Frequency of CYP3A4, CYP3A5, CYP2C9, and CYP2C19 variant alleles in patients receiving clopidogrel that experience repeat acute coronary syndrome.

The presence of cytochrome P450 (CYP) variant alleles may reduce the activation of the prodrug clopidogrel to its active state. This research evaluated the frequency of variant alleles in the genes coding for CYP3A4, CYP3A5, CYP2C9, and CYP2C19 enzymes in patients on clopidogrel therapy and experiencing repeat acute coronary syndrome (ACS) compared to a control group with a matching ethnic composition. Real-time polymerase chain reaction was used for allelic discrimination.

Comparison of Herbert and Acutrak screws in the treatment of scaphoid non-union and delayed union.

A retrospective analysis was performed on patients who had undergone surgery for delayed union or non-union of a scaphoid fracture. This was conducted to investigate if there was a difference in outcome between patients treated with the Acutrak screw or the Herbert screw. Twenty two cases were treated with a Herbert screw and 23 with an Acutrak screw.

Internal fixation of proximal humeral fractures.

We discuss the appropriate assessment and treatment options available for proximal humeral fractures. Important factors to consider are the fracture pattern, the bone quality and any co-morbidities. These are common injuries and are increasing in incidence due to an ageing population.

Dislocated Thompson hemiarthroplasty--the management of the recurrent dislocator.

Dislocation of a Thompson hemiarthroplasty of the hip is a serious complication with a high mortality rate. Previous papers have focused on surgical techniques to try and prevent dislocation. There is little in the literature on how to manage a patient after a dislocation.