T1D (Type 1 diabetes) is an autoimmune disease caused by the immune-mediated destruction of pancreatic β-cells. Studies in T1D patients have been limited by the availability of pancreatic samples, a protracted pre-diabetic phase and limitations in markers that reflect β-cell mass and function. The NOD (non-obese diabetic) mouse is currently the best available animal model of T1D, since it develops disease spontaneously and shares many genetic and immunopathogenic features with human T1D. Consequently, the NOD mouse has been extensively studied and has made a tremendous contribution to our understanding of human T1D. The present review summarizes the key lessons from NOD mouse studies concerning the genetic susceptibility, aetiology and immunopathogenic mechanisms that contribute to autoimmune destruction of β-cells. Finally, we summarize the potential and limitations of immunotherapeutic strategies, successful in NOD mice, now being trialled in T1D patients and individuals at risk of developing T1D.

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ObjectiveThree-dimensional printing is a revolutionary technology that is disrupting the status quo in surgery. It has been rapidly adopted by otolaryngology as a tool in surgical simulation for high-risk, low-frequency procedures. This systematic review comprehensively evaluates the contemporary usage of three-dimensional printed otolaryngology simulators.MethodA systematic review of the literature was performed with narrative synthesis.ResultsTwenty-two articles were identified for inclusion, describing models that span a range of surgical tasks (temporal bone dissection, airway procedures, functional endoscopic sinus surgery and endoscopic ear surgery). Thirty-six per cent of articles assessed construct validity (objective measures); the other 64 per cent only assessed face and content validity (subjective measures). Most studies demonstrated positive feedback and high confidence in the models’ value as additions to the curriculum.ConclusionWhilst further studies supported with objective metrics are merited, the role of three-dimensional printed otolaryngology simulators is poised to expand in surgical training given the enthusiastic reception from trainees and experts alike.

Background: Both age and comorbidity are accepted as significant prognostic factors for adverse perioperative outcomes in major surgery. Elderly patients may be overlooked for radical treatment for fear of poor perioperative outcome. We aim to assess the relationship between age, comorbidities and post-operative outcomes in a tertiary head and neck unit. Methods: A retrospective analysis was undertaken on 651 patients who underwent surgery for head and neck cancer at a tertiary hospital between 2007 and 2014. Results: A total of 253 (38.9%) patients were aged ≥70 years and 398 (61.1%) patients were ≤69 years. Age alone did not predict prolonged post-operative stay, perioperative complications nor perioperative mortality. Congestive cardiac failure and/or complicated diabetes were significantly associated with poor outcomes, as was male sex. Conclusion: Patients of any age with cardiac failure or complicated diabetes have a higher rate of post-operative complications in head and neck surgery. © 2019 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 851-855ANZJSurg.com