Trends in the surgical management of proximal humerus fractures over the last 20 years from Australian registry databases.

Background: Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.

Preoperative coagulopathy and blood transfusion requirements in children with intraventricular lesions undergoing neurosurgery: a retrospective cohort study.

Purpose: Pediatric patients undergoing neurosurgery pose risk of perioperative hemorrhage and clotting dysfunction which is increased in tumors with high vascularity, endothelial exposure, and necrosis. Lesions affecting the ventricular system may arise from several etiologies, including rare tumors. The present study aimed to study the preoperative coagulation and transfusion profile of pediatric patients undergoing neurosurgery for intraventricular lesions.

A comparative analysis of a central metaphyseal humeral fixation stemless shoulder arthroplasty to an anatomic shoulder arthroplasty in a national registry cohort.

Background: This study aimed to determine the revision outcome between a centrally fixed stemless anatomic design and other total anatomic shoulder replacements using data from a large national arthroplasty registry.

Methods: The study period was from December 2011 to December 2022 and included three cohorts; primary Affinis stemless anatomic (AFS), all other primary total stemless anatomic (sTSA) and primary total stemmed anatomic shoulder arthroplasty (aTSA). The endpoint was all-cause revision using cumulative percent revision (CPR).

Resuscitation in Paediatric Septic Shock Using Vitamin C and Hydrocortisone (RESPOND): The RESPOND Randomized Controlled Trial Protocol.

Objectives: Pediatric sepsis results in significant morbidity and mortality worldwide. There is an urgent need to investigate adjunctive therapies that can be administered early. We hypothesize that using vitamin C combined with hydrocortisone increases survival free of inotropes/vasopressors support until day 7 compared with standard care.

Surprise Baby: Abdominoplasty Performed During Unknown Pregnancy.

Abdominoplasty is a commonly performed procedure for patients after significant weight loss and in postpregnancy women. Stable weight and completed family planning are critical for optimal outcomes, as pregnancy postabdominoplasty can increase risks for both mother and fetus and potentially compromise aesthetic results. We present the first reported case of a patient undergoing abdominoplasty while unknowingly pregnant.

Trends, characteristics, and circumstances surrounding stimulant toxicity deaths in Ontario, Canada from 2018 to 2021.

Introduction: As the drug toxicity crisis continues to evolve globally, harms related to non-opioid substances, including stimulants, have risen in parallel. Our study aims were to describe trends in accidental stimulant toxicity deaths and to characterize demographic characteristics of decedents and the circumstances surrounding death.

Methods: We conducted a population-based repeated cross-sectional study, of all accidental stimulant toxicity deaths between January 1, 2018, and December 31, 2021, in Ontario, Canada.

Increasing Trends in the Pancreatitis Risk With Tumor Necrosis Factor Inhibitor Use.

Tumor necrosis factor (TNF) inhibitors are a class of pharmacologic agents used to treat a wide range of immunologic diseases. We present a systematic study of the pancreatitis risk with TNF inhibitor use through a retrospective case-control design disproportionality analysis of the U.S.

Availability of eye health interventions in basic schools in a Ghanaian municipality.

Introduction: Globally, 19 to 22 million children are visually impaired. A huge number of children therefore will not be able to learn effectively even if the best educational institutions are made available to them. This ultimately leaves a potential negative effect on their quality of life, educational opportunities and livelihoods.

Global collaboration between platform trials in surgery and anaesthesia.

Large, randomised trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.

Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA.

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT).

ALKBH1: emerging biomarker and therapeutic target for cancer treatment.

As neoplastic cells proliferate, disseminate, and infiltrate, they undergo substantial alterations in their epigenetic configuration. Among the pivotal enzymes implicated in this phenomenon is the AlkB family of demethylases, notably AlkB homolog 1 (ALKBH1), which demonstrates conspicuous upregulation across various malignancies. The heightened expression of ALKBH1 renders it a compelling candidate for the development of multifaceted anticancer modalities.

A Systematic Review of Multimodal Analgesic Effectiveness on Acute Postoperative Pain After Adult Cardiac Surgery.

Aim: To synthesise the best available empirical evidence about the effectiveness of multimodal analgesics on pain after adult cardiac surgery.

Design: A systematic review with meta-analysis.

Methods: Indexed full-text papers or abstracts, in any language, of randomised controlled trials of adult patients undergoing cardiac surgery investigating multimodal postoperative analgesic regimen effect on mean level of patient-reported pain intensity at rest.

Smart medical report: efficient detection of common and rare diseases on common blood tests.

Introduction: The integration of AI into healthcare is widely anticipated to revolutionize medical diagnostics, enabling earlier, more accurate disease detection and personalized care.

Methods: In this study, we developed and validated an AI-assisted diagnostic support tool using only routinely ordered and broadly available blood tests to predict the presence of major chronic and acute diseases as well as rare disorders.

Results: Our model was tested on both retrospective and prospective datasets comprising over one million patients.

Dual antiplatelet therapy after minor strokes or high-risk TIA: Evidence from the Austrian stroke registry.

Background And Purpose: Three large, randomized trials demonstrated the benefit of short-term dual antiplatelet therapy (DAPT) versus monotherapy after non-cardioembolic minor stroke or high-risk transient ischemic attack (TIA). The aim of this study was to evaluate effects of DAPT versus monotherapy on functional outcomes and safety in a real-life setting.

Methods: Patients with minor stroke (NIHSS <4) or high-risk TIA (ABCD2 score ≥4) of non-cardioembolic origin without major vessel occlusion or revascularization therapy (thrombolysis or thrombectomy) treated between 2018 and 2023 were analyzed based on a prospective nationwide stroke unit registry.

'QuickDASH' to find unique genes and biological processes associated with shoulder osteoarthritis: a prospective case-control study.

Objective: Osteoarthritis (OA) is a disease impacting the synovial joint complex, yet transcriptional changes specific to shoulder OA remain underexplored. This study aims to profile transcriptomic changes in periarticular tissues from patients undergoing shoulder replacement for OA. By correlating these profiles with QuickDASH scores-a validated measure of worsening shoulder function-this research seeks to understand the gene expression changes associated with clinical decline.

Brain volumes, cognitive, and adaptive skills in school-age children with Down syndrome.

Background: Down syndrome (DS) is the most common congenital neurodevelopmental disorder, present in about 1 in every 700 live births. Despite its prevalence, literature exploring the neurobiology underlying DS and how this neurobiology is related to behavior is limited. This study fills this gap by examining cortical volumes and behavioral correlates in school-age children with DS.

Global collaboration between platform trials in surgery and anaesthesia.

Large, randomized trials are the bedrock of evidence-based medicine, but the resources required to complete such trials greatly limit the number of important clinical questions that can be addressed within a reasonable period of time. Adaptive platform trials can identify effective, ineffective, or harmful treatments faster. These trials have been shown to deliver rapid evidence through the COVID-19 pandemic and are now being adopted across surgery and anaesthesia, with many opportunities for surgeons, anaesthetists, and other perioperative physicians to conduct and collaborate in platform trials.

Sonographic Assessment of Isthmocele and Its Obstetric Complications in Subsequent Pregnancies: A Pictorial Review.

Cesarean scar defect represents a significant pathology attributed to the rising prevalence of cesarean deliveries. While not commonplace, these lesions can give rise to severe obstetric consequences during subsequent pregnancies. Given the potential complications, it is advisable to screen for uterine niches using transvaginal ultrasound (TVUS) or contrast-enhanced TVUS for individuals planning to conceive.

Pelvic congestion syndrome: Not all pelvic pain is gynaecological.

Background: Chronic pelvic pain is a debilitating but common syndrome that is a burden both for patients and health systems. Pelvic congestion syndrome (PCS) contributes to 30-40% of patients presenting with chronic pelvic pain where no other cause is identified. However, PCS is poorly understood, underdiagnosed and undertreated, with the average time to diagnosis being reported as up to four years after initial presentation.

Management, outcomes and predictors of mortality of Cryptococcus infection in patients without HIV: a multicentre study in 46 hospitals from Australia and New Zealand.

Background: Limited data exist regarding outcomes of cryptococcosis in patients without HIV with few studies having compared outcomes of Cryptococcus gattii, versus C. neoformans, infection.

Methods: We conducted a retrospective study in 46 Australian and New Zealand hospitals to determine the outcomes of cryptococcosis in patients without HIV diagnosed between 2015 and 2019, and compared outcomes of C.

Factors influencing confidence in tracheal intubation among neonatal trainees: A questionnaire-based study.

Aim: Tracheal intubation (TI) is pivotal in managing critically ill neonates. This study aims to investigate the disparities in exposure and training techniques that affect self-perceived confidence in neonatal fellows concerning TI.

Methods: A comprehensive, structured questionnaire-based survey was conducted among neonatal trainees from October to November 2022.