Oncological and Clinical Impacts of Routine Splenic Flexure Mobilization in Anterior Resection.

Background Splenic flexure mobilization (SFM) is widely regarded as one of the most challenging steps in laparoscopic and robotic colorectal surgery, sparking ongoing debate. Some surgeons routinely advocate for SFM, citing its role in achieving greater left colonic reach, which facilitates a safe, tension-free, and well-vascularized anastomosis while adhering to oncological principles. Conversely, others argue that SFM does not consistently ensure these benefits and may increase the risk of complications, including splenic, bowel, or vascular injuries, as well as unnecessarily prolonging the procedure.

Medial posterior tibial slope measurements are overestimated on long radiographs and 3D CT compared to measurements on short lateral radiographs.

Purpose: This study assessed the measurements of the medial posterior tibial slope (MPTS) using long radiographs and three-dimensional (3D) computed tomography (CT) scans and compared them to measurements taken on short lateral knee radiographs. The study aimed to identify whether the at-risk slope measurements previously defined on the short radiographs would be similar to long radiographs and 3D CT scans.

Methods: A retrospective radiological review of 52 cases, who underwent planning for a slope-changing high tibial osteotomy and had short and long lateral radiographs and 3D CT scans of the tibia.

Developing a Curriculum for Trauma and Orthopaedic Higher Surgical Trainees: Implementing Small Group Teaching in a Regional Programme.

Introduction Small group teaching strategies have been considered more efficient than didactic lectures in motivating trainees. There is a lack of studies focusing on the use of small group discussions for higher surgical training. The aims of the current study were to report the implementation of small group teaching and to move away from didactic lectures for a regional trauma and orthopaedics higher surgical trainee teaching programme.

Assistance systems for patient positioning in radiotherapy practice.

Effective radiotherapy for cancer treatment requires precise and reproducible positioning of patients at linear accelerators. Assistance systems in digitally networked radiotherapy can help involved specialists perform these tasks more efficiently and accurately. This paper analyses patient positioning systems and develops new knowledge by applying the Design Science Research methodology.

Long-term safety and efficacy of fitusiran prophylaxis, and perioperative management in people with hemophilia A or B.

Fitusiran is an investigational small interfering RNA therapeutic that targets antithrombin (AT) to rebalance hemostasis in people with hemophilia. Here we present the results of the completed Phase 2 open-label extension study, which evaluated the long-term safety and efficacy of fitusiran in participants with moderate or severe hemophilia A or B, with or without inhibitors. Male participants who had completed the Phase 1 study (NCT02035605) were enrolled.

Predicting and managing intra-abdominal collections by image guided percutaneous drainage after cytoreductive surgery and hyperthermic intra peritoneal chemotherapy: A five-year experience with 1313 patients.

Introduction: Intraabdominal collections (IACs) are common following cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Inflammatory biomarkers and nutritional index (NI) may predict IACs. Management of IACs with image guided percutaneous drainage (IGPD) is an alternative to laparotomy.

Osteoporosis and Rheumatoid Arthritis: A Review of Current Understanding and Practice.

This review presents a current perspective on the association between rheumatoid arthritis (RA) and osteoporosis. Many factors contribute to the increased risk of osteoporosis and fracture in RA patients. These factors include advanced age, duration of disease, long-term glucocorticoid use, and poor inflammation control inflammation in RA.

Acute Lisfranc injury management.

Lisfranc injuries were previously described as fracture-dislocations of the tarsometatarsal joints. With advancements in modern imaging, subtle Lisfranc injuries are now more frequently recognized, revealing that their true incidence is much higher than previously thought. Injury patterns can vary widely in severity and anatomy.

Taking a systems approach to promote posttraumatic growth: A position paper.

As health systems emerge from the pandemic, academic medical centres are motivated to have a healthy and resilient workforce. In the face of the collective traumas of the pandemic, we took a systems approach to infuse wellness into our culture by modelling collective recovery in a non-traditional town hall. Over a dozen senior leaders, faculty, staff, and students shared their personal experiences in a virtual forum, nearly 1000 attendees communally supported one another.

A systematic review of simulation methods applied to cancer care services.

There is significant potential for Operational Research to support improvements in care services for cancer patients. In this systematic review, we examine computer simulation techniques used in supporting hospital-based cancer care, the type of problems addressed, the quality of the model and implementation, and the impact on patients. We identified 51 papers distributed between four problem types: patient flow/pathway modelling, scheduling, cost analysis, and resource allocation.

Point-of-Care Ultrasound of the Urinary Tract.

Point-of-care ultrasound (POCUS) provides immediate and useful information that aids clinical decision making at the bedside. The purpose of this article is to describe how POCUS can be integrated in the evaluation of the urinary system. In the first section, the authors aim to describe image acquisition and typical sonoanatomy of the kidney and bladder.

UKHCDO gene therapy taskforce: Guidance for implementation of haemophilia gene therapy into routine clinical practice for adults.

Introduction: 2022 was a landmark year with two adeno-associated viral vectors (AAVs) receiving conditional marketing authorization from EMA for the treatment of persons with severe haemophilia A and severe to moderately severe haemophilia B and a third in 2024. Gene therapy is a transformative, irreversible treatment with long-lasting effects, necessitating development of new clinical pathways to ensure optimal outcomes.

Aim: To develop a consensus framework and service specification for delivery of AAV gene therapy for haemophilia in adults within the UK using the hub-and-spoke model proposed by the European Association of Haemophilia and Allied Disorders and the European Haemophilia Consortium.

Screening doctors in training for dyslexia: the benefits of an inclusive screening approach.

There is a lack of suitable screeners for dyslexia for doctors in training, as the typical adult screeners do not cater for the needs of capable medical graduates. The aim of this research is to create an inclusive screening and training process for doctors with undiagnosed dyslexia. This involved working with doctors to co-create a new dyslexia screener tool.

Spontaneous Coronary Artery Dissection in a Patient With a Single Coronary Artery.

Spontaneous coronary artery dissection (SCAD) is an uncommon non-atherosclerotic etiology of acute coronary syndrome (ACS) characterized by the formation of a false lumen inside the arterial wall, resulting in sudden occlusion of blood flow without any trauma or intervention. The pathogenesis of SCAD is not completely understood, and the association between coronary artery anomalies and SCAD remains unclear. This case study reports a unique occurrence of non-ST-elevation myocardial infarction (NSTEMI) in a 43-year-old female patient.

Nanoparticle-Based Therapies for Cardiovascular Diseases: A Literature Review of Recent Advances and Clinical Potential.

Cardiovascular diseases (CVDs) present a significant global health burden and remain the leading cause of morbidity and mortality worldwide. Conventional pharmacological therapies have yielded limited success in addressing the underlying pathophysiology of these diseases, leading to the exploration of novel therapeutic approaches. Nanotechnology is transforming cardiovascular disease management by enabling the engineering of materials at the atomic and molecular levels.

Clinical Impact of Somatic Genomic Testing on Breast Cancer Care.

Developments in our understanding of the molecular biology of breast cancer have had a direct impact on the investigations needed to provide optimal breast cancer care. Somatic genomic tests are now used routinely to inform decisions regarding adjuvant chemotherapy use in selected early breast cancer patients, and to identify patients with advanced disease who can potentially benefit from novel targeted agents. In this overview, we describe the somatic genomic tests currently available within the National Health Service (NHS) for early and advanced breast cancer patients.

Paroxysmal Atrial Fibrillation as the First Presentation of Coronary Artery Spasm.

Atrial fibrillation (AF) is a common arrhythmia with increasing incidence and prevalence, associated with increased morbidity and mortality. The list of predisposing factors is extensive and includes coronary artery disease (CAD) as a significant trigger. Coronary spasm, an uncommon form of CAD, can very rarely present with AF.

Predicting the Antifungal Activity of Small Organic Compounds on Mold using Molecular Dynamics Simulations.

Atomistic models of the plasma membrane of the pathogenic mold are developed. These models are described with an empirical molecular mechanical (MM) force field in combination with molecular dynamics (MD) simulations. The solvated plasma membrane models are brought into contact with 35 small organic compounds to observe their impact on a variety of membrane properties.

Adjudication of Hospitalizations and Deaths in the IRONMAN Trial of Intravenous Iron for Heart Failure.

Background: Patients with heart failure and iron deficiency have diverse causes for hospitalization and death that might be affected by iron repletion.

Objectives: The purpose of this study was to explore causes of hospitalizations and deaths in a randomized trial (IRONMAN) of heart failure comparing intravenous ferric derisomaltose (FDI) (n = 568) and usual care (n = 569).

Methods: Patients with heart failure, left ventricular ejection fraction ≤45%, and either transferrin saturation <20% or serum ferritin <100 μg/L were enrolled.

Targeted Genetic Sequencing Analysis of 223 Cases of Pseudomyxoma Peritonei Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Shows Survival Related to GNAS and KRAS Status.

Background And Aim: Pseudomyxoma peritonei (PMP) is an unusual condition with unique behaviour caused by a mucinous neoplasm, usually arising from the appendix. The aim of this study was to evaluate the prevalence of genomic alterations in clinical specimens of PMP using a targeted assay and correlate the findings with clinical, pathological and outcome data. Sequencing data from 223 patients were analysed.

Methylphenidate differentially alters corticostriatal connectivity after traumatic brain injury.

Traumatic brain injury commonly impairs attention and executive function, and disrupts the large-scale brain networks that support these cognitive functions. Abnormalities of functional connectivity are seen in corticostriatal networks, which are associated with executive dysfunction and damage to neuromodulatory catecholaminergic systems caused by head injury. Methylphenidate, a stimulant medication that increases extracellular dopamine and noradrenaline, can improve cognitive function following TBI.