Annals of Medicine & Surgery最新文献

{"title":"Unusual presentations in systemic lupus erythematosus with concurrent IgA nephropathy lesion: a rare case report from Eastern Nepal","authors":"Popular Pokhrel, Nitesh Neupane, Nitesh Kumar Karna, Gopal Pokhrel, Niraj Chapagain, Abhas Niraula, Ajay Kumar Yadav","doi":"10.1097/ms9.0000000000002401","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002401","url":null,"abstract":"\u0000 \u0000 Systemic lupus erythematous (SLE) is an autoimmune disease involving multiple organs. While lupus nephritis (LN) is seen in SLE, concurrent IgA nephropathy lesion is rare. Uncommon manifestations like cutaneous ulcers and orbital involvement present diagnostic challenges and this case from Nepal emphasizes careful diagnostic approach in such cases.\u0000 \u0000 \u0000 \u0000 A 42-year-old female presented with bilateral lower limb swelling, gum bleeding, and epistaxis. Initial evaluation revealed pancytopenia and suspected renal involvement. Renal biopsy showed IgA nephropathy lesions, but clinical and laboratory findings favored lupus nephritis. Treatment with immunosuppressive agents was initiated. Despite therapy, the patient developed cutaneous ulcers and orbital cellulitis. Decreasing anti-ds DNA levels were noted during course of treatment.\u0000 \u0000 \u0000 \u0000 The diagnosis of lupus nephritis in the presence of IgA nephropathy lesions emphasizes the complexity of SLE diagnosis. Treatment with immunosuppressive agents targeting the underlying autoimmune process, yet development of cutaneous ulcers and orbital cellulitis highlights the importance of timely intervention in managing SLE complications. In resource-limited settings, clinicians should initiate interventions based on clinical and lab findings while awaiting detailed biopsy results.\u0000 \u0000 \u0000 \u0000 This case highlights diagnostic challenges in SLE and emphasizes the necessity for careful monitoring and timely intervention in managing complications. The interplay between SLE and IgA Nephropathy (IgAN) suggests that SLE may trigger or exacerbate it, complicating disease management. Further exploration is needed to enhance understanding and management of complex autoimmune disorders like SLE.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"63 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National trends of malpractice-related cardiovascular mortality within the United States, 1999-2020","authors":"Hamza Ashraf, Haider Ashfaq, N. S. Paryani, Shanza Malik, Ali Tariq Shaikh, Aalaa Saleh, Jehanzeb Ahmed Khan, Ishaque Hameed","doi":"10.1097/ms9.0000000000002399","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002399","url":null,"abstract":"Cardiovascular disease (CVD) stands as the leading cause of mortality in the USA, claiming a life every 33 seconds, while cardiology ranks among the top three specialties with malpractice-related claims. Our study aims to scrutinize gender disparities in CVD-related mortality linked with malpractice among the elderly population (≥65 y) in the USA. Data pertaining to malpractice incidents in CVD treatment spanning from 1999 to 2020 were sourced from the CDC Wonder database. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were computed. Join point regression analysis was used to determine the annual percent changes (APCs) with a 95% CI, stratified across variables such as age, race/ethnicity, census region, and urban or rural settings. Over the investigated period, 2,432 deaths in the US were attributed to CVD-related malpractice, with an AAMR of 2.7. Initially stable (1999- 2004), mortality rates experienced a significant decline until 2020. Females consistently exhibited a higher AAMR (2.7) than males (2.6). Notably, NH Black females recorded the highest AAMR (3.1), while NH Black males and NH Asian females reported the lowest (2.5). Furthermore, NH White males demonstrated a higher AAMR (2.7) than NH Black males (2.5); conversely, NH Black females exhibited a higher AAMR (3.1) than NH White females (2.7). Mortality rates were notably elevated in the West compared to the South, with both urban and rural areas indicating higher AAMRs in females. Our findings underscore the necessity for targeted interventions to address the pronounced disparities, particularly among NH Black women, individuals in the West, males, and urban locales.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"93 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing thyroid health: a pictorial journey through 2017 ACR TI-RADS and common thyroid pathologies","authors":"Prajwal Dahal, Sabina Parajuli, Prajina Pradhan","doi":"10.1097/ms9.0000000000002398","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002398","url":null,"abstract":"With the advent of high-resolution ultrasonography (HRUS), more thyroid nodules are being detected than ever before, and they are being identified at an earlier stage. It poses a challenge for radiologists and clinicians in deciding what to do next. Most nodules are benign and require no follow up and intervention. Even highly suspicious nodules can be followed up, if the size is small. Variations in HRUS interpretation among radiologists are common, with frequent misidentifications between spongiform and solid cystic lesions, hypoechoic and very hypoechoic nodules, and microcalcification and hyperechoic foci with comet tail artifacts. Cystic lesions with echogenic contents are often confused with solid nodules, cystic papillary carcinoma thyroid is often confused with colloid cysts. The 2017 ACR TI-RADS (American College of Radiology Thyroid Imaging Reporting and Data System) aims to standardize the interpretation of thyroid nodules and guide further management. Rather than giving specific diagnosis like colloid cyst, adenomatous nodule and papillary carcinoma; ACR TI-RADS classifies nodules from TI-RADS 1 to TI-RADS 5 based on HRUS characteristics and recommends further management. What we often read are textual contents that are theoretical, and in practice, we get confused while interpreting the characteristics of thyroid nodules. This review offers a detailed visual overview of the 2017 ACR TI-RADS and common thyroid conditions, explaining key features through imaging data and examples for consistent interpretation. Combining textual explanations with visual aids, this article provides practical guidance for interpreting thyroid nodules for radiologists, and clinicians seeking a clear understanding of thyroid imaging and pathology.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"36 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging biomarkers and clinical assessments in ALS patients: An exploratory study","authors":"Saharnaz Pezeshgi, Sadegh Ghaderi, Sana Mohammadi, Narges Karimi, Bentolhoda Ziaadini, Mahdi Mohammadi, Farzad Fatehi","doi":"10.1097/ms9.0000000000002332","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002332","url":null,"abstract":"Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Biomarkers are needed to improve diagnosis, gauge progression, and evaluate treatment. Diffusion tensor imaging (DTI) is a promising biomarker for detecting microstructural alterations in the white matter tracts. This study aimed to assess DTI metrics as biomarkers and to examine their relationship with clinical assessments in patients with ALS. Eleven patients with ALS and 21 healthy controls (HCs) underwent 3T MRI with DTI. DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were compared between key motor and extramotor tract groups. Group comparisons and correlations between DTI metrics also correlated with clinical scores of disability (ALSFRS-R), muscle strength (dynamometry), and motor unit loss (MUNIX). Widespread differences were found between patients with ALS and HCs in DTI metrics, including decreased FA and increased diffusivity metrics. However, MD and RD are more sensitive metrics for detecting white matter changes in patients with ALS. Significant interhemispheric correlations between the tract DTI metrics were also observed. DTI metrics showed symmetry between the hemispheres and correlated with the clinical assessments. MD, RD, and AD increases significantly correlated with lower ALSFRS-R and MUNIX scores and weaker dynamometry results. DTI reveals microstructural damage along the motor and extramotor regions in ALS patients. DTI metrics can serve as quantitative neuroimaging biomarkers for diagnosis, prognosis, monitoring of progression, and treatment. Combined analysis of imaging, electrodiagnostic, and functional biomarkers shows potential for characterizing disease pathophysiology and progression.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study on effects of defect closure versus non-closure in laparoscopic totally extraperitoneal repair of direct inguinal hernia","authors":"Vijay Pratap Sah, B. K. Sah, Nishant Sah, B. Khanal, Abhijeet Kumar, R. Gupta","doi":"10.1097/ms9.0000000000002408","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002408","url":null,"abstract":"\u0000 \u0000 Total extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) repair are the principal techniques in laparoscopic hernia repair. Seroma formation and pain are frequent complications of moderate-large size laparoscopic direct inguinal hernia mesh repair. This study was conducted to evaluate the feasibility of defect closure in moderate-large direct inguinal hernias and its effect on various outcomes.\u0000 \u0000 \u0000 \u0000 This is a prospective cohort study from September 2020 to August 2021, where a total of 88 patients with uncomplicated direct inguinal hernia (M3 or more) were enrolled in the study and divided into two equal groups of TEP defect closure and non-closure, and various outcome measures were noted.\u0000 \u0000 \u0000 \u0000 The majority of patients were male (94.31%), with a mean age range of 18–85 years, and had right-sided inguinal hernia (46.5%). Seroma formation at 10th POD in the defect closure and non closure were 24% and 33% (p-value: 0.225), which reduced to 11% and 18%, respectively, at 1 month (p-value: 1.000). All seromas resolved within 6 months. Pain in VAS at 10th POD in the defect closure and non-closure were 1.55±0.571 and 1.38±0.527, respectively (p-value: 0.121), which gradually decreased to 1.20±0.524 and 1.16±0.420 at a 6-month interval (p-value: 0.689). The mean operative time in the bilateral and unilateral defect closure groups was 72.3±4.1 and 56.5±4.3 min. respectively, whereas that in the bilateral and unilateral defect non-closure groups was 62.3±3.7 and 45.7±3.6 min. respectively.\u0000 \u0000 \u0000 \u0000 The defect closure was found to have higher pain and less seroma formation at various intervals of time following TEP for moderate-large direct inguinal hernia. Although these findings were statistically insignificant, they may be clinically significant, and further studies with a larger sample size are suggested.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"78 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerns regarding the alarming surge in HIV/AIDS cases in Pakistan","authors":"Tariq Siraj Qazi, Zhang Ying, Yuanyuan Xiao, Tooba Ali, Md Ariful Haque, Kamran Shahzad, Taimur khan, Aftab Ali Shah","doi":"10.1097/ms9.0000000000002400","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002400","url":null,"abstract":"","PeriodicalId":503882,"journal":{"name":"Annals of Medicine & Surgery","volume":"77 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intrathecal pethidine on Post-Spinal anesthesia shivering after cesarean section: a systematic review and Meta-Analysis","authors":"Muhammad Afzal, Amber Lee, Muhammad Asad, Alya Ali, A. Farrukh, Bader Semakieh, Yaxel Levin-Carrión, Shah Rukh Shah, Q. Khan","doi":"10.1097/ms9.0000000000002354","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002354","url":null,"abstract":"\u0000 \u0000 Spinal anesthesia is the most preferred method for cesarean section (C-section). This meta-analysis was performed to determine the effect low and high intrathecal doses of pethidine on the maternal outcomes after C-section.\u0000 \u0000 \u0000 \u0000 A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was performed. Random-effects meta-analysis was performed to derive odds ratios (ORs) from dichotomous data.\u0000 \u0000 \u0000 \u0000 Seventeen randomized controlled trials with 1,304 C-section patients were included. Patients who had received intrathecal pethidine experienced decreased shivering and intensity of shivering (OR 0.13; P<0.001) and (OR 0.21; P<0.001), respectively. Moreover, vomiting (OR 2.47; P=0.002) and pruritus (OR 5.92; P<0.001) were significantly higher in the pethidine group. There was no statistically significant difference in incidence of nausea (OR 2.55; P=0.06) and hypotension (OR 0.91; P=0.67).\u0000 \u0000 \u0000 \u0000 Intrathecal pethidine can effectively decrease shivering, though it increases the risk of vomiting and pruritus. No significant difference was found both in the maternal hypotension and nausea.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"31 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-driven transformations in diabetes care: a comprehensive literature review","authors":"Muhammad Iftikhar, Muhammad Saqib, S. N. Qayyum, Rehana Asmat, Hassan Mumtaz, Muhammad Rehan, Irfan Ullah, Iftikhar Ud-din, Samim Noori, Maleeka Khan, Ehtisham Rehman, Zain Ejaz","doi":"10.1097/ms9.0000000000002369","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002369","url":null,"abstract":"Artificial intelligence (AI) has been applied in healthcare for diagnosis, treatments, disease management and for studying underlying mechanisms and disease complications in diseases like diabetes and metabolic disorders. This review is a comprehensive overview of various applications of AI in the healthcare system for managing diabetes. A literature search was conducted on PubMed to locate studies integrating AI in the diagnosis, treatment, management and prevention of diabetes. As diabetes is now considered a pandemic now so employing AI and machine learning approaches can be applied to limit diabetes in areas with higher prevalence. Machine learning algorithms can visualize big datasets, and make predictions. AI-powered mobile apps and the closed-loop system automated glucose monitoring and insulin delivery can lower the burden on insulin. AI can help identify disease markers and potential risk factors as well. While promising, AI’s integration in the medical field is still challenging due to privacy, data security, bias, and transparency. Overall, AI’s potential can be harnessed for better patient outcomes through personalized treatment.","PeriodicalId":503882,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"115 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of knee osteoarthritis: radiography vs. ultrasonography in nepalese population: a cross-sectional study","authors":"Sundar Suwal, Bibek K.C., Shailendra Katwal, D. Chataut, Benu Lohani","doi":"10.1097/ms9.0000000000002393","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002393","url":null,"abstract":"\u0000 \u0000 Osteoarthritis is a degenerative and long-term debilitating disease with rising prevalence, predominantly involving larger joints including the knee joint. While radiography has traditionally been the primary modality for joint evaluation, there is a growing trend towards using ultrasonography for musculoskeletal disorders, including joint assessment. This study aimed to find the role of ultrasonography in the evaluation of osteoarthritis of knee joints with comparison to the radiographs.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional study done on patients with signs and symptoms of osteoarthritis of the knee who visited the radiology department for knee radiographs. Kellgren and Lawrence system was used for grading osteoarthritis in radiographs. Ultrasonography of knee joints was done with high-frequency probes and searched for joint space width, articular cartilage thickness, marginal osteophytes, meniscal extrusion, and other articular/ extra-articular abnormalities. The ultrasound findings were correlated with findings in anteroposterior and lateral radiographs.\u0000 \u0000 \u0000 \u0000 The mean number of osteophytes was higher in ultrasound compared to the radiographs (P<0.001). Mean joint spaces were comparable in both modalities. Meniscal extrusion was seen with ultrasonography, which significantly correlated with joint space width and cartilage thickness (P<0.005). Ultrasound also detected synovial changes, effusion, and Baker’s cyst.\u0000 \u0000 \u0000 \u0000 Although radiography is the standard first-line radiological investigation for the diagnosis of osteoarthritis of the knee joint, ultrasonography can be an adjunct as it well correlates with the radiograph findings and can provide more useful information.\u0000","PeriodicalId":503882,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"122 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on colorectal cancer in regional Northern Australia and changes to treatment related to distance to care: A retrospective cohort study","authors":"Richard Maguire, Shaurya Jhamb, Tegan Lun, Fathima Shaba Isaam, Avjit Singh, Tejminder Singh, Kyle Crowley, James Lonie, Jai Hoff, Alexander David Croese, C. Mushaya","doi":"10.1097/ms9.0000000000002397","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002397","url":null,"abstract":"\u0000 \u0000 The COVID-19 pandemic has created challenges in the diagnosis and management of colorectal cancer (CRC). It was proposed in regional Northern Australia that the distance to services could further impact cancer outcomes, leading to delayed diagnosis. We compared the outcomes of patients prior and during the pandemic; with a focus on whether patients were presenting in the emergency setting with more advanced disease. The distance to treatment was also analysed to see if there was any impact to the management of patients with colorectal cancer.\u0000 \u0000 \u0000 \u0000 A retrospective analysis of 444 patients that underwent treatment for colorectal cancer over 2 time periods were examined. Time period 1 (prior to COVID-19); March 2017-July 2019 and time period 2 (during COVID-19); March 2020-July 2022. Only patients with colorectal adenocarcinoma were included if they were primarily treated at a hospital in northern Australia; those with benign pathologies or recurrent disease were also excluded. Data was collected in terms of treatment and outcomes and compared between the two groups. A separate analysis of whether locality affected outcomes and referral times was also performed.\u0000 \u0000 \u0000 \u0000 In the time period prior to COVID-19 174 patients’ required invasive management, while in the second time period during COVID-19 there were 188 patients managed surgically or endoscopically. Of the patients managed prior to COVID-19 17/174 (9.8%) patients required emergency interventions, during COVID-19 this number increased to 37/188 (19.7%). This difference was deemed to be statistically significant (P\u0000 =0.008). No substantial difference in cancer staging at presentation was found between the two groups. There was an increase in complication rate found during COVID-19 34.6% vs 25.5% prior to COVID-19 (P =0.046). During COVID-19 the median time between General Practitioner (primary care physician) referral and colonoscopy was actually lower than prior to covid 26.5 vs 36 days (P=0.047). When comparing local to distant patients we found locally based patients had lower rates of neoadjuvant treatment 18.9% vs 30.4% (P=0.018) and higher rates of open surgery 39.1% vs 26.5%, P\u0000 =0.012. An increase in time between colonoscopy and outpatient department review (OPD) was seen in patients not from the local area 13 vs 18 days (P\u0000 =0.006).\u0000 \u0000 \u0000 \u0000 We found during the COVID-19 pandemic a greater proportion of patients were presenting with colorectal cancer that required emergency intervention. This may be due to decreased presentations to general practitioners due to lockdown causing potential delays in diagnosis. We did not see more advanced disease in these patients presenting emergently, between the two groups. Further assessment of local patients’ vs patients from distant sites, showed difference in how patients were managed but similar outcomes. Our large catchment area with distance to treatment in Northern Australia may further impact the management of colorectal cancer in the futu","PeriodicalId":503882,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"15 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}