Radiomics Biomarkers Correlate with CD8 Expression and Predict Immune Signatures in Melanoma Patients.

Treatment for metastatic melanoma includes targeted and/or immunotherapy. Although many patients respond, only a subset has complete response. As late-stage patients often have multiple tumors in difficult access sites, non-invasive techniques are necessary for the development of predictive/prognostic biomarkers.

Hip arthroscopy in patients less than 25 years of age in the treatment of labral tears: aetiology and clinical outcomes.

Background: Hip arthroscopy has evolved into a well-established and rapidly growing field of orthopedic surgery for the management of labral tears. The purpose of this study was to review clinical outcomes of patients less than 25 years of age undergoing hip arthroscopy for treatment of a labral tear.

Methods: From 2005 to 2013, 82 hips in 76 patients with mean age of 20.

Primary cutaneous melanoma of the scalp: Patterns of recurrence.

Introduction: Patients with primary melanoma of the scalp have been reported to have worse disease-related outcomes compared with other anatomical regions. There are few studies in the literature specifically addressing recurrence patterns and treatment outcomes for primary scalp melanoma as a discrete anatomical sub-region. We sought to identify key features adversely influencing disease control and survival and to clarify the role of resection plane, margin, and method of reconstruction in the management of this disease process.

Assessment of morbidity following regional nodal dissection in the axilla and groin for metastatic melanoma.

Background: This study assessed and compared the morbidity of nodal dissection in the axilla and groin including sentinel lymph node biopsy (SLNB), completion lymph node dissection for a positive SLNB (CLND) and therapeutic lymph node dissection (TLND) with and without adjuvant radiotherapy (RT).

Methods: Patients who had nodal dissection in the axilla or groin for cutaneous melanoma over an 18-year period (1995-2013) were prospectively documented on a database. The median follow-up was nearly 3 years.

Prospective study of patterns of surgical management in adults with primary cutaneous melanoma at high risk of spread, in Queensland, Australia.

Background: Knowledge of variation in diagnosis and surgery in high-risk primary melanoma patients is limited. We assessed frequency and determinants of diagnostic procedures, wide local excision (WLE) and sentinel lymph node biopsy (SLNB).

Methods: People in Queensland newly diagnosed with melanoma, clinical stage 1b or 2, were recruited prospectively.

Primary total knee arthroplasty twenty years after distal femoral cement augmentation of a giant cell tumor.

We present a case of knee reconstruction 20 years after treatment of a giant cell tumor (GCT) with curettage and cementation. There is currently an ongoing debate whether cement or allograft bone is the preferred material for filling the void after GCT curettage. In this case we were able to readily implant a primary total knee replacement without disturbing the existing well-interdigitated large cement bolus and did not require any stems or augments for the reconstruction.

Patterns of Recurrence in Patients with Stage IIIB/C Cutaneous Melanoma of the Head and Neck Following Surgery With and Without Adjuvant Radiation Therapy: Is Isolated Regional Recurrence Salvageable?

Background: Understanding recurrence patterns is vital for guiding treatment. This study describes recurrence patterns for patients with stage IIIB/C head and neck melanoma (HNM) after therapeutic lymph node dissection (TLND) ± adjuvant radiation therapy (RT). We also report outcomes for salvage therapy for patients with isolated regional relapse.

Supportive care needs, anxiety, depression and quality of life amongst newly diagnosed patients with localised invasive cutaneous melanoma in Queensland, Australia.

Objective: The aim of this paper is to determine levels of supportive care needs, anxiety, depression and symptoms amongst patients newly diagnosed with localised invasive primary melanoma and if these varied amongst patients who had a sentinel lymph node biopsy (SLNB). We also considered quality of life compared with general population norms.

Methods: Patients newly diagnosed with clinical stage IB-II invasive melanoma were ascertained through Queensland hospitals, specialist clinics and pathology laboratories.

Nomograms to predict recurrence and survival in stage IIIB and IIIC melanoma after therapeutic lymphadenectomy.

Background: Current staging algorithms in melanoma patients undergoing therapeutic lymph node dissection (LND) fail to accurately distinguish long-term survivors from those at risk of rapid relapse. Our goal was to establish and validate nomograms for predicting both recurrence and survival after LND.

Methods: A prospective cohort of stage IIIB and IIIC melanoma patients was ascertained from a tertiary hospital in Brisbane, Australia.

Current UK practice of pediatric supraglottic airway devices - a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland.

Objectives: Over half of general anesthetics in the UK involve supraglottic airway devices (SADs). The National Audit Project 4 undertaken by the Royal College of Anaesthetists demonstrated that aspiration was the most frequent complication relating to SAD use. SADs designed to reduce this risk (second-generation devices) are increasingly recommended in both adults and children.

An innovative approach for locally advanced stage III cutaneous melanoma: radiotherapy, followed by nodal dissection.

Patients with advanced nodal melanoma are typically managed with a regional nodal dissection; however, they have a high rate of distant relapse after surgery. This study assesses the role of preoperative radiotherapy to assist with the regional control in this subset of patients. Patients who had histologically confirmed stage III malignant melanoma and were treated with preoperative radiotherapy between 2004 and 2011 were eligible.

Four-limb compartment syndrome associated with the systemic capillary leak syndrome.

Systemic capillary leak syndrome, or the Clarkson syndrome, is an extremely rare condition in which increased capillary permeability results in a massive shift of fluid into the extravascular space. This is followed rapidly by hypotensive shock, haemoconcentration, and, potentially, substantial oedema of the limbs resulting in an acute compartment syndrome. It is important for orthopaedic surgeons to be aware of this syndrome as our medical colleagues, who initially care for these patients, are less familiar with the diagnosis and the need for emergency management of the associated compartment syndrome should it develop.

Audit of performance of size 1.5 ProSeal laryngeal mask airways in infants less than six months undergoing inguinal herniotomy.

Many anaesthetists have found the size 1.5 classic Laryngeal Mask Airway unsuitable for use in children under 10 kg, whereas recent studies evaluating the ProSeal Laryngeal Mask Airway (PLMA) show high success rates, even during laparoscopic surgery. Our routine practice has been to use tracheal intubation for inguinal herniotomy in children weighing less than 10 kg.

Microsurgical hepatic artery reconstruction in paediatric liver transplantation.

Background/aims: Hepatic artery thrombosis is a serious complication of paediatric liver transplantation often leading to retransplantation. It is also associated with decreased patient survival rates. In 1999 microsurgical hepatic artery reconstruction by Plastic and Reconstructive Surgeons was introduced to the Queensland Liver Transplant Service at the Royal Children's Hospital, Brisbane, in an attempt to decrease hepatic artery complications.

Comparison of the Cobalt Glidescope video laryngoscope with conventional laryngoscopy in simulated normal and difficult infant airways.

Aim: To evaluate the new pediatric Glidescope (Cobalt GVL Stat) by assessing the time taken to tracheal intubation under normal and difficult intubation conditions. We hypothesized that the Glidescope would perform as well as conventional laryngoscopy.

Background: A new pediatric Glidescope became available in October 2008.

A cohort evaluation of the pediatric ProSeal laryngeal mask airway in 100 children.

Background: The ProSeal laryngeal mask airway (PLMA) has been available in pediatric sizes in the UK since 2007. Although several non-UK studies have evaluated PLMAs in children, there are little published data regarding their use in this country. Having decided to introduce the pediatric PLMA into our practice, we chose to prospectively audit the first 100 uses as part of our clinical governance.

Desmoplastic melanoma: the role of radiotherapy in improving local control.

Background: Desmoplastic melanoma (DM) is a rare subtype of cutaneous malignant melanoma reported to have a high local recurrence rate with surgical excision alone. The incidence of regional and distant metastasis is considered to be lower than traditional cutaneous melanoma, warranting more aggressive treatment of local disease. We conducted a retrospective analysis of patients with DM treated through the Princess Alexandra Hospital Melanoma Clinic to address the role of radiotherapy in the local control of this tumour.

Evaluation of four manikins as simulators for teaching airway management procedures specified in the Difficult Airway Society guidelines, and other advanced airway skills.

Ten volunteers evaluated the performance of four currently available manikins: Airway Management Trainer, Airway Trainer, Airsim and Bill 1 as simulators for the 16 procedures described in the Difficult Airway Society Guidelines (DAS techniques) and eight other advanced airway techniques (non-DAS techniques), by scoring and ranking each manikin and procedure. Manikin performance was unequal (p < 0.0001 for both SCORE and RANK data for both DAS and non-DAS techniques).

Evaluation of four airway training manikins as simulators for inserting the LMA Classic*.

Airway manikins have traditionally been used for teaching mask ventilation and tracheal intubation. There is an increasing need to use manikins for training in procedures such as insertion of the laryngeal mask airway. We have assessed four new airway training manikins (latest versions of the Airway Trainer (Laerdal, Norway), Airway Management Trainer (Ambu, UK), 'Bill 1' (VBM, Germany) and Airsim (Trucorp, Ireland)) as simulators for insertion of the LMA Classic laryngeal mask airway.

Partial liquid ventilation and nitric oxide in experimental acute lung injury.

Objective: To investigate the effects of inhaled nitric oxide (iNO) and partial liquid ventilation (PLV) on oxygenation and pulmonary haemodynamics in acute lung injury (ALI), and to assess their effects on lung function, systemic haemodynamics and lung injury.

Methods: Using saline lung lavage, ALI was induced in 18 piglets. A control group was ventilated with conventional mechanical ventilation (CMV) for 2 h.

Laparotomy for necrotizing enterocolitis: intensive care nursery compared with operating theatre.

Objective: To determine whether neonates requiring laparotomy for necrotizing enterocolitis (NEC) are more stable perioperatively and have less disruption of physiological parameters if surgery is performed in the neonatal intensive care unit (NICU) compared with the operating theatre (OR).

Methodology: A retrospective case review was performed on 233 neonates referred for further surgical management of severe NEC in the period January 1989 to December 1997. Mortality and morbidity were compared by calculating the score for neonatal acute physiology (SNAP) and its attendant risk of mortality score.

Breast feeding practices and severe hyperbilirubinaemia.

This study establishes the association between early onset severe hyperbilirubinaemia (serum bilirubin (SBR) level greater than or equal to 272 mumol/L) with no assigned cause and breast feeding. The rates of breast feeding at hospital discharge increased from 46.4 to 75.