The Royal Adelaide Hospital (RAH), colloquially known by its initials or pronounced as "the Rah", is South Australia's largest hospital, owned by the state government as part of Australia's public health care system. The RAH provides tertiary health care services for South Australia and provides secondary care clinical services to residents of Adelaide's central metropolitan area, which includes the inner suburbs.The original Adelaide Hospital was built in 1840 at the eastern end of North Terrace, Adelaide, with its first building superseded in 1856 and many alterations and additions over the following 175 years. It was prefixed by the "Royal" in 1939. In 2017 it was replaced by the new hospital, built at the western end of North Terrace. The new hospital is the most expensive building ever built in Australia, and the most expensive hospital ever built anywhere in the world, at US$2.44 billion in construction and equipment costs. The redevelopment on the site of the old RAH is known as Lot Fourteen.
The osteoblast lineage has traditionally been viewed through a structural and metabolic lens, yet growing evidence indicates that these cells possess diverse functions, including roles in innate and adaptive immune responses. To establish a coherent mechanistic framework, we performed a systematic review of the literature concerning immune signalling, antigen presentation, and pathogen responses across the osteoblast lineage. We identified 463 unique studies, with 43 meeting the inclusion criteria. Our synthesis reveals a stage-specialised immune continuum. Osteoprogenitors appear to initiate early inflammatory signalling while mature osteoblasts operate as microbial sensors and conditional antigen-presenting cells via inducible expression of cell membrane and cytosolic pattern recognition receptors, and a functional major histocompatibility complex class II apparatus. Osteocytes, the most abundant and long-lived bone cell type, are also capable of detecting microbial danger and activate extensive interferon, chemokine and cytokine programmes within the lacunocanalicular network. Together, these properties define a stromal immune system that coordinates both innate and adaptive immunity across bone surfaces and the mineralised matrix. This osteoblast lineage-integrated immune architecture provides a conceptual basis for understanding osteomyelitis incidence and persistence, biomaterial–immune interactions, as well as inflammatory bone remodelling, reframing this lineage as a previously underappreciated regulator of skeletal and systemic immunity.
Synchronous measures of head kinematics and in vivo brain deformation during rapid head rotation are needed to advance understanding of traumatic brain injury (TBI) mechanics and enhance computational modeling as a tool for injury risk assessment and prevention. The aims of this study were to produce repeatable rapid rotation of the in vivo sheep head, to assess the viability of the sonomicrometry method for measuring multipoint brain displacement, and to quantify the in vivo brain deformation response to rapid rotation. In three anaesthetized adult sheep, arrays of sonomicrometry transceivers were implanted into the brain and rigidly attached to the inner skull surface. Repeatable, rapid, sagittal plane head rotation (nominally about the second cervical vertebra) was induced with a non-impact head rotation apparatus. Computed tomography imaging was performed to assess relative motion between transceivers and brain tissue. Three-dimensional brain displacement, strain, and head kinematics were assessed for repeatability. The location of up to 13 (mean = 11) brain transceivers were tracked in each of 11 rapid head rotation tests. Peak head angular acceleration and velocity were up to 38.56 krad/s2 and 30.43 rad/s, respectively, and average duration of head motion was 241.9 ± 23.1 ms. Pre-to-post-test transceiver displacement in brain tissue was less than the spatial resolution of the measurement system, and brain displacements measured during rapid head rotation had excellent repeatability (CORA score 0.99). Brain displacements and strains up to 2.47 mm and 18
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 myriad of pathological process may involve the pituitary stalk (infundibulum), and despite extensive investigations, biopsy is often required. Due to the rarity of the procedure, the risks and yield of stalk biopsy are not well known, with important implications for clinical decision making. A systematic review was performed in accordance with the PRISMA statement. Studies that reported diagnostic yield and complication rates after stalk biopsy were included. Bias was assessed using ROBINS-V2. A total of 13 studies, including 832 patients and 406 biopsies were included. Mean time from diagnosis to biopsy was 11 months. Preoperative visual symptoms were seen in 29.1
Scleritis is a rare and severe ocular inflammatory disease that is often associated with potentially sight-threatening ocular complications. The aim of the present study was to characterize ocular complications in non-infectious scleritis and identify predictive variables for their development. Data for this registry-based study were extracted from the AutoInflammatory Disease Alliance Network for Scleritis Registry. Univariate analysis was performed to examine potential associations of demographic and clinical variables with the development of ocular complications. Uveitis and peripheral ulcerative keratitis were considered to be extensions of the inflammatory process and not to be true structural complications. Predictive factors of ocular complications were assessed using regression analysis. The impact of ocular complications on visual acuity—measured by best-corrected visual acuity (BCVA)—was also analyzed. A total of 154 patients (218 eyes) with non-infectious scleritis were enrolled. In 58 of these patients (87 eyes), 102 ocular complications were recorded, with cataract, scleral and corneal thinning, and glaucoma and/or increased ocular pressure being the most frequently recorded complications. Ocular complications were found to be significantly more frequent among patients affected by granulomatosis with polyangiitis (GPA) (p < 0.0001) and concomitant uveitis (p = 0.023). The mean severity score was significantly higher among eyes experiencing ocular complications (p < 0.0001). Regression analysis identified three variables capable of predicting the development of ocular complications: a diagnosis of GPA [odds ratio (OR) 7.747, p < 0.0001]; the presence of concomitant uveitis (OR 3.648, p = 0.019); and a high severity score (OR 1.138, p = 0.044). Mean (± standard deviation) BCVA converted to logMAR was found to be significantly higher among eyes without ocular complications (0.12 ± 0.24 vs 0.27 ± 0.49; p = 0.005). Scleritis was accompanied by irreversible ocular complications in a considerable proportion of the patients enrolled in this study. Patients with a diagnosis of GPA, concomitant uveitis, and a higher severity score are more likely to develop ocular complications, and thus warrant a tighter follow-up schedule and early treatment in order to minimize the risk of poor visual prognosis.
