The Age-Old Question in Nipple-Sparing Mastectomy: Is Older Age a Contraindication?

Background: Nipple-sparing mastectomy (NSM) is infrequently performed in older women, at least in part owing to concerns regarding age-related complications. We describe postoperative outcomes of NSM in older women and risk factors for complications, with the goal of informing patient selection and decision-making.

Patients And Methods: Cases of NSM with immediate implant-based reconstruction were identified from an institutional database (2009-2019).

Tatton-Brown-Rahman syndrome: a new multiple endocrine neoplasia syndrome with intellectual disability?

We describe for the first time the case of a woman presenting with Tatton-Brown-Rahman syndrome (TBRS) and multiple endocrine neoplasia (MEN). She developed primary hyperparathyroidism at age 13, a pituitary cyst at age 14, adrenal tumor at age 21, and metastatic insulinoma at age 34. In addition, she showed intellectual disability, obesity, multiple lipomas, facial dysmorphia, hemihypertrophy and kyphoscoliosis.

Genetic and Genomic Approaches to the Study of Drug-Induced Liver Injury.

Idiosyncratic hepatotoxicity induced by prescribed drugs has been known since the early 20th century. Identifying risk factors, including genetic factors, that trigger this drug-induced liver injury (DILI) has been an important priority for many years, both to prevent drugs that cause liver injury being licensed and as a potential means of preventing at-risk patients being prescribed causative drugs. Improved methods for genomic analysis, particularly the development of genome-wide association studies, have facilitated the identification of genomic risk factors for DILI, but, to date, there are only two main examples, liver injury caused by amoxicillin-clavulanate (AC) and by flucloxacillin, where genetic risk factors causing the injury have been identified and replicated with understanding of the underlying mechanism.

A technology-enabled collaborative learning model (Project ECHO) to upskill primary care providers in best practice pain care.

Background The South Australian (SA) Chronic Pain Extension for Community Healthcare Outcomes (ECHO) Network was established to upskill primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach using didactic and case-based virtual mentoring sessions. The aims of this study were to assess: (a) participation, satisfaction (relevance, satisfaction with format and content, perceptions of the mentorship environment), learning (perceived knowledge gain, change in attitudes), competence (self-confidence) and performance (intention to change practice, perceived practice change) of the ECHO Network clinician participants; and (b) self-perceived barriers at the clinical, service and system level to applying the learnings. Methods A mixed methods, participatory evaluation approach was undertaken.