Abbas Mirzapour

Background/Objectives: Ureteric stents are commonly used in the management of urolithiasis but are associated with significant morbidity, leading to unplanned emergency department presentations and increased healthcare utilisation. This study aimed to evaluate whether reducing ureteric stent dwell time from three months to one month was associated with reduced stent-related emergency presentations. Secondary objectives were to assess post-ureteroscopy infective complications and identify predictors of emergency attendance. Methods: A retrospective cohort study was conducted across Western Sydney Local Health District, comparing patients undergoing ureteric stenting prior to ureteroscopy before (n = 189) and after (n = 244) an institutional policy change reducing time to definitive surgery from three months to one month. Patients aged ≥16 years with urolithiasis were included. Results: Following the policy change, mean waiting time for ureteroscopy decreased from 97.3 to 40.6 days. The proportion of patients presenting to the emergency department (ED) for stent-related symptoms decreased from 31.7% to 16.4% (p < 0.001), and mean presentations per patient declined from 0.60 to 0.21 (p < 0.001). Stent irritation accounted for most presentations. Using multivariable analysis, age < 50 years, immunosuppression, and positive pre-operative urine cultures were independently associated with ED attendance. Post-ureteroscopy infective complications were lower in the shortened dwell-time cohort (2.0% vs. 4.2%) but did not reach statistical significance (p = 0.26). Conclusions: Reducing routine ureteric stent dwell time from three months to one month was associated with significantly fewer stent-related emergency presentations. Shorter dwell protocols may reduce patient morbidity and healthcare utilisation and could be associated with lower rates of post-ureteroscopy infective complications.

Background and Aims: Examining lifestyle factors is an essential part of health promotion. The goal of this study was to translate, culturally adapt, and validate the Simple Lifestyle Indicator Questionnaire (SLIQ) for Farsi‐speaking populations. Additionally, it explored the relationship between lifestyle scores and behavior change mindset, focusing on readiness for change and personal control. Methods: A total of 91 healthy individuals were recruited and asked to complete the Farsi SLIQ, the International Physical Activity Questionnaire (IPAQ), and the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ). A translation‐back translation process was used to adapt the SLIQ, ensuring accuracy in cultural and linguistic contexts. Psychometric properties, including reliability and validity, were evaluated using Cronbach's α , intraclass correlation coefficients (ICCs), and Spearman's rank correlations. The relationship between behavior‐change dimensions and SLIQ scores was obtained using multivariable linear regression models. Results: The Farsi SLIQ showed moderate reliability as shown by Cronbach's α of 0.549 and significant correlations with IPAQ ( r = 0.250, p < 0.01) and HLPCQ ( β = 0.372, p < 0.05). Higher SLIQ scores were linked to better adherence to healthy behaviors and increased readiness for change. Adaptation showed cultural appropriateness with slight alterations. Regression analysis highlighted a significant relationship between SLIQ scores and daily routines, dietary choices, and personal control. Conclusion: The Farsi SLIQ is a reliable and valid tool for assessing lifestyle behaviors in clinical and research settings. Because the scale is simple, it is well suited for behavior‐change interventions; our findings also show that perceived control and readiness to change are key drivers of healthy lifestyles. However, findings should be interpreted cautiously because self‐reported data, particularly on alcohol and tobacco use, may be biased.

Background: Post-radiation angiosarcoma (AS) of the breast, also known as radiation-associated angiosarcoma (RAAS) or radiation-induced angiosarcoma (RIAS), is a rare complication after breast radiotherapy. The diagnosis and management of post-radiation AS is challenging because of its non-specific but aggressive presentation. This study aims to examine the experience of a local health district with post-radiation AS to improve awareness of this condition. Methods: A retrospective case series was performed on patients diagnosed with post-radiation AS within Western Sydney Local Health District between 2000-2021. Eligibility criteria included patients with histologically proven breast angiosarcoma and a history of past breast radiotherapy. Results: 11 patients had post-radiation AS of the breast. The annual incidence was 1 in 18,000 of the breast radiotherapy treated population. Descriptive analysis was performed on six patients. The median age was 67 years, with a median latency period of 5.5 years. All patients presented with non-specific skin changes. Core/punch biopsy was inconclusive in five patients. Mastectomy was the mainstay of treatment. Three patients had disease recurrence. The five-year survival rate was 68%. Conclusion: Post-radiation AS of the breast is a rare disease associated with a poor prognosis due to its aggressive nature and high recurrence rate. Diagnosis is challenging with high false-negative rates associated with imaging and biopsy. It is important to maintain a high index of suspicion in patients treated with past breast radiotherapy.

Background: The use of oral corticosteroids to treat idiopathic granulomatous mastitis (IGM) has been a point of controversy for a long time. In addition, a wide diversity of combinations with other therapies have been reported so far. This study aims to review the usage of oral corticosteroids and their combinations in the published literature. Methods: PubMed and Scopus were searched using the key word “granulomatous mastitis.” Citations were filtered in two stages, considering the titles/abstracts and full texts. Papers reporting the treatment of IGM with corticosteroids with/without other treatments were included. Results: Fifty-eight citations were included in this study, 31 of which had at least a group of patients treated only with systemic corticosteroids. Combination therapy of systemic steroids with immunosuppressants, surgical interventions, and antibiotics were used in 6, 12, and 13 studies, respectively. Conclusion: Considering the inconsistency of studies in reporting the severity of the disease, administered treatments, outcome of treatment, side effects, and follow-up, our study failed to provide solid evidence for using corticosteroids as the first step in the management of idiopathic granulomatous mastitis. There is still a need for further studies emphasizing the homogenization of such reports. In this regard, preparing a questionnaire to help homogenize future reports on IGM is highly recommended.

Background: Idiopathic granulomatous mastitis (IGM) is a challenging exclusion diagnosis for breast lesions, manifested as benign, chronic inflammation of the breast tissue. Although some evidence suggest that IGM cases are not uniformly distributed worldwide, few investigations have specifically addressed this topic. This study aims to examine the distribution of IGM cases among countries and races/ethnicities based on reported cases.Methods: A review of studies with a report of at least one IGM patient published from 2011 to 2020 inclusive was conducted. The search was performed in MEDLINE, and citations were filtered in two stages by title/abstract and full text. Those cases with a positive growth of pathogens, male granulomatous mastitis and review articles were excluded.Results: Among 365 retrieved publications, 218 were finally included based on the inclusion and exclusion criteria, comprising 7161 patients from 34 different countries. Turkey, the United States, and China were the countries where the most publications (including case reports) originated. Considering the number of patients within papers, Turkey, Iran, and China were the pioneers. Conclusion: Based on the published literature, some populations seem to be more prone to IGM. Further investigations may reveal the genetic and environmental factors associated with this disease in different geographic areas.