Floor and ceiling effects in the Oxford Shoulder Score : an analysis from the National Joint Registry.

Aims: The main objective of this study was to examine whether the Oxford Shoulder Score (OSS) demonstrated floor or ceiling effects when used to measure outcomes following shoulder arthroplasty in a large national cohort. Secondary objectives were to assess its pain and function subscales, and to identify independent predictors for patients achieving a postoperative ceiling score following shoulder arthroplasty.

Methods: Secondary database analysis of the National Joint Registry (NJR), which included 48,270 patients undergoing shoulder arthroplasty, was conducted.

Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People?

Study Objective: We determine whether the Clinical Frailty Scale applied at emergency department (ED) triage is associated with important service- and patient-related outcomes.

Methods: We undertook a single-center, retrospective cohort study examining hospital-related outcomes and their associations with frailty scores assessed at ED triage. Participants were aged 65 years or older, registered on their first ED presentation during the study period at a single, centralized ED in the United Kingdom.

Is perception of quality more important than technical quality in patient video cases?

Background: The use of video cases to demonstrate key signs and symptoms in patients (patient video cases or PVCs) is a rapidly expanding field. The aims of this study were to evaluate whether the technical quality, or judgement of quality, of a video clip influences a paediatrician's judgment on acuity of the case and assess the relationship between perception of quality and the technical quality of a selection of video clips.

Methods: Participants (12 senior consultant paediatricians attending an examination workshop) individually categorised 28 PVCs into one of 3 possible acuities and then described the quality of the image seen.

Getting rhythm: how do babies do it?

Objectives: To investigate the emergence of biological rhythms in the first months of life in human infants, by measuring age-related changes in core body temperature during night-time sleep, hormones (cortisol and 6-sulfatoxymelatonin) and the expression of a clock-controlled gene H3f3b in oral epithelial cells.

Design: Observational longitudinal study.

Setting: We measured overnight core body temperature, actigraphy, day-night urinary cortisol and 6-sulfatoxymelatonin, as well as circadian gene expression, in infants at home from March 2007 to July 2008 in Leicester.

What aspects of primary care predict emergency admission rates? A cross sectional study.

Background: From 2004 to 2009 there was almost a 12% rise in emergency admissions in England. This can be explained partly by an aging population and other socio-demographic characteristics, but much cannot be explained by these factors. We explored aspects of care, in addition to known demographic characteristics in general practice, that are associated with emergency admissions.

Management of displaced fractures of the waist of the scaphoid: meta-analyses of comparative studies.

Introduction: Scaphoid fractures with displacement have a higher incidence of nonunion that can cause pain and reduced movement, strength and function. The aim of this study was to review the evidence available and establish the risk of nonunion associated with management of displaced fractures of the waist of the scaphoid.

Methods: Electronic databases were searched using the Medical Subject Headings (MeSH) controlled vocabulary (scaphoid fractures, AND'd with displaced, or nonunion, or non-healing or cast immobilisation, or plaster or surgery).

Grip strength characteristics using force-time curves in rheumatoid hands.

The use of force-time curves in rheumatoid hands was investigated to assess peak force, average force, total grip time, area under the curve, and variability of the plateau region of the curves to identify the impact of different rheumatoid hand deformities on grip strength. We studied 43 patients - 10 men and 33 women - with established rheumatoid arthritis affecting their hands. Mean age was 61 years and mean duration of hand involvement was 13 years.

Screening for the metabolic syndrome using simple anthropometric measurements in south Asian and white Europeans: a population-based screening study. The Leicester Ethnic Atherosclerosis and Diabetes Risk (LEADER) Study.

Aims: To estimate the prevalence of metabolic syndrome in a general population sample of south Asians and white Europeans and compare predictors of metabolic syndrome, using ethnic specific definitions of obesity.

Methods: 3099 participants (71.4% white European, 28.

The prevalence of depression in white-European and South-Asian people with impaired glucose regulation and screen-detected type 2 diabetes mellitus.

Background: There is a clear relationship between depression and diabetes. However, the directionality of the relationship remains unclear and very little research has considered a multi-ethnic population. The aim of this study was to determine the prevalence of depression in a White-European (WE) and South-Asian (SA) population attending a community diabetes screening programme, and to explore the association of depression with screen-detected Type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR).

Diabetes: glycaemic control in type 2.

Introduction: Diabetes mellitus is now seen as a progressive disorder of glucose metabolism, affecting about 5% of the population worldwide, over 85% of whom have type 2 diabetes. Type 2 diabetes may occur with obesity, hypertension and dyslipidaemia (the metabolic syndrome), which are powerful predictors of CVD. Blood glucose levels rise progressively over time in people with type 2 diabetes regardless of treatment, causing microvascular and macrovascular complications.

Patients' perceptions of written consent: questionnaire study.

Objective: To examine patients' understanding of the status, function, and remit of written consent to surgery.

Design: Prospective questionnaire study. Questionnaires were sent to patients within one month of surgery.

Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis-a UK-wide study.

We sought to assess the interobserver variation of the new International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis when compared with the previous World Health Organization classification, when used by pathologists throughout the UK. We also sought differences in how the 2 classifications were applied to a single set of biopsies. Twenty unselected renal biopsies showing lupus nephritis were circulated to pathologists in the UK National Renal Pathology External Quality Assessment Scheme, before the ISN/RPS scheme was published, with a request to apply the World Health Organization classification.

Informed consent for elective and emergency surgery: questionnaire study.

Objectives: To evaluate women's experience of giving consent to obstetric and gynaecological surgery and to examine differences between those undergoing elective and emergency procedures.

Design: A prospective questionnaire study.

Setting: A large teaching hospital.

Randomised comparison of distension media for outpatient hysteroscopy.

Objective: To compare saline with and without added lignocaine and carbon dioxide distension for out patient hysteroscopy with regards to patient discomfort and hysteroscopic view.

Design: Single blind prospective randomised controlled trial.

Setting: Specialist out patient clinics in a large teaching hospital.

The long-term effectiveness of endometrial laser ablation: a survival analysis.

Objectives: To assess the long-term effectiveness of endometrial laser ablation and factors that predict long-term outcome.

Setting: A university teaching hospital.

Study Design: Postal questionnaires were sent to all women who underwent endometrial laser ablation between 1992 and 1998.

Carbonic anhydrase IX expression, a novel surrogate marker of tumor hypoxia, is associated with a poor prognosis in non-small-cell lung cancer.

Purpose: To evaluate carbonic anhydrase (CA) IX as a surrogate marker of hypoxia and investigate the prognostic significance of different patterns of expression in non-small-cell lung cancer (NSCLC).

Methods: Standard immunohistochemical techniques were used to study CA IX expression in 175 resected NSCLC tumors. CA IX expression was determined by Western blotting in A549 cell lines grown under normoxic and hypoxic conditions.