Watch and wait for Rectal Cancer: A 9 year Experience.

Background: Neoadjuvant long course chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. It can reduce tumour bulk, downstage, reduce the risk of local recurrence, and increase the possibility of clear resection margins. The aim of our study is to evaluate all patients over a 9 year period who underwent neoadjuvant chemoradiotherapy for rectal cancer and entered our watch and wait programme.

ISOFLURANE ANESTHESIA IN THE MADAGASCAR HISSING COCKROACH ().

This study investigated the efficacy of isoflurane in Madagascar hissing cockroaches (). Cockroaches ( = 12) were placed in a 2-L anesthesia chamber with isoflurane initiated at 5% at 2 L/m. Movement of antennae, mandibles, and legs and righting reflex were assessed, with full induction achieved when all responses had ceased for 2 m.

The 'Good Friday Agreement' and cancer research on the island of Ireland: Evidence for the impact of a tripartite cancer research partnership.

Aim: In 1999, a cooperative tripartite cancer research and training agreement was signed between Ireland (IE), Northern Ireland (NI) and the United States (US) National Cancer Institute, giving rise to the All-Ireland Cancer Consortium (AICC). We wished to consider if AICC increased the amount/impact of cancer research on the island of Ireland and what effect this enhanced research activity had on cancer services and cancer outcomes.

Methods: As comparator, we chose the city regions of Copenhagen and Lund & Malmö, whose physical connection was greatly improved following construction of bridges between Denmark and Sweden around the time AICC was established.

Bioaerosol Sampling to Detect Avian Influenza Virus in Hanoi's Largest Live Poultry Market.

Background: Newly emergent and virulent strains of H7N9 avian influenza virus are rapidly spreading in China and threaten to invade Vietnam. We sought to introduce aerosol sampling for avian influenza viruses in Vietnam.

Methods: During October 2017, National Institute for Occupational Safety and Health 2-stage aerosol samplers were assembled on a tripod and run for 4 hours.

Re-Staging Following Long-Course Chemoradiotherapy For Rectal Cancer: Does It Influence Management?

Background: In patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management. The need for restaging afterwards has been questioned as it may be difficult to interpret imaging due to local tissue effects of chemoradiotherapy. The purpose of this study was to determine if restaging affected the management of patients receiving long-course chemoradiotherapy for rectal cancer.

Recycling of jejunal effluent to enable enteral nutrition in short bowel syndrome.

A 41-year-old woman developed severe abdominal pain, distension and faeculent vomiting. CT of abdomen and pelvis revealed small bowel malrotation with a right paraduodenal hernia. At emergency laparotomy, a right paraduodenal hernia containing jejunum and ileum was identified.

Cytokine response to portal endotoxaemia and neutrophil stimulation in obstructive jaundice.

Introduction: An exaggerated proinflammatory response to endotoxaemia can occur in obstructive jaundice. The aims of this study were to determine the hepatic proinflammatory and anti-inflammatory cytokine response to endotoxaemia in experimental biliary obstruction and to determine the source of interleukin-6 (IL-6) using immunohistochemistry.

Methodology: Male Wistar rats were randomized into three groups: bile duct ligation (BDL), sham operation, and control groups.

The barrier method as a new tool to assist in career selection: covert observational study.

Objective: To determine if senior doctors' parking habits and skills are associated with clinical specialty and, if so, whether observation of junior doctors' parking could provide guidance in choice of specialty.

Design: Covert observational study.

Setting: Pass-card controlled consultants' car park (parking lot), December 2009.

Intra-abdominal drain fracture following pancreatic necrosectomy.

We describe a rare case of iatrogenic fracture of an intra-abdominal tube drain (Portex Robinson drain, Smiths Medical, Kent, UK) in a 74-year-old man. The fracture occurred at the level of an additionally placed fenestration and was identified on CT scanning prior to retrieval at planned re-laparotomy. This case highlights the potential dangers of modifying pre-formed drains and recommends against this practice.

Inflammatory infrarenal abdominal aortic aneurysm in a young woman.

Inflammatory abdominal aortic aneurysm is a rare cause of abdominal pain in young adults that may be difficult to diagnose in the Emergency Department. This case highlights the significance of this condition as a possible diagnosis in young patients presenting with abdominal symptoms. A 32-year old woman presented with lower abdominal and back pain.

Endoscopically assisted minimally invasive surgery for gallstones.

Background: We present a case report of Bouveret syndrome followed by a review of the recent literature regarding the management of this condition. Bouveret syndrome is a form of gastric outlet obstruction secondary to a gallstone which has eroded through the gallbladder into the duodenum. It is an uncommon variant of gallstone ileus.

Efficacy of botulinum toxin in chronic anal fissure.

Background: Chronic anal fissures (CAF) are caused by anal sphincter hypertonia leading to an ischaemic ulcer. By inducing temporary sphincter relaxation, botulinum toxin (Botox) injection has been shown to heal CAF in approximately 73-96% of cases in clinical trials.

Aim: This study looks at the efficacy of Botox clinical practice.

Serous adenocarcinoma of the sigmoid mesentery arising in cystic endosalpingiosis.

This case report describes a Mullerian serous adenocarcinoma arising within a multoloculated cyst lined by ciliated serous-type epithelium located in the sigmoid mesentery. Twenty years previously the patient underwent a hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. The ovaries contained bilateral serous cystadenofibromas, and multiple cysts lined by ciliated serous-type epithelium were present in the omentum.

Role of adenosine in immunomodulation: review of the literature.

Objective: Advances in the understanding of sepsis have failed to deliver satisfactory new treatments aimed at attenuating inflammatory-mediated organ dysfunction. Phagocytic cells play a pivotal role in driving the inflammatory response and causing direct tissue injury. Adenoreceptor stimulation may attenuate such inflammatory-mediated damage by down-regulating phagocytic activity and preventing excessive respiratory burst activation.

Phagocyte priming as a prognostic indicator in the intensive care unit.

Background: The purpose of this study was to study the temporal changes in circulating phagocyte respiratory burst activity and its relationship to mortality in intensive care unit (ICU) patients.

Methods: Thirty-seven consecutive patients over a 3-week period were studied on their first, third, and seventh day of admission to the regional ICU in Northern Ireland. Blood samples were assayed for respiratory burst activity using luminol-enhanced whole blood chemiluminescence.

Management of severe acute pancreatitis.

Background: Acute pancreatitis is still associated with significant morbidity and mortality. Current management guidelines are sometimes equivocal, particularly in relation to the surgical treatment of severe disease. This review assesses available investigative and treatment strategies to allow the development of a formalized management approach.

Successful colonoscopy; completion rates and reasons for incompletion.

Factors such as poor bowel preparation or obstructing colonic disease may confound the reporting of colonoscopy completion rates, as these factors are outside of the control of the endoscopist performing the procedure. By adjusting for these factors when calculating a colonoscopy completion rate, it may be possible to make a more accurate assessment of a unit's or individuals' competence. Details of two thousand two hundred and sixteen colonoscopies performed by four consultants and their trainees between 1993-2000 were analysed retrospectively from a prospective endoscopy database.

Ischemic preconditioning before lower limb ischemia--reperfusion protects against acute lung injury.

Objective: Prolonged limb ischemia followed by reperfusion (I/R) is associated with a systemic inflammatory response syndrome and remote acute lung injury. Ischemic preconditioning (IPC), achieved with repeated brief periods of I/R before the prolonged ischemic period, has been shown to protect skeletal muscle against ischemic injury. The aim of this study was to ascertain whether IPC of the limb before I/R injury also attenuates systemic inflammation and acute lung injury in a fully resuscitated porcine model of hind limb I/R.