The use of a porcine model to teach advanced abdominal wall dissection techniques.

Background: In the era of minimally invasive surgery, it is clear that a robust simulation model is required for the training of surgeons in advanced abdominal wall reconstruction. The purpose of this experimentation was to evaluate whether a porcine model could be used to teach advanced minimally invasive abdominal wall dissection techniques to novice surgeons. Secondary objectives included: time to completion, identification of various anatomical landmarks, to note the difference in porcine and human models and finally, the ability to dock a Da Vinci Xi robotic platform on the porcine model.

Pancreatic duct filling during cholecystectomy intraoperative cholangiogram and incidence of postoperative pancreatitis.

Background And Aim: Laparoscopic cholecystectomy (LC) with intraoperative cholangiography (IOC) is a commonly performed surgical procedure in most hospitals. Anecdotal evidence suggests that when the pancreatic duct (PD) inadvertently fills during IOC, there may be an increased risk of postoperative pancreatitis (POP). However, there is a paucity of information in the literature about both the incidence of pancreatitis post LC and the incidence of PD filling on IOC and any potential relationship between the two.

Prenatal diagnosis of congenital ventricular aneurysm and diverticulum: Prenatal features and perinatal management.

Unlabelled: Congenital ventricular diverticulum (VD) and aneurysm are rare cardiac developmental anomalies and their pathophysiology is still unclear. They present as an anomaly of the four chambers view, cardiomegaly, arrhythmia, pericardial effusion, or hydrops. They are usually isolated anomalies.

Cardiovascular events in perimembranous ventricular septal defect with left ventricular volume overload: a French prospective cohort study (FRANCISCO).

Unlabelled: The long-term prospective multi-centre nationwide (French) observational study FRANCISCO will provide new information on perimembranous ventricular septal defect with left ventricular overload but no pulmonary hypertension in children older than 1 year. Outcomes will be compared according to treatment strategy (watchful waiting, surgical closure, or percutaneous closure) and anatomic features of the defect. The results are expected to provide additional guidance about the optimal treatment of this specific population, which is unclear at present.

Blunt innominate artery trauma requiring repair and carotid ligation.

Traumatic dissection of the innominate artery is a rare clinical entity. Management of a patient with motorsensory compromise and dissection extending to the subclavian and right common carotid arteries is quite rare and can be quite involved. Here we present such a case and discuss the unique peri-operative decision-making in the context of what is reported in the literature.

Management of an enormous inferior mesenteric vein aneurysm.

Venous aneurysms are rare entities, with mesenteric venous aneurysms among the rarest reported. We present a case of a 66-year-old man with abdominal pain secondary to an enormous 7.8-cm inferior mesenteric vein aneurysm.

Spontaneous Superior Mesenteric Artery Branch Pseudoaneurysm: A Rare Case Report.

Background: Visceral arterial pseudoaneurysms (VAPAs) are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication.

Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram.

Review of aspirin and clopidogrel resistance in peripheral arterial disease.

Objective: Aspirin resistance (AR) and clopidogrel resistance (CR) are terms used to describe a reduction in the medication's efficacy in inhibiting platelet aggregation despite regular dosing. This review gives context to the clinical role and implications of antiplatelet resistance in peripheral arterial disease (PAD).

Methods: A review of English-language literature on AR and CR in PAD involving human subjects using PubMed and MEDLINE databases was performed in April 2017.

Beyond Histological Remission: Intramucosal Calprotectin as a Potential Predictor of Outcomes in Ulcerative Colitis.

Background And Aims: Histological remission and low faecal calprotectin are positive prognostic factors in ulcerative colitis [UC]. Intramucosal calprotectin [iMC], which can be readily determined by immunohistochemistry, has not so far been evaluated as a predictor of outcome in UC. We aimed to investigate the relationship between iMC and clinical, endoscopic, and histological measures of remission in UC, and the independent prognostic value of iMC.

Defining regions of interest using cross-frequency coupling in extratemporal lobe epilepsy patients.

Objective: Clinicians identify seizure onset zones (SOZs) for resection in an attempt to localize the epileptogenic zone (EZ), which is the cortical tissue that is indispensible for seizure generation. An automated system is proposed to objectively localize this EZ by identifying regions of interest (ROIs).

Methods: Intracranial electroencephalogram recordings were obtained from seven patients presenting with extratemporal lobe epilepsy and the interaction between neuronal rhythms in the form of phase-amplitude coupling was investigated.

Gamma (30-80Hz) bicoherence distinguishes seizures in the human epileptic brain.

We have applied wavelet bicoherence (BIC) analysis to human iEEG data to characterize non-linear frequency interactions in the human epileptic brain. Bicoherence changes were most prominent in the gamma (30-80 Hz) frequency band, and allowed for the differentiation between seizure and non-seizure states in all patients studied (n=3). While gamma band BIC values increased during seizure activity, this trend was only observed in a select number of electrode(s) located on the implanted patient subdural grids.

Hybrid repair of symptomatic aberrant right subclavian artery and Kommerell's diverticulum.

Introduction: An aberrant right subclavian artery (ARSA) with or without an associated Kommerell's diverticulum (KOD) is a rare vascular anomaly. Patients with an ARSA may present with a variety of symptoms, including rupture. Options for repair include open, endovascular, and a hybrid approach, with no clear consensus on which is best because of the rarity of the anomaly.

The role of delta-modulated high frequency oscillations in seizure state classification.

High frequency oscillations (HFOs), which collectively refer to ripples (80-200 Hz) and fast ripples (>200 Hz), have been implicated as key players in epileptogenesis. However, their presence alone is not in and of itself indicative of a pathological brain state. Rather, spatial origins as well as coexistence with other neural rhythms are essential components in defining pathological HFOs.

Classification of Multiple Seizure-Like States in Three Different Rodent Models of Epileptogenesis.

Epilepsy is a dynamical disease and its effects are evident in over fifty million people worldwide. This study focused on objective classification of the multiple states involved in the brain's epileptiform activity. Four datasets from three different rodent hippocampal preparations were explored, wherein seizure-like-events (SLE) were induced by the perfusion of a low - Mg(2+) /high-K(+) solution or 4-Aminopyridine.

Capturing the state transitions of seizure-like events using Hidden Markov models.

The purpose of this study was to investigate the number of states present in the progression of a seizure-like event (SLE). Of particular interest is to determine if there are more than two clearly defined states, as this would suggest that there is a distinct state preceding an SLE. Whole-intact hippocampus from C57/BL mice was used to model epileptiform activity induced by the perfusion of a low Mg(2+)/high K(+) solution while extracellular field potentials were recorded from CA3 pyramidal neurons.

Barriers faced by migrants in accessing healthcare for viral hepatitis infection.

Background: The morbidity and mortality of hepatitis B virus- and hepatitis C virus-related complications are disproportionately higher in the culturally and linguistically diverse population (CALD) when compared with Australian-born individuals.

Aim: This project aims to elucidate the barriers faced by the CALD population in accessing viral hepatitis management.

Method: CALD outpatients attending a viral hepatitis clinic in a tertiary teaching hospital were invited to participate in interviews.

Influenza myocarditis and myositis: case presentation and review of the literature.

Myocarditis, a general inflammatory condition of the heart muscle, can result from a variety of etiologies, the most common being viral. Despite common pathogens, concomitant myocarditis and myositis remains a rare event. Although a common cause of respiratory illness, extrapulmonary infections with influenza are infrequent.

General practitioners' knowledge and management of viral hepatitis in the migrant population.

Background: Escalating morbidity and mortality associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major health burden in Australia, particularly among migrants from endemic areas who may present late.

Methods And Aims: We evaluated the knowledge and educational needs of general practitioners (GPs) in the St George Division, Sydney which serves a large migrant population. The aims of the study were to identify gaps in knowledge about viral hepatitis that may affect management and referral patterns.

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support.

Current hospital administrative practices categorize health care centres in a network of  'spokes' (primary care centres) and 'hubs' (tertiary care centres). For the treatment of cardiogenic shock, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres nationwide and are, thus, only available to patients living in close proximity to these centres. The relatively lower technical requirements of the Impella Recover LP 5.

Taking NIRS-BCIs outside the lab: towards achieving robustness against environment noise.

This paper reported initial findings on the effects of environmental noise and auditory distractions on the performance of mental state classification based on near-infrared spectroscopy (NIRS) signals recorded from the prefrontal cortex. Characterization of the performance losses due to environmental factors could provide useful information for the future development of NIRS-based brain-computer interfaces that can be taken beyond controlled laboratory settings and into everyday environments. Experiments with a hidden Markov model-based classifier showed that while significant performance could be attained in silent conditions, only chance levels of sensitivity and specificity were obtained in noisy environments.

On the use of peripheral autonomic signals for binary control of body-machine interfaces.

In this work, the potential of using peripheral autonomic (PA) responses as control signals for body-machine interfaces that require no physical movement was investigated. Electrodermal activity, skin temperature, heart rate and respiration rate were collected from six participants and hidden Markov models (HMMs) were used to automatically detect when a subject was performing music imagery as opposed to being at rest. Experiments were performed under controlled silent conditions as well as in the presence of continuous and startle (e.

Minimally invasive left-heart decompression during venoarterial extracorporeal membrane oxygenation: an alternative to a percutaneous approach.

Decompression of the left-heart following initiation of extracorporeal membrane oxygenation, is at times required. In the setting of a closed chest this can present a challenge. We present a minimally invasive approach to left-heart decompression in an adult-sized patient, where a percutaneous option was not feasible.