The timing of oral P2Y12 inhibitor administration in patients with non-ST elevation acute coronary syndromes (NSTEACS) has been a matter of substantial debate over the last 2 decades.^1-4 Pretreatment, defined as oral P2Y12 inhibitor administration prior to angiography and usually at the time of diagnosis, has been commonly used with the rationale that there may be greater platelet inhibition at time of percutaneous coronary intervention (PCI); there may be reduced ischemic events while awaiting angiography; and more potent antiplatelet agents, such as glycoprotein IIb/IIIa inhibitors, may be avoided.⁴ While these reasons may be logical, there are limited data to support this approach. Previous guidelines supporting a pretreatment strategy relied mostly on older and indirect data,^5,6 and the most recent comprehensive meta-analysis (performed in 2014), which did not support pretreatment, relied mostly on observational rather than randomized data.^1,7 Arguments against pretreatment mainly relate to increased bleeding risk among patients who require PCI, in addition to those who need coronary artery bypass grafting (in whom surgery may be delayed with increased risk of postoperative bleeding) and those who may have an alternate diagnosis (eg, aortic dissection). European guidelines recently changed to recommend against pretreatment in patients with NSTEACS based on several trials and observational studies.^8-12 However, debate still remains regarding the optimal approach,¹³ and several further trials have been published that allow for a more comprehensive pooled systematic review.

The review examines the vital role of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in the diagnosis, staging, and treatment of prostate cancer (PCa). It focuses on the superior diagnostic abilities of PSMA PET/CT for identifying both nodal and distant PCa, and its potential as a prognostic indicator for biochemical recurrence and overall survival. Additionally, we focused on the variability of PSMA’s expression and its impact on personalised treatment, particularly the use of [¹⁷⁷Lu] Lu-PSMA-617 radioligand therapy. This review emphasises the essential role of PSMA PET/CT in enhancing treatment approaches, improving patient outcomes, and reducing unnecessary interventions, positioning it as a key element in personalised PCa management.

Objective: To examine the role of bowel diversion and reconstructive surgeries in managing Fournier's gangrene (FG) to facilitate multidisciplinary collaboration between urologists, colorectal and plastic surgery teams. Methods: A review of the literature was conducted using the databases Medline, Embase, PubMed in June 2023. The review included studies that evaluated the outcomes of FG following reconstructive surgeries or diverting colostomies. Results: The existing evidence suggests that bowel diversion and colostomy formation could reduce the need for further debridement, shorten the time to wound healing, and facilitate skin graft or flap uptake in patients with FG. Additionally, the psychological impact of a stoma was shown not to be a major concern for patients. However, stoma carries a risk of perioperative complications and therefore may prolong the length of hospital stay. In reviewing the evidence for reconstruction in FG, large and deep defects seem to benefit from skin grafts or flaps. Noticeably, burial of testicles in thigh pockets has grown out of favour due to concerns regarding the thermoregulation of the testicles and the psychological impact on patients. Conclusion: The use of bowel diversion and reconstructive surgeries in managing FG is case dependent. Therefore, it is important to have close discussions with colorectal and plastic surgery teams when managing FG.