dental and ear, nose and throat (ENT) conditions holds significant importance in the pre-transplantation evaluation for individuals undergoing liver transplantation. This evaluation aims to address concerns related to dental and ENT issues both before and after liver transplantation. These concerns include the risk of sepsis, the impact of post-transplantation immunosuppression, the detection of existing malignancies, including oral potentially malignant disorders (OPMDs), and identifying any contraindications to the transplantation procedure.

Global transcriptome analysis reveals Salmonella Typhimurium employs nitrate metabolism to combat bile stress.

Salmonella Typhimurium is an enteric pathogen that is highly tolerant to bile. Next-generation mRNA sequencing was performed to analyze the adaptive responses to bile in two S. Typhimurium strains: wild type (WT) and a mutant lacking cold shock protein E (ΔcspE).

Successful management of a thoracoabdominal impalement injury.

A 63-year-old female presented to the hospital with a history of alleged accidental fall onto a rusted iron rod. She was hypotensive but stable. Cooling of the rod while cutting the protruding part was performed as per basic trauma life support (BTLS) access.

Inpatient outcomes of inflammatory bowel disease in hospitalized patients with COVID-19: analysis of a nationally representative sample.

Purpose: To compare the risks of adverse outcomes, including mortality, gastrointestinal bleeding, and venous thromboembolism, between COVID-19 patients with inflammatory bowel disease (IBD) and those without IBD.

Methods: We analyzed data from the National Inpatient Sample between January and December 2020. The study included adult patients with Crohn's disease (CD) and ulcerative colitis (UC) who contracted COVID-19.

IFN-γ lowers tumor growth by increasing glycolysis and lactate production in a nitric oxide-dependent manner: implications for cancer immunotherapy.

Introduction: Interferon-gamma (IFN-γ), the sole member of the type-II interferon family, is well known to protect the host from infectious diseases as well as mount anti-tumor responses. The amounts of IFN-γ in the tumor microenvironment determine the host responses against tumors; however, several tumors employ evasive strategies by responding to low IFN-γ signaling.

Methods: In this study, the response of various tumor cell lines to IFN-γ was studied .

A Rare Case of Premenarchal Ovarian Abscess Presenting as an Acute Abdomen.

Ovarian abscesses are usually seen in females of reproductive age group. They may occur secondary to urinary tract infections, pelvic inflammatory diseases, or gastrointestinal infections. They are uncommon in premenarchal females.

Iliac Artery-Inferior Vena Cava-Duodenal Fistula: An Unusual Cause of Massive Gastrointestinal Bleeding.

An arteriovenous-enteric fistula is a 3-way connection between the vascular and enteric system and associated with high mortality. We describe a case of iliac artery-inferior vena cava-duodenal fistula in a young female with a retroperitoneal mass presenting with sepsis and hemorrhagic shock with a catastrophic clinical course. These fistulas can be missed on endoscopy/colonoscopy and are usually diagnosed on computed tomography angiogram of the abdomen.

Comparison of Masticatory Efficiency and Patient Satisfaction of Injection-Molded Conventional Complete Dentures and Biofunctional Prosthetic System Dentures: A Parallel Randomized Clinical Trial.

Introduction Complete loss of natural teeth severely compromises the masticatory efficiency of geriatric patients and directly affects their general health. Biofunctional prosthetic system (BPS) has been developed as an alternate method of denture fabrication to match the higher expectations of patients. Studies comparing BPS dentures with injection-molded conventional complete dentures (IM-CCD) are lacking.

Delayed Presentation of Malrotation: Case Series and Literature Review.

Background: Intestinal malrotation is a congenital anomaly resulting from abnormal or incomplete rotation and fixation of the midgut during embryogenesis. It commonly presents in the neonatal period (75%) with sudden onset bilious vomiting and rarely beyond infancy (<10%).

Aim: The aim of the study was to highlight the clinical features, radiological findings, and treatment outcomes of patients with malrotation presenting beyond infancy.

Pathophysiology and management of liver cirrhosis: from portal hypertension to acute-on-chronic liver failure.

Cirrhosis transcends various progressive stages from compensation to decompensation driven by the severity of portal hypertension. The downstream effect of increasing portal hypertension severity leads to various pathophysiological pathways, which result in the cardinal complications of cirrhosis, including ascites, variceal hemorrhage, and hepatic encephalopathy. Additionally, the severity of portal hypertension is the central driver for further advanced complications of hyperdynamic circulation, hepatorenal syndrome, and cirrhotic cardiomyopathy.

Oral Rehabilitation of a Patient with Papillon Lefèvre Syndrome Using Fixed Full-Arch Hybrid Prostheses Supported by Four Axially Loaded Implants: A Case Report with Four-Year Follow-up.

This report details the successful prosthetic rehabilitation of a 25-year-old male patient with Papillon Lefèvre Syndrome (PLS) using an implant-supported hybrid prosthesis. Six implants were placed in the maxilla, and four were placed in the mandibular arch. All implants were inserted axially (non-tilted) and were planned to be loaded after a healing period of 6 months.

Characterization and synergy studies of Caudoviricete Escherichia phage FS2B infecting multi-drug resistant uropathogenic Escherichia coli isolates.

Escherichia coli is one of the most common causes of urinary tract infections. However, a recent upsurge in antibiotic resistance among uropathogenic E. coli (UPEC) strains has provided an impetus to explore alternative antibacterial compounds to encounter this major issue.

Growth and development of oncology nursing in Asia.

Oncology nursing is increasingly recognized around the world as being vitally important for an effective cancer control system. Granted, there is variation between and among countries/regions regarding the strength and nature of that recognition, but oncology nursing is clearly seen as a specialty practice and as a priority for development in cancer control plans, especially for high resource countries/regions. Many countries/regions are beginning to recognize that nurses are vitally important to their cancer control efforts and nurses require specialized education and infrastructure support to make a substantial contribution.

An Unusual Presentation of Segmental Arterial Mediolysis.

Segmental arterial mediolysis (SAM) is a rare nonatherosclerotic and noninflammatory disease that often affects medium to large-sized arteries. We report a case of SAM involving bilateral hepatic arteries in an elderly woman. Although her initial presentation mimicked vasculitis, the clinical course and imaging led to the diagnosis of SAM.

Fecal microbiota transplantation compared with prednisolone in severe alcoholic hepatitis patients: a randomized trial.

Background: Severe alcoholic hepatitis (SAH) has high 90-day mortality. Prednisolone therapy has shown modest survival benefits over placebo at 28 but not 90 days. Fecal microbial transplantation (FMT) has shown promise in these patients.