Outcomes of Knee Dislocations and Subluxations in Polytrauma Patients at a Major Trauma Center.

Background This is a retrospective service evaluation of outcomes of polytrauma patients sustaining knee dislocations and subluxations within a major trauma center (MTC). Polytrauma patients with knee dislocations are complex to manage and often sustain multiple life-threatening injuries. Although treatments have progressed, no consensus remains on management timing and strategy.

The Importance of Surgical Cutting Time as a Key Performance Indicator Alongside Touchtime Utilisation in Operating Theatre Efficiency Optimisation.

Aims The Getting It Right First Time (GIRFT) programme has set targets to achieve 85% touchtime utilisation by 2024/25. Touchtime utilisation is a measure of theatre productivity, defined as the time from the start of anaesthesia to the time a patient leaves the theatre for all cases on a defined theatre list as a percentage of total available theatre time. No published evidence examines touchtime utilisation as a measure of theatre efficiency and its correlation with surgical cutting time.

Intra-articular steroids for the treatment of coxarthrosis; a retrospective cohort study comparing three contrast techniques.

Introduction: Intra-articular steroid injections (IAS) are a treatment for coxarthrosis. This study examines the efficacy of three fluoroscopy-guided IAS contrast techniques for coxarthrosis: contrast-assisted (Iohexol), air arthrogram-assisted and blind (contrast/air free) and stratifies efficacy based on multiple patient variables.

Materials And Methods: A cohort of 307 hip IAS was retrospectively analysed over a four-year period.

Connecting patients notified with hepatitis C to treatment (CONNECT Study): A randomized controlled trial of active case management by a health department to support primary care practitioners.

Background: Despite subsidised access to direct-acting antivirals (DAAs), hepatitis C (HCV) treatment uptake in Australia is declining. Interventions are needed to link people living with HCV to care and treatment. We implemented and measured effectiveness of a state-wide, health department-led, enhanced case management through the primary care practitioner for all HCV notifications, aiming to encourage and support treatment commencement.

Patients presenting to an acute general hospital with acute mental health needs: a retrospective observational cohort study.

Objectives: To examine the numbers and patterns of patients presenting to an urban acute general hospital with acute mental health presentations and to further investigate any variation related to the COVID-19 pandemic.

Design: Retrospective observational cohort study.

Setting: An urban acute general hospital in London, UK, comprising of five sites and two emergency departments.

Colorectal resections during the COVID-19 pandemic: a national survey of practice during first lockdown.

Introduction: The first wave of the COVID-19 pandemic led to an unprecedented time for the management of colorectal cancer, with uncertainty as to cancer-specific risks and the circumventing of gold standard oncological strategies. Our study aimed to acquire a snapshot of the practice of multidisciplinary team (MDT) management and variability in response to rapidly emerging guidelines.

Methods: The survey was disseminated to 150 colorectal cancer MDTs across England and Wales taken from the National Bowel Cancer Audit data set between 15 April and 30 June 2020 for completion by colorectal surgeons.

21 Century Approaches for Evaluating Exposures, Biological Activity, and Risks of Complex Substances: Workshop highlights.

The June 2019 workshop 21st Century Approaches for Evaluating Exposures, Biological Activity, and Risks of Complex Substances, co-organised by the International Council of Chemical Association's Long-Range Research Initiative and the European Commission's Joint Research Centre, is summarised. Focus was the need for improved approaches to evaluate the safety of complex substances. Approximately 10% and 20% of substances registered under the EU chemicals legislation are 'multi-constituent substances' and 'substances of unknown or variable compositions, complex reaction products and biological substances' (UVCBs), respectively, and UVCBs comprise approximately 25% of the U.

Superheat: An R package for creating beautiful and extendable heatmaps for visualizing complex data.

The technological advancements of the modern era have enabled the collection of huge amounts of data in science and beyond. Extracting useful information from such massive datasets is an ongoing challenge as traditional data visualization tools typically do not scale well in high-dimensional settings. An existing visualization technique that is particularly well suited to visualizing large datasets is the heatmap.

Network-based biomarkers enhance classical approaches to prognostic gene expression signatures.

Background: Classical approaches to predicting patient clinical outcome via gene expression information are primarily based on differential expression of unrelated genes (single-gene approaches) or genes related by, for example, biologic pathway or function (gene-sets). Recently, network-based approaches utilising interaction information between genes have emerged. An open problem is whether such approaches add value to the more traditional methods of signature modelling.

Reproductive toxicity evaluation of dietary butyl benzyl phthalate (BBP) in rats.

Butyl benzyl phthalate (BBP) was administered in the diet at 0, 750, 3750, and 11,250 ppm ad libitum to 30 rats per sex per dose for two offspring generations, one litter/breeding pair/generation, through weaning of F2 litters. Adult F0 systemic toxicity and adult F1 systemic and reproductive toxicity were present at 11,250 ppm (750 mg/kg per day). At 11,250 ppm, there were reduced F1 and F2 male anogenital distance (AGD) and body weights/litter during lactation, delayed acquisition of puberty in F1 males and females, retention of nipples and areolae in F1 and F2 males, and male reproductive system malformations.

Toxicological review of inorganic phosphates.

Inorganic phosphate salts are widely used as food ingredients and in a variety of commercial applications. The United States Food and Drug Administration (FDA) considers inorganic phosphates "Generally Recognized As Safe" (GRAS) (FDA, 1973a, 1979) [FDA: Food and Drug Administration 1973a. GRAS (Generally Recognized as Safe) food ingredients-phosphates.

Effect of butyl benzyl phthalate on reproduction and zinc metabolism.

Butyl benzyl phthalate (BBP) has been shown to be teratogenic. One mechanism contributing to the teratogenicity of several developmental toxicants, is chemical-induced changes in maternal zinc (Zn) metabolism which result in an increased synthesis of maternal liver metallothionein (Mt), and a subsequent reduction in Zn delivery to the conceptus. We investigated the effects of maternal BBP exposure on maternal-fetal Zn metabolism in Wistar rats.

Migraine in twins raised together and apart.

History of headache and migraine diagnosed by structured interview utilizing International Headache Society criteria was obtained in two samples of female twin pairs--154 raised together and 43 raised apart since infancy. Zygosity was determined by standard methods. Probandwise concordance rates were determined.

Living with a person who has Parkinson's disease: the spouse's perspective by stage of disease. Parkinson's Study Group.

The objective of this study was to examine the experience of spouses caregiving for their spouse with Parkinson's disease (PD) and to determine whether their experiences differed by stage of disease. By using a cross-sectional design and mail questionnaire data from 380 spouse caregivers across 23 sites of the Parkinson Study Group, key caregiver variables were examined by stage of PD. Three categories of variables--caregiver role strain (10 measures), caregiver situation (four measures), and caregiver characteristics (four measures)--were analyzed by using t tests with Bonferroni correction.

Client assessment tool: a means to enhance nurse-client-physician collaboration.

The fast pace of a headache clinic prompted the authors to develop chart forms which covered all aspects of history and treatment specific to headache clients. The effort proved to be beneficial in promoting better communication between caregivers and clients due to ease and thoroughness of documentation. Use of such a tool may promote cost effectiveness, better nurse-client-physician relationships and ultimately improved client outcomes.

Alteration of thyroid homeostasis by UDP-glucuronosyltransferase inducers in rats: a dose-response study.

UDP-glucuronosyltransferase (UDP-GT) inducers have been shown to lower plasma levels of thyroxine (T4) by increasing its glucuronidation and elimination by the liver. However, there are no dose-response studies to address the relationship between induction of hepatic UDP-GT and alteration in thyroid homeostasis. Therefore, rats were fed a basal diet or a diet mixed with phenobarbital (PB: 600, 1200, 1800 or 2400 ppm), pregnenolone-16 alpha-carbonitrile (PCN: 250, 500, 1000 or 2000 ppm), 3-methylcholanthrene (3MC: 62.

Reduction of thyroid hormone levels and alteration of thyroid function by four representative UDP-glucuronosyltransferase inducers in rats.

Male Sprague-Dawley rats (250-275 g) were fed diets containing four representative UDP-glucuronosyltransferase (UDP-GT) inducers, phenobarbital (PB), 3-methylcholanthrene (3MC), and pregnenolone-16 alpha-carbonitrile (PCN), as well as a polychlorinated biphenyl (PCB) mixture for 21 days to determine their effect on thyroid hormone levels and thyroid gland function. On Days 3, 7, 14, and 20, blood was collected and serum levels of free and total thyroxine (T4), free and total triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were determined by radioimmunoassay. On Day 21, following treatment with Na131I, the thyroid glands were removed and weighed, and the amount of 131I incorporated was determined.

Effect of progesterone pretreatment on cadmium toxicity in male Fischer (F344/NCr) and Wistar (WF/NCr) rats.

A previous report indicated that progesterone pretreatment can markedly reduce cadmium (Cd) toxicity in male NAW mice. Therefore we examined the effects of progesterone pretreatment on Cd toxicity in male Fischer (F344) and Wistar (WF) rats. A single subcutaneous injection of 10 or 30 mumole (CdCl2)/kg proved nonlethal over 24 hr but caused the typical spectrum of testicular lesions in these rats.

Outpatient care of the headache client: a challenging specialty.

Care of persons with headache is complex because they often present with symptoms that are difficult to classify and manage. Pharmacologic interventions for headache prevention and acute attacks, as well as behavioral and life-style changes, can significantly improve the quality of life for many. Advocacy begins by exploring all aspects of physical and emotional health so the client is involved in the holistic approach to headache management.

Effect of progesterone pretreatment on cadmium toxicity in the male Fischer (F344/NCr) rat.

A previous report has indicated that progesterone pretreatment can markedly reduce cadmium toxicity in male NAW mice. Therefore we examined the effects of progesterone pretreatment on cadmium toxicity in male Fischer (F344/NCr) rats. A single sc injection of 20 mumol CdCl2/kg proved nonlethal over 24 hr but caused the typical spectrum of testicular lesions in these rats.

Rat liver microsomal UDP-glucuronosyltransferase activity toward thyroxine: characterization, induction, and form specificity.

Glucuronidation of thyroxine (T4) by liver microsomal UDP-glucuronosyltransferase (UDP-GT) is a predominant pathway by which T4 is deactivated. This study was conducted to characterize in vitro T4 UDP-GT activity in rat liver microsomal preparations, to determine if T4 glucuronidation is mediated by a particular form of UDP-GT, and to determine if T4 glucuronidation can be increased by microsomal enzyme inducers. Characterization of microsomal T4 UDP-GT activity led to the establishment of optimal assay conditions.