International Alliance of Urolithiasis (IAU) guidelines on the management of pediatric urolithiasis.

The aim of this study was to construct the sixth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the management of pediatric patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of literature in the PubMed database from January 1952 to December 2023. Each generated recommendation was graded using a modified GRADE methodology.

Understanding implementation of a complex intervention in a stroke rehabilitation research trial: A qualitative evaluation using Normalisation Process Theory.

Background: The Implicit Learning in Stroke study was a pilot cluster randomised controlled trial, investigating the use of different motor learning strategies in acute stroke rehabilitation. Participating Stroke Units (n = 8) were from the South East/West regions of the UK, with the experimental intervention (implicit learning) being delivered by clinical teams. It required therapists to change how they gave instructions and feedback to patients during rehabilitation.

Occult penile fracture: An atypical presentation.

Penile fracture is a urological emergency. Most cases are under reported due to social stigma. It is caused by rupture of the tunica -albuginea of corpora cavernosa.

Supine percutaneous nephrolithotomy in a 9-month infant.

Treatment of nephrolithiasis in infants is challenging. There are no separate guidelines for the management of renal stones in infants. There is a recent surge in doing PCNL in supine position.

Bilateral simultaneous RIRS for calculus anuria in a 4 months male baby.

Treatment of pediatric stone disease is a challenge, more so, in the case of infants. Infantile anuria due to calculus disease is rare, as pre-renal causes predominate. Retrograde intrarenal surgery is a less often sorted modality in infants, due to the lingering skepticism regarding handling pediatric ureters and urethra.

Investigating the prevalence of anxiety and depression in people living with patellofemoral pain in the UK: the Dep-Pf Study.

Background and aims Patellofemoral pain (PFP) is a common knee condition causing pain around or behind the kneecap which is exacerbated by certain activities. Traditionally it has been viewed as a self-limiting condition. Recent research proves this is not the case and the evidence for poor long-term outcomes is growing.

Determinants of breast cancer early detection for cues to expanded control and care: the lived experiences among women from Western Kenya.

Background: Estimately, 70-80% of cancer cases are diagnosed in late stages in Kenya with breast cancer being a common cause of mortality among women where late diagnosis is the major ubiquitous concern. Numerous studies have focused on epidemiological and health policy dynamics essentially underestimating the determining factors that shape people's choices and cues to health care service uptake. The study sought to evaluate the knowledge, attitude and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies.

EZH2 promotes invasion and metastasis of laryngeal squamous cells carcinoma via epithelial-mesenchymal transition through H3K27me3.

Enhancer of Zeste Homolog 2(EZH2), which can change chromatin structure by tri-methylation of the 27th lysine of H3 in nucleosome histone (H3K27me3), is involved in different types of cancers. However, the role and mechanism underlying aberrant EZH2 expression in laryngeal squamous cells carcinoma (LSCC) remain unclear. In the present study, we found that down-regulation of EZH2 and H3K27me3 in LSCC cells (Hep-2 and SCC10A) resulted in an mesenchymal-epithelial transition(MET) like cell morphology and lower invasion in vitro, weakened tumor growth, intrahepatic and pulmonary metastasis in vivo.

Comparative Outcomes Assessment: Hip Hemiarthroplasty as an Alternative to THA in Patients with Surgically Pristine Acetabulum-Is There Still a Role?

This is a retrospective review of 243 hip arthroplasties treated with either hemiarthroplasty (61 surgeries-Group 1) or total hip arthroplasty (182 surgeries-Group 2). The mid- to long-term results of relatively similar, predominately young patient cohorts were assessed annually via radiographs and the Harris Hip Scores for pain and clinical function. Groin pain persisted in 16.

Surveying young patients.

The East of England Ambulance Service NHS Trust (the Trust) was keen to engage young patients and to encourage them to give feedback about the service they had received. The standard Trust satisfaction survey was modified for use with young patients, and this had the effect of increasing the response rate from this patient group by 8%, and increasing the percentage of young patients aged 5-10 years completing the survey themselves by 29%. The vast majority of parents/guardians were happy for the Trust to survey their child, but the age of the child affected to whom they would like the survey sent.

Beyond tamoxifen: extended and late extended endocrine therapy in postmenopausal early breast cancer.

Breast cancer is a leading cause of cancer death among women worldwide. The majority of cases are oestrogen receptor- or progesterone receptor-positive and, therefore, potentially sensitive to endocrine therapy. A significant risk of recurrence and death persists following initial diagnosis, with over one half of all recurrences and two thirds of breast cancer-related deaths reported to occur following completion of standard adjuvant tamoxifen therapy.

Preoperative radiotherapy combined with 5 days per week capecitabine chemotherapy in locally advanced rectal cancer.

There is increasing evidence supporting the use of preoperative chemoradiotherapy in patients with locally advanced rectal cancer in an attempt to facilitate complete surgical resection with clear margins. We describe our experience of using a 5-day per week regime of preoperative capecitabine chemoradiotherapy. Between November 2004 and September 2006, 70 patients with MRI-defined locally advanced rectal cancer were selected for treatment.

Omission of concurrent chemoradiation after a response to neoadjuvant chemotherapy in locally advanced rectal cancer with a synchronous liver metastasis: a note of caution.

There is clear evidence to support the use of pre-operative concurrent chemo-radiotherapy (CRT) in locally advanced rectal cancer. In the UK, most patients are selected for treatment if the resection margin is predicted to be involved. The selection criteria used includes primary tumours that threaten the resection margins on high-resolution pelvic MRI and low tumours requiring abdominoperineal excision.

Radiotherapy following breast-conserving surgery for screen-detected ductal carcinoma in situ: indications and utilisation in the UK. Interim findings from the Sloane Project.

Use of radiotherapy (RT) after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) varies according to country, precedent and prejudice. Results from a preliminary analysis of the data available within the UK Sloane Project can be appreciated in the context of the uncertainty concerning the selection of adjuvant RT following BCS for DCIS. There was a marked geographical variation in the use of RT within the United Kingdom.

Aromatase inhibitors and musculoskeletal symptoms.

Aims: Recent evidence shows aromatase inhibitors (AIs) to be of benefit over tamoxifen in the adjuvant setting. It is also apparent that musculoskeletal symptoms associated with AIs may be a significant problem in the clinical setting. The aim of this article is to review the data on AIs with respect to musculoskeletal symptoms in the adjuvant setting.

Is there a role for radiotherapy in operable rectal cancer?

Most patients presenting with rectal cancer will have "operable" disease. The main aim in treating these patients is to achieve complete surgical resection while minimising the rate of local recurrence. The use of radiotherapy has been shown to decrease local recurrence rates and the evidence suggests that this should be used preoperatively.

Psychosexual function and impact of gynaecological cancer.

A diagnosis of gynaecological cancer and its treatment are usually associated with many physical and psychological changes, both as a result of the diagnosis itself and of the usual treatments of surgery, radiotherapy and/or several months of chemotherapy. Patients often experience symptoms such as fatigue, abdominal swelling and pain, and suffer from emotional distress and disturbances of their life style. Sexual functioning can also be affected.

An examination of the levels of confidence that consultants have in routinely collected clinical information.

Anecdotal evidence suggests that consultants have a low level of confidence in routinely collected clinical data. The aims of this study were to assess the actual levels of confidence in clinical information experienced by consultants and to understand the factors affecting confidence. A questionnaire was devised incorporating a scale to measure levels of confidence.

Oxygen: kill or cure? Prehospital hyperoxia in the COPD patient.

High concentration oxygen therapy has long been a mainstay of prehospital treatment. Guidelines for its administration have for many years also cautioned its use with patients with chronic obstructive pulmonary disease (COPD). Successive guidelines and prehospital textbooks have advocated the use of 28% oxygen masks and re-emphasised the importance of the dangers of hyperoxia, often drawing upon the classic theory of hypoxic drive.

A phase I/II study of oxaliplatin when added to 5-fluorouracil and leucovorin and pelvic radiation in locally advanced rectal cancer: a Colorectal Clinical Oncology Group (CCOG) study.

The purpose of this study was to evaluate the maximum tolerated dose (MTD) and recommended dose of oxaliplatin given synchronously with 5-fluorouracil (5FU), leucovorin (LV) and preoperative pelvic radiation for primary unresectable, locally advanced, rectal cancer. Preoperative pelvic radiotherapy using a three- or four-field technique and megavoltage photons comprised 45 Gy given in 25 fractions, 1.8 Gy per fraction, and delivered with escalating doses of oxaliplatin in combination with low-dose LV and 5FU.

Imaging for prostate cancer.

The increased incidence and awareness of prostate cancer, together with developments in treatment, has generated a significant need for appropriate imaging to detect and stage the tumour initially, guide radiotherapy delivery and monitor disease on follow-up. Transrectal ultrasound is usually the first imaging investigation, and its role is primarily to guide prostate needle biopsy. It also has an established role in imaging-guided treatments, such as brachytherapy.

Investigation into dosimetric effect of a MAGNA-SITE tissue expander on post-mastectomy radiotherapy.

It is increasingly common for radiotherapy departments to encounter high density objects in patients being planned for radiotherapy. Many cases, such as artificial hip prostheses, are well documented. In our cancer center we have recently come across a new type of implant--a McGhan Style 133 Tissue Expander--implanted in patients who have undergone a mastectomy and will in future have breast reconstruction.