Intravenous Tranexamic Acid Given at Femoral Fragility Fracture Surgery Reduces Blood Transfusion Requirements Fourfold.

Aims: This study aims to determine whether intraoperative intravenous (IV) tranexamic acid (TXA) affects blood loss following the surgical management of femoral fragility fractures (FFF).

Methods: This was a single centre (university teaching hospital) non-randomised case-control study. There were 361 consecutive patients with FFF admitted over a 4-month period were included (mean age 81.

Risk factors for antimicrobial resistance in patients with bacteraemia related to urinary tract infection.

Introduction: NHS Lothian policy has recently changed to avoid first-line use of trimethoprim for uncomplicated urinary tract infections (UTI) in patients with risk factors for trimethoprim resistance, in line with national guidance. This study aimed to identify risk factors for antimicrobial resistance in bacteraemia related to UTI.

Methods: A retrospective cohort study of 687 patients with bacteraemia related to UTI in NHS Lothian from 01/02/18 to 29/02/20 was undertaken.

Interventions for healthcare providers to improve treatment and prevention of female genital mutilation: a systematic review.

Background: Studies on healthcare providers' awareness, knowledge and attitudes regarding female genital mutilation (FGM) have shown a lack of awareness of the prevalence, diagnosis, and management of FGM. Our objective was to systematically review the literature on interventions improving healthcare providers' capacities of prevention and treatment of FGM.

Methods: Systematic review of the published and grey literature on interventions aimed at improving healthcare providers' capacities of prevention and treatment of FGM (1995-2015).

Chilaiditi syndrome precipitated by colonoscopy: a case report and review of the literature.

Chilaiditi syndrome is a rare condition defined by the presence of gastrointestinal symptoms associated with the radiological finding of segmental interposition of the bowel between the liver and the diaphragm. While it is infrequently indentified as a source of abdominal pain, Chilaiditi syndrome carries clinical significance as it can lead to a number of serious complications including intestinal obstruction, perforation, and ischemia. A 58-year-old woman presented with Chilaiditi syndrome immediately following colonoscopic evaluation.

Idiopathic granulomatous mastitis associated with corynebacterium sp. Infection.

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory condition of the breast. The etiology and treatments options of IGM remain controversial. Previous case reports have suggested that Corynebacterium sp.

Biomarkers predicting clinical outcome of epidermal growth factor receptor-targeted therapy in metastatic colorectal cancer.

The monoclonal antibodies panitumumab and cetuximab that target the epidermal growth factor receptor (EGFR) have expanded the range of treatment options for metastatic colorectal cancer. Initial evaluation of these agents as monotherapy in patients with EGFR-expressing chemotherapy-refractory tumors yielded response rates of approximately 10%. The realization that detection of positive EGFR expression by immunostaining does not reliably predict clinical outcome of EGFR-targeted treatment has led to an intense search for alternative predictive biomarkers.

Review article: panitumumab--a fully human anti-EGFR monoclonal antibody for treatment of metastatic colorectal cancer.

Background: Panitumumab is a fully human monoclonal IgG2 antibody targeting the epidermal growth factor receptor (EGFR).

Aim: To review the efficacy of panitumumab in the treatment of metastatic colorectal cancer (mCRC).

Methods: Available literature identified from PubMed and conference websites was reviewed.

Becaplermin.

Becaplermin is a recombinant human platelet-derived growth factor B-chain homodimer (rh-PDGF-BB) for topical treatment of full-thickness diabetic neuropathic ulcers and pressure ulcers. rh-PDGF-BB promotes wound healing, probably by increasing granulation tissue formation via increased migration and proliferation of cells, with subsequent extracellular matrix deposition. Accelerated healing has been demonstrated in healthy and healing-impaired animals and in patients with lower extremity diabetic neuropathic ulcers and pressure ulcers.

Combination hepatitis a-hepatitis B vaccine.

The adult formulation of this combination hepatitis A-hepatitis B vaccine contains 720 enzyme-linked immunosorbent assay units (EU) of formalin-inactivated hepatitis A virus strain HM175 and 20mug of recombinant DNA yeast-derived hepatitis B surface antigen adsorbed onto aluminium salts in 1ml for injection. The paediatric formulation contains half this dosage in 0.5ml for injection.

Socioeconomic position and incident mobility impairment in the Cardiovascular Health Study.

Background: We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly.

Methods: We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States.

Results: Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group.

Iliofemoral venous pressure correlates with intraabdominal pressure in morbidly obese patients.

Clinically, it has been observed that severely and morbidly obese individuals more often have venous leg symptoms related to venous stasis than normal-weight persons have. Obesity is associated with an increased intraabdominal pressure (IAP). The increased IAP in severely and morbidly obese patients would reasonably cause an elevated iliofemoral venous pressure (IFVP), which transmits via incompetent femoral veins, causing venous stasis in the lower limbs.

Just get out the door! Importance of walking outside the home for maintaining mobility: findings from the women's health and aging study.

Objectives: To determine the association between volitional walking behavior and change in walking ability and lower extremity function over 1 year in functionally limited older women.

Design: Longitudinal cohort study.

Setting: Data were collected in participant's homes in Baltimore, Maryland.

MMPI-2 scores in the outcome prediction of gastric bypass surgery.

Background: A psychological assessment is critical for morbidly obese patients seeking Roux-en-Y gastric bypass (RYGBP) surgery. The Minnesota Multiphasic Personality Inventory (MMPI) has been widely used in past psychological studies of bariatric surgery patients, but, to date, there is no published research on the more recent version of the MMPI, the Minnesota Multiphasic Personality Inventory-2 (MMPI2), and its relation to RYGBP outcome. This investigation was designed to evaluate the predictive validity of the MMPI-2 with respect to outcome of RYGBP for morbid obesity.

Older adults with Alzheimer disease, comorbid arthritis and prescription of psychotropic medications.

Objectives: It is assumed that analgesia is underutilized among those with Alzheimer disease and that these patients may be inappropriately prescribed neuroleptics and benzodiazepines. The current study examines this assertion.

Design: For this study, prescription levels of analgesics and psychotropic medications for Alzheimer disease patients with (n=245) and without (n=215) musculoskeletal conditions (i.

Socioeconomic gradients in health status over 29 years of follow-up after midlife: the Alameda county study.

Socioeconomic status is well known to be associated with inverse gradients in a wide range of health outcomes. Very little is known about the precise shape of these relationships and how they evolve through the life-course, although recent work has suggested steep non-linearities for mortality in samples of the entire population that include the very poor. We investigate the shape of gradients, against baseline family income, in gender-specific prevalence rates for seven self-reported health outcomes commonly used on surveys, in a cohort of 1190 men and 1302 women representative of Alameda County, California, aged 40-59 in 1965.

Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels.

Objectives: To test whether accelerated sarcopenia in older persons with high interleukin (IL)-6 serum levels plays a role in the prospective association between inflammation and disability found in many studies.

Design: Cohort study of older women with moderate to severe disability.

Participants: Six hundred twenty older women from the Women's Health and Aging Study in whom information on baseline IL-6 serum level was available.

Client-centred care: making the ideal real.

Providing quality care in a timely manner is a key goal of the healthcare system. Who defines quality care is a pivotal question to be answered in an era of well-informed clients. The Registered Nurses Association of Ontario's (RNAO) Client-Centred Care Best Practice Guideline puts patients where they belong--at the centre of care.

The ankle brachial index and change in lower extremity functioning over time: the Women's Health and Aging Study.

Objectives: To define the association between baseline ankle brachial index (ABI) level and subsequent onset of severe disability.

Design: Prospective cohort study.

Setting: Baltimore community.

Differential effects of premorbid physical and emotional health on recovery from acute events.

Objectives: Emotional health may have an important effect on disease onset, but there has been little work evaluating premorbid emotional health on recovery from disability that results from acute medical events. The aim of this study is to determine whether premorbid emotional health is predictive of recovery in functional ability 1 year after reporting a stroke, heart attack, or hip fracture (event).

Design: A prospective cohort study of an older population-based sample from 1986 to 1992.

Progressive versus catastrophic loss of the ability to walk: implications for the prevention of mobility loss.

Objectives: Loss of mobility is an important functional outcome that can have devastating effects on quality of life and the ability of older persons to remain independent in the community. Although a large amount of research has been done on risk factors for disability onset, little work has focused on the pace of disability progression. This study characterizes the development of severe walking disability over time and evaluates risk factors and subsequent mortality as they relate to mobility disability with progressive or catastrophic onset.

Neighborhood environment and loss of physical function in older adults: evidence from the Alameda County Study.

Research suggests that neighborhood environment may influence functional health at an older age. This study examined the association between neighborhood problems and incidence of overall and lower-extremity functional loss. A total of 883 participants in the Alameda County Study who were aged 55 years and older and functionally healthy were questioned in 1994 and 1995 as part of an ongoing cohort study.

Topical eflornithine.

Eflornithine is a specific, irreversible inhibitor of the enzyme ornithine decarboxylase which is thought to slow hair growth by inhibiting this enzyme in hair follicles. Percutaneous absorption of eflornithine in women with unwanted facial hair (hirsutism) was < 1% when the 15% cream was applied twice daily to a shaved 50 cm2 area of skin under the chin. In clinical studies in women with excessive, unwanted facial hair, eflornithine 15% cream was superior to placebo in reducing hair growth, as demonstrated by objective and subjective methods, after 2 to 8 weeks' treatment.