Ureter as the Content in a Large Inguino Scrotal Hernia: A Diagnostic Dilemma for Unprepared Surgeons.

We present a case of a 60-year-old gentleman, who was referred for an inguinal hernia repair. A previous CT scan had reported a right pelvic kidney and the presence of the right ureter in the hernial sac. He had no urinary symptoms and there was no biochemical evidence of compromised renal function.

An optimal window of platelet reactivity by LTA assay for patients undergoing percutaneous coronary intervention.

Objective: This study was aimed to determine how platelet reactivity (PR) on dual antiplatelet therapy predicts ischemic and bleeding events in patients underwent percutaneous coronary intervention (PCI).

Design: A total of 2768 patients who had received coronary stent implantation and had taken aspirin 100 mg in combination with clopidogrel 75 mg daily for > 5 days were consecutively screened and 1885 were enrolled. The recruited patients were followed-up for 12 months.

Intensified antiplatelet therapy in patients after percutaneous coronary intervention with high on-treatment platelet reactivity: the OPTImal Management of Antithrombotic Agents (OPTIMA)-2 Trial.

High on-treatment platelet reactivity (HOPR) is associated with increased risk of cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). We randomised post-PCI patients with HOPR after 5 days of standard dual antiplatelet therapy (DAPT) to intensified therapy with aspirin 100 mg once daily in combination with either clopidogrel 150 mg once daily, clopidogrel 75 mg once daily plus cilostazol 100 mg twice daily, ticagrelor 90 mg twice daily, or standard therapy with clopidogrel 75 mg once daily (STD) for 1 month, after which all patients were switched to standard DAPT for a further 11 months. The primary outcome was residual HOPR rate at 1 month.

Pharmacodynamic effects of indobufen compared with aspirin in patients with coronary atherosclerosis.

Purpose: This study aimed to investigate the pharmacodynamic effects of indobufen and low-dose aspirin in patients with coronary atherosclerosis.

Methods: In the first phase, 218 patients with coronary atherosclerosis were randomly assigned to receive aspirin 100 mg once daily (standard dose); 100 mg once every 2 days; 100 mg once every 3 days; 50 mg twice daily; 75 mg once daily; 50 mg once daily; or indobufen 100 mg twice daily for 1 month. In the second phase, 20 healthy subjects were treated with indobufen 100 mg twice daily for 1 week followed after a 2-week washout by aspirin 100 mg once daily for 1 week.

Serum uric acid level negatively correlated with the prevalence of clopidogrel low response in patients undergoing antiplatelet treatment with aspirin and clopidogrel.

Background And Aims: It has been reported that elevated serum uric acid (SUA) is related to inflammation and potentially to platelet hyper-reactivity. However, the relationship between elevated SUA and residual platelet reactivity is uncertain in patients on dual antiplatelet treatment (DAPT) with aspirin and clopidogrel.

Methods And Results: A cross-sectional cohort study was conducted on 2569 patients undergoing DAPT with aspirin and clopidogrel.

Medium- to long-term results of acromioclavicular joint stabilisation using the Ligament Augmentation Reconstruction System (LARS) ligament.

Background: Opinion is divided as to optimum management of grade III acromioclavicular joint injuries that have failed conservative management. We objectively investigated the radiological and functional outcome of acromioclavicular joint reconstruction using the Ligament Augmentation Reconstruction System (LARS®).

Methods: Retrospective review of patients with LARS reconstruction of acromioclavicular joint dislocations with minimum six-year follow-up.

Gastrocolic fistula, a rare complication.

A 77-year-old male presented with diarrhoea, weight loss and faeculent vomiting. CT scan identified a stricturing lesion in the transverse colon. The man, however, had no features suggestive of large bowel obstruction.

De Garengeot hernia: a forgotten rare entity?

We report the case of a 79-year-old woman who presented with an increasingly painful lump in her right groin for 24 h. An incidental femoral hernia was detected on her CT scan nearly 8 months ago while investigating her medical conditions. However, its management was deferred on account of ongoing medical illness.

Abdominal cocoon.

Intestinal obstruction secondary to cocoon formation is not common. We report a case of a patient who had presented with abdominal pain and distension accompanied by vomiting. Investigations, laparotomy and histology together revealed primary peritoneal carcinoma as the cause of the patient's symptoms.

Lateral epicondylitis: a review of pathology and management.

Lateral epicondylitis, or 'tennis elbow', is a common condition that usually affects patients between 35 and 55 years of age. It is generally self-limiting, but in some patients it may continue to cause persistent symptoms, which can be refractory to treatment. This review discusses the mechanism of disease, symptoms and signs, investigations, current management protocols and potential new treatments.

Current trends in staging rectal cancer.

Management of rectal cancer has evolved over the years. In this condition preoperative investigations assist in deciding the optimal treatment. The relation of the tumor edge to the circumferential margin (CRM) is an important factor in deciding the need for neoadjuvant treatment and determines the prognosis.

Late onset mesh infection following laparoscopic inguinal hernia repair.

In our series of 710 consecutive laparoscopic total-extra-peritoneal hernia repairs over a period of 10 years (2001-2010), the authors report a rare case of delayed mesh infection developing 7 years postoperatively. A 56-year-old patient presented with diarrhoea and fullness in right iliac fossa region. Radiological imaging confirmed a floating mesh in a fluid-containing cavity.

Evaluation of the role of laparoscopic ultrasonography in the staging of oesophagogastric cancers.

Introduction: The role of laparoscopic ultrasound (LUS) during staging laparoscopy for pancreatic cancers is established but remains debatable in evaluating oesophagogastric cancers.

Methods: A retrospective consecutive case series consisting of patients undergoing staging laparoscopy in two centres (centre A and B) was carried out over a 5-year period (2000-2005). Patients in centre B underwent LUS following laparoscopic assessment using a 7.

CT guided diagnostic foot injections.

Aim: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot.

Materials And Methods: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach.

Anti-heat-shock protein 70 kDa antibodies in vascular patients.

Introduction And Aim Of Study: there is recent evidence that the immune system plays an essential role in the pathogenesis of atherosclerosis, with both cellular and humoral mechanisms being involved. Heat-shock proteins (HSPs) have been detected in atherosclerotic lesions, and antibodies to HSPs have also been found to be raised in patients with carotid stenoses. The aim of our study was to examine the level of anti-HSP70 antibodies in patients with other vascular diseases.