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Saiful Miah,1,2 Karl H Pang,3 Wayne Rebello,4 Zoe Rubakumar,4 Victoria Fung,5 Suresh Venugopal,6 Hena Begum4 1Division of Surgery and Interventional science, University College London, London, UK; 2Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust, London, UK; 3Academic Urology Unit, University of Sheffield, Sheffield, UK; 4Medical School, University of Sheffield, Sheffield, UK; 5Department of Plastic Surgery, Royal Hallamshire Hospital, Sheffield, UK; 6Department of Urology, Chesterfield Royal Infirmary, Chesterfield, UK Background: We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods: A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results: Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001). Conclusion: UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants. Keywords: foundation school, UK postgraduate training, location of training, social relationships

Amara G Nandikolla, Sangeetha Venugopal, Jesus Anampa Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Albert Einstein Cancer Center, Bronx, NY, USA Background: Li–Fraumeni Syndrome (LFS) is a rare disease with autosomal dominant inheritance linked to germline mutations of tumor suppressor gene TP53. These patients are predisposed to malignancies such as sarcoma, breast cancer, leukemia, and other malignancies. Breast cancer, the most common malignancy in adult patients with LFS, has an early-onset presentation and is usually treated as per the guidelines for the general population due to the limited literature about breast cancer in LFS. We aimed to describe our institutional experience treating patients with breast cancer and LFS to contribute to literature about this entity. Design: Retrospective single-institution case-series study. We searched for cases with LFS and breast cancer from 01/01/2000 to 12/31/2015 with treatment received at our institution. Results: We identified 4 cases (2 African Americans, 1 Indian, and 1 Hispanic) in 4 different families, who were diagnosed with LFS after presenting with breast cancer. Three cases were triple-negative disease and 1 case was ER+, HER2 positive disease. They were treated with mastectomy and a third-generation breast chemotherapy regimen and/or trastuzumab-containing regimen. Radiation therapy was used in 2 patients. Breast cancer recurrence was seen in 1 patient, while three other malignancies were identified after breast cancer treatment (1 breast sarcoma, 1 leiomyosarcoma, and 1 myelodysplastic syndrome). A patient, who underwent surveillance with a positron emission tomography-computed tomography scan, was found to have a stage I leiomyosarcoma and was treated with surgical resection, but then developed metastatic disease requiring cytotoxic chemotherapy. Conclusion: Breast cancer among patients with LFS needs a multidisciplinary treatment approach. Surgical management follows the guidelines for the general population. Risk–benefit assessment of chemotherapy and radiotherapy needs to be performed carefully in a case-by-case approach. Patients should undergo multimodality cancer surveillance, preferably in the context of a clinical trial. Keywords: breast cancer, Li–Fraumeni syndrome, hereditary breast cancer, TP53

Saiful Miah,1,2 Charlotte Gunner,3 Lucy Clayton,4 Suresh Venugopal,5 Nigel R Boucher,5 Bo Parys61Division of Surgery and Interventional Science, University College London, London, UK; 2Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; 3Urology Department, Raigmore Hospital, Inverness, UK; 4Psychiatry Department, Highbury Hospital, Nottingham, UK; 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK; 6Urology Department, Rotherham General Hospital, Rotherham, UKIntroductionRenal colic is often described by patients as the worst pain ever experienced.1 Pain during childbirth is also similarly described.2 To date, no study has comparatively evaluated the pain of renal colic to that of childbirth in female patients who have experienced both. Furthermore, no such study has evaluated the perception that men with renal colic have with respect to the pain experienced during childbirth. Here we present our cross-sectional observational study to address these questions. The primary objectives of our study were to answer these questions and highlight the severity of renal colic which is not always faced and treated aggressively.

The article "EDTA-Dependent Pseudo Thrombocytopenia: A Case Series" published in the Journal of Cardiovascular Disease Research discusses a phenomenon where platelet clumping leads to falsely low platelet counts in blood tests using EDTA as an anticoagulant. The study reports four cases of EDTA-dependent pseudo thrombocytopenia, highlighting the importance of considering this phenomenon when interpreting low platelet counts. The article also explores the association of EDTA-dependent pseudo thrombocytopenia with various conditions and emphasizes the need for clinical suspicion to differentiate this artifact from true thrombocytopenia. [Extracted from the article]

This study investigated the impact of heat stress on growth and carcass traits in four poultry genotypes—Giriraja, Country chicken, Naked Neck and Kadaknath reared in a hot and humid tropical environment. Birds from all genotypes had ad libitum access to feed and water while being challenged with consistently high environmental temperatures in the experimental shed. Daily diurnal meteorological data were recorded inside and outside the shed. The study specifically examined growth variables and carcass characteristics. Significant differences (p < 0.01) were observed in body weight and average daily gain at various intervals. Notably, feed intake showed significant differences (p < 0.01) across weeks, indicating interactions between genotypes and time intervals. The feed conversion ratio (FCR) varied significantly (p < 0.01), with the highest FCR recorded in the Kadaknath breed. Livability percentages were similar across groups, except for Giriraja, which had significantly lower livability (p < 0.01). Carcass traits, including dressing, wings, feathers and giblet percentages, showed significant differences among genotypes (p < 0.01). Hepatic mRNA expression of growth‐related genes revealed numerical variations, with Naked Neck displaying the highest (p < 0.05) fold change in IGF‐1 expression compared to other genotypes. The study recognized in the Naked Neck genotype to possess higher resilience in maintaining homoeostasis and uncompromised growth under heat stress, providing valuable insights for sustainable poultry farming in challenging environmental conditions. [ABSTRACT FROM AUTHOR]