A Focus Group Discussion Study Exploring General Surgery Trainees' Views on Evidence-Based Medicine Within Their Training Program in the United Kingdom.

Introduction: Evidence-based Medicine (EBM) is fundamental to modern healthcare and its integration into postgraduate curricula is strongly advocated. Despite its relevance, incorporating EBM in postgraduate training, specifically in general surgery, is fraught with challenges. This study aims to explore the perceptions of general surgical trainees regarding EBM, focusing on the process of achieving competency, assessment and its associated challenges.

Near-infrared fluorescent imaging for parathyroid identification and/or preservation in surgery for primary hyperparathyroidism.

Introduction: Near infrared autofluorescence (NIRAF) is a novel intraoperative technology that has shown promising results in the localisation of parathyroid glands (PGs) over the last decade. This study aimed to assess the potential utility of NIRAF in first time surgery for primary hyperparathyroidism (PHPT).

Methods: An observational study over a period of 3 years in patients who underwent surgery for PHPT was designed.

Evaluating the performance of artificial intelligence software for lung nodule detection on chest radiographs in a retrospective real-world UK population.

Objectives: Early identification of lung cancer on chest radiographs improves patient outcomes. Artificial intelligence (AI) tools may increase diagnostic accuracy and streamline this pathway. This study evaluated the performance of commercially available AI-based software trained to identify cancerous lung nodules on chest radiographs.

Findings of pilot study following the implementation of point of care intraoperative PTH assay using whole blood during surgery for primary hyperparathyroidism.

Objective: To report findings of pilot study using a novel point of care (POC) intraoperative parathyroid hormone (IOPTH) assay for parathyroid hormone (PTH) using whole blood during surgery for primary hyperparathyroidism (PHPT).

Methods: Patients undergoing surgery for primary hyperparathyroidism from March to November 2022 where intraoperative PTH assay was performed using the NBCL CONNECT IOPTH and the laboratory PTH assay were included (group 1). The biochemistry results were reviewed to determine concordance between NBCL and lab PTH values and diagnostic test parameters of the NBCL CONNECT assay.

Abnormal Calcium Levels are Associated With Worse Maternal and Fetal Outcomes; Results From an Exploratory Study.

Context: Precise estimates of the incidence of hyper- and hypocalcemia in pregnancy are unknown. Abnormal calcium levels have been associated with unfavorable pregnancy-related outcomes.

Objective: Determine frequency of hypercalcemia and hypocalcemia in pregnancy when tested and their associations with maternal and fetal outcomes.

Quality of Life in Post-Surgical Hypoparathyroidism (PoSH) in Thyroid and Parathyroid Surgery.

Background: Post-surgical hypoparathyroidism (PoSH) is often long term, with significant associated morbidity and ongoing treatment. A recent systematic review found impaired quality of life (QoL) in patients with PoSH, despite stable treatment. Most studies did not include an appropriate control arm and further studies were recommended, taking into account underlying disease and comorbidities.

Primary hyperparathyroidism in pregnancy: experience of a tertiary centre.

Background And Purpose: The management of primary hyperparathyroidism (PHPT) during pregnancy is challenging and there is no clear consensus on whether it increases the risk of complications in pregnancy. We conducted this study to review the maternal and fetal outcomes of pregnant women treated for PHPT in a single centre.

Methods: Data on relevant clinical parameters, demographics, management strategies, maternal and fetal outcomes were collected from the medical records of pregnant patients with PHPT diagnosed between 2012 and 2019.

Parathyroid hormone of ≥1.6 pmol/L at 6 months is associated with recovery in 'long-term' post-surgical hypoparathyroidism.

Objective: Post-surgical hypoparathyroidism (PoSH) usually settles within few months after thyroid surgery, but several patients require long-term supplementation with calcium/activated vitamin D. When PoSH persists beyond 6 months, it is considered 'chronic' or 'permanent', however, late recovery has been reported. The aim of this study was to determine the frequency of late recovery and explore factors predicting late recovery of parathyroid function.

The influence of incidental detection of thyroid nodule on thyroid cancer risk and prognosis-A systematic review.

Background: Clinically inapparent thyroid nodules discovered serendipitously on imaging for nonthyroid indications are termed as thyroid incidentalomas. It is unclear whether these incidentalomas have a lower prevalence of malignancy or slower tumour progression compared to symptomatic nodules. The aims of this systematic review were to determine the impact of incidental detection of thyroid nodules on both the risk of malignancy and on prognosis in patients with thyroid cancer.

Parathyroid cancer: A systematic review of diagnostic biomarkers.

Introduction: Parathyroid cancers are rare and difficult to distinguish from benign parathyroid tumours. Prediction of malignancy often relies on intraoperative assessment of invasion. Standard histology is also inadequate; especially in the absence of local invasion, lymph nodal disease and metastasis.

Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery.

Background: Electrical impedance (EI) measures tissue resistance to alternating current across several frequencies and may help identify tissue type. A recent rabbit model demonstrated that electrical impedance spectroscopy (EIS) may facilitate identification of parathyroid glands and potentially improve outcomes following surgery. This study looks at the EI patterns of soft tissues in the human neck to determine whether parathyroid tissue can be accurately identified.

Acute non-traumatic adrenal haemorrhage-management, pathology and clinical outcomes.

Background: Acute adrenal haemorrhage is a rare medical emergency. The aim of the series was to study the clinical presentation and management of patients presenting with acute non-traumatic adrenal haemorrhage.

Methods: The records of patients presenting with an acute abdomen secondary to adrenal haemorrhage and treated in a tertiary endocrine surgical unit over a period of 6 years were reviewed.