Trans-radial access (TRA) offers advantages in elective settings, but its safety and feasibility in emergencies remain understudied. This study compares TRA and trans-femoral access (TFA) in emergency embolizations at a Level 1 trauma center. Ethical approval was obtained for this retrospective analysis. A total of 421 emergency embolizations performed on 389 patients were included. TRA (n = 95, including 44 distal radial) and TFA (n = 326) were compared for technical success rate, procedural success rate, and access-site complications. Multivariate analysis was used to identify independent predictors of complications. TRA patients were younger (median 58 vs. 66 years; p = 0.044) with less hypertension (33.7
Fusion surgery, where laparoscopic techniques are purposefully integrated into robotic surgery, is a novel approach that can be used in colorectal surgery. However, a standard definition and practical guidance are lacking. Therefore, this study aimed to generate consensus to standardise the definition of fusion surgery and consequently raise awareness of fusion surgical approaches and their appropriate use cases. We conducted a two-round modified Delphi study with 17 colorectal surgeons from Asia–Pacific (5 Steering Committee [SC]; 12 Expert Panellists [EP]). Statements were drafted by the SC based on clinical experience, published literature and comments from the EP. The EP rated these statements anonymously on a 5-point Likert scale. A virtual expert meeting was held between voting rounds to discuss the statements. Consensus was predefined as ≥ 75
A low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet is a primary therapy for irritable bowel syndrome (IBS). One-on-one sessions with registered dietitians (RDs) require considerable resources and may not be readily available. This literature review assessed the impact of a low FODMAP diet group education in patients with IBS. Three relevant articles were identified. The RD-led low FODMAP diet group education was found to significantly improve gastrointestinal symptoms with good diet adherence. Patient preferences for education format varied, with approximately a quarter favoring group education and over 40% expressing no preference. Group education can be a practical and cost-effective alternative in IBS management.
Homocysteine is a sulfhydryl-containing amino acid formed during the metabolism of methionine. Hyperhomocysteinemia is currently considered a weak prothrombotic factor, and it is still unclear whether administration of folate and B12, that reduce homocysteine levels acting as cofactors of the enzymes involved in the methionine metabolism, may decrease the risk of arterial and/or venous thromboembolic events. In this case report, we describe a young patient admitted at Tan Tock Seng Hospital in Singapore, with cerebral venous thrombosis associated with intermediate hyperhomocysteinemia treated with direct oral anticoagulation and vitamin supplementation. Hyperhomocysteinemia is generally a modest prothrombotic risk factor. Persistent intermediate elevations may be observed in young patients with recurrent arterial and venous thrombosis, but causality cannot be inferred from a single case. In this patient, long-term anticoagulation was guided by recurrent unprovoked events, and vitamin supplementation addressed a correctable deficiency. The case highlights the importance of comprehensive evaluation and individualized management in young patients presenting with unexplained thrombotic events.
Diagnostic errors in mammography—particularly missed or delayed breast cancer detection—have a substantial impact on patient outcomes. These misdiagnoses remain a leading cause of malpractice claims in radiology, underscoring their serious clinical and legal implications. Contributing factors to errors in breast imaging include reader-related cognitive biases, lesion characteristics, patient-specific variables, and technical limitations. To address these challenges, a systematic approach is essential. Key strategies include structured error recognition, peer review processes, and robust quality assurance programs. Educational initiatives and system-level interventions—such as structured training, continuous feedback loops, and the integration of AI-driven computer-aided detection (CAD) tools—can significantly reduce diagnostic errors and enhance accuracy in breast imaging interpretation. This article aims to highlight common pitfalls in mammography, analyze root causes, and propose practical strategies for improvement. Real-life cases of missed diagnoses are included to reinforce key learning points and support radiologists in improving diagnostic precision and improving patient care. Missed or delayed breast cancer diagnoses stem from multiple factors. A multi-pronged strategy—combining peer review, bias mitigation, education, supportive environments, and AI tools—can improve diagnostic accuracy and enhance interpretive accuracy and advance quality standards in breast imaging practice.
