The Role of Cytoreductive Surgery in Platinum-Resistant Ovarian Cancer (PROC): A Systematic Review.

Background/objective: Platinum-resistant ovarian cancer (PROC) has limited therapeutic options, and the role of cytoreductive surgery (CRS) in improving survival outcomes remains uncertain. We performed a systematic review to evaluate the oncological benefit of CRS on PROC patients and the associated surgical morbidity and mortality.

Methods: We followed a prospective protocol according to PRISMA guidelines.

The latest in clinical trial results of 5-alpha reductase inhibitors in combination regimens for benign prostatic hyperplasia.

Introduction: BPH/male LUTS is a prevalent condition in the aging male population with multifactorial pathophysiology. Pharmacotherapy remains the cornerstone of treatment in patients who fail conservative treatment. 5-α-Reductase inhibitors (5-ARIs) are the only class of medication shown to reduce the risk of acute retention and BPH-related surgery and, thus, are commonly used along with other "short acting" medications in combination treatments.

Small bowel lymphangioma: a multidisciplinary approach to diagnostic uncertainty.

Intra-abdominal lymphangioma, a rare benign lymphatic malformation resulting from an obstruction to lymphatic channels, often has non-specific clinical manifestations. Low incidence rates of this condition, paired with its unusual presentation and ambiguous radiological appearance, commonly lead to diagnostic uncertainty. This pathology can result in significant morbidity and mortality, emphasising the need to achieve early diagnosis and management despite these challenges.

Perception of Telemedicine and Remote Learning Following the COVID-19 Pandemic: A Health Education England Survey of London Obstetrics and Gynaecology Trainees.

Purpose: To determine the level of uptake of telemedicine among postgraduate obstetrics and gynaecology (O&G) trainees in London, and how they perceive its impact on their training.

Methods: A mixed-methods survey aimed at exploring trainee perspectives of telemedicine use in clinical practice and its implications for training. Study participants were O&G specialist doctors on the London (UK) training programme.

Understanding Medical Students' Perceptions of Failure in Medical School.

This paper explores medical students' perceptions of failure through a qualitative approach, using semi-structured interviews to gather insights from six students across different academic years at Queen Mary University of London. The study aims to understand how students define failure, its causes, and its impact on their academic and personal lives. Key findings reveal that failure is perceived as multifaceted, influenced by internal and external expectations, and evolves throughout medical school.

Influence of CReatine Supplementation on mUScle Mass and Strength After Stroke (ICaRUS Stroke Trial): A Randomized Controlled Trial.

Background/objectives: The acute phase of stroke is marked by inflammation and mobility changes that can compromise nutritional status. This study was a randomized, double-blind, placebo-controlled trial evaluating the effectiveness of creatine supplementation for older people during seven days of hospitalization for stroke compared to usual care.

Method: The primary outcome measures were changes in functional capacity, strength, muscle mass, and muscle degradation.

Successful surgical management of uveitic glaucoma in a sarcoidosis patient with cutaneous manifestations.

Sarcoidosis is a systemic granulomatous disease with variable ocular involvement. The most common ocular manifestation is uveitis, which can have potentially sight threatening complications such as glaucoma. We present the case of a man in his 30s with sarcoidosis and recurrent anterior uveitis, necessitating surgical intervention to control intraocular pressure and prevent further glaucomatous optic neuropathy progression.

Mandibular Advancement Devices in Obstructive Sleep Apnea and Its Effects on the Cardiovascular System: A Comprehensive Literature Review.

Background: Obstructive sleep apnea syndrome (OSA) is a chronic inflammatory disease characterized by endothelial dysfunction and cardiovascular complications. Continuous positive airway pressure (CPAP) is the standard treatment, hence poor adherence has prompted interest in mandibular advancement devices (MAD) as an alternative. This comprehensive review aimed to explore the effects of MAD therapy on oxidative stress, inflammation, endothelial function, and its impact on the cardiovascular risk in OSA patients.

Adult risk groups for vaccine preventable respiratory infections: an overview of the UK environment.

Introduction: Vaccine-preventable respiratory infections (VPRI) including those caused by Streptococcus pneumoniae, influenza, respiratory syncytial virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pose substantial challenges to health and social care systems. In the UK, routine adult respiratory vaccination programs are in place. The objective of this article is to review the current evidence on the impact of four seasonal VPRIs in adults risk group definitions and to explore the strengths and limitations of current recommendations, and to identify evidence gaps for further research.

Should viscoelastic testing be a standard point-of-care test on all intensive care units?

Viscoelastic tests (VETs) have transformed assessment of haemostasis and transfusion practices in trauma, cardiac and liver transplantation centres. Impaired haemostasis is a common problem on the general intensive care unit (ICU), but routine use of VETs is rare. We have accordingly reviewed the evidence to determine whether there is evidence to support the use of VETs as a standard point of care test on all ICUs in assessing and managing patients.

Rostral fluid shifts and other mechanisms of interaction between obstructive sleep apnea and heart failure - a systematic review.

<b>Introduction:</b> Obstructive sleep apnea (OSA) is a chronic inflammatory disorder characterized by episodes of total or partial upper airway obstruction during sleep. Untreated OSA leads to various cardiovascular complications, including heart failure (HF), both involving complex and detrimental pathophysiological processes.<b>Aim:</b> The aim of this study is to describe the role of rostral fluid shifts and other mechanisms responsible for the co-existence of OSA and HF, providing insight into potential diagnostic and therapeutic strategies.

Suction use in ureterorenoscopy: A systematic review and meta-analysis of comparative studies.

Objectives: Ureterorenoscopy is seeing a bloom of technological advances, one of which is incorporating suction. The objective of this study is to systematically review existing literature regarding suction use in rigid and flexible ureterorenoscopy and perform meta-analysis of studies comparing suction versus no suction ureteroscopy or mini percutaneous nephrolithotomy (PCNL).

Methods: A literature search was performed (November 2023) in MEDLINE, Embase and Cochrane CENTRAL.

Using simulated bronchoscopy to improve training on intensive care units in a north London NHS trust.

Flexible bronchoscopy is a vital tool that is used for both diagnostic and therapeutic indications on the intensive care unit. During the COVID pandemic, training opportunities to perform such a skill were decreased and novel methods of teaching, including using bronchoscopy simulators, were explored out of necessity. The aim of this quality improvement project was to investigate how training on an intensive care unit prepared trainees for carrying out bronchoscopy, and whether a simulated bronchoscopy session with a high-fidelity simulator could be a useful adjunct to gain experience.

Trends in Gender, Ethnicity and Less-Than-Full-Time Training among Reconstructive Plastic Surgery Registrars and Consultants between 2009 and 2020.

Objective: This study aimed to examine the trends in gender, ethnicity and less-than-full-time (LTFT) training in reconstructive plastic surgery from 2009 to 2020 in the UK by comparing them to overall surgical specialties.

Methods: We analysed NHS Digital workforce data from 2009 to 2020 by examining trends in gender, ethnicity and LTFT working among reconstructive plastic surgery consultants and registrars and comparing them to overall surgical specialties. Data were analysed using linear regression models.

A Prospective Study of Sutured Versus Non-sutured Subcutaneous Fat Tissue in Laparotomy Wound Closure.

Background This study was conducted to determine the wound-related complications, such as wound dehiscence, delayed post-operative stay, and reinterventions in both groups, and compare the incidence of surgical site infection in elective laparotomy wounds in two groups - those with closing subcutaneous fat tissue and those without. Methods At the Government Medical College, Thrissur, 248 patients undergoing elective abdominal surgeries during the period from August 2019 to August 2020 participated in this one-year prospective cross-sectional study. The institutional ethics committee approved the study, and participants provided written informed consent.

Analgesia for emergency laparotomy: a systematic review.

Poorly controlled pain is common after emergency laparotomy. It causes distress, hinders rehabilitation, and predisposes to complications: prolonged hospitalisation, persistent pain, and reduced quality of life. The aim of this systematic review was to compare the relative efficacies of pre-emptive analgesia for emergency laparotomy to inform practice.

Why so slow? Models of parkinsonian bradykinesia.

Bradykinesia, or slowness of movement, is a defining feature of Parkinson disease (PD) and a major contributor to the negative effects on quality of life associated with this disorder and related conditions. A dominant pathophysiological model of bradykinesia in PD has existed for approximately 30 years and has been the basis for the development of several therapeutic interventions, but accumulating evidence has made this model increasingly untenable. Although more recent models have been proposed, they also appear to be flawed.