Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Purpose: A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia. Methods: A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality. Results: Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73–1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34–0.80; P=0.003). Conclusion There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.

Acute Respiratory Distress Syndrome (ARDS) is a severe condition characterized by extensive lung inflammation and increased alveolar-capillary permeability, often triggered by infections or systemic inflammatory responses. Mesenchymal stem cells (MSCs)-based therapy holds promise for treating ARDS, as MSCs manifest immunomodulatory and regenerative properties that mitigate inflammation and enhance tissue repair. Primed MSCs, modified to augment specific functionalities, demonstrate superior therapeutic efficacy in targeted therapies compared to naive MSCs. This study explored the immunomodulatory potential of MSCs using mixed lymphocyte reaction (MLR) assays and co-culture experiments with M1/M2 macrophages. Additionally, RNA sequencing was employed to identify alterations in immune and inflammation-related factors in primed MSCs. The therapeutic effects of primed MSCs were assessed in an LPS-induced ARDS mouse model, and the underlying mechanisms were investigated through spatial transcriptomics analysis. The study revealed that MSCs primed with IFN-γ and IL-1β significantly enhanced the suppression of T cell activity compared to naive MSCs, concurrently inhibiting TNF-α while increasing IL-10 production in macrophages. Notably, combined treatment with these two cytokines resulted in a significant upregulation of immune and inflammation-regulating factors. Furthermore, our analyses elucidated the mechanisms behind the therapeutic effects of primed MSCs, including the inhibition of inflammatory cell infiltration in lung tissue, modulation of immune and inflammatory responses, and enhancement of elastin fiber formation. Signaling pathway analysis confirmed that efficacy could be enhanced by modulating NFκB and TNF-α signaling. In conclusion, in early-phase ARDS, primed MSCs displayed enhanced homing capabilities, improved lung function, and reduced inflammation.

Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Purpose: A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia. Methods: A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality. Results: Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73–1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34–0.80; P=0.003). Conclusion There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.

Purpose: A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia. Methods: A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality. Results: Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73–1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34–0.80; P=0.003). Conclusion There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.

Acute Respiratory Distress Syndrome (ARDS) is a severe condition characterized by extensive lung inflammation and increased alveolar-capillary permeability, often triggered by infections or systemic inflammatory responses. Mesenchymal stem cells (MSCs)-based therapy holds promise for treating ARDS, as MSCs manifest immunomodulatory and regenerative properties that mitigate inflammation and enhance tissue repair. Primed MSCs, modified to augment specific functionalities, demonstrate superior therapeutic efficacy in targeted therapies compared to naive MSCs. This study explored the immunomodulatory potential of MSCs using mixed lymphocyte reaction (MLR) assays and co-culture experiments with M1/M2 macrophages. Additionally, RNA sequencing was employed to identify alterations in immune and inflammation-related factors in primed MSCs. The therapeutic effects of primed MSCs were assessed in an LPS-induced ARDS mouse model, and the underlying mechanisms were investigated through spatial transcriptomics analysis. The study revealed that MSCs primed with IFN-γ and IL-1β significantly enhanced the suppression of T cell activity compared to naive MSCs, concurrently inhibiting TNF-α while increasing IL-10 production in macrophages. Notably, combined treatment with these two cytokines resulted in a significant upregulation of immune and inflammation-regulating factors. Furthermore, our analyses elucidated the mechanisms behind the therapeutic effects of primed MSCs, including the inhibition of inflammatory cell infiltration in lung tissue, modulation of immune and inflammatory responses, and enhancement of elastin fiber formation. Signaling pathway analysis confirmed that efficacy could be enhanced by modulating NFκB and TNF-α signaling. In conclusion, in early-phase ARDS, primed MSCs displayed enhanced homing capabilities, improved lung function, and reduced inflammation.

Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Purpose: A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia. Methods: A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality. Results: Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73–1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34–0.80; P=0.003). Conclusion There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.