Building effective relationships in global surgery: an exploratory qualitative study.

Background: The rise in malignant hepatopancreatobiliary tumors disproportionately affects low- and middle-income countries (LMICs) due to systemic challenges. In 2023, the International Hepatopancreatobiliary Association (IHPBA) launched a relationship-building initiative to mitigate outcome disparities by increasing capacity and quality. This study aimed to understand the dynamics and value of such collaborations.

Factors Affecting Quality Control (QC) Failure Rates in Somatic Breast Cancer (BRCA) Gene Testing in Castrate Resistant Prostate Cancer: Experiences From an Australian Cancer Care Centre.

Aims: Castrate-resistant prostate cancer (CRPC) is a common malignancy with poor prognostic outcomes. Breast cancer (BRCA) genes 1 and 2 mutations occur in prostate cancers and confer poorer prognoses. Somatic BRCA testing can lead to inconclusive results, which can gatekeep patients from accessing targeted medications.

Hot chocolate: pre-warming chocolate agar improves correct organism identification from choc drop by 16.1.

Blood cultures are an important test for the diagnosis of sepsis, and the time to an accurate result can allow for optimized antibiotic therapy. The 'choc drop' is a commonly performed, reliable and cheap rapid identification method, using a drop of positive blood culture broth incubated for a short period (2-4 h) before performing matrix-assisted laser desorption/ionization time-of-flight MS on any early growth/microbiological veil present. Due to the short incubation time (~2 h), agar plates may not reach the target temperature for optimal bacterial growth, leading to reduced accuracy of identification.

How I do it-tubular trans-spinous process muscle-sparing approach for bilateral lumbar microdiscectomy: surgical technique with illustrative video.

This video demonstrates our surgical approach for an entirely tubular trans-spinous process bilateral lumbar discectomy. A 47-year-old man presented with 12 months of severe predominantly right L5 radiculopathy. Magnetic resonance imaging revealed a large diffuse disc bulge at L4/5 resulting in bilateral lateral recess and central stenosis.

The Management of Parkinson's Disease Before, during and after Pregnancy-an MDS Scientific Issues Committee Review.

Background: Pregnancy after a Parkinson's diagnosis presents complex challenges. Due to the paucity of literature, there is no evidence-based guidelines and protocols for preconception care, management of pregnancy, childbirth and the postpartum period in women with early-onset Parkinson's disease (PD). Decision-making can be fraught with uncertainty for both patients and healthcare providers.

A population-based study of cause-specific mortality in First Nations Australians with cirrhosis: impact of cardiometabolic comorbidities and liver disease risk factors.

Background: Liver disease is an important contributor to high mortality in First Nations Australians. We describe cause-specific mortality by First Nations status in people with cirrhosis.

Methods: Population-based retrospective cohort analysis of all adults with cirrhosis admitted to hospitals in the state of Queensland (2007-2022).

How should glucocorticoid and mineralocorticoid replacement be optimised in a young patient with classic 21-hydroxylase congenital adrenal hyperplasia?

This article aims to provide a simple clinical approach to understanding and managing steroid supplementation in young adults and adult patients with classical congenital adrenal hyperplasia secondary to 21-hydroxylase deficiency (21OHD). It aims to overcome the clinical inertia that leads to glucocorticoid excess in these patients, particularly addressing the adult endocrinologist at the transition when they meet the patient with 21OHD with 'fresh eyes'.

SGNDV-001: disitamab vedotin with pembrolizumab in HER2-expressing locally advanced or metastatic urothelial carcinoma.

Introduction: Platinum-based chemotherapy for the treatment of locally advanced or metastatic urothelial carcinoma (la/mUC), has been the first-line standard of care for many decades. Enfortumab vedotin, an antibody-drug conjugate, combined with pembrolizumab, a programmed death 1 (PD-1) inhibitor, recently demonstrated improved efficacy versus chemotherapy in la/mUC. Since 60%-80% of patients with UC have tumors expressing human epidermal growth factor receptor 2 (HER2), HER2-directed vedotin-based antibody-drug conjugates may also be beneficial in la/mUC.

Point-of-Care Intestinal Ultrasound Impacts Inflammatory Bowel Disease Care and Reduces the Need for Additional Investigations.

Background And Aim: Intestinal ultrasound (IUS) has emerged as a widely used point-of-care (POC) tool for guiding inflammatory bowel disease (IBD) treatment. This study aims to assess the impact of POC IUS on clinical decision-making in IBD.

Methods: We performed a retrospective review of outpatient cases utilizing POC IUS at a tertiary center between October 2021 and March 2023.

McCune-Albright syndrome: a case of an adult with fibrous dysplasia, severe cardiopulmonary complications, acromegaly, and chronic myeloid leukemia.

McCune-Albright syndrome (MAS) is a rare mosaic disorder characterized by the classic triad of fibrous dysplasia of bone (FD), café-au-lait skin macules, and hyperfunctioning endocrinopathies. MAS is caused by a postzygotic mutation in the G-protein alpha subunit (GNAS) gene resulting in G-protein α-subunit somatic activation. There is no approved treatment for MAS.

Patient Preferences for Treatment Attributes in Inflammatory Bowel Disease: A Discrete Choice Experiment Among Patients in Five Non-Western Countries.

Introduction: Understanding patient preferences is important for facilitating informed decision-making in managing patients with inflammatory bowel disease (IBD). This study explored the preferences of patients with Crohn's disease (CD) and ulcerative colitis (UC) regarding advanced therapy treatment attributes in five non-Western countries: Argentina, Australia, Brazil, Saudi Arabia and Taiwan.

Methods: Adult patients with self-reported CD or UC treated for ≥ 6 months participated in this cross-sectional online survey.

Upadacitinib and vedolizumab combination therapy for the management of refractory ulcerative colitis and Crohn's disease.

Background/aims: Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal tract, and encompasses both ulcerative colitis (UC) and Crohn's disease (CD). Refractory disease is common, a combination of advanced drug therapies may be required to obtain maximal efficacy. We describe the use of upadacitinib therapy in combination with vedolizumab therapy for the management of refractory UC and CD.

Gut-associated metabolites and diabetes pathology: a systematic review.

Background: As the global prevalence of diabetes mellitus reaches epidemic proportions, research into new therapeutic targets that address the underlying pathomechanisms of the disease is essential. Recent studies have elucidated the fundamental role of intestinal metabolic pathways in human health and disease processes and yet, the underlying cause of metabolic dysregulation in diabetes is largely unknown. Therefore, this systematic review aimed to identify the intestinal metabolomic profiles associated with gestational diabetes mellitus, type 1 diabetes mellitus, pre-diabetes mellitus, and type 2 diabetes mellitus.

The effectiveness of orienteering exercise on improving physical fitness and cognitive functions in non-athletes: a systematic review and meta-analysis.

Objectives: Orienteering exercise combines physical and cognitive function training, but its interventional effects remain unclear. Hence, in this study, we examined the effectiveness of orienteering exercise interventions in improving physical fitness and cognitive functions by a systematic review, meta-analyses, subgroup analyses, and meta-regression.

Study Design: Systematic review and meta-analysis.

Visual loss during pregnancy due to physiological pituitary hyperplasia.

Physiological pituitary hyperplasia is due to adenohypophyseal cell number increase and is characterised by diffuse isodense pituitary enlargement beyond age-appropriate sizes. It most commonly occurs in females undergoing reproductive changes (puberty, pregnancy, menopause). We report a case of pituitary hyperplasia (pituitary height 14 mm) in a 33-year-old female presenting as vision changes at 34 weeks 'gestation.

Internet access and use for health information and its association with health outcomes in older adults in 30 countries.

Background: Older adults, as a vulnerable population, typically show lower engagement with eHealth technologies. Limited internet access and low use for health information may contribute to poorer health outcomes.

Objectives: The purposes of this study were to examine differences in socio-demographics and compare healthy lifestyles, health statuses and attitudes toward online health information among different groups of internet access and use for health information.

Prognostic value of isolated tumor cells in sentinel lymph nodes in intermediate-risk endometrial cancer: results from an international, multi-institutional study.

Objective: This study assessed oncologic outcomes of patients with intermediate-risk endometrioid endometrial cancer and isolated tumor cells (ITC) (≤0.2 mm or ≤200 cells) in sentinel lymph nodes (SLNs).

Methods: Patients with SLN-ITC diagnosed between 2012 and 2019 were identified from 19 centers worldwide, while SLN-negative patients were identified at Mayo Clinic, Rochester between 2014 and 2018.

Infliximab-Induced Pulmonary Sarcoidosis Treated With Upadacitinib: A Case Report and Review of the Literature.

Sarcoidosis is a multisystem granulomatous disorder of unclear aetiology. It can develop de novo or occur as a reaction to certain medications. While infliximab is commonly used for treating inflammatory conditions such as inflammatory bowel disease, paradoxical sarcoidosis secondary to tumor necrosis factor alpha (TNF-α) inhibitors is a rare complication.

Refocusing research: A mixed methods study to evaluate utilisation of the top 10 priorities for occupational therapy research in the United Kingdom.

Introduction: The top 10 priorities for occupational therapy research in the United Kingdom were identified via a priority setting partnership and published in 2020. This study aimed to evaluate utilisation of the top 10 priorities since 2020 and identify recommendations to re-focus research efforts.

Method: A mixed methods approach involving evidence checking and stakeholder consultation was undertaken.

Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy.

The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal.

Virtual cycling in urban green and blue vs gray spaces: The efficacy of mental health and physical activity.

Objectives: An urban environment may be stressful, potentially leading to poor mental health. Natural elements are important in urban environments with many restorative and potential health benefits compared to artificial elements. Virtual reality can simulate an urban environment in a digital world.

Dietary Fibre Modulates Gut Microbiota in Late Pregnancy Without Altering SCFA Levels, and Propionate Treatement Has No Effect on Placental Explant Function.

Dietary fibre promotes health, partly by mediating gut microbiota and short-chain fatty acid (SCFA) production. Pregnancy alters the relationship between dietary composition and the gut microbiota, and it is unclear if fibre intake during late pregnancy alters the abundance of SCFA bacteria and circulating SFCA concentrations. The aim of this study was to determine the impact of dietary fibre on faecal microbiome composition and circulating concentrations of SCFA acetate, butyrate, and propionate in late pregnancy.