A service evaluation of patients suspected of Cauda Equina Syndrome referred to accident and emergency departments from a national telephone triage service.

Background: The presentation and management of Cauda Equina Syndrome (CES) remains contentious in medical literature, however it is widely agreed that CES requires emergency medical attention. Physiotherapists will often refer suspected cases to A&E departments for emergency medical review in order to safeguard patient safety.

Objectives: To evaluate the management of patients triaged by a national telephone service referred to A&E for suspected CES.

SHADES of grey - The challenge of 'grumbling' cauda equina symptoms in older adults with lumbar spinal stenosis.

Diagnosing cauda equina syndrome is challenging in older adults with lumbar spinal stenosis. Understanding these challenges is vital for clinicians who are faced with difficult decisions about when to refer for investigation or surgical management. This is a growing clinical issue because of the escalating prevalence of lumbar spinal stenosis in our ageing population, and increasing demands on healthcare services including imaging and surgical services.

Assessment and management of cauda equina syndrome.

Introduction: Cauda equina syndrome (CES) is a rare condition that affects the nerves in the spine supplying the bladder, bowel and sexual function. Identification and subsequent urgent action is required to avoid permanent damage to these essential organs. Delays in diagnosis can have devastating and life changing consequences for patients and result in high cost negligence claims.

Transcription of Biotic Stress Associated Genes in White Clover (Trifolium repens L.) Differs in Response to Cyst and Root-Knot Nematode Infection.

The transcription of four members of the Kunitz proteinase inhibitor (KPI) gene family of white clover (Trifolium repens L.), designated as Tr-KPI1, Tr-KPI2, Tr-KPI4 and Tr-KPI5, was investigated at both local infection (roots) and systemic (leaf tissue) sites in white clover in response to infection with the clover root knot nematode (CRKN) Meloidogyne trifoliophila and the clover cyst nematode (CCN) Heterodera trifolii. Invasion by the CRKN resulted in a significant decrease in transcript abundance of Tr-KPI4 locally at both 4 days post-infection (dpi) and at 8 dpi, and an increase in transcription of Tr-KPI1 systemically at 8 dpi.

Patient and caregiver experience following ambulatory surgery: qualitative analysis in a cohort of patients 65 yr and older.

Purpose: Patients over the age of 65 represent 15% of Canada's population and one-third of patients undergoing surgery. Older surgical patients often have lasting disability following "minor" ambulatory procedures. This study sought to explore the postoperative experience of ambulatory surgery, as described by older surgical patients and their caregivers.

Evidence from central Mexico supporting the Younger Dryas extraterrestrial impact hypothesis.

We report the discovery in Lake Cuitzeo in central Mexico of a black, carbon-rich, lacustrine layer, containing nanodiamonds, microspherules, and other unusual materials that date to the early Younger Dryas and are interpreted to result from an extraterrestrial impact. These proxies were found in a 27-m-long core as part of an interdisciplinary effort to extract a paleoclimate record back through the previous interglacial. Our attention focused early on an anomalous, 10-cm-thick, carbon-rich layer at a depth of 2.

Using consensus methods in developing clinical guidelines for exercise in managing persistent low back pain.

Objectives: To generate expert consensus evidence for the purpose of developing more complete guidelines for people with persistent low back pain than is possible using current research evidence alone. Gaps in research evidence lead to incomplete practice recommendations unless a scientific process can provide supplementary consensus evidence that is a basis for additional recommendations.

Design: A modified Nominal Group Technique (NGT).

Shock-synthesized hexagonal diamonds in Younger Dryas boundary sediments.

The long-standing controversy regarding the late Pleistocene megafaunal extinctions in North America has been invigorated by a hypothesis implicating a cosmic impact at the Allerød-Younger Dryas boundary or YDB (approximately 12,900 +/- 100 cal BP or 10,900 +/- 100 (14)C years). Abrupt ecosystem disruption caused by this event may have triggered the megafaunal extinctions, along with reductions in other animal populations, including humans. The hypothesis remains controversial due to absence of shocked minerals, tektites, and impact craters.

Perceptions of outpatients regarding the attire of physiotherapists.

Purpose: This study investigated perceptions of patients regarding physiotherapists' attire.

Methods: Three hundred patients in three publicly funded outpatient physiotherapy clinics were asked to complete a questionnaire, ranking four photographed modes of attire (lab coat, tailored dress, "scrubs," and jeans) in terms of professionalism, preference, and appropriateness and rating their level of agreement with four statements about physiotherapists' attire.

Results: Response rate was 63.

Resistance Reactions to Meloidogyne trifoliophila in Trifolium repens and T. semipilosum.

The predominant root-knot nematode in New Zealand pastures is Meloidogyne trifoliophila, and a recurrent selection program in Trifolium repens has developed resistance to this species. No data are available, however, on the mechanisms of resistance in T. repens or resistant genotypes of T.