Are Current Patient-Reported Outcome Measures Fit for Purpose to Evaluate Unicompartmental Knee Arthroplasty?

The optimal procedure for isolated end-stage medial compartment knee osteoarthritis (OA) remains uncertain, with debate persisting between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The aim of this narrative review is to evaluate current outcome measures in knee arthroplasty (KA) and explore how evolving patient populations and technological advancements may necessitate the use of different patient-reported outcome measures (PROMs) for evaluating UKA. While UKA offers potential advantages over TKA in early pain relief and functional outcomes, most randomised control trials using traditional PROMs have failed to show definitive superiority.

Vitamin D deficiency in hip fracture patients is associated with an increased mortality risk.

Purpose: The aims were to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture.

Methods: A retrospective study was undertaken including all patients aged over 50 years that were admitted with a hip fracture to a single centre during a 24-month period. Serum vitamin D levels on admission, patient demographics, perioperative variables and mortality were collected.

The functional and psychological impact of delayed hip and knee arthroplasty: a systematic review and meta-analysis of 89,996 patients.

This systematic review and meta-analysis aimed to determine the impact of presurgical waiting times on pre-/post-operative joint specific pain and function, health-related quality of life (HRQOL) and perspectives of patients awaiting primary elective total hip (THR) and knee (TKR) replacements. MEDLINE, EMBASE, PUBMED, and CENTRAL databases were searched from inception until 30th January 2023 (CRD42022288128). Secondary literature and unpublished datasets containing paediatric, non-elective, partial, or revision replacement populations were excluded.

Modified Shock Index as a Predictor of Admission and In-hospital Mortality in Emergency Departments; an Analysis of a US National Database.

Introduction: The modified shock index (MSI) is the ratio of heart rate to mean arterial pressure. It is used as a predictive and prognostic marker in a variety of disease states. This study aimed to derive the optimal MSI cut-off that is associated with increased likelihood (likelihood ratio, LR) of admission and in-hospital mortality in patients presenting to emergency department (ED).

Clinical frailty is independently associated with joint-specific function and health-related quality of life in patients awaiting a total hip or knee arthroplasty.

The aims were to assess whether preoperative joint-specific function (JSF) and health-related quality of life (HRQoL) were associated with level of clinical frailty in patients waiting for a primary total hip arthroplasty (THA) or knee arthroplasty (KA). Patients waiting for a THA (n = 100) or KA (n = 100) for more than six months were prospectively recruited from the study centre. Overall,162 patients responded to the questionnaire (81 THA; 81 KA).

Significant deterioration in quality of life and increased frailty in patients waiting more than six months for total hip or knee arthroplasty : a cross-sectional multicentre study.

Aims: The primary aim of this study was to assess whether patients waiting six months or more for a total hip (THA) or knee (KA) arthroplasty had a deterioration in their health-related quality of life (HRQoL). Secondary aims were to assess changes in frailty and the number of patients living in a state considered to be worse than death (WTD), and factors associated with changes in HRQoL and frailty.

Methods: This cross-sectional study included 326 patients, 150 males (46.

Intervention rates are low after direct discharge from the Edinburgh trauma triage clinic: Outcomes of 6,688 patients.

Aim: The Edinburgh Trauma Triage clinic (TTC) is an established form of Virtual Fracture clinic (VFC) that permits the direct discharge of simple, isolated fractures from the Emergency Department (ED). Small, short-term cohort studies of similar systems have been published, but to detect low rates of complications requires a large study sample and longer-term follow-up. This study details the outcomes of all patients with injuries suitable for a direct discharge protocol over a four-year period, reviewed at a minimum of three years after attendance.

Novel lipophosphonoxin-loaded polycaprolactone electrospun nanofiber dressing reduces Staphylococcus aureus induced wound infection in mice.

Active wound dressings are attracting extensive attention in soft tissue repair and regeneration, including bacteria-infected skin wound healing. As the wide use of antibiotics leads to drug resistance we present here a new concept of wound dressings based on the polycaprolactone nanofiber scaffold (NANO) releasing second generation lipophosphonoxin (LPPO) as antibacterial agent. Firstly, we demonstrated in vitro that LPPO released from NANO exerted antibacterial activity while not impairing proliferation/differentiation of fibroblasts and keratinocytes.

Epidemiology of American Football Injuries at Universities in the United Kingdom.

Background: College-level American football injury data are routinely collected; however, data relating to American football injuries at universities in the United Kingdom have never been reported.

Purpose: To describe the epidemiology of UK university American football injuries.

Study Design: Descriptive epidemiology study.

Cytotoxicity of the effector protein BteA was attenuated in Bordetella pertussis by insertion of an alanine residue.

Bordetella bronchiseptica and Bordetella pertussis are closely related respiratory pathogens that evolved from a common bacterial ancestor. While B. bronchiseptica has an environmental reservoir and mostly establishes chronic infections in a broad range of mammals, B.

The impact of a preoperative information leaflet on expectation management, satisfaction and patient outcomes in patients undergoing knee arthroscopy.

Background: This study examined the effects of a patient information leaflet on outcomes related to patient satisfaction following knee arthroscopy.

Methods: Cohort study of patients listed for knee arthroscopy under the care of a single surgeon over a nine-month period (May 2017-January 2018) following the introduction of an information leaflet as an adjunct to the consent process. Outcome data was collected postoperatively through telephone follow-up.

Shock index as a predictor of hospital admission and inpatient mortality in a US national database of emergency departments.

Study Objectives: The shock index (SI), defined as the ratio of the heart rate (HR) to the systolic blood pressure (BP), is used as a prognostic tool in trauma and in specific disease states. However, there is scarcity of data about the utility of the SI in the general emergency department (ED)population. Our goal was to use a large national database of EDs in the United States (US) to determine whether the likelihood of inpatient mortality and hospital admission was associated with initial SI at presentation.

The Emergency Department Crash Cart: A systematic review and suggested contents.

Background: As the field of Emergency Medicine grows worldwide, the importance of an Emergency Department Crash Cart (EDCC) has long been recognized. Yet, there is paucity of relevant peer-reviewed literature specifically discussing EDCCs or proposing detailed features for an EDCC suitable for both adult and pediatric patients.

Methods: The authors performed a systematic review of EDCC-specific literature indexed in Pubmed and Embase on December 20, 2016.

Hospital Surge Capacity: A Web-Based Simulation Tool for Emergency Planners.

The National Center for the Study of Preparedness and Catastrophic Event Response (PACER) has created a publicly available simulation tool called Surge (accessible at http://www.pacerapps.org) to estimate surge capacity for user-defined hospitals.

Clinical metrics in emergency medicine: the shock index and the probability of hospital admission and inpatient mortality.

Study Objectives: The shock index (SI), defined as the ratio of HR to systolic BP, has been studied as an alternative prognostic tool to traditional vital signs in specific disease states and subgroups of patients. However, literature regarding its utility in the general ED population is lacking. Our main objective was to determine the probability of admission and inpatient mortality based on the first measured SI at initial presentation in the general adult ED population in our tertiary care centre.

Pediatric Emergency Department Return: A Literature Review of Risk Factors and Interventions.

Background And Objective: Children discharged from emergency departments (EDs) are often at risk for ED return. The objective was to identify risk factors and interventions to mitigate or prevent ED return among this patient population.

Methods: Structured literature review of PubMed and clinicaltrials.

Disaster Metrics: Evaluation of de Boer's Disaster Severity Scale (DSS) Applied to Earthquakes.

Introduction: Quantitative measurement of the medical severity following multiple-casualty events (MCEs) is an important goal in disaster medicine. In 1990, de Boer proposed a 13-point, 7-parameter scale called the Disaster Severity Scale (DSS). Parameters include cause, duration, radius, number of casualties, nature of injuries, rescue time, and effect on surrounding community.

Troponin elevations only detected with a high-sensitivity assay: clinical correlations and prognostic significance.

Objectives: With clinical use of high-sensitivity troponin I (hsTnI), more frequent troponin elevations will occur. However, the burden and implications of these elevations are not well understood. The authors quantified the prevalence of elevated hsTnI in patients presenting with possible acute coronary syndrome (ACS) who do not have elevated troponin with a current generation assay (cardiac troponin I [cTnI]) and determined the association of these newly detected elevations with a composite of all-cause mortality and subsequent cardiac hospitalization.

Availability and diversity of training programs for responders to international disasters and complex humanitarian emergencies.

Introduction: Volunteers and members of relief organizations increasingly seek formal training prior to international field deployment. This paper identifies training programs for personnel responding to international disasters and complex humanitarian emergencies, and provides concise information - if available- regarding the founding organization, year established, location, cost, duration of training, participants targeted, and the content of each program.

Methods: An environmental scan was conducted through a combination of a peer-reviewed literature search and an open Internet search for the training programs.

Comparing the accuracy of syndrome surveillance systems in detecting influenza-like illness: GUARDIAN vs. RODS vs. electronic medical record reports.

Background: A highly sensitive real-time syndrome surveillance system is critical to detect, monitor, and control infectious disease outbreaks, such as influenza. Direct comparisons of diagnostic accuracy of various surveillance systems are scarce.

Objective: To statistically compare sensitivity and specificity of multiple proprietary and open source syndrome surveillance systems to detect influenza-like illness (ILI).

Critical resources for hospital surge capacity: an expert consensus panel.

Background: Hospital surge capacity (HSC) is dependent on the ability to increase or conserve resources. The hospital surge model put forth by the Agency for Healthcare Research and Quality (AHRQ) estimates the resources needed by hospitals to treat casualties resulting from 13 national planning scenarios. However, emergency planners need to know which hospital resource are most critical in order to develop a more accurate plan for HSC in the event of a disaster.

Fellowships in international emergency medicine in the USA: a comparative survey of program directors' and fellows' perspectives on the curriculum.

Objective: Experts have proposed core curriculum components for international emergency medicine (IEM) fellowships. This study examined perceptions of program directors (PDs) and fellows on whether IEM fellowships cover these components, whether their perspectives differ and the barriers preventing fellowships from covering them.

Methods: From 1 November 2011 to 30 November 2011, a survey was administered to PDs, current fellows and recent graduates of the 34 US IEM fellowships.

Interventions to mitigate emergency department and hospital crowding during an infectious respiratory disease outbreak: results from an expert panel.

Objective: To identify and prioritize potential Emergency Department (ED) and hospital-based interventions which could mitigate the impact of crowding during patient surge from a widespread infectious respiratory disease outbreak and determine potential data sources that may be useful for triggering decisions to implement these high priority interventions.

Design: Expert panel utilizing Nominal Group Technique to identify and prioritize interventions, and in addition, determine appropriate "triggers" for implementation of the high priority interventions in the context of four different infectious respiratory disease scenarios that vary by patient volumes (high versus low) and illness severity (high versus low).

Setting: One day in-person conference held November, 2011.