Bridging Distances and Enhancing Care: A Comprehensive Review of Telemedicine in Surgery.

Telemedicine in surgical care has undergone rapid advancements in recent years, leveraging technologies such as telerobotics, artificial intelligence (AI) diagnostics, and wearable devices to facilitate remote evaluation and monitoring of patients. These innovations have improved access to care, reduced costs, and enhanced patient satisfaction. However, significant challenges remain, including technical barriers, limited tactile feedback in telesurgery, and inequities arising from digital literacy and infrastructure gaps.

Understanding the disconnect between lifestyle advice and patient engagement: a discourse analysis of how expert knowledge is constructed by patients with CHD.

Objective: Adherence to healthy lifestyle advice is effective in prevention of non-communicable diseases like coronary heart disease (CHD). Yet patient disengagement is the norm. We take a novel discursive approach to explore patients' negotiation of lifestyle advice and behaviour change.

An unusual cause of bleeding in primary hypothyroidism.

A 10-yr-old female was referred due to prolonged bleeding lasting for a week following tooth extraction. She had heavy periods since she was 9. Her height was < 0.

Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status.

Objectives: To assess whether prodromal symptoms of rheumatoid arthritis (RA), as recorded in the Clinical Practice Research Datalink Aurum (CPRD) database of English primary care records, differ by ethnicity and socioeconomic status.

Methods: A cross-sectional study to determine the coding of common symptoms (≥0.1% in the sample) in the 24 months preceding RA diagnosis in CPRD Aurum, recorded between January 1st 2004 to May 1st 2022.

Preoperative Snack Prescription: A Single-Centre Experience in Optimising Preoperative Fasting Time and Enhancing Guideline Adherence.

Objectives Preoperative fasting plays a pivotal role in adequately preparing patients for anaesthesia and surgical procedures. However, it is imperative to consider not only the medical aspects but also patients' overall comfort, as this can significantly contribute to improved surgical outcome. The primary objective of this quality improvement project (QIP) is to provide healthcare professionals, including anaesthetists, surgeons, nurses, and stakeholders with information regarding insights required to embrace the concept of preoperative snack prescription as a strategy for enhancing patient-centred care.

Case Report: Atypical presentation of non-functional gonadotropinoma.

Gonadotropinoma is the most common non-functional pituitary adenoma comprising 10%-30% of all pituitary adenomas. They are benign slow-growing tumours originating from adenohypophysis and rarely become malignant. Its presentation can be atypical, such as visual disturbance, and most patients presenting to an ophthalmologist for visual correction are eventually found to have a field defect.

Magnetic resonance imaging has a limited role in investigating odynophagia if examination is normal: A binary logistic regression analysis of 484 patients presenting to a tertiary head and neck clinic.

Introduction: Investigation of head and neck cancers places a significant burden on the National Health Service and effective resource allocation is of perpetual importance. Existing risk calculators are designed to stratify the likelihood of underlying malignancy according to symptoms, but are less relevant in secondary care as they do not integrate clinical examination findings (e.g.

An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs.

Backgrounds & Aims: Primary biliary cholangitis (PBC) is a chronic liver disease in which autoimmune destruction of the small intrahepatic bile ducts eventually leads to cirrhosis. Many patients have inadequate response to licensed medications, motivating the search for novel therapies. Previous genome-wide association studies (GWAS) and meta-analyses (GWMA) of PBC have identified numerous risk loci for this condition, providing insight into its aetiology.

X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

Background & Aims: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease.

Methods: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals).

Reasons for non-recruitment of eligible patients to a randomised controlled trial of secondary prevention after intracerebral haemorrhage: observational study.

Background: Recruitment to randomised prevention trials is challenging, not least for intracerebral haemorrhage (ICH) associated with antithrombotic drug use. We investigated reasons for not recruiting apparently eligible patients at hospital sites that keep screening logs in the ongoing REstart or STop Antithrombotics Randomised Trial (RESTART), which seeks to determine whether to start antiplatelet drugs after ICH.

Method: By the end of May 2015, 158 participants had been recruited at 108 active sites in RESTART.

A case report of an 80 year old man with mesenteric panniculitis, a raised lactate and hyperglycaemia.

Introduction: Mesenteric panniculitis is a rare condition which presents as abdominal pain. It involves benign inflammatory or fibrotic changes affecting the mesentery of the bowel.

Presentation Of Case: An 80 year old man presented with severe abdominal pain of acute onset.

Dense calcification in a GH-secreting pituitary macroadenoma.

Unlabelled: A 30-year-old female presented with a history of secondary amenorrhoea, acromegalic features and progressive visual deterioration. She had elevated serum IGF1 levels and unsuppressed GH levels after an oral glucose tolerance test. Magnetic resonance imaging revealed a heterogeneously enhancing space-occupying lesion with atypical extensive calcification within the sellar and suprasellar areas.

Complementary and psychological therapies in a rural hospital setting.

The National Institute for Clinical Excellence (NICE) (2004) in the UK has led the way in recognising the need for a holistic approach to the support and care of people with cancer, with the publication of Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer. This article describes a three-year project, funded by the Big Lottery Fund through Macmillan Cancer Support. The project is being implemented by an art therapist, clinical psychologist, complementary therapist and administrator together with the existing team of three Macmillan nurses, an art therapist and two Macmillan occupational therapists.

The efficacy of plain films vs MRI in the detection of scaphoid fractures.

An investigation was carried out to determine whether or not professionals perceived plain film radiography to be the 'gold-standard' in the detection of scaphoid fractures. Literature highlighted that plain film radiography was an unreliable method for detecting such fractures and that magnetic resonance imaging (MRI) should now be regarded as the new 'gold-standard'. Using a quantitative method, a total of 100 postal questionnaires were sent out to radiologists in 20 different imaging departments throughout the United Kingdom (UK) asking them their opinion on this controversial subject.

New insights into the phylogeny of Entamoeba species provided by analysis of four new small-subunit rRNA genes.

Sequences of small-subunit rRNA genes have been obtained for four new isolates of Entamoeba. Phylogenetic analyses give new insights into the evolution of these organisms. A novel Entamoeba from pigs in Vietnam that produces uninucleate cysts proved to be unrelated to other uninucleated cyst-producing species.

Internal transcribed spacer dimorphism and diversity in Dientamoeba fragilis.

The internal transcribed spacer (ITS) region of the ribosomal RNA operon is frequently used for detecting sequence variation among closely related species as it is usually homogeneous within strains but evolves more rapidly than ribosomal RNA coding regions. We have studied this region in both genotypes of the human intestinal parasite Dientamoeba fragilis. In contrast to most organisms, we have identified extensive variation between copies of the sequence within the same strain.

Plasma purine nucleoside phosphorylase in cancer patients.

Background: Purine nucleoside phosphorylase (PNP) is the purine salvage enzyme that converts guanosine to guanine and inosine to hypoxanthine.

Methods: 279 samples from patients with differing cancers were collected during treatment at both pre- and post-dose stages for plasma PNP activity and compared with a normal population.

Results: Normal plasma PNP activity was found to be 3.

Estimation of guanine deaminase using guanosine as a "prosubstrate".

Plasma guanine deaminase (guanase; GD) is well established as an indicator of hepatocellular disease, recently being applied in the detection of hepatitis C in donor blood and in the diagnosis of hepatoma. No totally efficient, simple method for the estimation of plasma GD activity is routine since both guanine and 8-azaguanine, the substrates of the enzyme, are scarcely soluble in water. This difficulty in preparing stable substrates of sufficient concentration has resulted in methods that are both troublesome and inaccurate.