Temporal Analysis of the Incidence, Mortality and Disability-Adjusted Life Years of Benign Gallbladder and Biliary Diseases in High-Income Nations, 1990-2019.

Objective: The aim of this observational study was to analyze trends in the incidence, mortality, and disability-adjusted life years (DALYs) of benign gallbladder and biliary diseases across high-income countries between 1990 and 2019.

Background: Benign gallbladder and biliary diseases place a substantial burden on healthcare systems in high-income countries. Accurate characterization of the disease burden may help optimize healthcare policy and resource distribution.

Lack of regional pathways impact on surgical delay: Analysis of the Orthopaedic Trauma Hospital Outcomes-Patient Operative Delays (ORTHOPOD) study.

Introduction: Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital systems, particularly with regards to elective services. We demonstrate through a multicentre, multinational study, the impact of this at scale.

Trends in the mortality, incidence and disability-adjusted life-years of appendicitis in EU15+ countries: an observational study of the Global Burden of Disease Database, 1990-2019.

Background: Appendicitis places a substantial burden on healthcare systems, with acute appendicitis alone being the most common abdominal surgical emergency worldwide. Further characterisation of the disease burden in EU15+ countries may help optimise the distribution of healthcare resources. The aim of this observational study was to assess the trends in mortality, incidence and disability-adjusted life-years (DALYs) of appendicitis across European Union (EU) 15+ countries between the years 1990 and 2019, Supplemental Digital Content 3, http://links.

ORthopaedic trauma hospital outcomes - Patient operative delays (ORTHOPOD) Study: The management of day-case orthopaedic trauma in the United Kingdom.

Introduction: ORTHOPOD: Day Case Trauma is a multicentre prospective service evaluation of day-case trauma surgery across four countries. It is an epidemiological assessment of injury burden, patient pathways, theatre capacity, time to surgery and cancellation. It is the first evaluation of day-case trauma processes and system performance at nationwide scale.

Differences in Patterns of Recurrence Between Primary and Interval Debulking Surgery for Advanced Ovarian Cancer.

Background/aim: This study aimed to identify differences in the pattern and timing of recurrence in patients with advanced ovarian cancer undergoing primary (PDS) or interval debulking surgery after neoadjuvant chemotherapy (NACT).

Patients And Methods: Data were prospectively collected on 105 patients from June 2016 to March 2020.

Results: There were 30 (50%) recurrences in the PDS group compared to 32 (72.

Height and body mass index in molecularly confirmed Silver-Russell syndrome and the long-term effects of growth hormone treatment.

Objective: Silver-Russell syndrome (SRS) causes short stature. Growth hormone (GH) treatment aims to increase adult height. However, data are limited on the long-term outcomes of GH in patients with molecularly confirmed SRS.

Perineal hernia repair after extralevator abdominoperineal excision, how we do it (PERineal Laparoscopic Sling: PERLS Technique).

Purpose: Recent shift to radical extralevator abdominoperineal excision (ELAPE) approach has seen an increased incidence of post-operative perineal hernia. However, there is no standardised surgical approach for its repair. The aim of this study was to report intra and post-operative results of the perineal hernia repair by the novel trans-abdominal PERineal Laparoscopic Sling (PERLS) Technique in patients who developed post-operative perineal hernia following ELAPE.

Analgesia in the Initial Management of Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Background: The optimal analgesic strategy for patients with acute pancreatitis (AP) remains unknown.

Objective: The present systematic review and meta-analysis aims to compare the efficacy of different analgesic modalities trialled in AP.

Methods: A systematic search of PubMed, MEDLINE, EMBASE, CENTRAL, SCOPUS and Web of Science conducted up until June 2021, identified all randomised control trials (RCTs) comparing analgesic modalities in AP.

Quantifying evidence toward pathogenicity for rare phenotypes: The case of succinate dehydrogenase genes, SDHB and SDHD.

Purpose: The weight of the evidence to attach to observation of a novel rare missense variant in SDHB or SDHD in individuals with the rare neuroendocrine tumors, pheochromocytomas and paragangliomas (PCC/PGL), is uncertain.

Methods: We compared the frequency of SDHB and SDHD very rare missense variants (VRMVs) in 6328 and 5847 cases of PCC/PGL, respectively, with that of population controls to generate a pan-gene VRMV likelihood ratio (LR). Via windowing analysis, we measured regional enrichments of VRMVs to calculate the domain-specific VRMV-LR (DS-VRMV-LR).

Laminopathies: should Wenckebach be a cause for concern? A case report.

Background: cardiomyopathy is a cause of dilated cardiomyopathy (DCM) characterized by aggressive heart failure, high risk of arrhythmias, and sudden cardiac death. We present a case of a male presenting with an mutation with an aggressive DCM leading to sudden cardiac death (SCD).

Case Summary: A 42-year-old male presented with the feeling of lethargy and intermittent dizziness.

Primary care management of hidradenitis suppurativa: a cross-sectional survey of UK GPs.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that causes painful discharging nodules and skin tunnels. HS has associations with several systemic diseases, including cardiovascular disease (CVD), anxiety, and depression. High levels of chronic morbidity suggest an important role for primary care.

Clinical likelihood ratios and balanced accuracy for 44 in silico tools against multiple large-scale functional assays of cancer susceptibility genes.

Purpose: Where multiple in silico tools are concordant, the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) framework affords supporting evidence toward pathogenicity or benignity, equivalent to a likelihood ratio of ~2. However, limited availability of "clinical truth sets" and prior use in tool training limits their utility for evaluation of tool performance.

Methods: We created a truth set of 9,436 missense variants classified as deleterious or tolerated in clinically validated high-throughput functional assays for BRCA1, BRCA2, MSH2, PTEN, and TP53 to evaluate predictive performance for 44 recommended/commonly used in silico tools.

Sex-based inequalities in contemporary UK hospital management of stable chest pain.

Objective: We surveyed UK practice of National Institute for Health and Care Excellence (NICE) "Recent onset chest pain" guidance (CG95, 2016), stratified by sex. We looked for sex-related differences in referral to computed tomographic coronary angiography (CTCA) and subsequent functional imaging (FI), invasive coronary angiography (ICA) and revascularisation.

Methods: This was a prospective analysis of CTCA practice in 8 UK centres between 2018 and 2020.

A case of the crossed coronaries.

Coronary artery anomalies are rare; however, can be a potential cause of significant morbidity and even mortality. Crossed left anterior descending and left circumflex arteries is a rare finding, and therefore the significance of this finding is not well understood. CT coronary angiography is an excellent non-invasive modality which enables the diagnosis of such abnormalities, and it is likely that with the increased use of CT coronary angiography in cardiology, other similar cases will be diagnosed.

Hyper-dominance of the left anterior descending artery-a large territory.

Coronary artery anomalies are rare and a potential cause of significant morbidity and mortality. A hyper-dominant left anterior descending artery is extremely rare with only 17 cases reported in the literature. Occlusion of a hyper-dominant left anterior descending artery can cause a massive myocardial infarction affecting a large myocardial territory and therefore clinicians should be aware of its importance.

Cardiac arrest in a patient with trichorhinophalangeal syndrome and dilated cardiomyopathy.

A 44-year-old woman with known trichorhinophalangeal syndrome presented with an unheralded out of hospital cardiac arrest. Transthoracic echocardiography showed severe left ventricular systolic dysfunction with an ejection fraction <25% and cardiac MRI confirmed a diagnosis of congenital non-ischaemic dilated cardiomyopathy. The case highlights a very rare syndrome, it is previously unknown association with dilated cardiomyopathy and the possible benefit of cardiac screening for patients with known trichorhinophalangeal syndrome.

Simulation-based surgical education for glaucoma versus conventional training alone: the GLAucoma Simulated Surgery (GLASS) trial. A multicentre, multicountry, randomised controlled, investigator-masked educational intervention efficacy trial in Kenya, South Africa, Tanzania, Uganda and Zimbabwe.

Background/aim: Glaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma.

Methods: We designed a randomised controlled, parallel-group trial.