A Rare Case of Disseminated Tuberculosis Presenting As a Frontal Headache and Photophobia in the UK.

Tuberculosis is a disease caused by  (TB), demonstrating a vast clinical spectrum that can potentially involve all systems of the body. We present the case of a female in her late 20s, with an employment background in healthcare. She recently moved to the UK from India.

Tissue Plasminogen Activator (tPA) Use in Persistent Loculated Ascites.

Spontaneous bacterial peritonitis (SBP) complicated by loculated ascites presents a therapeutic challenge, particularly when standard of care or surgical intervention is not feasible. This case report documents the successful use of intraperitoneal tissue plasminogen activator (tPA) as adjunctive salvage therapy in an adult female with decompensated liver cirrhosis and loculated infected ascites. After no improvement in the patient's clinical condition following 14 days of intravenous antibiotics, catheter-directed intraperitoneal tPA was administered for three days, resulting in the improvement of her abdominal pain and resolution of the loculations.

A Longitudinal analysis of weight changes before and after total hip arthroplasty: Weight trends, patterns, and predictors.

Background: It is crucial to understand weight trends in patients undergoing total hip arthroplasty (THA).

Objective: To evaluate preoperative and postoperative weight trends for patients undergoing primary THA and factors associated with clinically significant weight change.

Methods: A prospective cohort who underwent primary unilateral THA (n= 3,011) at a tertiary healthcare system (January 2016 to December 2019) were included in the study.

EEG-based sensorimotor neurofeedback for motor neurorehabilitation in children and adults: A scoping review.

Objective: Therapeutic interventions for children and young people with dystonia and dystonic/dyskinetic cerebral palsy are limited. EEG-based neurofeedback is emerging as a neurorehabilitation tool. This scoping review maps research investigating EEG-based sensorimotor neurofeedback in adults and children with neurological motor impairments, including augmentative strategies.

Students' perspectives from co-designed, lived experience eating disorders education: A qualitative inquiry.

Background: There is an intricate connection between eating disorders and trauma. Despite this, traditional eating disorders education for health professions has not taken a trauma-informed approach.

Aim: We aimed to explore the reflections of graduate entry dietetic and undergraduate nursing students who participated in a trauma-informed, co-designed education innovation that focussed on an individual's storied lived experience.

A single-step extraction and immobilization of soybean lipolytic enzymes by using a purpose-designed copolymer of styrene and maleic acid as a membrane lysis agent.

Approaches aiming to recover proteins without denaturation represent attractive strategies. To accomplish this, a membrane lysis agent based on poly(styrene--maleic acid) or PSMA was synthesized by photopolymerization using Irgacure® 2959 and carbon tetrabromide (CBr) as a radical initiator and a reversible chain transfer agent, respectively. Structural elucidation of our in-house synthesized PSMA, so-called photo-PSMA, was performed by using NMR spectroscopy.

Recognizing the Sex Disparity in Surgeons Performing Total Knee Arthroplasty.

Background: There is an unambiguous sex disparity in the field of orthopaedic surgery, with women making up only 7.4% of practicing orthopaedic surgeons in 2022. This study seeks to evaluate the sex distribution among orthopaedic surgeons engaged in primary total knee arthroplasty (TKA) between 2013 and 2020, as well as the procedural volume attributed to each provider.

Lower 90-day inpatient readmission and 1-year reoperation in patients undergoing robotic versus manual total hip arthroplasty through an anterior approach.

Background: The value of robotic-assisted total hip arthroplasty (rTHA) has yet to be determined compared to conventional manual THA (mTHA).

Objective: Evaluate 90-day inpatient readmission rates, rates of reoperation, and clinically significant improvement of patient-reported outcome measures (PROMs) at 1-year in a cohort of patients who underwent mTHA or rTHA through a direct anterior (DA) approach.

Methods: A single-surgeon, prospective institutional cohort of 362 patients who underwent primary THA for osteoarthritis via the DA approach between February 2019 and November 2020 were included.

'You don't see what I see': Co-designing simulation to uncover and address cognitive bias in healthcare.

Educational Challenge: Each year, adverse events are reported in healthcare, of which many relate to healthcare workforce cognitive bias. The active involvement of workforce and consumers in the review and co-design of effective training for the healthcare workforce to recognise, monitor, and manage unconscious bias is required.

Proposed Solution: We used participatory action research to co-design an innovative, interprofessional simulation based on 'real world' clinical incidents and lived experiences to improve the delivery of safe, high quality, consumer-focused healthcare.

Are Femoral Stems in Primary Total Knee Arthroplasty Cost Effective in High Fracture Risk Patients? A Risk Model and Cost Analysis.

Femoral stemmed total knee arthroplasty (FS TKA) may be used in patients deemed higher risk for periprosthetic fracture (PPF) to reduce PPF risk. However, the cost effectiveness of FS TKA has not been defined. Using a risk modeling analysis, we investigate the cost effectiveness of FS in primary TKA compared with the implant cost of revision to distal femoral replacement (DFR) following PPF.

Low cytotoxicity, antibacterial property, and curcumin delivery performance of toughness-enhanced electrospun composite membranes based on poly(lactic acid) and MAX phase (TiAlC).

MXenes, synthesized from their precursor MAX phases, have been extensively researched as additives to enhance the drug delivery performance of polymer matrices, whereas there is a limited number of previous reports on the use of MAX phases themselves for such applications. The use of MAX phases can exclude the complicated synthesis procedure and lessen resultant production and environmental costs required to convert MAX phases to MXenes. Herein, electrospun membranes of poly(lactic acid) (PLA) and a MAX phase (TiAlC) have been fabricated for curcumin delivery.

Journal Metrics of Orthopaedic Journals between 2016 and 2021: Trends and Comparisons with Other Specialties.

Bibliometric analysis plays a crucial role in elucidating publication trends and aids scholars in gauging the reach of prospective journals for their research dissemination. Concerns with impact factor (IF) have led us to examine the trends in IF, corrected IF (cIF), and Citescore in orthopaedic journals from 2016 to 2021 and compare them with internal medicine and general surgery journals. Journal IF and cIF were obtained from Journal Citation Reports and Citescore data from the Elsevier Scopus database for the years 2016 to 2021.

Diagnosis, Treatment, and Outcomes of Crystalline Arthropathy in the Setting of Total Knee Arthroplasty: A Critical Analysis Review.

» Emerging evidence suggests the prevalence of crystalline arthropathy (CA) in the setting of total knee arthroplasty (TKA) is increasing, and diagnosis of CA is often intricate because of symptom overlap with other common postoperative complications such as periprosthetic joint infection (PJI). Consequently, an accurate and timely diagnosis becomes pivotal in guiding the choice of treatment.» CA includes gout and calcium pyrophosphate deposition (CPPD) disease, and accurate diagnosis in patients with prior TKA requires a multifaceted approach.

Team Approach: Bone Health Optimization in Orthopaedic Surgery.

» Bone health optimization (BHO) has become an increasingly important consideration in orthopaedic surgery because deterioration of bone tissue and low bone density are associated with poor outcomes after orthopaedic surgeries.» Management of patients with compromised bone health requires numerous healthcare professionals including orthopaedic surgeons, primary care physicians, nutritionists, and metabolic bone specialists in endocrinology, rheumatology, or obstetrics and gynecology. Therefore, achieving optimal bone health before orthopaedic surgery necessitates a collaborative and synchronized effort among healthcare professionals.

Arthrofibrosis After Total Knee Arthroplasty: A Critical Analysis Review.

» Arthrofibrosis after total knee arthroplasty (TKA) is the new formation of excessive scar tissue that results in limited ROM, pain, and functional deficits.» The diagnosis of arthrofibrosis is based on the patient's history, clinical examination, absence of alternative diagnoses from diagnostic testing, and operative findings. Imaging is helpful in ruling out specific causes of stiffness after TKA.

What Drives the Material Costs of Total Knee Arthroplasty in the Operating Room?

Introduction: Approximately one-third of US healthcare spending is related to surgical care. Optimizing operating room (OR) spending is crucial, specifically for high-volume procedures like total knee arthroplasty (TKA). Therefore, the primary objective was to identify leading material drivers of cost for TKA procedures within the OR.

Establishing patient-centered metrics for the knee injury and osteoarthritis outcome score following medial unicompartmental knee arthropalsty.

Background: This study aimed to determine the minimal clinically important difference (MCID) and the patient acceptable symptoms state (PASS) threshold for the knee injury and osteoarthritis outcome score (KOOS) pain subscore, KOOS physical short form (PS), and KOOS joint replacement (JR) following medial unicompartmental knee arthroplasty (mUKA).

Methods: Prospectively collected data from 743 patients undergoing mUKA from a single academic institution from April 2015 through March 2020 were analyzed. Patient-reported outcome measures (PROMs) were collected both pre-operatively and 1-year post-operatively.

Intraincisional Pin Placement is Safe for Robotic-Assisted Total Knee Arthroplasty.

Background: While robotic-arm assisted total knee arthroplasty (RA-TKA) has seen a major increase in its utilization, it requires bone array pins to be fixed into the femur and tibia, which intrinsically carries a risk. As it is currently off-label with some robotic platforms to place pins intraincisional, we aimed to evaluate the safety of intraincisional pin placement during RA-TKAs.

Methods: A prospective cohort of 2,343 patients who underwent RA-TKA at a North American Healthcare System between January 2018 and March 2022 was included.

Stakeholder perspectives on co-designing a post-registration mental health nursing curriculum: A case study.

Introduction: Globally, healthcare regulatory bodies require providers of academic programs to involve service users in the design and delivery of education, yet concrete and tested directions for operationalising this are lacking. Service users' involvement in education is often passive, ad-hoc and tokenistic, with limited input at the program development level.

Aim: To explore the co-design processes and outcomes of a collaborative revision of an Australian post-registration mental health nursing curriculum.

Effect of operative time in outcomes following surgical fixation of hip fractures: a multivariable regression analysis of 35,710 patients.

Background: Prolonged operative time is a risk factor for increased morbidity and mortality after open reduction and internal fixation (ORIF) of hip fractures. However, the quantitative nature of such association, including graduated risk levels, has yet to be described. This study outlines the graduated associations between operative time and (1) healthcare utilisation, and (2) 30-day complications after ORIF of hip fractures.

Hip Abductor Reconstruction with the Use of Mesh and Distal Cerclage Cable Fixation: A Case Report and Surgical Technique.

Case: This is a case of a 71-year-old female patient with recurrent instability and complex hip abductor deficiency after total hip arthroplasty (THA) who was treated successfully with an abductor reconstruction with gluteal transfer with mesh reconstruction. The patient returned to nonassisted ambulation with no further THA dislocations at the 1-year follow-up.

Conclusion: Abductor deficiencies after THA are complex and have a high potential for long-term disability if not properly diagnosed and treated.

Robotic-Assisted Conversion of a Failed Medial Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty: A Case Report.

Case: An 81-year-old man with a history of left medial unicompartmental knee arthroplasty (mUKA) 8 years prior presented to the outpatient clinic with gradually increasing medial left knee pain of 6 years of duration. He underwent left conversion robotic-assisted total knee arthroplasty (RA TKA). At 1-year follow-up, the patient reported satisfactory clinical outcomes and excellent component alignment on x-rays.

Revision Total Hip Arthroplasty Using a Tibial Cone and Impaction Grafting for Severe Femoral Bone Loss: A Case Report.

Case: An 84-year-old woman presented 6 years after revision total hip arthroplasty (rTHA) with worsening hip pain and a Paprosky classification IIIB femoral defect. rTHA was performed using a proximal femur replacement. Given her osteoporosis and poor bone stock, a tibial cone and impaction grafting (IG) were used for megaprosthesis fixation.

Return to Sports and Return to Work After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Background: Return to work (RTW) and sports (RTS) are critical gauges to improvement among patients after total knee arthroplasty (TKA). This study aimed to determine rates, timelines, and prognostic factors associated with RTW and RTS outcomes after primary TKA.

Methods: A systematic review was conducted on MEDLINE, Embase, and CENTRAL databases, with 44 studies meeting inclusion/exclusion criteria.