Targeting P21-Activated Kinase 2 as a Novel Therapeutic Approach to Mitigate Endoplasmic Reticulum Stress in Heart Failure With Preserved Ejection Fraction.

Background: Heart failure with preserved ejection fraction (HFpEF) is linked to prolonged endoplasmic reticulum (ER) stress. P21-activated kinase 2 (Pak2) facilitates a protective ER stress response. This study explores the mechanism and role of Pak2 in HFpEF pathology.

Parastomal Varices as an Atypical Source of Bleeding From a Urostomy in a Patient With Alcoholic Liver Disease.

Parastomal varices are an uncommon but significant source of hemorrhage in patients with portal hypertension, often posing diagnostic and therapeutic challenges. We report the case of a 73-year-old male with a history of alcoholic liver disease and a urostomy following cystoprostatectomy for bladder cancer. The patient presented with profuse bleeding from his urostomy site.

Hydroxychloroquine in combination with platinum doublet chemotherapy as first-line treatment for extensive-stage small cell lung cancer (Study 15): A randomised phase II multicentre trial.

Background: Most patients with small-cell lung cancer (SCLC) present with extensive-stage (ES) disease and have a poor prognosis despite achieving high initial response rates to platinum-based doublet chemotherapy. This study evaluated whether adding hydroxychloroquine (HCQ) to chemotherapy could improve outcomes.

Methods: This was a randomised multicentre phase II trial.

An Unusual Presentation of Urinary Retention in a Young Male Patient With Neurofibromatosis Type 1.

Acute urinary retention (AUR) in young adults is an uncommon presentation often signalling an underlying pathology, particularly when associated with genetic conditions like neurofibromatosis type 1 (NF1). We report the case of a 25-year-old male with a known family history of NF1, who presented with acute urinary retention and progressive pelvic pain. Physical examination was notable for axillary freckling and café-au-lait spots, consistent with NF1.

Analgesic Effect of Caudal and Abdominal Nerve Blocks among Children Undergoing Inguinal Surgeries: An Original Research.

Context: Pediatric inguinal surgeries sometimes cause considerable post-operative pain that requires effective analgesics. Caudal and abdominal nerve blocks may help this population with pain. It is uncertain how successful they are compared.

Have changes in colorectal surgery training impacted on mortality in cancer patients? A retrospective cohort study of 51,562 procedures.

Introduction: The aim of this study was to explore whether there were any differences in consultant colorectal surgeon training and adjusted 90-day postoperative colorectal cancer mortality rates (AMR).

Methods: We undertook a retrospective analysis of outcomes data published on the Association of Coloproctology of Great Britain and Ireland (ACPGBI) website. A total of 51,562 procedures for patients in England diagnosed with large bowel cancer between 2010 and 2015, registered under 551 consultants were included.

Comparing the Efficacy of Povidone-Iodine Versus Normal Saline in Laparotomy Wound Irrigation to Prevent Surgical Site Infections: A Meta-Analysis.

Surgical site infections (SSIs) are a known complication of laparotomies and intra-abdominal surgical operations leading to remarkable consequences on mortality, morbidity, and expenses. The study aims to assess the efficiency of irrigating laparotomy incision sites with povidone-iodine (PVI) or normal saline (NS) in diminishing the rate of SSIs in patients undergoing gastrointestinal operations for varying indications. Randomized controlled trials (RCTs) highlighting the contribution of laparotomy wound irrigation with PVI in opposition to NS in patients planned for laparotomy addressing numerous gastrointestinal issues, and their role in reducing SSI risk were obtained via searching of standard electronic medical databases.

Comparing Thoracic Epidural Anaesthesia to Rectus Sheath Catheter Analgesia for Postoperative Pain After Major Abdominal Surgeries: A Systematic Review.

Controlling postoperative pain is essential for the greatest recovery following major abdominal surgery. Thoracic epidural analgesia (TEA) has traditionally been considered the preferred method of providing pain relief after major abdominal surgeries. Thoracic epidural analgesia has a wide range of complications, including residual motor blockade, hypotension, urine retention with the need for urinary catheterisation, tethering to infusion pumps, and occasional failure rates.

Evaluating the Safety and Outcomes of Oesophagogastroduodenoscopy in Elderly Patients Presenting With Acute Upper Gastrointestinal Bleeding.

Aims: In the absence of evidence-based guidelines regarding the safety and appropriateness of emergency endoscopy in elderly, co-morbid and frail patients, we aimed to find clinical outcomes in elderly patients who have undergone gastroscopy following an acute upper gastrointestinal bleeding (UGIB).

Methods: We carried out a retrospective observational study of patients aged 70 years and older who had undergone emergency oesophagogastroduodenoscopy (OGD) at the Royal Sussex County Hospital, Brighton, United Kingdom, between May 2020 and January 2022. Data collected for analysis included Glasgow-Blatchford score, age, gender, endoscopic findings, endoscopic treatments, immediate complications, 90-day complications, 30-day and 90-day survival, length of hospital stay and re-bleeding.

Rupture of Anterior Cruciate Ligaments and the Lever Test in Diagnosis: A Critical Review.

Anterior Cruciate Ligament (ACL) rupture is known to be one of the most common musculoskeletal injuries in active individuals especially athletes. Approximately 200.000 ACL injuries occur every year of which 100,000 require surgery.

The British Orthopaedic Oncology Management (BOOM) audit.

Aims: Most patients with advanced malignancy suffer bone metastases, which pose a significant challenge to orthopaedic services and burden to the health economy. This study aimed to assess adherence to the British Orthopaedic Oncology Society (BOOS)/British Orthopaedic Association (BOA) guidelines on patients with metastatic bone disease (MBD) in the UK.

Methods: A prospective, multicentre, national collaborative audit was designed and delivered by a trainee-led collaborative group.

A Case of Intramuscular Lipoma of Thenar Eminence With a Short Review of Published Hand Lipoma Case Reports.

Lipoma is a common soft tissue tumour in the human body, but at the same time is very rare in the palm and rarer still in the thenar region. These lipomas in the hand can give rise to various problems such as cosmetic, functional, and neurological compromise among others and removing them becomes important when symptomatic. Diagnosing a hand pathology becomes important as a missed diagnosis can have long-term functional consequences for a patient.

Delay in loop ileostomy reversal surgery does not impact upon post-operative clinical outcomes. Complications are associated with an increased loss of microflora in the defunctioned intestine.

Loop ileostomy is a common surgical procedure to allow downstream tissue healing, with the aim of re-joining the bowel approximately 12 months later. The reversal procedure is associated with a substantial morbidity up to 40%. Our previous research demonstrated that defunctioned ileum becomes atrophied, with extensive microbial dysbiosis.

A scoping review of clinical practices and adherence to UK national guidance related to the placement and position confirmation of adult nasogastric feeding tubes.

Introduction: The administration of nutrition or medication into the lungs or pleura via a misplaced nasogastric feeding tube is considered a never event. Despite guidance from the National Patient Safety Agency and NHS Improvement this never event is regularly reported. Confirmation of correct placement and correct use of nasogastric tubes requires appropriate actions and decisions by a multidisciplinary team.

Complications associated with lumbar discectomy surgical techniques: a systematic review.

Background: Open discectomy (OD) and microdiscectomy (MD) are routine procedures for the treatment of lumbar disc herniation. Minimally invasive surgery (MIS), such as micro-endoscopic discectomy (MED) and full endoscopic discectomy (FED), offers potential advantages (less pain, less bleeding, shorter hospitalisation and earlier return to work), but their complications have not yet been fully evaluated. The aim of this paper was to identify the frequency of these complications with a focus on MIS in comparison to OD/MD.

Non-surgical Management of an Acute Isolated Volar Dislocation of the Distal Radioulnar Joint.

Introduction: Isolated distal radioulnar joint dislocations are rare and commonly missed on radiographs. Knowledge of the management of these injuries, therefore, has room for improvement. We present a case with an alternative method of closed reduction.

Calcaneocuboid capsuloligamentous soft-tissue entrapment: a rare cause of acquired equinovarus deformity.

Acquired equinovarus deformity is rare, with most cases related to congenital disorders such as clubfoot. We describe a unique case of traumatic capsuloligamentous soft-tissue entrapment within the calcaneocuboid joint in a 13-year-old girl, causing an acquired equinovarus deformity. This required surgical exploration and joint fixation.

Neonatal venolymphatic malformation with spontaneous parotid duct rupture: first case report.

Disorders of salivary glands especially the parotid gland very rare among neonates and children other than cytomegaly and parotitis epidermica. Venolymphatic malformations are very rare in children. Such presentation around the parotid region yet to be reported.

Analysis of postoperative complications following elective arthroscopic surgeries of the knee- a retrospective cohort study.

Background: Since their introduction, arthroscopic procedures have been increasingly utilized for the treatment of knee pathologies, especially Anterior Cruciate Ligament (ACL) reconstruction. Reduction of post-operative morbidity, shortened hospital stay and recovery period have all been identified as the benefits of arthroscopy. However, despite tremendous increase in the number of these procedures done, the postoperative complications associated have been infrequently analyzed.

Thigh Abscess as an Uncommon Complication of Left-Sided Colonic Diverticulitis and the Pitfalls in Treatment: An Interesting Case Report.

Colonic diverticulitis is one of the common causes of surgical intervention in general surgical practice. In most cases, surgical intervention depends on the presence of a collection around the sigmoid colon, the feasibility of percutaneous drainage, and the patient's medical condition. The collection can occur in the thigh in rare cases due to a fistulous communication with the retroperitoneum and can track gravitationally along the psoas muscle into the thigh and leg without any discernible collection around the sigmoid colon or in the abdominal cavity.

Dynamic Hip Screw Plate Length in Stable Intertrochanteric Fracture Neck of Femur: A Systematic Review.

There has always been a debate between the use of four and two-hole plate for the fixation of stable intertrochanteric fractures. The choice is usually influenced by the general practice of the particular institution and the surgeon's preference. While the dynamic hip screw (DHS) is the implant of choice for stable intertrochanteric fractures of the femur, the length of the side plate to be chosen for optimal results has no clear consensus and previous studies regarding the same have been inconclusive.

Pneumomediastinum and subcutaneous emphysema post cocaine and amphetamine insufflation.

A 20-year-old gentleman presented with blood-streaked vomitus after insufflation of an unknown amount of powder cocaine and amphetamine. This was taken with an unspecified amount of alcohol. Other notable symptoms were dysphagia, chest pain, palpitations and the patient reported a 'crunchy' sensation in his chest.

Urinary retention secondary to bladder herniation in the inguinal canal - Case report and review of literature.

Bladder herniation in the inguinal canal is a rare occurrence, reported for the first time in 1951 as Scrotal Cystocele. Most cases are incidental intraoperative findings, with no particular manifestation. Few reports of symptomatic patients have been documented in literature.

A hierarchical Bayesian approach for detecting global microbiome associations.

The human gut microbiome has been shown to be associated with a variety of human diseases, including cancer, metabolic conditions and inflammatory bowel disease. Current approaches for detecting microbiome associations are limited by relying on specific measures of ecological distance, or only allowing for the detection of associations with individual bacterial species, rather than the whole microbiome. In this work, we develop a novel hierarchical Bayesian model for detecting global microbiome associations.