Mpox in 2023: Current Epidemiology and Management

Lecture: Biliary tract cancer (BTC), including intrahepatic cholangiocarcinoma (IHCC), extrahepatic cholangiocarcinoma (EHCC), ampulla of Vater cancer (AVC) and gallbladder cancer (GBC), accounts for 3% of all gastrointestinal malignancies. The incidence of BTC is increasing globally and is generally higher in Asian countries than inWestern countries, especially IHCC in Thailand, China and South Korea. In general, incidence of IHCC is higher than that of EHCC in Asian countries, while the opposite occurs in Western countries. In Taiwan, the incidence of GB cancer and EHCC was stable at 3/100000, but the incidence of IHCC was increasing, esp in male. Surgery is still the main stream for the treatment of BTC, however, the recurrence rate is still high. The gold standard therapy is chemotherapy with gemcitabine and cisplatin, but there is no consensus for standard second-line treatment. Recent progress in comprehensive genomic profiling for advanced BTC has helped to clarify tumorigenesis and facilitate the coming era of precision medicine. Fibroblast growth factor receptor 2 (FGFR2) fusion and isocitrate dehydrogenase (IDH)-and BRAF mutation-enriched populations have survival benefits from the corresponding inhibitors. Several interesting targeted agents for monotherapies or combination therapies with other compounds are currently ongoing or recruiting.

Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates

Underactive bladder (UAB) is a major component of lower urinary tract symptoms. The physiopathology mechanisms underlying UAB include detrusor underactivity, acontractile detrusor, and reduced or absent bladder sensation. UAB can influence lower and upper urinary tract function and lead to serious consequences; however, the symptom syndrome is poorly understood and incompletely researched at present. Moreover, there is no agreement among authorities regarding the terminology, definition, epidemiology, classification, risk factors, animal model, pathogenesis, diagnosis, and treatment of UAB. In this review, we discuss the current terminology, epidemiology, physiopathology, evaluation, and management of UAB.

The Next Frontier in Neurocritical Care in Resource-Constrained Settings

Cardiovascular implantable electronic device (CIED) implantation rate has substantially risen in the foregoing decades. Unfortunately, this upsurge in CIED implantation rate has been accompanied by a disproportionate rise in the rate of CIED infections. Device infection is a major complication of CIED implantation, necessitating removal of an infected device followed by systemic antimicrobial therapy and reimplantation of a new system. In this article, we review the current epidemiology, risk factors, diagnostic strategy and contemporary management of CIED infection. In addition, we address the vexing question of how to best manage patients with Staphylococcus aureus bacteremia, in the setting of an implanted device, but no overt clinical signs of CIED infection. Lastly, we discuss the preventive strategies to minimize risk of CIED infection.

Hepatitis C Virus in Pregnancy: An Opportunity to Test and Treat