Christchurch Hospital is the largest tertiary hospital in the South Island of New Zealand. The public hospital is in the centre of Christchurch city, on the edge of Hagley Park, and serves the wider Canterbury region. The Canterbury District Health Board (CDHB) operates the hospital with funding from the government.Christchurch Hospital is the major trauma centre for northern and central Canterbury, and the tertiary major trauma centre for the wider Canterbury and West Coast regions. It has the busiest ED in the South Island and sees more major trauma than any other hospital in New Zealand, and all but a handful of hospitals in Australia.The Christchurch School of Medicine is on the hospital campus, the school provides teaching for fourth, fifth and sixth year medical students, and is part of the University of Otago.A new building, sitting behind the original Christchurch Hospital buildings, named ‘Waipapa’ was opened in 2020 and houses Canterbury DHB’s acute services. Christchurch Hospital’s Emergency Department is now located within Waipapa.The hospital’s helipad now sits atop of the Waipapa building, and replaces the previous one situated in Hagley Park, 500 m (1,600 ft) to the southwest along Hagley Avenue.
To compare perioperative, oncological, and survival outcomes of total gastrectomy (TG) versus subtotal gastrectomy (SG) in patients with locally advanced distal diffuse gastric adenocarcinoma treated with perioperative 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) chemotherapy. Diffuse distal gastric cancer is characterized by infiltrative growth patterns and early nodal metastasis. Whilst radical resection remains the cornerstone of curative treatment, the optimal extent of surgery with TG or SG, remains debated. This international multicenter cohort study analyzed data from patients with histologically confirmed diffuse gastric adenocarcinoma, located > 5 cm from the gastroesophageal junction. Endpoints included surgical margin status, nodal yield, perioperative morbidity, recurrence patterns, time-to-recurrence (TTR), and overall survival (OS). Outcomes were compared using multivariate analyses. In total, 188 (39.0
A simple head tap can stimulate inner ear otolith organ activation. In this pilot proof-of-concept study, midline forehead taps were delivered in the magnetic resonance imaging (MRI) scanner to elicit an observable response in the areas most suspected of representing a vestibular cortex. In three right-handed and three left-handed healthy adult volunteers, manual midline forehead taps delivered in the fMRI scanner gave consistent brain responses at the temporoparietal junctions, although there was not an intensity correlation with handedness. Five of six showed an expected somatosensory response. In a further three participants, two profoundly deaf, there were activations; specifically, these results suggest a vestibular response and not an auditory response. Based on a positron emission tomography (PET) scan study employing 'natural' vestibular stimuli with no likelihood of artefact responses, the fMRI scan data was analysed for the presence of insula and Heschl's gyrus responses, which were found. The insular cortex, particularly the posterior insula, is the most frequently responding structure in all vestibular imaging studies and appears to be the most important as being, or as constituting part of, the vestibular cortex. This fMRI technique is simple, noninvasive and could be automated by compressed air.
ZNF711 is one of eleven zinc-finger genes on the X chromosome that have been associated with X-linked intellectual disability. This association is confirmed by the clinical findings in 20 new cases in addition to 11 cases previously reported. No consistent growth aberrations, craniofacial dysmorphology, malformations or neurologic findings are associated with alterations in ZNF711. The intellectual disability is typically mild and coexisting autism occurs in half of the cases. Carrier females show no manifestations. A ZNF711-specific methylation signature has been identified which can assist in identifying new cases and in confirming the pathogenicity of variants in the gene.
BACKGROUND:Measurement of cardiac troponin (cTn) using high-sensitivity assays is recommended for the diagnosis of myocardial infarction. We determined sex-specific and uniform 99th percentile upper reference limits (URLs) using the new Elecsys® Troponin T high-sensitivity Gen 6 assay in a global, healthy reference range cohort. METHODS:Lithium-heparin plasma and serum samples were prospectively collected from apparently healthy individuals aged ≥20 years across 34 global sites in the United States, Europe, China, and Japan. cTnT was measured using the Troponin T high-sensitivity Gen 6 assay on the Cobas® e 801 analyzer. Exclusion criteria were defined according to the 2022 IFCC guidance. Uniform and sex-specific 99th percentile URLs and nonparametric 95% CIs were determined in plasma and serum separately and combined. RESULTS:The final study population comprised 4147 participants (52.5% female) with a median (25th-75th percentiles) age of 48.0 (33.0-59.0) years; 45.8%, 47.9%, 5.2%, and 1.1% were White, Asian, Black, and other/unknown, respectively. For sample matrices combined (n = 8294), 81.0% and 99.2% of cTnT values were above the limit of detection in females and males, respectively. Sex-specific 99th percentile URLs (95% CI) were 18 (16-23) ng/L for females and 32 (28-35) ng/L for males; the uniform 99th percentile URL was 27 (24-31) ng/L. URLs were comparable in plasma and serum samples. CONCLUSIONS:This study determined sex-specific and uniform 99th percentile URLs for the Troponin T high-sensitivity Gen 6 assay that were comparable irrespective of the matrix used in a large, global, healthy reference population.
Functional/Dissociative Seizures (FDS) are presentations that appear like epileptic seizures but occur without abnormal cortical electrical activity in the brain. Abnormal respiratory patterns, particularly hyperventilation, have been frequently observed in people with FDS, suggesting this may be a potential therapeutic target. This scoping review aimed to explore the various applications of breathing techniques in the treatment of FDS, synthesizing evidence from clinical and case-based articles to provide a comprehensive overview of this therapeutic modality. Systematic searches were conducted in MEDLINE Complete, Embase, and PsycINFO databases to identify published case reports, case series, clinical trials, clinician perspectives, and book chapters reporting on the use of breathing as a primary or adjunct intervention in patients with diagnosed FDS. Of the 4123 articles identified, 28 were included in the final synthesis (18 = case reports/series; 10 = clinical trials). The majority of articles integrated breathwork within broader psychotherapeutic approaches, with only two using it as a standalone intervention. Findings provide preliminary support for the feasibility and potential benefit of breathing techniques in FDS management; however, the evidence remains limited, heterogeneous, and indirect. Further controlled studies are needed to clarify the mechanisms and efficacy of breathwork interventions for FDS.
