Systematic Review and Meta-analysis: Does Anterior-Posterior Spinal Fusion Still have a Role in Severe Thoracic Adolescent Idiopathic Scoliosis?

Background: Debate exists as to whether anterior-posterior spinal fusion (APSF), rather than posterior-only spinal fusion (PSF), provides benefit for treating severe thoracic adolescent idiopathic scoliosis (AIS). This systematic review and meta-analysis compare (1) Cobb angle correction, (2) complication and reoperation rate, (3) pulmonary function, (4) number of fused segments, and 5) patient-reported outcome measures (PROMs) in both groups.

Methods: Electronic databases were searched to identify studies that met the following inclusion criteria: comparative studies (level 3 or above), severe thoracic curves (≥ 70°), age ≤ 16, AIS aetiology, Lenke 1-4 curves and follow-up ≥ 1 year for ≥ 95% of patient population.

Increased endothelial inflammation, sTie-2 and arginase activity in umbilical cords obtained from gestational diabetic mothers.

Objective: The aim of this study was to determine subclinical inflammation in umbilical vein derived endothelial cells (HUVECs) obtained from Asian Indian subjects with gestational diabetes (GDM) and to determine levels of angiogenic factors and arginase activity in their cord blood.

Methods: This case-control study included 38 control and 30 GDM subjects. Subjects were confirmed as GDM based on 75g oral glucose tolerance test (OGTT) conducted in the second trimester of pregnancy.

Critical appraisal workshops to promote evidence-based healthcare.

We evaluated the effect of literature appraisal workshops on participants views, attitudes and knowledge about evidence-based medicine in the West Midlands region in 1998. The performance of 55 practitioners was evaluated, before and after attending the workshop. After attending the workshop, participants paid more attention to the study design (81% vs.

Postgraduate journal club as a means of promoting evidence-based obstetrics and gynaecology.

We assessed the feasibility of a new educational programme to teach critical appraisal of the medical literature to postgraduate trainees. The new programme used a journal club format where selection of topics and articles was driven by clinical problems arising in day-to-day practice. Papers were appraised critically according to validated guidelines using computer software for appraisal, electronic storage and retrieval.

An unusual cause of urinary retention in early pregnancy.

Urinary retention is a rare complication of early pregnancy with few serious sequelae. A Medline search found no association between urinary symptoms and cervical pregnancy. This case describes urinary retention resulting from a cervical pregnancy and describes a proposed mechanism to explain the presenting symptoms.

Assessments in evidence-based medicine workshops: loose connection between perception of knowledge and its objective assessment.

The outcome of continuing education programs is often based on self-assessment. We evaluated the relationship of self-assessment of knowledge based on rating scales with scores obtained on objective validated tests in evidence-based medicine workshops. In the West Midlands region (1998), 55 participants attended three workshops in critical appraisal of the medical literature.

Modernizing the journal club.

Traditionally journal clubs provide a forum to learn presentation skills. We propose a new approach to teaching and learning in journal clubs, focusing on literature acquisition and critical appraisal skills. This approach will enable trainees to use journal clubs for personal professional development as well as for application of new knowledge in clinical medicine to improve patients' outcomes.

A controlled analysis of authorship trends over two decades.

Objective: The purpose was to assess authorship trends over time by taking account of publication type and controlling for number of investigating centers and funding status in a multivariable analysis.

Study Design: A database of 403 randomized studies and 193 controlled observational studies was assembled by means of a combination of electronic and hand search of 4 generic obstetrics and gynecology journals for the years 1975, 1980, 1985, 1990, and 1995. A multivariable logistic regression model was built for evaluating the effect of time on authorship with multiauthored articles as the binary outcome variable (articles were classified as either those with <6 authors or those with >/=6).

Pruritus in pregnancy and obstetric cholestasis.

Pruritus is often considered a common but minor symptom of pregnancy. However, pruritus caused by obstetric cholestasis is increasingly being recognized as a cause of so-called 'unexplained' stillbirths. This article reviews recent literature and outlines possible management strategies with the aim of reducing maternal morbidity and improving perinatal outcome.

Logistic regression models in obstetrics and gynecology literature.

Objective: To evaluate the reporting of multivariable logistic regression analyses and assess variations in quality over time in the obstetrics and gynecology literature.

Methods: Methodologic criteria for reporting logistic regression analyses were developed to identify problems affecting accuracy, precision, and interpretation of this approach to multivariable statistical analysis. These criteria were applied to 193 articles that reported multivariable logistic regression in the issues of four generic obstetrics and gynecology journals in 1985, 1990, and 1995.

The diagnostic accuracy of ultrasound scan in predicting endometrial hyperplasia and cancer in postmenopausal bleeding.

Objective: To determine the accuracy of ultrasound scan in the diagnosis of endometrial hyperplasia and cancer in postmenopausal bleeding.

Design: A prospective diagnostic accuracy study (1996-97).

Setting: Minimal access surgical training centers in two large teaching hospitals.

Role of laparoscopy in the management of chronic pelvic pain.

Laparoscopy has rapidly become an important diagnostic and therapeutic tool in gynaecological surgery. The entity of chronic pelvic pain is best investigated laparoscopically before any treatment is planned. Often diagnosis and treatment can be a one-stage procedure.

Persistent ectopic pregnancy following conservative surgery for tubal pregnancy.

Objective: To audit the incidence and management of persistent ectopic pregnancy following conservative tubal surgery performed at laparotomy and via the laparoscope.

Design: A retrospective analysis of the case records.

Setting: The Birmingham and Midland Hospital for Women.