Update on Menopause Hormone Therapy; Current Indications and Unanswered Questions.

Objective: To provide clinicians involved in managing menopause with a summary of current evidence surrounding menopause hormone therapy (MHT).

Design: The authors evaluate and synthesize existing pooled evidence relating to MHT's clinical indications, efficacy, and safety and explore the limitations of existing data.

Patients: The review focuses on MHT-related outcomes in women with natural-timed menopause captured within observational studies, RCTs, and pooled data from pivotal meta-analyses and reviews.

Vulvar inspection at the time of cervical cancer screening: European Society of Gynaecological Oncology (ESGO), International Society for the Study of Vulvovaginal Disease (ISSVD), European College for the Study of Vulval Disease (ECSVD), and European Federation for Colposcopy (EFC) consensus statements.

Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions.

Minimally invasive compared to open surgery in patients with low-risk cervical cancer following simple hysterectomy: An exploratory analysis from the Gynegologic Cancer Intergroup/Canadian Cancer Trials Group CX.5/SHAPE trial.

Objective: The Laparoscopic Approach to Cervical Cancer trial demonstrated that minimally invasive radical hysterectomy was associated with worse disease-free survival and overall survival among women with early-stage cervical cancer. It is unknown whether this applies to patients with low-risk disease following simple hysterectomy.

Methods: Among patients who underwent simple hysterectomy in the Simple Hysterectomy And PElvic node assessment trial, univariate and multivariate Cox models were used to assess the association of minimally invasive versus open surgery with clinical outcomes, including pelvic and extra-pelvic recurrence-free survival, overall recurrence-free survival, and overall survival.

The Impact of Permanent Pacemaker Implantation After TAVI on Mortality and Quality of Life: A POPular TAVI Substudy.

Background: Conduction disturbances are common after transcatheter aortic valve implantation (TAVI) and frequently require permanent pacemaker implantation (PPI). Data regarding its impact on mortality and morbidity are conflicting. This study aims to assess the impact of PPI before or within 30 days after TAVI on mortality and health-related Quality of Life (QoL) during the first year after TAVI.

Quality-of-Life Measurement in Epidermolysis Bullosa. Position Statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient-Oriented Outcomes and External Experts.

In this paper, the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life (QoL) and Patient-Oriented Outcomes presents its position statements on health-related (HR) QoL assessment in epidermolysis bullosa (EB). The EADV TF on QoL and Patient-Oriented Outcomes recommends the use of the EB-specific instrument QOLEB in patients over the age of 10 years and, in addition to the QOLEB, the use of iscorEB-p in moderate-to-severe EB; the IntoDermQoL proxy instrument with its EB-specific module should be used in children aged under 5 years. The EB-specific instrument iscorEB-p, and the dermatology-specific instrument CDLQI may measure HRQoL in children with EB aged from 5 to 10 years.

Determining safety, usability, acceptability and potential for clinical use of an innovative walking frame design with in- and community patients.

Purpose: Falls cost the NHS over £2 billion a year, with incidence increasing rapidly with age. Design of indoor walking frames remains limited, often needing to be lifted and not supporting sit-to-stand and turning manoeuvres, which can lead to falling. This study explored aspects of safety and satisfaction and potential for clinical use of a novel prototype walking frame.

Performance of sentinel lymph node biopsy after neoadjuvant chemotherapy in clinically node positive breast cancer patients: systematic review and meta-analysis.

Background: The reliability of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) in patients with initially node-positive breast cancer is still controversial. This meta-analysis is conducted to investigate the feasibility and accuracy of SLNB after NACT in patients with initially positive axillary nodes.

Methods: We conducted a literature search using Medline, PubMed, Embase, Central, and SCOPUS up until April 2021 for studies on the performance of SLNB following NACT.

Renal Histopathological Changes in Children With Congenital Ureteropelvic Junction Obstruction.

Renal histologic changes in congenital ureteropelvic junction obstruction (UPJO), although well documented, are sparsely studied in children. This study aims to establish a histological grading depending on the glomerular and tubulo-interstitial changes in hydronephrotic kidneys and determine correlation with age at surgery and impact on function post-pyeloplasty. A renal cortical wedge biopsy was obtained after pyeloplasty and histological changes were graded from 1 to 4.

The Impact of Surgeon Experience-Consultant Versus Supervised Trainees After Elective Infrarenal EVAR: Short-term to Mid-term Outcomes.

Introduction: Vascular trainees are required to have a comprehensive training program, encompassing the completion of clinical, surgical, and research tasks. To fulfill their surgical abilities and performance, sufficient supervised operating time is mandatory. After open vascular procedures, it has been observed that trainee involvement does not lead to detrimental outcomes.

Family planning, reproductive health and pregnancy after bariatric surgery: a survey of bariatric healthcare professionals in Switzerland.

Aims: A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.

Methods: We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland.

Blastic plasmacytoid dendritic cell neoplasm: a Swiss case series of a very rare disease and a structured review of the literature.

Introduction: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a very rare disease, with unique diagnostic challenges and often dismal outcome. There are no widely accepted treatment guidelines available. Lymphoma-like regimens with or without autologous or allogenic transplantation were the cornerstone of most therapeutic concepts.

Practice Guidelines for the Value Evaluation of Clinical Pharmacy Services (version 2).

Objective: To optimize the construction of pharmaceutical services in medical institutions, advance the development of clinical pharmacy as a discipline, enhance the level of clinical pharmacy services, systematically implement and evaluate clinical pharmacy practices, and improve patient therapeutic outcomes, we have developed the Practice Guidelines for the Value Evaluation of Clinical Pharmacy Services (Version 2).

Methods: This guideline was designed following the World Health Organization (WHO) Guideline Development Manual. The Delphi method was employed to identify clinical questions.

An explorative qualitative study of barriers to the use of health and mental health services among migrant female sex workers in Germany and needs for action.

Background: Migrant female sex workers (MFSWs) can be exposed to various health risks due to their occupation, including mental and physical health, substance use, and experience of violence. However, they face substantial barriers to accessing healthcare services. The inadequate access to medical care for migrant female sex workers poses a challenge to the German healthcare system.

Prevalence, risk and resilience factors of mental health conditions among female sex workers: a systematic review and meta-analysis.

Introduction: Female sex workers are a vulnerable hard-to-reach group. Research in this field is scarce due to several issues, such as methodological difficulties or societal stigmatization. Most of the available literature focuses on sexually transmittable diseases.

The usefulness of Charlson Comorbidity Index (CCI) scoring in predicting all-cause mortality in Outpatients with Clinical Diagnoses of COPD.

Background: Since comorbid conditions are frequently present in chronic obstructive pulmonary disease (COPD) and affect outcome, a composite scoring system to quantify comorbidity might be helpful in assessing mortality risk.

Methods: We tested the hypothesis that the Charlson Comorbidity Index (CCI) score at the time of an outpatient medical clinic encounter for COPD predicts all-cause mortality. Cox Proportional Hazards analyses were used in 200 randomly selected patients to relate CCI scores to all-cause mortality out to 5 years.

Gut Microbiome and Metabolome Changes in Chronic Low Back Pain Patients With Vertebral Bone Marrow Lesions.

Background: Chronic low back pain (LBP) is a significant global health concern, often linked to vertebral bone marrow lesions (BML), particularly fatty replacement (FR). This study aims to explore the relationship between the gut microbiome, serum metabolome, and FR in chronic LBP patients.

Methods: Serum metabolomic profiling and gut microbiome analysis were conducted in chronic LBP patients with and without FR (LBP + FR,  = 40; LBP,  = 40) and Healthy Controls (HC,  = 31).

Case report: Dirofilarial infection of the face.

An 18-year-old male patient from Ukraine, living in Germany for 2 years, presented with a painless subcutaneous swelling on the left cheek that had been present for several months. Finally, the diagnosis of subcutaneous dirofilariasis caused by was confirmed by 12S rRNA gene PCR and sequencing from tissue by nematode-specific PCRs followed by sequencing after surgical resection of the lesion. Microfilaremia was ruled out and no further treatment was required.

Delirium and Cognitive Screening in National Hip Fracture Registries: Scoping Review Protocol.

Background: Delirium and cognitive impairment are common in hip fracture populations and are associated with significant adverse patient outcomes. National hip fracture registries facilitate improvements in patient outcomes and care quality, such as reduced mortality and the development of specialist multidisciplinary services. However, there is substantial variation in the data collected and reported in relation to delirium and cognition, which impedes international comparison and may reduce quality of care.

Naxos Disease and Related Cardio-Cutaneous Syndromes.

Naxos disease is a rare autosomal recessive condition combining arrhythmogenic right ventricular cardiomyopathy, woolly hair, and palmoplantar keratoderma. The first identified causative variant was in the gene encoding the desmosomal protein plakoglobin. Naxos disease exhibits fibro-fatty myocardial replacement with immunohistological abnormalities in cardiac protein and signaling pathways, highlighting the role of inflammation and potential anti-inflammatory treatments.

The feasibility and safety of robotic-assisted salvage radical cystectomy.

Objectives: To evaluate the feasibility and safety of robotic-assisted salvage radical cystectomy (RA-SRC).

Materials And Methods: We retrospectively searched the prospectively collected surgical database of two highly experienced robotic urological surgeons for cases of RA-SRC, defined as RARC performed post-previous pelvic RT for palliative or oncologic treatment purposes. Collected data included demographic and clinical information and outcome measures including operative course, hospital stay and complications.

Current attitudes to testicular prosthesis insertion during radical orchidectomy-An international perspective.

Objectives: This study aimed to assess current international clinician practices, attitudes and barriers related to testicular prosthesis implantation in patients with testicular cancer at the time of radical inguinal orchidectomy.

Methods: An international online survey of urologists who perform radical orchidectomy for testicular cancer was developed. The recruitment process used social media and the emailing lists of national urological societies.

The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data.

Objectives: To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.

Patients And Methods: Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars).

Does the transfer of knowledge from the pioneer generation to the second-generation speed-up the learning curve of robot-assisted partial nephrectomies? TRANSFER trial (UroCCR n°83).

Objectives: The objective is to compare the learning curves between two pioneer and three second-generation surgeons for RAPN in terms of WIT, CD and positive surgical margins.

Materials And Methods: The charts of consecutive RAPNs of three centres were reviewed from the UroCCR prospective database. The experience was assessed by a regression model for each group.