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Hepatic vein reconstruction during hepatectomy:A feasible and underused technique

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 421-427页

作者： Manish Ahuja Kunal Joshi Chris Coldham Paulo Muiesan Bobby Dasari Manuel Abradelo Ravi Marudanayagam Darius Mirza John Isaac David Bartlett Nikolaos A Chatzizacharias Robert P Sutcliffe Keith J Roberts Department of HPB and Liver Transplant Surgery University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Immunology and Immunotherapy University of BirminghamBirminghamUK

Complete surgical resection(R0)of liver tumors,primary or metastatic,remains the main objective in management of primary and metastatic liver tumors[1].Tumors invading to the proximity of the hepatic venous outflow pose a peculiar challenge to achieve R0 resections,because this location may render a tumor *** median survival of patients with liver tumor without surgery is less than 12 months[2].Even with surgery,post-hepatectomy liver failure and subsequently increased mortality are the main problems associated with complex resection[3].Moreover,when the vein is affected,vein resection and subsequent reconstruction are *** resection is a standard practice in liver resection and transplantation[4],for example,hepatic vein reconstruction during a living-donor liver transplant,porto-mesenteric axis reconstruction during resection of advanced pancreatic cancer and caval reconstruction during resection of retroperitoneal ***,novel techniques like total hepatic vascular exclusion(HVE)[5],veno-venous bypass[6]and ex vivo hepatic resection[7,8]have facilitated curative resections of tumors close to one or more major hepatic veins.

关键词： hepatectomy surgery mortality

Catatonia:A deep dive into its unfathomable depths

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World Journal of Psychiatry 2024年第2期14卷 210-214页

作者： Peter Phiri Gayathri Delanerolle Oliver Hope Tharangini Murugaiyan Geoffrey Dimba Shanaya Rathod Zukiswa Zingela Research&Innovation Department Southern Health NHS Foundation TrustSouthampton SO303JBUnited Kingdom School of Psychology Faculty of Environmental and Life SciencesUniversity of SouthamptonSouthampton SO171BJHampshireUnited Kingdom Acute Inpatients Services Southern Health NHS Foundation TrustBasingstoke RG249RHUnited Kingdom Home Treatment Team South WestSurrey and Borders Partnerships NHS Foundation TrustGuildford GU27XLSurreyUnited Kingdom Faculty of Health Sciences Nelson Mandela UniversitySummerstrand 6001GqeberhaSouth Africa

This editorial addresses catatonia,a complex neuropsychiatric syndrome characterised by a spectrum of psychomotor *** editorial seeks to clarify the ambiguous aspects of catatonia,integrating recent research findings,including global studies and diagnostic *** discusses catatonia’s clinical manifestations,prevalence,and associated psychiatric and medical conditions,with particular emphasis on its frequent co-occurrence with schizophrenia and mood *** prevalence of catatonia,which varies across psychiatric populations,is illustrated by a significant study conducted in Nelson Mandela Bay,South *** study provides valuable insights into the effectiveness of the Bush-Francis Screening Instrument compared to the Diagnostic and Statistical Manual 5 criteria in diagnosing *** editorial evaluates treatment approaches,primarily focusing on benzodiazepines and electroconvulsive therapy,and discusses emerging therapeutic *** underscores the importance of robust diagnostic frameworks and early intervention in managing catatonia,as recommended by the latest evidence-based consensus ***,it suggests future research directions,particularly in exploring the neurobiological and genetic factors of catatonia,to enhance our understanding and improve treatment *** editorial succinctly aims to demystify catatonia and provide valuable insights for clinicians and researchers in mental health care.

关键词： Catatonia Schizophrenia Neuropsychiatry Benzodiazepines Electroconvulsive therapy Bush-Francis screening instrument Diagnosis

Safety of tranexamic acid in surgically treated isolated spine trauma

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World Journal of Orthopedics 2024年第4期15卷 346-354页

作者： Wajiha Zahra Sandeep Krishan Nayar Ashwin Bhadresha Vinay Jasani Syed Aftab Trauma and Orthopedics Department University Hospital of North Midlands NHS TrustStoke-on-Trent ST46QGUnited Kingdom Trauma and Orthopedics Department Royal London HospitalBarts Health InstituteLondon E11BBUnited Kingdom Craniospinal Services University Hospital of North Midlands NHS TrustStokeon-Trent ST46QGUnited Kingdom Spine Department Royal London HospitalBarts Health InstituteLondon E11BBUnited Kingdom

BACKGROUND Tranexamic acid(TXA),a synthetic antifibrinolytic drug,effectively reduces blood loss by inhibiting plasmin-induced fibrin *** is the first study in the United Kingdom to investigate the effectiveness of TXA in the surgical management of isolated spine *** To assess the safety of TXA in isolated spine *** primary and secondary outcomes are to assess the rate of thromboembolic events and to evaluate blood loss and the incidence of blood transfusion,*** This prospective observational study included patients aged≥17 years with isolated spine trauma requiring surgical intervention over a 6-month period at two major trauma centers in the United *** We identified 67 patients:26(39%)and 41(61%)received and did not receive TXA,*** groups were matched in terms of age,gender,American Society of Anesthesiologists grade,and mechanism of injury.A higher proportion of patients who received TXA had a subaxial cervical spine injury classification or thoracolumbar injury classification score>4(74%vs 56%).All patients in the TXA group underwent an open approach with a mean of 5 spinal levels involved and an average operative time of 203 min,compared with 24 patients(58%)in the non TXA group who underwent an open approach with an average of 3 spinal levels involved and a mean operative time of 159 *** patients who received TXA,blood loss was<150 and 150–300 mL in 8(31%)and 15(58%)patients,*** were no cases of thromboembolic events in any patient who received *** Our study demonstrated that TXA is safe for isolated spine *** is challenging to determine whether TXA effectively reduces blood loss because most surgeons prefer TXA for open or multilevel ***,larger studies are necessary to explore the rate,dosage,and mode of administration of TXA.

关键词： Tranexamic acid Infection Trauma Thromboembolic disease Minimally invasive Percutaneous

Trends in mortality among the geriatric population undergoing Surgical aortic valve replacement (SAVR) and potential racial disparities: a 20-year perspective via the National (Nationwide) Inpatient Sample

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Journal of Geriatric Cardiology 2024年第7期21卷 716-722页

作者： Nomesh Kumar Kamleshun Ramphul FNU Bawna Nitish Behary Paray Mansimran Si-ngh Dulay Jasninder Singh Dhaliwal Shruti Aggarwal Sebastian Mactaggart Suma Sri Chennapragada Shaheen Sombans Renuka Verma Hemamalini Sakthivel Raheel Ahmed Department of Internal Medicine Detroit Medical Center Sinai Grace-Wayne State UniversityMichiganUSA In-dependent Researcher TrioletMauritius Independent researcher Farmington HillsMichiganUSA Royal Devon University Healthcare nhs foundation trust ExeterUnited Kingdom Royal Brompton Hospital part of Guy’s and St.Thomas’NHS Foundation TrustLondonUnited Kingdom Department of Internal Medicine University of Cali-forniaRiversideUSA Independent Researcher New DelhiIndia northumbria Hospitals nhs foundation trust NewcastleUnited Kingdom Department of Internal Medicine Louisiana State UniversityShreveportUSA Sha-heen Sombans Independent ResearcherHyderabadIndia Department of Internal Medicine Kirk Kerkorian School of Medicine at UNLVLas VegasUSA One Brooklyn Health System/Interfaith Medical Ctr Program BrooklynNYUSA

Background Racial disparities in cardiovascular conditions are well *** similar race-based discrepancies in health outcomes also exist among elderly patients undergoing surgical aortic valve replacement(SAVR) for aortic stenosis remains *** We abstracted data from the National(Nationwide) Inpatient Sample over a 20-year period from 2001 to 2020 using specific ICD-9 and ICD-10 *** included patients aged ≥ 60 and ≤ 80 years with races recorded as White,African American,or Hispanic at the time of their hospitalization for *** analyzed and reported the baseline characteristics,risk-adjusted inhospital mortality,and complications stratified by *** Of 420,181 patients studied,90.0% identified as White,4.0% as African American and 6.0% as *** a decrease in overall in-hospital mortality rates from 3.8% between 2001-2005 to 1.8% between 2016-2020,African Americans had higher odds of all-cause in-hospital deaths compared to Whites(a OR = 1.390,P < 0.001).Additionally,they were more likely to experience cardiogenic shock(a OR = 1.241,P < 0.001) and acute kidney injury(a OR = 1.314,P < 0.001) as well as more likely to require organ support such as IABP use(a OR = 1.336,P < 0.001) or invasive mechanical ventilation(a OR = 1.342,P < 0.001).Interestingly,African Americans were less likely to report events of acute ischemic stroke compared to Whites(a OR = 0.852,P < 0.001).Conclusions Despite a reassuring reduction in overall in-hospital mortality rates of geriatric patients undergoing SAVR for aortic stenosis,racial disparities in health outcomes remain pervasive with minorities more likely to report higher in-hospital morbidity and mortality.

关键词： mortality likely spite

Tendoscopic Surgery for Peroneal Tendons Instability: A Literature Review

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Open Journal of Orthopedics 2024年第3期14卷 139-148页

作者： Islam Mubark Amr Abouelela Mahmoud Elbakry Tarek El Gamal Department of Trauma and Orthopaedics University Hospitals Birmingham NHS Foundation Trust Birmingham UK Department of Trauma and Orthopaedics Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK Department of Trauma and Orthopaedics University Hospitals of Derby and Burton NHS Foundation Trust Derby UK

Introduction: There has been a surge in the use of tendoscopic surgery for treating peroneal tendons instability. The novelty of this approach demanded a literature review of its indications, limitations, and clinical outcomes. Aim: a literature review of the clinical studies reporting on tendoscopic peroneal tendon stabilisation surgery along with its outcomes and complications. Methods: We carried out a comprehensive review of the literature up until September 2022 with an extensive search of the MEDLINE, Embase and Cochrane library databases. Results: Initial search resulted in 66 articles. Four duplicate articles were removed. Further 30 articles were excluded after title and abstract screening. Eight studies satisfied the inclusion criteria and were included in this review. Articles were analysed for outcomes and complications. Conclusion: The tendoscopic technique for peroneal tendon instability is an effective and safe surgical technique with very low failure rate. Levels of Evidence: Level IV.

关键词： Peroneal Tendons Instability Tendoscopy

Biobanks and biomarkers:Their current and future role in biomedical research

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World Journal of Methodology 2024年第4期14卷 77-83页

作者： Michael Colwill Samantha Baillie Richard Pollok Andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

The importance and utility of biobanks has increased exponentially since their inception and *** used as part of translational research,they now contribute over 40%of data for all cancer research papers in the United States of America and play a crucial role in all aspects of *** classification systems exist but a simplified approach is to either classify as population-based or disease-oriented *** historically publicly funded institutions,there has been a significant increase in industry funded entities across the world which has changed the dynamic of biobanks offering new possibilities but also new *** face legal questions over data sharing and intellectual property as well as ethical and sustainability questions particularly as the world attempts to move to a low-carbon *** collaboration is required to address some of these challenges but this in itself is fraught with complexity and *** review will examine the current utility of biobanks in the modern healthcare setting as well as the current and future challenges these vital institutions face.

关键词： Biobanks Biomarkers Biomedical research Research methodology Research ethics

Losartan Induced Angioedema, a Rare Case Report and the Dilemma of Using Angiotensin II Receptor Blockers in Patients with Previous Angioedema with Angiotensin Converting Enzyme Inhibitors

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Open Journal of Emergency Medicine 2024年第3期12卷 69-76页

作者： Sayani Banerjee Abdul Sajjad Pathan Department of Emergency Medicine Weston General Hospital University of Bristol & Weston NHS Foundation Trust Weston Super Mare UK Department of Emergency Medicine Royal Surrey NHS Foundation Trust Guilford UK

Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.

关键词： Angioedema Airway Emergency Acute Presentation

Gastrointestinal tuberculosis:Diagnostic approaches for this uncommon pathology

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World Journal of Clinical Cases 2024年第23期12卷 5283-5287页

作者： Lottie Brown Michael Colwill Andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and highlighted the atypical manner in which gastrointestinal tuberculosis(TB)can *** literature with regards to this rare pathology is limited to case reports and case series with the largest being published using data from between 2003 and ***,since then the diagnostic tools available have significantly changed with more modern and increasingly accurate tests now *** editorial reviews the current state of the art with regards to diagnosis in gastrointestinal TB.

关键词： Gastrointestinal tuberculosis Diagnostic approach Microbiology Serology Molecular diagnosis Infectious disease

Research surveys and their evolution:Past,current and future uses in healthcare

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World Journal of Methodology 2024年第4期14卷 91-95页

作者： Michael Colwill Richard Pollok Andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

Research surveys are believed to have originated in antiquity with evidence of them being performed in ancient Egypt and *** the past century,their use has grown significantly and they are now one of the most frequently employed research methods including in the field of *** validation techniques and processes have allowed researchers to broaden the scope of qualitative data they can gather through these surveys such as an individual’s views on service quality to nationwide surveys that are undertaken regularly to follow healthcare *** article focuses on the evolution and current utility of research surveys,different methodologies employed in their creation,the advantages and disadvantages of different forms and their future use in healthcare *** also review the role artificial intelligence and the importance of increased patient participation in the development of these surveys in order to obtain more accurate and clinically relevant data.

关键词： Research surveys Methodology Sampling Artificial intelligence