Exploring Trauma Simulation: Insights from the Simulation in Trauma Across Resident Training (START) Study and Trainee Experiences.

Introduction and objective Advancements in technology have presented an opportunity to incorporate simulation training into the trauma and orthopedic (T&O) curriculum. This study aimed to assess the perspective of T&O trainees regarding the acceptability and perceived educational impact of simulation training before and after a training day. This includes identifying the resources that trainees are likely to use and find helpful when preparing for a new or unfamiliar procedure, as well as evaluating their opinions on different levels of simulation fidelity.

Definition and validation of a system for classifying the undersized Corail femoral stem in total hip arthroplasty.

Introduction: The uncemented total hip arthroplasty relies on a secure initial fixation of the femoral stem to achieve osseointegration. Undersizing of the femoral implant compromises this. Surgeons routinely review postoperative radiographs to assess appropriate sizing, but existing methods of assessment lack standardisation.

Pyomyositis of Gluteus medius: A case report and review of the literature.

Introduction: We present a case of 12 year old boy presented with right hip pain, fever and antalgic gait. Inflammatory markers were raised at presentation. The pelvic radiograph and ultra sound scan of right hip joint did not detect any abnormality.

Blood Metal Ion Thresholds to Identify Patients with Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris: An External Multicenter Validation Study of Birmingham Hip Resurfacing and Corail-Pinnacle Implants.

Background: The authors of recent studies have reported newly devised implant-specific blood metal ion thresholds to predict adverse reactions to metal debris (ARMD) in patients who have undergone unilateral or bilateral metal-on-metal (MoM) hip arthroplasty. These thresholds were most effective for identifying patients at low risk of ARMD. We investigated whether these newly devised blood metal ion thresholds could effectively identify patients at risk of ARMD after MoM hip arthroplasty in an external cohort of patients.

Bilateral transient osteoporosis of the hip in a 20-year-old man.

Transient osteoporosis is a rare musculoskeletal condition that has been reported in pregnant women and middle-aged men. We present a bilateral case in a young man. A 20-year-old man presented with spontaneous onset left hip pain.

Management of acute anterior shoulder dislocation.

Shoulder dislocation is the most common large joint dislocation in the body. Recent advances in radiological imaging and shoulder surgery have shown the potential dangers of traditional reduction techniques such as the Kocher's and the Hippocratic methods, which are still advocated by many textbooks. Many non-specialists continue to use these techniques, unaware of their potential risks.

Blood loss following total knee replacement is reduced when using computer-assisted versus standard methods.

Perioperative blood loss was compared in 136 patients (2 groups of 68 patients) who underwent total knee arthroplasty (TKA). Blood loss was significantly lower when using a computer-navigated technique in comparison to a method employing intramedullary femoral rods. Total blood loss was calculated from body weight, height and haematocrit change, using a model that has been shown to reliably estimate true blood loss.

Reduction of blood loss in primary hip arthroplasty with tranexamic acid or fibrin spray.

Background And Purpose: Previous studies have shown that either fibrin spray or tranexamic acid can reduce blood loss at total hip replacement, but the 2 treatments have not been directly compared. We therefore conducted a randomized, controlled trial.

Patients And Methods: In this randomized controlled trial we compared the effect of tranexamic acid and fibrin spray on blood loss in cemented total hip arthroplasty.

Reducing blood loss in primary knee arthroplasty: a prospective randomised controlled trial of tranexamic acid and fibrin spray.

A prospective, randomised controlled trial compared the effects of two medications intended to reduce blood loss from total knee arthroplasty. Patients were randomised to one of the following three treatment groups: 10mg/kg tranexamic acid at given at induction of anaesthesia, 10 ml of fibrin spray administered topically during surgery, or to a control group receiving neither treatment. Sixty six patients underwent elective cemented total knee arthroplasty; computer navigation was used in all cases.

Alpha4 is a ubiquitin-binding protein that regulates protein serine/threonine phosphatase 2A ubiquitination.

Multiple regulatory mechanisms control the activity of the protein serine/threonine phosphatase 2A catalytic subunit (PP2Ac), including post-translational modifications and its association with regulatory subunits and interacting proteins. Alpha4 is a PP2Ac-interacting protein that is hypothesized to play a role in PP2Ac ubiquitination via its interaction with the E3 ubiquitin ligase Mid1. In this report, we show that alpha4 serves as a necessary adaptor protein that provides a binding platform for both PP2Ac and Mid1.

Targeting protein serine/threonine phosphatases for drug development.

With the recent clinical success of drugs targeting protein kinase activity, drug discovery efforts are focusing on the role of reversible protein phosphorylation in disease states. The activity of protein phosphatases, enzymes that oppose protein kinases, can also be manipulated to alter cellular signaling for therapeutic benefits. In this review, we present protein serine/threonine phosphatases as viable therapeutic targets, discussing past successes, current challenges, and future strategies for modulating phosphatase activity.

"About a cupful"--a prospective study into accuracy of volume estimation by medical and nursing staff.

In this prospective study, medical and nursing health care professionals were asked to visually estimate various fluid volumes. The aims were to assess overall accuracy, and to identify factors that caused error. The effects of fluid volume, colour and clinical experience were analysed.

An automated fluorescence-based method for continuous assay of PP2A activity.

Protein serine/threonine phosphatase (PP2A) is a major cellular enzyme implicated in the control of numerous signaling processes. The accurate measurement of PP2A activity in crude cell lysates, immune complexes, and purified preparations provides insight into the function and regulation of this essential enzyme, which, in turn, can lead to a better understanding of the signaling pathways that it modulates. The method presented here utilizes 6,8-difluoro-4-methylumbelliferyl phosphate (DiFMUP) and a FLEXstation for the continuous measure of PP2A activity associated with many different protein preparations.

Parallel purification of three catalytic subunits of the protein serine/threonine phosphatase 2A family (PP2A(C), PP4(C), and PP6(C)) and analysis of the interaction of PP2A(C) with alpha4 protein.

The protein serine/threonine phosphatase (PP) type 2A family consists of three members: PP2A, PP4, and PP6. Specific rabbit and sheep antibodies corresponding to each catalytic subunit, as well as a rabbit antibody recognizing all three subunits, were utilized to examine the expression of these enzymes in select rat tissue extracts. PP2A, PP4, and PP6 catalytic subunits (PP2A(C), PP4(C), and PP6(C), respectively) were detected in all rat tissue extracts examined and exhibited some differences in their levels of expression.