Bone regeneration with hydroxyapatite particles loaded in photo-cross-linkable hydrogel: An experimental study.

This study explores the use of in situ cross-linked hyaluronic acid methacryloyl (HAMA) and hydroxyapatite particles (HAP) for bone defect repair. Human periodontal ligament stem cells (PDLSCs) were isolated and co-cultured with the HAMA-HAP composite. Osteogenic differentiation was evaluated using Alizarin Red staining, alkaline phosphatase activity quantification, and polymerase chain reaction (PCR).

Evaluation of a chat GPT generated patient information leaflet about laparoscopic cholecystectomy.

Background: Artificial intelligence is increasingly being used in all aspects of life in information compilation and writing, and this includes healthcare. This study aimed to evaluate a Chat GPT generated patient information leaflet (PIL) against a surgeon generated version, in order to explore a potential application of this artificial intelligence language processing model.

Methods: Cross-sectional study, undertaken May to June 2023, asking two cohorts (patients and doctors) to complete a questionnaire evaluating a Chat GPT generated PIL and a surgeon generated PIL about laparoscopic cholecystectomy.

The safety and efficacy of laparoscopic retrograde appendicectomy, base-to-tip approach.

Background: Laparoscopic appendicectomy is one of the most frequently performed surgical procedures worldwide. There is limited evidence evaluating the role and safety of laparoscopic retrograde appendicectomy (LRA), base to tip approach, compared to standard laparoscopic antegrade appendicectomy (LAA), tip to base approach. This study aims to assess the safety of LRA compared to LAA in terms of intra-abdominal collection (IAC) rate and using Sunshine Appendicitis Grading System (SAGS).

Challenges in managing upper gastrointestinal bleeding secondary to primary squamous cell carcinoma of the pancreas: a case report and literature review.

Background: Primary pancreatic squamous cell carcinoma (SCC) is a rare type of pancreatic cancer, with an incidence of 5% of all pancreatic cancers. This condition is associated with a poor prognosis, and no optimal treatment has been established (Zhang et al. in Medicine (Baltim).

Learning curve of laparoscopic inguinal hernia repair: systematic review, meta-analysis, and meta-regression.

Background: Laparoscopic inguinal hernia repair has a long learning curve. It can be a technically challenging procedure and initially presents an unfamiliar view of inguinal anatomy. The aim of this review was to evaluate published literature relating to the learning curve of laparoscopic inguinal hernia repair and identify the number of cases required for proficiency.

Dantrolene Administration in the Management of the Prehospital Patient with Methylenedioxymethamphetamine Overdose: A Case Series and Literature Review.

Methylenedioxymethamphetamine (MDMA) is a psychoactive substance that is used commonly as a recreational drug at rave music festivals. MDMA intoxication can cause a myriad of symptoms and side effects including the manifestation of hyperpyrexia in patients. Hyperpyrexia can mimic a heat stroke and ultimately lead to various forms of end-organ damage.

Metal stents are safe and cost-effective for preoperative biliary drainage in resectable pancreaticobiliary tumours.

Backgrounds: To compare the complication rates and overall costs of self-expandable metal stents (SEMS) and plastic stents (PS) in clinically indicated preoperative biliary drainage (PBD) prior to a pancreatoduodenectomy (PD).

Methods: We conducted an Australian multicentre retrospective cohort study using the databases of four tertiary hospitals. Adult patients who underwent clinically indicated endoscopic PBD prior to PD from 2010 to 2019 were included.

Evaluation of palliative treatments in unresectable pancreatic cancer.

Background: Pancreatic ductal adenocarcinoma (PDAC) presents as unresectable disease in 80% of patients. Limited Australian data exists regarding management and outcome of palliative management for PDAC. This study aims to: (i) identify patients with PDAC being managed with palliative intent; (ii) assess the type of palliative management being used.

An intraoperative diagnosis of sclerosing encapsulating peritonitis: a case report.

Primary sclerosing encapsulating peritonitis (SEP) is an idiopathic and rare condition characterized by chronic peritoneal inflammation. We describe the case of an intraoperative diagnosis of SEP, presenting as a mimicker of small bowel obstruction. The patient was a 59-year-old male with suspected small bowel obstruction.

Retrograde jejunogastric intussusception presenting as haematemesis in a patient following pancreaticoduodenectomy.

Intussusception is defined as the invagination of one part of the gastrointestinal tract into another. Jejunogastric intussusception is a rare phenomenon following major upper abdominal surgery, where its aetiology is not well understood. We describe a 68-year-old woman who presented with abdominal pain and haematemesis on the background of a previous pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer.

A Delayed Diagnosis of Hemorrhagic Shock in a Patient with Alcoholic Cirrhosis and Ascites on Bedside Ultrasound.

Undifferentiated shock is a common and challenging problem in critical care. We present a case of hemorrhagic shock due to splenic and hepatic lacerations diagnosed by bedside paracentesis, initially misclassified as septic shock due to suspected spontaneous bacterial peritonitis (SBP). .

Laparoscopic EndoClose fixation of a peritoneal catheter reduces migration.

Background: With the introduction of laparoscopic Tenckhoff catheter insertion in the early 1990s, catheter malposition resulting in malfunction remains a frequent complication, often requiring surgical or radiological intervention. In this pioneer study, we describe the technique of suturing the Tenckhoff catheter using an EndoClose (Medtronic, Macquarie Park, NSW, Australia) device to the anterior abdominal wall during laparoscopic insertion and compare its outcomes with those not sutured.

Methods: This is a retrospective study of all patients who underwent laparoscopic Tenckhoff catheter insertion at Western Health from January 2013 to June 2018.

Splenic autotransplantation: a systematic review.

Background: Splenectomy is a surgical procedure indicated in a variety of medical conditions including trauma. Post-operatively, there is a lifelong risk of developing overwhelming sepsis from encapsulated bacteria, most commonly due to Streptococcus pneumoniae. Splenic autotransplantation has been proposed as a method to recover splenic function in patients requiring splenectomy with otherwise normal spleens.

Progressive disseminated histoplasmosis with concomitant disseminated nontuberculous mycobacterial infection in a patient with AIDS from a nonendemic region (California).

Background: Opportunistic infections, while well studied in the AIDS population, continue to have variable and surprising presentations. Here, we present a case of disseminated histoplasmosis with disseminated nontuberculous mycobacterial infection in a 50 year old man with long standing AIDS living in a non-endemic area.

Case Presentation: Patient presented with a constellation of symptoms, and imaging of the chest showed a pulmonary mass with cavitation, multiple nodules, and ground glass opacities.

Paraneoplastic syndrome as the presentation of limited stage small cell carcinoma.

Background: Small cell lung carcinoma (SCLC) is one of the deadliest forms of lung cancer due to its poor prognosis upon diagnosis, rapid doubling time, and affinity for metastasis. As 60-70% of patients with SCLC have disseminated disease upon presentation, it is imperative to determine the extent of disease burden for treatment. As a neuroendocrine carcinoma, clinicians must pay close attention to abnormal findings in a smoker that could lead to earlier diagnosis and better prognostication.

Fatal outcome in a Hispanic woman with moyamoya syndrome and Graves' disease.

Unlabelled: We describe the case of a young Hispanic female who presented with thyrotoxicosis with seizures and ischemic stroke. She was diagnosed with a rare vasculopathy - moyamoya syndrome. After starting antithyroid therapy, her neurologic symptoms did not improve.

Irrigation versus suction alone during laparoscopic appendectomy; A randomized controlled equivalence trial.

Introduction: The objective of this study was to compare operative peritoneal irrigation versus suction alone during laparoscopic appendectomy in adult patients; our hypothesis was that the two methods are equivalent in terms of rate of post-operative intra-abdominal abscess. There has been only one prospective, randomized, superiority trial in children, that showed non-significant difference in the rate of intra-abdominal abscess comparing irrigation to suction alone during laparoscopic appendectomy for perforated appendicitis. Non-significant difference in a superiority trial does not imply equivalence.

Old technique revisited with surgical innovation: complicated Mallory-Weiss tear with bleeding gastric ulcer exclusion.

Mallory-Weiss tears (MWTs) rarely require surgical intervention. A 60-year-old female presented with massive hematemesis secondary to MWT and gastric ulceration. After failure of endoscopic management, an operative approach was embarked on, with a direct surgical hemostasis of the Mallory-Weiss tear and exclusion of the gastric ulcer.

Prospective evaluation of the Sunshine Appendicitis Grading System score.

Background: Although there is a wealth of information predicting risk of post-operative intra-abdominal collection and guiding antibiotic therapy following appendicectomy, confusion remains because of lack of consensus on the clinical severity and definition of 'complicated' appendicitis. This study aimed to develop a standardized intra-operative grading system: Sunshine Appendicitis Grading System (SAGS) for acute appendicitis that correlates independently with the risk of intra-abdominal collections.

Methods: Two-hundred and forty-six patients undergoing emergency laparoscopy for suspected appendicitis were prospectively scored according to the severity of appendicitis and followed up for complications including intra-abdominal collection.

Peroxisome proliferator-activated receptor-α staining is associated with worse outcome in colorectal liver metastases.

Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear receptors involved in lipid metabolism and liver response to injury. We hypothesised that differences in the expression of PPARs may reflect differences in the cellular microenvironment of the liver and, consequently, in the behaviour of colorectal liver metastases. Of the 145 patients who underwent hepatectomy for colorectal liver metastases between 1998 and 2007, 103 had adequate tissue for PPAR staining and histological re-evaluation.