Outcomes of 100 Squamous Cell Carcinomas of the Upper Limb: 100 Squamous Cell Carcinomas of the Upper Limb.

Background: Rates of recurrence, metastases, and mortality for squamous cell carcinoma (SCC) of the upper limb have not been clearly defined.

Objective: We aimed to characterize these tumors and assess the long-term outcomes, comparing with current literature.

Methods And Materials: A retrospective review was performed on 100 consecutive primary cutaneous upper limb SCCs managed surgically by a single hand surgeon between 2012 and 2019.

Six-month safety and efficacy outcomes from the randomized-controlled arm of the WRAPSODY Arteriovenous Access Efficacy (WAVE) trial.

Stenosis within the arteriovenous fistula (AVF) of hemodialysis patients leads to vascular access dysfunction and inadequate hemodialysis. Percutaneous transluminal angioplasty (PTA) is the standard therapy for stenosis. However, rates of restenosis and loss of access patency remain high.

The clinical and molecular landscape of diffuse hemispheric glioma, H3 G34-mutant.

Background: Diffuse hemispheric glioma, histone 3 (H3) G34-mutant, has been newly defined in the 2021 WHO classification of central nervous system tumors. Here we sought to define the prognostic roles of clinical, neuroimaging, pathological, and molecular features of these tumors.

Methods: We retrospectively assembled a cohort of 114 patients (median age 22 years) with diffuse hemispheric glioma, H3 G34-mutant, CNS WHO grade 4 and profiled the imaging, histological and molecular landscape of their tumors.

Controversies in thyroid disease management in pregnancy.

Adequate control of thyroid function is crucial for optimal pregnancy outcomes and neurodevelopment of the offspring, and testing for thyroid function is ideally performed using manufacturer- and gestation-specific reference ranges. While universal screening for thyroid dysfunction is not recommended, targeted case finding of women at risk of thyroid disease during pregnancy is advised. A number of controversies continue to fuel debate including: (i) the target range for thyroid stimulating hormone (TSH) in women with subfertility planning pregnancy, (ii) management of mild thyroid hypofunction before and during pregnancy, (iii) the treatment of thyroid peroxidase (TPO) antibody-positive euthyroid women with levothyroxine, (iv) the optimal choice of antithyroid treatment in women with hyperthyroidism.

Accelerated epigenetic ageing after burn injury.

Individuals who suffer a major burn injury are at higher risk of developing a range of age-associated diseases prematurely leading to an increase in mortality in adult and juvenile burn injury survivors. One possible explanation is that injury is accelerating the biological ageing process. To test this hypothesis, we analysed DNA methylation in peripheral blood mononuclear cells from adult burn-injured patients (> 5%TBSA) upon admission to hospital and 6 months later, to calculate an epigenetic clock value which can be used to determine biological age.

Neo-adjuvant FOLFOX with and without panitumumab for patients with KRAS-wt locally advanced colon cancer: results following an extended biomarker panel on the FOxTROT Trial embedded phase II population.

Background: The FOxTROT trial has reported advantages of neoadjuvant chemotherapy (NAC) in locally advanced colon cancer (LACC). Here we present results of the embedded randomized phase II trial testing the addition of panitumumab to neoadjuvant FOLFOX compared with FOLFOX alone in RAS and BRAF-wild-type patients and with biomarker hyperselction.

Patients And Methods: Patients had operable, CT-predicted stage T3-4, N0-2, M0 colon adenocarcinoma.

Accelerator neutron sources for BNCT: Current status and some pointers for future development.

Recent decades have seen the development of accelerator neutron sources suitable for installation in a hospital setting. Numerous challenges have been faced and solved to deliver technology which continues to transform the field of BNCT. This paper begins by briefly reviewing the technologies which are currently, or soon will be, in clinical use.

Ethnicity-specific patterns of epigenetic age acceleration in rheumatoid arthritis.

Rheumatoid arthritis (RA) is an age-related chronic inflammatory disease which may include accelerated biological ageing processes in its pathogenesis. To determine if increased biological age is associated with risk of RA and/or is present once disease is established. We used DNA methylation to compare biological age (epigenetic age) of immune cells in adults at risk of RA and those with confirmed RA, including twins discordant for RA.

Cellular interactions in self-directed immune mediated liver diseases.

The lymphocyte population must traverse a complex path throughout their journey to the liver. The signals which these cells must detect, including cytokines, chemokines and other soluble factors, steer their course towards further crosstalk with other hepatic immune cells, hepatocytes and biliary epithelial cells. A series of specific chemokine receptors and adhesion molecules drive not only the recruitment, migration, and retention of these cells within the liver, but also their localisation.

Comparing the Efficacy and Safety of the Transperineal Versus Transrectal Prostate Biopsy Approach in the Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis.

Prostate cancer (PCa) has high prevalence rates in men and is a leading cause of cancer-related death. Transrectal (TR) biopsy has traditionally been the gold standard for diagnosis, but transperineal (TP) biopsy is increasingly favoured due to its lower infection risk. However, debate remains regarding which method has superior cancer detection rates.

Diagnosis and management of monoclonal gammopathy of renal significance: A British Society for Haematology good practice paper.

This guideline provides consensus opinion on the investigations required for people presenting with suspected monoclonal gammopathy of renal significance to both nephrology and haematology physicians. The guideline discusses the principles of treating a patient with MGRS and provides recommendations for both supportive management and haematological therapy. It details the recommended on-going monitoring required for both specialty areas.

Dermatologic surgery: An update on Secondary Intention Healing and Adjuncts: Part 2.

Secondary intention healing (SIH) is utilised by various surgical specialities. The formation of granulation tissue is crucial for initiating the healing process, necessitating robust support at this stage. Numerous adjunct therapies are available, with new developments aimed at treating both acute and chronic wounds undergoing SIH.

A review of Secondary Intention Healing in Dermatology and Dermatologic Surgery: Part 1.

Secondary intention healing (SIH) describes wounds healing from the base upwards, without direct closure. This starts with granulation of the wound, followed by re-epithelialisation and contraction. The surgeon and patient need to weigh up advantages and disadvantages of SIH versus other reconstruction methods.

Efficacy of Bisphosphonates in Reducing Fracture Risk Among Postmenopausal Women With Osteoporosis.

Background: Postmenopausal women are often affected by osteoporosis, a disorder that lowers bone density, increases the risk of fractures, and has a major negative influence on quality of life.

Objective: This study aimed to assess the efficacy of bisphosphonates in reducing fracture risk among postmenopausal women with osteoporosis by analyzing their impact across various fracture sites, treatment durations, and patient subgroups.

Methodology: A retrospective cohort research was conducted between January 2021 and December 2022 at Hayatabad Medical Complex (HMC), Peshawar.

Thyroid Functions and Cognitive Decline in the Elderly.

Background The maintenance of cognitive health depends on thyroid hormones, and it is becoming more widely acknowledged that thyroid hormone issues may be a factor in cognitive decline in the aged. Objective This study aimed to investigate the association between thyroid hormone levels and cognitive decline among elderly individuals, considering the influence of age-related factors and comorbidities. Methodology Over the course of two years, 218 adults 60 years of age and older with clinically diagnosed hypothyroidism or subclinical thyroid disease were included in a prospective observational research.

Management of partial extensor tendon lacerations of the hand and forearm: A national survey of practice in the United Kingdom.

Background: Partial extensor tendon lacerations of the hand and forearm are common. There is a lack of evidence to guide their management and it is also unclear at what threshold surgeons would consider repair necessary. This study aimed to identify national surgical management of partial extensor tendon lacerations of the hand and forearm (zones 2-8) and assess surgeons' willingness to randomise in a future trial.

Functional Outcomes of the Management of Acromioclavicular Joint Dislocation With a Clavicle Hook Plate: A Retrospective Study.

Background: Dislocation of the acromioclavicular joint (ACJ), accounting for 9%-12% of all shoulder injuries, is a frequent shoulder problem. Clavicular hook plates have proven to be a successful implant choice for surgical management. The benefit of this method is that it preserves the diarthrosis of the ACJ while reducing dislocation.

The Influence of Timing of Surgery on Postoperative Length of Hospital Stay in Closed Ankle Fractures.

Background Ankle fractures are prevalent lower limb injuries that often necessitate surgical intervention to restore joint stability and functionality. Delays in surgical management can extend hospital stays and elevate the risk of complications. This study aims to evaluate the effect of surgical timing on the postoperative length of hospital stay in patients with closed ankle fractures managed through open reduction and internal fixation (ORIF).

Interplay between periodontitis and chronic kidney disease.

Periodontitis is a ubiquitous chronic inflammatory disease affecting the supporting tissues of the teeth and is a major cause of multiple tooth loss. Despite being preventable, periodontitis and dental caries are responsible for more years lost to disability than any other human condition. The most severe form of periodontitis affects 1 billion individuals, and its prevalence is increasing globally.

A Review of Photon-Counting Computed Tomography (PCCT) in the Diagnosis of Cardiovascular Diseases.

Photon-counting computed tomography (PCCT) is an innovative mechanism used for imaging and provides higher spatial resolution and contrast sensitivity in comparison with the orthodox energy-integrating detectors (EIDs). Unlike EID-based CT systems, which indirectly convert X-ray photons to electrical signals, PCCT directly counts and quantifies each photon's energy, enhancing image quality and material separation. With all of these features, PCCT is especially useful for cardiovascular imaging, where it is essential to precisely observe cardiac tissues, vascular structures, and coronary arteries.

FRED-UK: Multicentre UK experience of FRED and FRED Jr flow re-direction endoluminal device for intracranial aneurysms: 6 months and 1 year clinical and anatomical results.

Background: Flow diverting stents (FDS) are an established endovascular treatment for intracranial aneurysms but are reported to have varying rates of adequate occlusion and thromboembolic complications. This study reports clinical safety and efficacy results of the FRED and FRED Jr FDS in clinical practice in the UK at 6 months and 1 year.

Methods: The FRED-UK study is a single arm, multicentre, prospective, observational study conducted in the UK.

Changes in peak oxygen consumption in Fabry disease and associations with cardiomyopathy severity.

Background: Fabry disease (FD) causes multiorgan sphingolipid accumulation, with cardiac involvement responsible for the largest burden of morbidity and mortality. Exercise intolerance in FD is prevalent, yet the mechanisms of this are poorly understood. The aim of this study was to assess exercise intolerance in FD and identify whether this correlates with the phase of cardiomyopathy.

Evaluating Risk Factors and the Burden of Silent Myocardial Ischemia Among Diabetic Patients.

Introduction: Silent myocardial ischemia (SMI) is a significant concern for diabetic patients, often remaining undetected until severe complications arise. Prolonged hyperglycemia, poor glycemic control, and lifestyle factors contribute to its risk, with older adults and those with long-standing diabetes particularly vulnerable.

Objective: To assess the prevalence and predictors of SMI in adults with diabetes, emphasizing long-term management and monitoring.