Is mesh related morbidity the real thread in ventral rectopexy? Results of a retrospective international multicentre comparative analysis of biologic versus synthetic mesh.

Aim: Ventral mesh rectopexy (VMR) is an established surgical treatment for rectal prolapse and outlet obstruction. In contrast to continental Europe, in the UK and US the use of synthetic mesh has been abandoned in favour of biologic mesh, due to concerns regarding mesh related morbidity. The current study investigated if either material is superior, in terms of clinical recurrence and mesh related complications.

Examining the role of patient-reported external factors and risk of relapse in anti-neutrophilic cytoplasmic autoantibody vasculitis.

The role of stressors, insect bites, and infections on disease relapse of ANCA vasculitis has yet to be entirely explored, with limited retrospective studies focused on disease onset from small participant cohorts. Our study analyzes longitudinal survey data from 2011-2022 to evaluate this perspective from a large ANCA vasculitis cohort. We collected surveys every three to six months to obtain information on self-reported psychological stressors and significant life events, insect bites, and infections throughout clinical disease.

Kidney Disease Progression in Membranous Nephropathy among Black Participants with High-Risk APOL1 Genotype.

Background: Disparity in CKD progression among Black individuals persists in glomerular diseases. Genetic variants in the apolipoprotein L1 ( APOL1 ) gene in the Black population contribute to kidney disease, but the influence in membranous nephropathy remains unknown.

Methods: Longitudinally followed participants enrolled in the Glomerular Disease Collaborative Network or Cure Glomerulonephropathy Network were included if they had DNA or genotyping available for APOL1 (Black participants with membranous nephropathy) or had membranous nephropathy but were not Black.

A novel reticular node in the brainstem synchronizes neonatal mouse crying with breathing.

Human speech can be divided into short, rhythmically timed elements, similar to syllables within words. Even our cries and laughs, as well as the vocalizations of other species, are periodic. However, the cellular and molecular mechanisms underlying the tempo of mammalian vocalizations remain unknown.

Palliative Nerve Block for Penile Calciphylaxis: A Case Report on Ultrasound-Guided Phenol Neurolysis.

A 78-year-old man with uncontrolled diabetes, heart failure, and hemodialysis-dependent end-stage renal disease presented with intractable penile pain secondary to calciphylaxis and necrosis of his glans penis. Given pain refractory to pharmacologic management and refusal of surgery, treatment entailed an ultrasound-guided dorsal penile nerve block with 5 mL of aqueous 4% phenol bilaterally. The patient reported immediate relief and died pain-free 3 months later.

Changing paradigm of sacral neuromodulation and external anal sphincter repair for faecal incontinence in specialist centres.

Aim: The aim of this study was to determine whether the paradigm of surgical intervention for faecal incontinence (FI) has changed between 2000 and 2013.

Method: This was a multi-centre retrospective study of patients who had undergone either sacral neuromodulation (SNM) or delayed sphincter repair or sphincteroplasty (SR) as a primary surgical intervention for FI in five centres in Europe and one in the United States. The flow of patients according to the intervention, sustainability of the treatment at a minimum follow-up of 5 years, complications and requirement for further interventions were recorded.

Adverse obstetric history is not a risk factor for poor outcome after ventral rectopexy for obstructive defaecation syndrome.

Aim: Ventral rectopexy (VR) has gained popularity in the management of obstructive defaecation syndrome (ODS) due to a symptomatic rectocele ± intussusception. Data on the efficacy and safety of VR are variable and there are few predictors of successful outcome. This study aimed to examine whether or not an adverse obstetric history influenced the functional outcome following VR for ODS.

Preferential Targeting of Lateral Entorhinal Inputs onto Newly Integrated Granule Cells.

Mature dentate granule cells in the hippocampus receive input from the entorhinal cortex via the perforant path in precisely arranged lamina, with medial entorhinal axons innervating the middle molecular layer and lateral entorhinal cortex axons innervating the outer molecular layer. Although vastly outnumbered by mature granule cells, adult-generated newborn granule cells play a unique role in hippocampal function, which has largely been attributed to their enhanced excitability and plasticity (Schmidt-Hieber et al., 2004; Ge et al.

Laparoscopic ventral mesh rectopexy for obstructive defecation syndrome: still the way to go?

Laparoscopic ventral mesh rectopexy (VMR) has become a popular surgical technique for treating women with full-thickness rectal prolapse with a low recurrence rate, as demonstrated by several studies. In addition, it is increasingly applied to female patients with obstructive defecation syndrome (ODS) caused by intussusception ± rectocele. Functional improvement can be achieved in a high number of patients with ODS, but expectations need to be discussed carefully, as a few patients may not benefit at all.

Mercaptopurine versus placebo to prevent recurrence of Crohn's disease after surgical resection (TOPPIC): a multicentre, double-blind, randomised controlled trial.

Background: Up to 60% of patients with Crohn's disease need intestinal resection within the first 10 years of diagnosis, and postoperative recurrence is common. We investigated whether mercaptopurine can prevent or delay postoperative clinical recurrence of Crohn's disease.

Methods: We did a randomised, placebo-controlled, double-blind trial at 29 UK secondary and tertiary hospitals of patients (aged >16 years in Scotland or >18 years in England and Wales) who had a confirmed diagnosis of Crohn's disease and had undergone intestinal resection.

Lymphangiosarcoma of the scalp.

Background: Lymphangiosarcoma is a rare, aggressive malignancy that originates from the endothelial cells lining lymphatic vessels and carries an extremely poor prognosis. Its clinical and histologic features are often indistinguishable from angiosarcoma.

Objective: We sought to better characterize the clinical and histologic features of lymphangiosarcoma.

Regional distribution of Ginkgo biloba-induced c-Fos immunoreactivity.

A growing literature supports the notion that Ginkgo biloba has cognitive enhancing and anxiolytic properties; however, its effects on neuronal populations have yet to be characterized. The present study used c-Fos immunoreactivity (Fos-IR) to characterize functional activity in selected brain regions following administration of a standardized Ginkgo biloba extract. Because Ginkgo is typically consumed orally, Exp 1 sought to identify patterns of neural activity induced by oral administration.

Self-expanding metallic stent insertion in the proximal colon.

Objective: Colonic obstruction may be relieved by the insertion of a self-expanding metallic stent (SEMS), either for permanent palliative relief or as a bridge to surgery. Lesions proximal to the descending colon can be more difficult to intubate and stent [1]. SEMS placement in the more proximal colon lesions has been reported in only a few cases [2,4].

Outcomes of the rectal remnant following colectomy for ulcerative colitis.

Objective: Controversy surrounds the optimal surgical management of the distal rectal remnant during colectomy for ulcerative colitis (UC) and the potential benefit from the placement of a rectal catheter for remnant drainage. This study reviews the clinical outcomes of patients who have undergone colectomy for UC with intra-peritoneal closure of the rectal remnant.

Method: Analysis of prospective data lodged on Lothian Surgical Audit databases from patients treated in a tertiary coloproctology unit over 11 years.

Genetic characterization of diverse HIV-1 strains in an immigrant population living in New York City.

New York City (NYC) is one of the original foci of the HIV-1 epidemic and has a greater number of AIDS cases than any other city in the United States. NYC also hosts the highest number of immigrants among the nation's cities: more than 2 million among a total population of 8 million. Such a high rate of immigration could act as a potential source for introducing and disseminating novel HIV-1 strains into the United States.

Challenges of war surgery in Mallavi, Sri Lanka.

Northern Sri Lanka has been separated by an active front line from the remainder of the country and has lacked basic facilities, including hospital care, because of the war between the government and the Tamil Tigers. This article reports on the resulting situation in one district hospital in the region and on the work of Médecins sans Frontières in providing specialist hospital care under such difficulties.

Obstetrics during Civil War: six months on a maternity ward in Mallavi, northern Sri Lanka.

A long-term, large-scale ethnic armed conflict continues in Sri Lanka, where militant separatists control a northern section of the island. The conflict has resulted in a large population of internally displaced persons and a shortage of medical staff. Drug and equipment shortages compound the difficulty in access to medical care.