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Burden and distribution of venous thromboembolism across cancer types and stages: a meta-analysis of observational studies.

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication among patients with cancer. This systematic review and meta-analysis aimed to quantify the proportion of VTE across different cancer types, stages, and study settings.MethodsA comprehensive literature review was conducted to identify observational studies reporting VTE events in cancer patients. Studies were categorized into population-based and hospital-based settings to compare VTE prevalence. Cancer types were classified by anatomical origin, and cancer stages (Stage I-IV). Meta-analytic techniques were appl

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… 23) | I–IV Vormittag et al. ( 24 ) | Austria | 2009 | Hospital Based | 840 | 462/378 | Mean age: 62 years | 62 | Brain (103), Breast (136), Lung (120), Upper gastrointestinal (36), Colorectal (111), Pancreas (47), Kidney (24), Prostate (105), Multiple myeloma (17) | II and IV Saadeh et al. ( 25 ) | Ireland … The United States and Canada are marked, along with several countries in Europe and Asia, including Sweden, Ireland, Netherlands, Austria, Italy, Greece, Saudi Arabia, and Japan. The studies employed two principal research designs: hospital-based and population-based ( Table 1 ). …

Oncology biosimilars: New developments and future directions.

Biologicals have become an integral part of cancer treatment both as therapeutic agents and as supportive care agents. It is important to know that biologics are large, complex molecular entities requiring extensive immunogenicity testing and pharmacovigilance strategies to ensure no immune response is evoked in the body. Oncology's pharmacological market is dominated by biologics; however, their high development and manufacturing costs are burdensome to health care systems. Biologics being the most expensive prescription drugs on the market limit the accessibility for necessary treatment in t

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… . | 2018 Fulphila® | Mylan S.A.S | 2018 Udenyca® | ERA Consulting GmbH | 2018 Pelmeg® | Mundipharma Corporation (Ireland) Limited | 2018 Ziextenzo® | Sandoz GmbH | 2018 Grasustek® | Juta Pharma GmbH | 2019 Cegfila® | Mundipharma Corporation (Ireland) Limited | 2019 Nyvepria® | Pfizer Europe MA EEIG | … Biosimilar manufacturer | Approval date Avastin® (Bevacizumab) | Genentech, Inc. | Mvasi® (bevacizumab‐awwb) | Amgen Inc | 2017 Zirabev® (bevacizumab‐bvzr) | Pfizer Inc. | 2019 Rituxan® (Rituximab) | Genentech, Inc. | Truxima® (rituximab‐abbs) | Celltrion, Inc | 2018 Ruxience® (rituximab‐pvvr) | Pfizer Ireland …

Procedure-specific outcomes of bipolar versus monopolar electrocautery in primary hip and knee arthroplasty: A systematic review and meta-analysis.

BACKGROUND: Bipolar (BP) electrocautery has been introduced as an alternative to monopolar (MP) electrocautery in arthroplasty, with proposed advantages including reduced blood loss and improved haemostasis. This study aimed to compare peri-operative blood loss and haemoglobin levels associated with bipolar versus monopolar electrocautery in PrimaryTHA and TKA. METHODS: A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed in accordance with PRISMA guidelines. MEDLINE, EMBASE, and Cochrane databases were searched by two independent reviewers. Studies compa

Transanal minimally invasive surgery (TAMIS) versus transanal endoscopic microsurgery (TEM) for local excision of rectal neoplasms: A systematic review and meta-analysis.

BACKGROUND: Local excision techniques, including transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS), are widely used for selected rectal neoplasms, though direct comparative evidence remains limited. METHODS: A PRISMA-guided systematic review and meta-analysis (PROSPERO CRD420251125364) searched MEDLINE, Embase, Scopus, and Cochrane CENTRAL for comparative studies of TAMIS versus TEM/TEO. Primary endpoints were resection quality and a harmonised composite "poor-quality resection" endpoint (R1 margin and/or specimen fragmentation). Random-effects meta-anal

Correlation between consultant presence and clinical outcome for trauma laparotomy - Implications for surgical training.

BACKGROUND: Surgical training relies on graduated levels of responsibility, where incrementally less supervision is required as the trainee progresses. Emergency trauma laparotomy is both a high risk operation and an important training opportunity; a balance must be maintained between ensuring patient safety and allowing trainee surgeons to develop independent competence. This study set out to assess whether consultant presence at trauma laparotomy results in improved outcomes and to develop criteria for consultant attendance. METHODS: We retrospectively analysed 1300 trauma laparotomies at a

Peroneus longus versus hamstring tendon autografts in arthroscopic anterior cruciate ligament reconstruction: A randomised controlled study.

BACKGROUND: Hamstring tendon autograft is widely used for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding graft size, harvest duration, and donor-site morbidity. Peroneus longus tendon (PLT) autograft has emerged as a potential alternative. This study compared PLT and hamstring tendon (HT) autografts in arthroscopic ACL reconstruction. METHODS: A randomised controlled study was conducted at a tertiary orthopaedic centre. Adults with ACL rupture were allocated to HT (n = 81) or PLT (n = 81) autograft. Primary outcomes included graft harvest time and graft dimens

Post-operative mobilisation and mobility outcomes after pelvic exenteration surgery for colorectal cancer.

BACKGROUND: Total pelvic exenteration surgery varies in the level of resection performed and requirement for reconstructive surgery. This study aimed to describe the recovery of mobility in the post-operative period and how it varies according to the surgery performed. METHODS: A retrospective audit of 104 patients was conducted, reflecting surgery conducted over a 7-year period. Data was collected until hospital discharge. Mobility was measured using the Intensive Care Mobility Scale. Results were analysed based on three levels of perineal resection (pelvic exenteration without abdominoperin

Arthroscopy of femoroacetabular impingement and osteoarthritis: a systematic review.

BACKGROUND AND PURPOSE: Although studies suggested an association between patient factors and various outcome measures in the surgical management of femoroacetabular impingement (FAI), there is a lack of consistent evidence of the influence of osteoarthritis (OA) in patients with FAI syndrome treated arthroscopically. This systematic review investigated the influence of OA on the outcome of arthroscopy for FAI. METHODS: The present systematic review followed the PRISMA statement. Web of Science, PubMed, and Embase were accessed in June 2024. All the clinical investigations comparing the outco

Do peri-operative prophylactic antibiotics reduce pin-site infection after K-wire application in closed fractures? An international prospective cohort study.

BACKGROUND AND PURPOSE: The role of peri-operative prophylactic antibiotics in preventing pin-site infection after percutaneous K-wire fixation of closed fractures is unclear, and guidance does not address this procedure. This study evaluated whether prophylaxis reduces infection risk in this setting. METHODS: International, multicentre, prospective cohort study across 30 hospitals in three countries (United Kingdom, Spain, Greece) from December 2023 to October 2024, including patients with distal radius or supracondylar elbow fractures managed by percutaneous K-wire fixation. Antibiotic admi

When to refer for surgery in long bone metastases: A powered multivariate analysis of fracture risk and simple algorithm for referral for surgery (the metastatic fracture prediction met FRAP score).

BACKGROUND: It is difficult to predict the risk of pathological fracture in patients with bone metastases. Popular scoring systems like Mirels' may overestimate need for surgery by 20%. The aim was to identify predictors of fracture at 6 months in patients with long bone metastases managed non-surgically. PATIENTS AND METHODS: This was an adequately powered retrospective analysis of individuals with a long bone metastasis. Patients were identified from radiology reports and excluded if they had prophylactic surgery or died within 3 months. A literature review and pilot study identified 13 var

Accelerating care for knee injuries: Impact of a novel acute knee injury virtual triage clinic on timely diagnosis and treatment.

INTRODUCTION: Knee injuries are a common presentation to Emergency Departments (ED). Initial assessment prioritizes the exclusion of fractures, dislocations and other urgent pathologies. However, subsequent soft-tissue knee injuries referral pathways to orthopedic services remains inconsistent. Variability in orthopedic referral pathways may lead to delays in definitive diagnosis and intervention, potentially compromising recovery and long-term functional outcomes. METHODS: This study reviews the first 250 patients referred from ED to an acute knee injury virtual triage clinic. Virtual clinic

Can we reduce the residual use of Hartmann's procedure in generalized peritonitis due to perforated colonic diverticulitis ?

AIM OF THE STUDY: Primary anastomosis (PA) is now recommended for most cases of diverticular peritonitis. However, recent studies have shown that Hartmann's Procedure (HP) is still included in the majority of practice patterns. The aim of this study was to analyze situations wherein HP was carried out and to define its remaining place among current treatment options for generalized peritonitis. METHODS: We performed a retrospective cohort study of patients who underwent sigmoidectomy for diverticular peritonitis at Rouen University Hospital between 2004 and 2020. Logistic regression was compu

Neoadjuvant tyrosine kinase inhibitor therapy for locally advanced, well-differentiated thyroid cancer.

INTRODUCTION: Locally advanced, well-differentiated thyroid cancer presents a surgical challenge, particularly when tumours involve the airway or other critical structures. Neoadjuvant tyrosine kinase inhibitors (TKIs) may downsize disease and improve operability, but evidence remains limited. This study reports oncological and surgical outcomes following neoadjuvant TKI therapy in a single-centre cohort. METHODS: A retrospective cohort study was conducted of patients with locally advanced, well-differentiated thyroid cancer treated with pre-operative TKI therapy between 2016 and 2025. Clinic

Risk and predictors of postoperative mortality in patients with liver cirrhosis undergoing trauma laparotomy: A systematic review and meta-analysis with meta-regression.

AIMS: To evaluate the effect of liver cirrhosis on postoperative mortality after trauma laparotomies. METHODS: A PRISMA-compliant meta-analysis with meta-regression using random-effects modelling was conducted (last search: 25 August 2025). All studies comparing the risk of postoperative mortality in adult patients with and without liver cirrhosis undergoing trauma laparotomies were included. The certainty of evidence was evaluated using GRADE system. RESULTS: Eight studies comprising 3,285 patients were included (cirrhosis group: 733; no cirrhosis group: 2,552). Both groups were comparable

The importance of mechanism in penetrating spinal injuries - A comparative study between gunshot wounds versus stab wounds to the spine managed at a major trauma centre in South Africa.

INTRODUCTION: Although both gunshot wounds (GSW) and stab wounds (SW) can cause a penetrating spinal injury, the mechanisms underlying these injuries are distinct. This study compares spinal GSWs and SWs regarding their presenting characteristics, associated injuries, clinical management, and patient outcomes. METHODS: Longitudinal data (2012-2022) were collected from the Hybrid Electronic Medical Registry database to identify all patients with spinal GSW and SW over the study period. RESULTS: There were 201 (54%) patients with spinal GSW and 169 (46%) patients with spinal SW. Thoracic level

Review of chest injuries in a trauma centre without local cardiothoracic surgery.

BACKGROUND AND AIMS: The vast majority of UK Major Trauma Centres either have on site cardiothoracic surgery or are located in proximity to a cardiothoracic centre. One exception is Ninewells Hospital, Dundee, which is located 70 miles from the nearest cardiothoracic department. The nature of this atypical arrangement and its implications are reviewed. METHODS AND RESULTS: The Scottish Trauma Audit group (STAG) was searched for details of patients sustaining a thoracic injury and presenting to NHS Tayside over a 17 month period. Data were analyzed for demographic information, mechanisms of in

Outcome of pedicle screw surgery in spondylolisthesis patients with and without modic changes.

OBJECTIVES: Lumbar spondylosthesis is a relatively common complication. This study was designed and conducted with the aim of investigating the role of Modic changes in the surgical results of patients with spondylolisthesis who undergo posterolateral fusion with pedicle screws. METHODS: In this prospective cohort study, 83 patients diagnosed with degenerative spondylolisthesis with or without Modic changes and candidates for posterolateral fusion surgery with pedicle screws were included. The patients were divided into three groups: Modic 0, 35 people; Modic I, 26 people; and Modic II, 22 pe

Periprosthetic femoral fractures: Ten-year clinical experience using a fracture-specific fixation system: A retrospective study.

BACKGROUND: Incidence of periprosthetic femoral fractures (PFFs) is increasing with rising use of hip and knee arthroplasty in the elderly population. These injuries require complex management and are associated with high morbidity and mortality. AIM: To evaluate outcomes and complications of PFFs in 111 patients treated with Zimmer Biomet Non-Contact Bridging (NCB) plating over a 10-year period. METHODS: Retrospective analysis of 111 patients treated with NCB plating from 2012 to 2022 at a single UK centre was conducted. Fractures were classified by the Unified Classification System (UCS).

Neurodiversity in surgery: Embracing cognitive difference in a demanding profession.

BACKGROUND: Neurodiversity encompasses natural variations in cognitive functioning, including autism spectrum disorder, ADHD, and specific learning difficulties. While the concept is increasingly recognised in education and general workplaces, its relevance in medicine and particularly in surgery, remains underexplored. METHODS: We conducted a systematic review in accordance with PRISMA 2020. Searches of PubMed, Embase, Medline, Global Health and PsycINFO databases up to July 2025 identified studies on neurodivergence among surgeons and healthcare professionals. Eligible publications addresse

Implementation of a national clinical guideline for cauda equina syndrome improves referral quality and reduces delays to MRI.

BACKGROUND: Cauda equina syndrome (CES) is a neurological emergency with significant potential for permanent morbidity and medicolegal consequences. Timely MRI is essential, yet delays remain common. The Irish Health Service Executive (HSE) published a National Clinical Guideline for CES in June 2024. This study evaluates the impact of its introduction on referral quality and time to MRI in a tertiary, non-spinal centre. METHODS: A retrospective review of all suspected CES referrals from the emergency department to the orthopaedic department was performed over a 40-month period spanning guide