[How to deal with unexplained dyspnoea].

Unexplained dyspnoea is defined as a chronic (≥ 3 months) and significant (mMRC ≥ 2) dyspnoea without a diagnosis after clinical examination, chest X-ray, biological work-up and electrocardiogram. This condition affects 15 % of patients with dyspnoea and is associated with prolonged diagnostic delay and difficulties in patient referral. This article presents the definition and epidemiology of unexplained dyspnoea, as well as the useful elements of the history and clinical examination.

[COMISA: co-morbid insomnia and sleep apnea].

Obstructive sleep apnea (OSA) is a frequent pathology with clinical implications. Its comorbidity with the complaint of insomnia is common, and has been increasingly studied in recent years, due to the multiple negative synergies highlighted by these two conditions, notably on all-cause excess mortality, cardiovascular risk, quality of life and sleep, as well as mental health. This comorbidity between insomnia and sleep apnea has recently been referred to as COMISA («co-morbid insomnia and sleep apnea»).

Impact of Gender-confirming Chest Surgery on Sexual Health: A Prospective Study.

Background: Few studies have evaluated the improvement of the sexual well-being of transgender patients after breast augmentation or bilateral mastectomy. This prospective study aims to assess the potential improvement in body awareness during sexual intercourse, as well as the nipple-areolar complex (NAC) sensitivity recovery after gender-confirming chest surgery.

Methods: From October 2019 up to April 2021, all transgender patients eligible for gender-confirming chest surgery in our institution were asked to fill out two questionnaires, namely BREAST-Q (a patient-reported outcome measure for use in reconstructive breast surgery and clinical practice) and Body Exposure during Sexual Activities Questionnaire (scientifically validated self-report assessments of body-image experiences in the context of sexual relations).

A New Non-Invasive Method for Positioning a Below-Knee Amputee with an Ipsilateral Intertrochanteric Fracture on a Traction table: A Case Report and Mini Review.

Introduction: Proximal femur fractures in below-knee amputees pose significant surgical challenges due to difficulties in positioning and stabilizing the residual limb for fracture reduction. In the current literature, there is no consensus on the optimal management strategy, but the inverted boot positioning method seems to be an adequate and non-invasive technique. However, in our case, this method was not possible due to limited knee flexion, so we describe our technique and compare the different modalities described in the literature, highlighting their advantages and disadvantages.

The Effects of Systemic Tranexamic Acid Administration on Drainage Volume, Duration of Drain Placement, and Length of Hospital Stay in Skin- and Nipple-Sparing Mastectomies with Immediate Expander-Based Breast Reconstruction.

: Skin- (SSM) and nipple-sparing (NSM) mastectomies are frequently performed surgeries with a considerable risk for post-operative hematoma or seroma. Tranexamic acid (TXA) is a potent antifibrinolytic drug commonly used in many surgical fields but rather novel in plastic and, specifically, breast surgery. This study investigates the influence of TXA in patients undergoing SSM or NSM with expander-based reconstruction (EbR) on post-operative outcomes.

Cancer Therapy-Induced Encephalitis.

Encephalitis associated with cancer therapies is a rare but serious complication that can significantly impact patients' quality of life and it requires prompt identification and management. Over the past two decades, immunotherapy-particularly immune checkpoint inhibitors-has become a cornerstone of cancer treatment, with up to half of metastatic cancer patients in economically developed countries now receiving these therapies. The widespread adoption of immunotherapy has led to improved survival rates and long-term remissions, even in patients with advanced metastatic disease.

Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms.

Purpose: The objectives of the study were to evaluate the validity of intraoperative flash visual evoked potentials (VEPs) when electroretinograms (ERGs) were unstable, to compare white versus red light-emitting diodes, and to assess the impact of luminance on ERG variability.

Methods: Thirty patients were included (Inomed system; pre- and postoperative visual fields). Possible changes in visual fields were assessed with mean defects in perimetry.

Abscopal effect induced by cryoablation in a 55-year-old patient with metastatic dedifferentiated liposarcoma: a case report.

Background: Metastatic dedifferentiated liposarcoma (DDLPS) is primarily managed with chemotherapy, yet with poor response rate. Locoregional therapies, such as radiotherapy and percutaneous cryoablation, can provide palliation for inoperable metastatic sarcomas. In rare instances, those ablative therapies can elicit an immune-mediated regression of untreated metastases in a process named the abscopal effect.

[Acute abdominal pain in general practice].

Acute abdominal pain (AAP) represents the 9th most common complaint in general practice. The etiologies are multiple: a third are non-specific, but around 10% require hospital treatment. An accurate history enables a correct diagnosis in 76% of cases, and abdominal palpation can detect a possible surgical abdomen.

[Prostate cancer screening : to be recommended in 2024?].

The Prostate Specific Antigen (PSA) blood test is still the only screening tool for prostate cancer. It is recommended between the ages of 50 and 69 as part of a shared decision making process between a patient and his or her doctor using a decision aid, as the test carries a significant risk of overdiagnosis. If a patient wishes to be screened, either because he is at higher risk, or because he places greater importance on a modest reduction in cancer-related mortality, the frequency of screening depends on his age, family history, and whether he is part of a high-risk group.