METHODS: We report on a series of 31 patients who underwent dry MT with artificial pneumothorax induction using Veress needle under thoracic ultrasonography (TUS) guidance. A procedure was considered technically successful if it met all the following criteria: successful pneumothorax induction, allowing smooth insertion of the semi-rigid thoracoscope; absence of immediate significant procedural-related complications; and no delayed complications such as persistent air leaks, defined as leakage lasting more than 5 days necessitating extended chest tube placement.
RESULTS: Complete pneumothorax induction was achieved in 25 cases, resulting in an 80.6% technical success rate; however, biopsies were successfully performed in all cases. The most frequent histopathological diagnoses were malignancy (n=9, 29.0%), followed by inflammatory pleuritis (n=8, 25.8%) and tuberculosis (n=8, 25.8%). No procedural complications were reported.
CONCLUSION: These results indicate that TUS-guided dry MT utilizing a Veress needle is technically feasible and secure when performed by experienced MT practitioners in TUS.
AIM: The examinations aim to calculate the intraocular lens (IOL) power required to achieve emmetropia following cataract surgery.
METHODS: Five Bornean sun bears diagnosed with cataracts at the Bornean Sun Bear Conservation Centre in Malaysia underwent ocular examination under general anesthesia. Keratometry and biometry data, including anterior chamber depth, crystalline lens thickness, and axial globe length, were collected using an automated keratometer and B-mode ultrasound. The Retzlaff, Binkhorst, Colenbrander, and Fyodorov formulas were used to estimate the required IOL power.
RESULTS: The mean corneal keratometric power was 56.94 D, the mean axial globe length was 12.93 mm, and the mean calculated postoperative anterior chamber depth was 4.77 mm. The mean calculated IOL power was +92.96 D. Conclusion: Aphakic cataract surgery were decided following these findings showing no available commercial IOL implants for this species. These findings provide valuable baseline data for optimizing cataract surgery in Bornean sun bears.
PURPOSE: This study aims to assess the precision of ultrasound in identifying upper limb peripheral nerves by comparing ultrasonographic findings with direct human cadaveric dissection.
METHOD: Fourteen fresh-frozen upper limb specimens were examined in February 2023. Ultrasound assessments were performed by two experienced musculoskeletal radiologists using three linear probes (15 MHz, 24 MHz, and a 22 MHz hockey stick probe). Seven peripheral nerves were identified and marked using dye injections. Subsequent dissections were conducted under loupe magnification by hand surgeons.
RESULT: The recurrent motor branch of the median nerve exhibited the lowest discrepancy (mean 1.014 ± 1.459 mm) and the highest accuracy (64.29% of specimens). The greatest discrepancy was observed in the branch of the musculocutaneous nerve to the brachialis (mean 5.114 ± 3.758 mm). The interrater correlation coefficient (ICC) varied across nerve sites, ranging from - 6.298 to 0.795, with the highest ICC observed in the superficial branch of the ulnar nerve (0.795, 0.066).
CONCLUSION: These findings suggest that ultrasound is a valid and effective tool for identifying peripheral nerve branches in the upper limb, particularly for superficial nerves. Improved accuracy in ultrasound-guided nerve identification may enhance surgical precision and reduce complications in nerve-related procedures.
OBJECTIVES: This review focuses on colorectal cancer (CRC) and hepatocellular carcinoma (HCC) as exemplar conditions, synthesising current evidence on disparities across the care continuum and exploring strategies to mitigate them.
METHODS: Current national data and published evidence were reviewed to assess inequities in disease prevalence, access to care, and outcomes across socioeconomic strata, regions, and ethnic groups. The analysis also examined workforce distribution, policy frameworks, and emerging interventions aimed at addressing these disparities.
RESULTS: Disease prevalence and outcomes are markedly worse in socioeconomically deprived regions; liver disease mortality is more than twice as high in the poorest deciles, and CRC survival is significantly lower among disadvantaged populations. Access to care remains uneven-deprived groups exhibit lower CRC screening uptake, delayed diagnoses, and higher emergency presentation rates. Routine HCC surveillance in at-risk patients is inconsistently delivered. Workforce shortages and maldistribution exacerbate these inequities, with under-resourced regions facing longer waiting times and limited specialist access. Systemic challenges, including social determinants, data deficits, and policy underprioritisation, further hinder progress.
EMERGING DEVELOPMENTS: Promising advances include the NHS's expansion of community diagnostic centres, targeted workforce investment, national hepatitis C virus (HCV) elimination programmes, and structural interventions such as minimum unit pricing for alcohol. Technological innovations-including non-invasive diagnostics and digital tools-offer additional opportunities to bridge care gaps.
CONCLUSIONS: Targeted actions, such as implementing primary care FibroScan services, CRC outreach initiatives with GP endorsement, and patient navigation for HCC surveillance, are critical to reducing inequalities and improving outcomes. By addressing upstream determinants and ensuring that innovations reach under-served populations, the UK can progress toward reducing GI health inequalities, improving outcomes, and achieving more uniform digestive health across all communities.
METHODS: Available meeting reports since inception in 2022 and registration data for the year 2024 were analyzed. Meeting recordings were reviewed to describe the cases presented for opinion. A focus group discussion was conducted among core team members to evaluate the virtual meetings.
RESULTS: From January 2022 to August 2024, the Southeast Asian pediatric neurosurgery group organized 16 online meetings to discuss 50 patients. Based on the report for 12 meetings (75%), the mean number of participants for each session was 45 ± 11, with 91% ± 5% of the attendees being present for at least 15 minutes. Review of 2024 registration data showed that 142 unique participants from 15 countries attended the 5 meetings for this year. Most were neurosurgery residents (65%) and neurosurgery consultants (23%). Of 50 cases presented, the majority were tumors (52%) and craniofacial disorders (16%). Discussions centered on most probable diagnosis (34%), best treatment option (90%), and recommended surgical approach (82%).
CONCLUSIONS: International case discussions in pediatric neurosurgery are feasible and sustainable online, with the potential to improve service delivery, strengthen the workforce, and grow professional networks. Leadership and time commitment from a core group are essential to ensure the success of these global neurosurgery collaborations.