Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program.

We present a case study on the design and implementation of a value-based bundled package of care for patients with early-stage breast cancer treated in the private health sector in Australia. Value-based healthcare is an essential change to how we deliver healthcare, shifting the focus from paying for individual services provided to a focus on the health outcomes gained over a full cycle of care. The Australian health system has unintentionally created barriers to value-based cancer care through fragmented care pathways and complex funding arrangements where patients can unexpectedly encounter high out-of-pocket costs.

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.

Hidden Treasure: Congenital Adhesions Necessitating an Alternative Approach to Laparoscopic Appendicectomy.

Congenital adhesions are rare findings in adults. We present a case of appendicitis in a middle-aged male with extensive congenital adhesions of the terminal ileum to the right lateral abdominal wall. The small bowel mesentery completely obscured the inflamed appendix.

Quantitative Micro-Elastography Enables In Vivo Detection of Residual Cancer in the Surgical Cavity during Breast-Conserving Surgery.

Unlabelled: Breast-conserving surgery (BCS) is commonly used for the treatment of early-stage breast cancer. Following BCS, approximately 20% to 30% of patients require reexcision because postoperative histopathology identifies cancer in the surgical margins of the excised specimen. Quantitative micro-elastography (QME) is an imaging technique that maps microscale tissue stiffness and has demonstrated a high diagnostic accuracy (96%) in detecting cancer in specimens excised during surgery.

Collapsing Glomerulopathy Superimposed on Diabetic Nephropathy.

Diabetic nephropathy (DN) is characterized by progressive increase in proteinuria and decline in renal functions. Various forms of nondiabetic kidney disease may be superimposed on DN, which can alter the progression of DN. Collapsing glomerulopathy (CG) may superimpose on DN, and is characterized by rapid worsening of renal failure and has poor prognosis.