Predictors of Bilateral Disease in Low-Risk Papillary Thyroid Cancer: Histopathologic Insights and Preoperative Ultrasonography.

Background: With the current shift toward de-escalation of surgical management in low-risk papillary thyroid cancer (PTC), understanding predictors and the clinical significance of additional tumors in the contralateral lobe is important. This study investigated the histopathologic predictors of bilateral disease in low-risk PTC patients and the utility of preoperative ultrasonography in guiding completion thyroidectomy decisions.

Methods: Patients treated with total thyroidectomy (TT) for low-risk PTCs (< 4 cm) at the Endocrine Surgical Unit of the Royal North Shore Hospital, University of Sydney from 2013 to 2020 were identified from a prospectively maintained database.

The effect of adductor canal block on outcomes of total knee arthroplasty: A single centre, historical cohort study.

Background: Adductor canal blocks (ACBs) have been associated with reduced pain following total knee arthroplasty (TKA). There is a paucity of evidence regarding whether these early differences impact longer term outcomes. This study aimed to identify whether using ACB in TKA was associated with improvements in both early and late outcomes.

Experiences of Māori and Pacific women recruited into a pregnancy clinical trial in Aotearoa, New Zealand: a Kaupapa Māori qualitative study.

Objectives: To explore the perspectives of Māori and Pacific women who participated in the Fish Oil study to ascertain what barriers and facilitators may exist for successfully recruiting Māori and Pacific women into clinical trials.

Design: A Kaupapa Māori qualitative study.

Setting: Auckland, New Zealand.

Rome IV functional defecation disorder: time for a change in symptom criteria for improved clinical relevance?

Introduction: Defecatory disorders are common affecting up to 8% of the population. Rome IV diagnostic criteria are used to define this condition and therefore select patients for the gold standard therapy, anorectal biofeedback. The aim of this study was to test the current Rome IV FDD criteria in a real-world population by utilizing the response to biofeedback as a validation tool.

Surgery for Olecranon Fractures in the Elderly (SOFIE): Results of the SOFIE Randomized Controlled Trial.

Background: The financial and resource burden of management of olecranon fractures in the elderly is likely to increase with an aging population. There is limited evidence guiding treatment choice in this cohort. This study aimed to determine whether operative treatment of displaced olecranon fractures in elderly patients provides superior 12-month functional outcomes compared to nonoperative treatment.

FXYD3 Is Frequently Expressed in Pancreatic Ductal Adenocarcinoma but Does Not Predict Survival.

Background: FXYD3 is a Na/K-ATPase modulator which is upregulated in pancreatic ductal adenocarcinoma (PDAC), but its prognostic role is unknown. This study evaluated FXYD3 expression in chemo-naive patients with surgically-resected PDAC at a single centre (1993-2014).

Method: FXYD3 expression was assessed in tumour specimens using immunohistochemistry.

Cardiovascular, kidney and safety outcomes with canagliflozin in older adults: A combined analysis from the CANVAS Program and CREDENCE trial.

Aim: SGLT2 inhibitors may be underused in older adults with type 2 diabetes due to concerns about safety and tolerability. This pooled analysis of the CANVAS Program and CREDENCE trial examined the efficacy and safety of canagliflozin according to age.

Methods: Pooled individual participant data from the CANVAS Program (n = 10 142) and CREDENCE trial (n = 4401) were analysed by baseline age (<65 years, 65 to <75 years, and ≥75 years).

Anticoagulation and associated complications in veno-arterial extracorporeal membrane oxygenation in adult patients: A systematic review and meta-analysis.

Objective: To describe the incidence of bleeding and thrombotic complications in VA-ECMO according to anticoagulation strategy.

Design: This systematic review and meta-analysis included randomised controlled trials (RCTs) and observational studies reporting bleeding and thrombotic complications in VA-ECMO. The incidence of primary outcomes according to anticoagulation drug and monitoring test was described.

Encountering Arc of Bühler during pancreaticoduodenectomy surgery.

The Arc of Bühler (AoB) is a rare anatomical variant in gastrointestinal vasculature where there is an aberrant anastomotic vessel between coeliac and superior mesenteric arteries. We present a rare case where AoB was noted intraoperatively to have haemodynamically significant flow in the context of coeliac artery stenosis, supplementing arterial supply to the hepatic artery proper via the gastroduodenal artery (GDA). An interpositional jump graft between the aorta and the GDA stump was created using the long saphenous vein, and flow was restored.

The short-term impact of copayment reductions for government subsidised medicines in Australia.

Background: This study aims to examine the short-term, population-level effects of the 2023 Australian Pharmaceutical Benefits Scheme (PBS) copayment reduction on prescription volume, patients' out-of-pocket (OOP) expenditure, and government contributions.

Research Design And Methods: We conducted a quasi-experimental study using national data from January 2021 to April 2024. For system-level analysis, we examined all drugs used by general patients, focusing on 252 drugs that were 'above copayment' during 2022-2023.

A Core Outcome Set for Adult General ICU Patients.

Objectives: Randomized clinical trials informing clinical practice (e.g., like large, pragmatic, and late-phase trials) should ideally mostly use harmonized outcomes that are important to patients, family members, clinicians, and researchers.

Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography.

Background: There is limited data showing the predictive accuracy of traditional cardiovascular risk scores (CVRS) to predict asymptomatic coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA).

Methods: Asymptomatic individuals without known CAD undergoing a screening CCTA and sufficient data to calculate their CVRS, were extracted retrospectively. Atherosclerosis was extracted using natural language processing of the CCTA report, including the coronary artery calcium score (CACS) and the extent and severity of CAD.

A 10-Year Comparative Analysis of the Two Most Common Reverse Total Shoulder Arthroplasty Implants (Delta Xtend and SMR) in the New Zealand Joint Registry.

Hypothesis And Background: As the incidence of reverse total shoulder arthroplasty (RTSA) continues to rise, better understanding of the long-term risks and complications is necessary to determine the best choice of implant. The majority (75%) of RTSA performed in New Zealand use either SMR (Systema Multiplana Randelli, Lima-LTO, Italy) or Delta Xtend (DePuy Synthes, USA). The aim of this registry-based study was to compare implant survival, risk of revision and reasons for revision between the two most frequently used RTSA prostheses: SMR and Delta Xtend.

The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency.

Background: The Adelaide Score is an artificial intelligence system that integrates objective vital signs and laboratory tests to predict likelihood of hospital discharge.

Methods: A prospective implementation trial was conducted at the Lyell McEwin Hospital in South Australia. The Adelaide Score was added to existing human, artificial intelligence, and other technological infrastructure for the first 28 days of April 2024 (intervention), and outcomes were compared using parametric, non-parametric and health economic analyses, to those in the first 28 days of April 2023 (control).

Mortality in ischaemic stroke patients without standard modifiable risk factors: An analysis of the Riksstroke registry.

Introduction: Little is known of the long-term prognosis of patients with acute ischaemic stroke in the absence of standard modifiable stroke risk factors (SMoRFs). In acute coronary syndromes, patients without modifiable risk factors have a higher mortality rate. We analysed data from the Swedish Stroke Register to determine survival of patients without SMoRFs following an ischaemic stroke.

Exploring a novel outcome measure of symptom progression in knee osteoarthritis utilizing a large randomized trial.

Objectives: Explore a newly defined composite measure of symptom progression for knee osteoarthritis (KOA) in a large, randomized study of a potential disease-modifying osteoarthritis drug (DMOAD).

Design: Using longitudinal KOA studies, a potential composite endpoint of time to symptom progression was defined as the first occurrence of worsening of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain of ≥10 points with no improvement (≤9 point decrease) in WOMAC Function (0-100 scale). A post hoc analysis explored discrimination and association with structural outcomes in the sprifermin FORWARD trial through Years 3 and 5.

Predictors of Outcomes After Gastric Peroral Endoscopic Myotomy for Refractory Gastroparesis: A Systematic Review.

Introduction: Gastroparesis is a debilitating gastroduodenal disorder for which gastric peroral endoscopic myotomy (GPOEM) has emerged as an efficacious treatment option. However, response to GPOEM varies between 50% and 80%, such that preoperative predictors of treatment success are needed to guide patient selection.

Methods: We performed a systematic review to identify predictors of clinical and functional response to GPOEM among adult patients with gastroparesis (PROSPERO: CRD42023457359).

Trends in the surgical management of proximal humerus fractures over the last 20 years from Australian registry databases.

Background: Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.

Insight into a multifunctional potassium channel Kv1.3 and its novel implication in chronic kidney disease.

Chronic kidney disease (CKD), a global public health problem, causes substantial morbidity and mortality worldwide. Innovative therapeutic strategies to mitigate the progression of CKD are needed due to the limitations of existing treatments. Kv1.

Biomimetic Proteoglycans for Intervertebral Disc (IVD) Regeneration.

Intervertebral disc degeneration, which leads to low back pain, is the most prevalent musculoskeletal condition worldwide, significantly impairing quality of life and imposing substantial socioeconomic burdens on affected individuals. A major impediment to the development of any prospective cell-driven recovery of functional properties in degenerate IVDs is the diminishing IVD cell numbers and viability with ageing which cannot sustain such a recovery process. However, if IVD proteoglycan levels, a major functional component, can be replenished through an orthobiological process which does not rely on cellular or nutritional input, then this may be an effective strategy for the re-attainment of IVD mechanical properties.

Opioid-induced respiratory depression: clinical aspects and pathophysiology of the respiratory network effects.

Important insights and consensus remain lacking for risk prediction of opioid-induced respiratory depression (OIRD), reversal of respiratory depression (RD), the pathophysiology of OIRD, and which sites make the most significant contribution to its induction. The ventilatory response to inhaled carbon dioxide is the most sensitive biomarker of OIRD. To accurately predict respiratory depression (RD), a multivariant RD prospective trial using continuous capnograph and oximetry examining 5 independent variables: age ≥60, sex, opioid naivety, sleep disorders, and chronic heart failure (PRODIGY trial), was undertaken.