Haemorrhoids
8,139 women from the national nutrition survey. The age at which the two conditions travelled together most closely was not old age, which is where the pelvic floor usually gets looked at.
Catherine Cho5 min read
Varicose Veins
A randomised trial of class I stockings found the symptom score falling from 8.90 to 6.37 while the untreated group stayed put. What it did not test is whether stockings change anything a patient would still care about in five years.
Catherine Cho6 min read
Urinary Tract Infection
A hazard ratio of 0.874, and a confidence interval running from 0.585 to 1.309. That interval is the reason this is reassurance rather than proof.
Chloe Moon6 min read
Overactive Bladder
147 women, three arms, six weeks of treatment, and a negative result reported as a negative result. One secondary outcome moved, and the authors say plainly that it was not corrected for multiple testing.
Olivia Kim6 min read
Prostate
0.83 percent against 0.88 percent, and an adjusted odds ratio of 0.997. The finding does not retire the warning — it is what a warning looks like once surgeons have acted on it.
David Seo5 min read
Signed opinion — marked as opinion in structured data, not reporting.
From Practice
A surgeon on why the veins a patient can see and the symptoms a patient can feel are measured separately, what the staging system is actually for, and which findings move a leg from a cosmetic question to a medical one.
From Practice
A urologist who helped write Korea's guideline on antibiotic treatment of community-acquired urinary tract infection on why the right first choice is a local question, what a culture is actually for, and when a course should be changed rather than extended.
From Practice
A head and neck surgeon on what the follow-up ultrasound is looking for, which features actually predict recurrence in the cervical lymph nodes, and why a recurrence found there is not the same event as a cancer coming back elsewhere.
One question, one self-contained answer, sources listed.
Usually not. Cervical cancer screening is not recommended after hysterectomy in the absence of a history of cervical intraepithelial neoplasia grade 2 or higher, yet in the 2014 to 2016 Korean National Cancer Screening Survey of 6,807 women aged 30 to 74, 61.8 percent of women who had undergone a hysterectomy had been screened in the previous two years against 64.7 percent of women with an intact uterus — and among women aged 30 to 44 the position reversed outright, 77.8 percent of those with a hysterectomy against 57.1 percent of those without.
Equivalent on the main outcome, more comfortable afterwards. In a systematic review and meta-analysis of 21 studies covering 7,844 patients and 9,677 limbs, cyanoacrylate ablation and endovenous radiofrequency ablation showed no significant difference in great saphenous vein occlusion rate or Venous Clinical Severity Score, while cyanoacrylate produced less ecchymosis (5.96 against 10.97 percent, P = .01), less paraesthesia (1.24 against 2.97 percent, P = .04) and a shorter procedure time — but rare serious harms specific to the glue, including a fatal pulmonary embolism and a severe granuloma, appear only as case reports and are not counted in that comparison.
Prior PSA testing is associated with a large difference in the treatment a man receives: among 166,848 Korean men newly registered with prostate cancer between 2010 and 2020, those with at least three PSA tests across at least two years beforehand received surgery in 45.6 percent of cases against 33.8 percent of those never tested, while hormone therapy was used in 42.3 percent of the tested group against 59.7 percent of the untested — and the untested group's higher cumulative spending came from being on systemic treatment for longer rather than from any treatment costing more per month.
The associations are real but they are not causal: in Korean national cohorts, haemorrhoidal disease carried a hazard ratio of 1.243 for all-cause dementia among 381,031 people followed a median 15.5 years, and 1.073 for heart failure among 356,033 people followed a median 13.3 years — but the authors of the dementia study state that haemorrhoidal disease may serve as a marker of an underlying systemic condition rather than directly causing dementia, and there is no mechanism by which veins at the anal canal would affect the brain or strain the heart.
Age by itself is not what determines the outcome — a Korean series found perioperative results in patients over 80 were influenced by the severity of the gallbladder disease rather than by chronological age — and the risk of not operating is substantial: among 29,818 Medicare patients admitted urgently with acute cholecystitis, the 25 percent who did not have their gallbladder removed during that admission had a 38 percent gallstone-related readmission rate over the next two years against 4 percent in those who did.
The published evidence shows it generating procedures rather than answers. In the Study of Health in Pomerania, 3,371 of 6,753 participants had whole-body magnetic resonance imaging and 8,208 incidental findings were disclosed to 4,707 participants, after which biopsy rates rose from 6.9 to 9.9 per 100 observation years — and the rise fell disproportionately on biopsies that found nothing malignant, with a non-malignant biopsy rate ratio of 1.39 (95% CI 1.22 to 1.58) among participants who received a disclosure against 1.09 (0.85 to 1.38) among those who did not.