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Adnexal torsion is a gynaecological emergency in which prompt diagnosis and management are critical to preserving ovarian function. However, the clinical presentation is often non-specific, and diagnosis primarily relies on pelvic ultrasound, a modality with limited sensitivity that can lead to misdiagnosis and unnecessary surgery. Contrast-enhanced ultrasound (CEUS) has emerged as a promising imaging technique that may enhance diagnostic accuracy by better characterising adnexal vascularisation.
The aim of this study is to assess whether the addition of CEUS to standard diagnostic procedures can reduce the rate of unnecessary emergency surgeries. Specifically, we compare two diagnostic strategies in cases of high clinical suspicion of adnexal torsion: the current standard approach versus an experimental strategy incorporating CEUS. The primary outcome is the rate of inappropriate surgical interventions, defined as emergency surgery performed within 6 hours without intraoperative confirmation of torsion.
This is a prospective, open-label, multicentre, randomised (1:1), controlled, superiority trial. A total of 256 women presenting with a high clinical suspicion of adnexal torsion will be enrolled over a period of 36 months. Participants will be randomly assigned to either the standard diagnostic strategy or an experimental strategy that includes CEUS. The primary endpoint is the proportion of emergency surgical procedures (performed within 6 hours of hospital admission) in which adnexal torsion is not confirmed.
The study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) on 28 October 2024. The results of this study will be published in peer-reviewed journals and presented at relevant national and international conferences. The ethical approval number from the CPP is 6115.
NCT06677554; 2024-511720-13-00.
To explore the existential lived experiences of emerging adult siblings of children with complex care needs.
A qualitative phenomenological design.
In-depth conversational interviews were conducted between February and June 2022 with nine emerging adult siblings (aged 16–27), who grew up with a brother or sister with complex care needs. Data were analysed using van Manen's phenomenology of practice approach.
Five core themes were identified: Loss of a familiar world: the profound changes and disruptions in siblings' lives. The sibling bond: endured and enduring love. Embracing the load: balancing responsibilities. Being behind the scenes: a lonely childhood. Jigsaw falling into place: siblings finding clarity and forging their own paths.
Early experiences of growing up with a sibling who has complex care needs, may resurface or shift in meaning, impacting long-term existential well-being, particularly when siblings feel overlooked by families, educators, and healthcare professionals. These silenced experiences often persist into emerging adulthood, shaping emotional health, relationships, and life choices.
The underrecognized existential needs of these siblings call for intentional, person-centred care. Our research advocates early, targeted interventions, emphasizing the pivotal role of nurses. A lifeworld-led phenomenological approach equips nurses to more effectively attend to the unmet needs of siblings within family care settings.
The research followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Emerging adult siblings with lived experience of growing up alongside a brother or sister with complex care needs contributed important insights into the interpretation of findings, ensuring relevance to clinical nursing.
Research indicates that leadership in the health professions can facilitate improvement of quality and efficiency of healthcare services. In the Philippines, leadership in the health professions plays a critical role in driving improvements in healthcare delivery and health professions education. Thus, the landscape of leadership in the health professions merits continuous exploration and deeper understanding. This scoping review aims to explore the landscape of leadership in the health professions in the Philippines. The scoping review will include published and unpublished research papers of any kind, such as primary research studies, systematic reviews, meta-analyses, letters, guidelines, websites, blogs and grey literature that report about leadership in the health professions in the Philippines. Exclusions are leadership studies on the health professions that discuss the professions outside the scope and context of the practice.
The Joanna Briggs Institute (JBI) methodological framework for scoping review will be used in this review. A three-step search strategy will be used consisting of an initial search, full search and screening of reference lists. The databases that will be included are Cinahl Ultimate, Cochrane Library, Scopus, Embase, Emcare, Web of Science, JBI Evidence-based Practice Database, PubMed/Medline, ERIC, local journals and grey literature to determine pertinent sources about the topic. Sources searched will be screened by two independent reviewers and data will be extracted using a data extraction table. Disagreements will be resolved by a discussion through a third reviewer. The results of the search and the study inclusion process will be reported in full in the final scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review flow diagram. Search strategy using the included databases started in August to September 2025, data extraction will start by October 2025, data analysis will start by November 2025 and the review is expected to be completed by December 2025.
This study does not involve human participants and has been reviewed and classified for exempted review by the University of the Philippines Manila Research Ethics Board, which is a committee whose task is to make sure that research participants are protected from harm. The findings of the scoping review will be disseminated through conference presentations and publication in a scientific journal.
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