Defining the Optimal Treatment Strategy in Patients With Uterine Serous Carcinoma.

Aims: Uterine serous carcinoma (USC) is an aggressive subtype of endometrial cancer with high rates of relapse and death. As adjuvant therapy might be beneficial in early-stage disease, the impact of standard complete surgical staging is questioned. Therefore, we wanted to explore the optimal treatment strategy for women diagnosed with USC.

Technical aspects of inguino scrotal hernia surgery in developing countries.

Purpose: Technical aspects of inguinoscrotal herniorrhaphy performed in low to middle income countries (LMICs) are described here to help surgeons who will operate on these challenging hernias in austere settings.

Methods: Technical considerations related to operative repair were delineated with the consensus of 7 surgeons with extensive experience in inguinoscrotal hernia repair in LMICs. Important steps and illustrations were prepared accordingly.

An open-source, expert-designed decision tree application to support accurate diagnosis of myeloid malignancies.

Accurate, reproducible diagnoses can be difficult to make in haemato-oncology due to multi-parameter clinical data, complex diagnostic criteria and time-pressured environments. We have designed a decision tree application (DTA) that reflects WHO diagnostic criteria to support accurate diagnoses of myeloid malignancies. The DTA returned the correct diagnoses in 94% of clinical cases tested.

Granulocytic sarcoma: An uncommon cause of systemic inflammatory response syndrome.

Granulocytic sarcoma rarely arises from adrenal glands. Its necrosis can lead to systemic inflammatory response syndrome (SIRS), causing clinical difficulty in diagnosis without imaging and both biochemical and histological analysis. Compressive effects of the tumor may mask its source, and therefore, prompt resuscitation, symptom control, and investigation are vital in preventing clinical deterioration.

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications.

Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs).

Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as 'night-time' when induction was between 8:00 PM and 7:59 AM.

Relationship of Nocturnal Sleep Dysfunction and Pain Subtypes in Parkinson's Disease.

Background: Little research has been conducted regarding the relationship between sleep disorders and different pain types in Parkinson's disease (PD).

Objective: To explore the influence of the various pain subtypes experienced by PD patients on sleep.

Methods: Three hundred consecutive PD patients were assessed with the PD Sleep Scale-Version 2 (PDSS-2), King's PD Pain Scale (KPPS), King's PD Pain Questionnaire (KPPQ), Visual Analog Scales for Pain (VAS-Pain), and Hospital Anxiety and Depression Scale.

A review of 571 radiographs on Tuffier's inter-cristal line and its' application in lumbar spinal surgery.

Background: Tuffier's line (TL) is an anatomical landmark used to identify the L4/5 interspace by palpating inter-cristal level in lumbar spinal surgery. The routine use of pre-operative pre-incision radiographs for level check by spinal surgeons is variable due to reliance on this palpation. The anatomical violation of neighbouring normal levels in microscope assisted lumbar surgery is unknown.

Validation of the multiplier method for leg-length predictions on a large European cohort and an assessment of the effect of physiological age on predictions.

Purpose: The Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort was used to determine the accuracy of the Paley multiplier method for predicting leg length. Using menarche as a proxy, physiological age was then used to increase the accuracy of the multiplier.

Methods: Chronological age was corrected in female patients over the age of eight years with documented date of first menses.

Faecal calprotectin as a marker for oesophago-gastric cancer.

Background: Faecal calprotectin has been shown to be useful as a non-invasive screening test to differentiate functional from organic bowel disease, and it has been noted to be elevated in colorectal cancer. The aim of this study was to describe concentrations of faecal calprotectin in patients with oesophago-gastric cancer and investigate any potential discriminatory power of the test.

Patients: Faecal calprotectin was measured in samples from 39 patients with known oesophago-gastric cancer and in 191 samples from control subjects.

Extrication time prediction tool.

Background: Many patients will require extrication following a motor vehicle collision (MVC). Little information exists on the time taken for extrication or the factors which affect this time.

Objective: To derive a tool to predict the time taken to extricate patients from MVCs.

Medicinal brandy.

This paper describes the use of brandy and other forms of alcohol in the latter part of the 19th and early 20th centuries. Its prime use was as a cardiac stimulant as it seemed to increase the cardiac output and blood pressure. However it was also recognised as a depressant and was used as a sedative.

A complication of Le Fort I osteotomy.

Le Fort I osteotomy is a routine procedure for oral and maxillofacial surgeons. Following advances in instrumentation and anaesthesia, it is usually carried out safely as an elective procedure in hospitals with no adverse complications. Life-threatening complications are rare although the operation is performed in an area with an extensive vascular supply.

Imaging of Horner's syndrome.

Horner's syndrome, or oculosympathetic paresis, results from interruption of the sympathetic trunk innervation to the eye and presents typically with meiosis, ptosis and facial anhydrosis on the affected side.(1) The pathological process ranges from benign, such as cluster headache, or life threatening, such as lung malignancy. Appropriate imaging requires an anatomical appreciation of the complex and circuitous route the neuronal pathway takes as it passes from the central nervous system to the eye.

Management of colorectal cancer: variations in practice in one hospital.

Aims: The Royal College of Surgeons of England and the Association of Coloproctology of Great Britain and Ireland guidelines for the management of colorectal cancer were published in 1996. We audited our practice against these guidelines.

Methods: Data from 211 consecutive patients undergoing colorectal cancer surgery, between September 1999 and September 2000, have been prospectively collected.

Cytokine gene polymorphisms in acute pancreatitis.

Context: Pro-inflammatory and regulatory cytokines play a key role in the pathogenesis of acute pancreatitis. Genetic loci encoding cytokines have been shown to be polymorphic, in some cases influencing protein expression.

Objective: To investigate if TNF and IL-10 gene loci are associated with the occurrence or severity of acute pancreatitis.

Hereditary multiple glomangiomas.

Hereditary multiple glomangiomas are an interesting rare problem which can either present as multiple painful cutaneous lesions or, rarely, a cosmetic challenge due to site, size or number of lesions. It may also pose a diagnostic dilemma, which can only be settled by biopsy. Malignant change in glomangioma is extremely rare and only a few cases are well documented in literature.

Effect of anti-APO1 on spontaneous apoptosis of B cells in chronic lymphocytic leukaemia: the role of bcl-2 and interleukin 4.

The cell surface protein apolipoprotein 1 (APO1) is expressed on various cell types including malignant lymphoid cells. Triggering of APO1 protein with antibody (Ab) induces apoptosis in APO1-expressing cells. We examined the effect of anti (alpha) APO1 Ab on spontaneous apoptosis (SA) and bcl-2 expression in B cell chronic lymphocytic leukaemia (B-CLL) in vitro.