CRC in our institution is more often seen in younger individuals than what is reported in population-based cancer registries from other parts of the country. The reasons for this are not clear. Therefore, further studies are required to address the role of diet and personal habits with CRC in this region. Also, a high index of suspicion among young adults is necessary.

Background Hepatocellular carcinoma (HCC) is a major global health issue, accounting for 75%–85% of primary liver cancer cases. HCC has huge molecular heterogeneity, and the treatment varies among the patients. The aim of this study is assess the effect of surgery, chemotherapy, and radiation on the mortality risk in hepatocellular carcinoma (HCC) patients. Methods A retrospective cohort study, obtaining HCC patients' data from the Surveillance, Epidemiology, and End Results (SEER) database. The analyses were conducted using the SPSS software. We investigated the effect of surgery, chemotherapy, and radiation on the mortality risk factors using the Kaplan–Meier and the Cox regression tests in the univariate and multivariate analyses. Results A total of 68270 HCC patients, of whom 56347 patients died, were analyzed. In patients who performed surgery, the mortality risk was higher in patients aged ≥50 years, Black, single and widowed, regional and distant stages, and grades II, III, and IV (HR, 1.143), (HR, 1.057), (HR, 1.095), (HR, 1.284), (HR, 1.341), (HR, 2.291), (HR, 1.125), (HR, 1.711), and (HR, 1.894) respectively. In patients who received chemotherapy, the risk was lower in females (HR, 0.948), but higher in widowed (HR, 1.143), in regional and distant stages (HR, 1.479), and (HR, 2.439) respectively, and grades III, and IV (HR, 1.741), and (HR, 1.688) respectively. In patients who received beam radiation, the risk was higher in Black (HR, 1.195), widowed (HR, 1.181), regional (HR, 1.439), and distant stages (HR, 2.287), and in grades III (HR, 1.594), and IV (HR, 1.694). Conclusion In HCC patients, Black, widowed, regional, and distant stages, grades III and IV had higher mortality risks in several treatment options. In patients who underwent surgery, ≥50 years and grade II also had a higher risk. We recommend future research to assess the radiation sequence with surgery.

To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. Subjects and MethodsThe uroLogical tEAching in bRitish medical schools Nationally (LEARN) study was a national multicentre cross-sectional evaluation. Year 2 to Year 5 medical students and Foundation Year (FY) 1 doctors were invited to complete a survey between 3 October and 20 December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). ResultsIn all, 7063/8346 (84.6%) responses from all 39 UK medical schools were included; 1127/7063 (16.0%) were from FY1 doctors who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory-based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and

Aims This systematic review seeks to identify and discuss clinical outcomes in polytrauma patients who undergo surgical fixation of unstable spinal fractures. Specifically, this review aims to address the question of whether one surgical treatment modality outperforms other surgical approaches. Methods PubMed and the Cochrane Library database were systematically searched for case reports and clinical studies using key words and MeSH terms. Titles and abstracts were skimmed, and relevant articles were identified for further analysis. A total of 96 results were returned, 16 of which were included for full-text review.  Results Six articles met the inclusion criteria. Four case reports, one case series, and one retrospective study published variable datasets, and each article failed to include highly relevant information. Thus, while conclusive statements about clinical outcomes in this population cannot be made, specific recommendations for future publications can.  Conclusion Limited studies, a small overall cohort, and inconsistent reporting of data preclude a comprehensive systematic review of clinical outcomes. However, this review serves to highlight the need for consistent and standardized reporting guidelines for this cohort. In addition, two cases were successfully treated with minimally invasive techniques, suggesting that viable surgical options exist for patients who cannot undergo open spine surgery. Finally, these data support early surgical intervention when medically possible.

Patients undergoing total hip or knee arthroplasty (THA/TKA) are commonly associated with high pain scores and narcotic use. Duloxetine is effective in relieving chronic pain. The aim of this study was to evaluate the safety and efficacy of duloxetine for pain management following THA/TKA.Five major databases (PubMed, Embase, Scopus, Cochrane, and Web of Science) were searched for randomised controlled trials (RCTs) that compared duloxetine to placebo in patients that underwent THA/TKA. The primary outcome was pain reduction with rest and movement at short-term and long-term time intervals. Secondary outcomes were the use of analgesics, length of stay, and safety profile. The risk of bias was assessed using the Cochrane tool. Data were pooled using RevMan 5.4. The results were reported as mean difference (MD) or standardised MD (SMD) and 95% confidence intervals (CI).Eight RCTs with 767 patients were included. 50.2% (n=385/767) of patients received duloxetine. After one day, duloxetine was superior to the control regarding pain reduction with rest (SMD= −0.22 [−0.41, −0.03], p=0.02) after sensitivity analysis and pain reduction at movement (SMD= −0.39 [−0.55, −0.24], p<0.001). Similarly, after 12 weeks, duloxetine significantly reduced pain with rest (SMD= −0.3 [−0.52, −0.09], p=0.006) and pain with movement (SMD= −0.52 [−0.87, −0.17], p=0.003). In addition, after sensitivity analysis, duloxetine was associated with less analgesic use after one day (MD= −4.65 [−7.3, −2.01], p<0.001) and two days (MD= −5.65 [−10.62, −0.67], p=0.03). Patients who received duloxetine also required fewer analgesics after three days. However, there was no significant difference between the duloxetine and control groups in analgesic use after one week, length of stay, and adverse events.Duloxetine was superior to the placebo regarding short-term and long-term pain reduction with rest and movement following THA/TKA. Duloxetine reduced postoperative analgesic use. There was no significant difference between duloxetine and placebo regarding adverse events and length of stay.