Citations

Primary sternal osteomyelitis (PSO) is an exceptionally rare infection of the sternum, typically occurring in the context of trauma, surgery or immunocompromise. We report the case of a previously healthy adolescent boy in his second decade of life presenting with fever, chest pain and localised tenderness without any identifiable risk factors. Initial workup, including a chest X-ray and echocardiogram, was unremarkable, but persistent bacteraemia with methicillin-sensitive Staphylococcus aureus prompted further imaging. MRI revealed sternal osteomyelitis with a small parasternal abscess. The patient was successfully treated with intravenous antibiotics alone, avoiding surgical intervention. This case highlights the importance of thorough physical examination and maintaining a high index of suspicion for PSO in patients with unexplained fever and chest wall tenderness, even in the absence of traditional risk factors. Early diagnosis and targeted therapy are essential to optimise outcomes in this rare condition.

Background: Underrepresented persons are often not included in biomedical research. It is unknown if the general Asian American population is being represented in All of Us . The purpose of this study was to compare the Asian demographic data in the All of Us cohort with the Asian nationally representative data from the American Community Survey. Method: Demographic characteristics and health literacy of Asians in All of Us were examined. Findings were qualitatively compared with the Asian data in the 2019 American Community Survey 1-year estimate. Results: Compared with the national composition of Asians, less All of Us participants were born outside the United States (64% vs 79%), were younger, and had higher levels of education (76% vs 52%). Over 60% of All of Us participants reported high levels of health literacy. Conclusion: This study had implications for the development of strategies that ensure diverse populations are represented in biomedical research.

Abstract Background Previous studies comparing early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis were incomplete. A meta-analysis was undertaken to compare the cost-effectiveness, quality of life, safety and effectiveness of ELC versus DLC. Methods PubMed, Embase, the Cochrane Library and Web of Science were searched for randomized clinical trials (RCTs) that compared ELC (performed within 7 days of symptom onset) with DLC (undertaken at least 1 week after symptoms had subsided) for acute cholecystitis. Results Sixteen studies reporting on 15 RCTs comprising 1625 patients were included. Compared with DLC, ELC was associated with lower hospital costs, fewer work days lost (mean difference (MD) –11·07 (95 per cent c.i. –16·21 to −5·94) days; P < 0·001), higher patient satisfaction and quality of life, lower risk of wound infection (relative risk 0·65, 95 per cent c.i. 0·47 to 0·91; P = 0·01) and shorter hospital stay (MD −3·38 (−4·23 to −2·52) days; P < 0·001), but a longer duration of operation (MD 11·12 (4·57 to 17·67) min; P < 0·001). There were no significant differences between the two groups in mortality, bile duct injury, bile leakage, conversion to open cholecystectomy or overall complications. Conclusion For patients with acute cholecystitis, ELC appears as safe and effective as DLC. ELC might be associated with lower hospital costs, fewer work days lost, and greater patient satisfaction.