Introduction of a Pre-admission Pharmacist Service Utilising the Surgical Ward Pharmacist.

The challenge with obtaining a best possible medication history (BPMH) post-surgery is the delay in clarifying medications due to decreased post-operative cognitive status and pain, which can lead to missed or late administration of medications. Studies have suggested that unintentional medication discrepancies at the time of admission are common in general medical patients. To investigate if a pre-admission pharmacist completing BPMHs for adult elective surgery patients with planned overnight admission increases the proportion of patients with (i) a BPMH completed, (ii) medication reconciliation completed and (iii) all home medications charted correctly within 24 hours of admission.

The Fate of the Shoulder Post Rotator Cuff Repair: Biomechanical Properties of the Supraspinatus Tendon and Surrounding Structures.

The study aimed to describe the changes in biomechanical properties of the supraspinatus tendon, deltoid muscle, and humeral head post arthroscopic rotator cuff repair using shear wave elastography. Shear wave velocity of the tendon, deltoid, and humeral head of 48 patients was measured at predetermined sites at 1 week, 6 weeks, 12 weeks, 6 months, and 12 months post repair. One-way ANOVA with Tukey's correction and Spearman's correlation were performed.

An assessment of factors associated with early postoperative stiffness in arthroscopic rotator cuff repair.

Background: Postoperative stiffness affects up to 20% of patients following arthroscopic rotator cuff repair. Recent evidence indicates that early postoperative stiffness may associated with lower retear rates. This study aimed to identify the independent predictors of early postoperative stiffness.

Developing the supraparticle technology for round window-mediated drug administration into the cochlea.

The semi-permeable round window membrane (RWM) is the gateway to the cochlea. Although the RWM is considered a minimally invasive and clinically accepted route for localised drug delivery to the cochlea, overcoming this barrier is challenging, hindering development of effective therapies for hearing loss. Neurotrophin 3 (NT3) is an emerging treatment option for hearing loss, but its therapeutic effect relies on sustained delivery across the RWM into the cochlea.

Left bundle branch area pacing for heart failure patients requiring cardiac resynchronization therapy: A meta-analysis.

Introduction: Left bundle branch area pacing (LBBP) is a novel conduction system pacing method to achieve effective physiological pacing and an alternative to cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) for patients with heart failure with reduced ejection fraction (HFrEF). We conduted this meta-analysis and systemic review to review current data comparing BVP and LBBP in patients with HFrEF and indications for CRT.

Methods: We searched PubMed/Medline, Web of Science, and Cochrane Library from the inception of the database to November 2022.

Identification of novel tetrahydroquinoxaline derived phenyl ureas as modulators of the hepatitis B virus nucleocapsid assembly.

A key step of hepatitis B virus (HBV) replication is the selective packaging of pregenomic RNA (pgRNA) by core protein (Cp) dimers, forming a nucleocapsid where the reverse transcriptional viral DNA replication takes place. One approach in the development of new anti-HBV drugs is to disrupt the assembly of HBV nucleocapsids by misdirecting Cp dimers to assemble morphologically normal capsids devoid of pgRNA. In this study, we built upon our previous discovery of benzamide-derived HBV capsid assembly modulators by exploring fused bicyclic scaffolds with an exocyclic amide that is β, γ to the fused ring, and identified 1,2,3,4-tetrahydroquinoxaline derived phenyl ureas as a novel scaffold.

Acromion and Distal Clavicle Grafts for Arthroscopic Glenoid Reconstruction.

Background: We intended to determine if an acromion or distal clavicle bone graft could restore large glenoid defects using two novel, screw-free graft fixation techniques.

Methods: Twenty-four sawbone shoulder models were divided into four groups (n = 6 per group) according to fixation technique and bone graft: (1) modified buckle-down technique with clavicle graft, (2) modified buckle-down technique with acromion graft, (3) cross-link technique with acromion graft, (4) cross-link technique with clavicle graft. Testing was performed sequentially in (1) intact models, (2) after creation of a 30% by-width glenoid defect and (3) after repair.

Shoulder Arthroplasty as a Day Case: Is It Better?

: A retrospective case-controlled study was performed to evaluate the outcomes of shoulder arthroplasty performed as a day case in carefully selected patients, compared to the traditional inpatient approach. : Patients who had total or hemiarthroplasty of the shoulder performed as a day case or inpatient procedure were recruited. The primary outcome compared rates of uneventful recovery, defined by the absence of complications or readmission to the hospital within six months of surgery, between the inpatient and outpatient groups.

Revision Rotator Cuff Repair With Versus Without an Arthroscopically Inserted Onlay Bioinductive Implant in Workers' Compensation Patients.

Background: The addition of onlay biological grafts to augment difficult rotator cuff repairs has shown encouraging results in a case series.

Purpose/hypothesis: The purpose of this study was to determine whether the addition of an onlay bioinductive implant would improve repair integrity, shear wave elastographic appearance of the repaired tendon and patch, and patient-rated and/or surgeon-measured shoulder function when used in workers' compensation patients undergoing revision arthroscopic rotator cuff repair. We hypothesized that the addition of the bioinductive implant would enhance repair integrity and clinical outcomes compared with standard repair.

Ultrasound Guided Arthroscopic Removal of Calcific Tendonitis: A Minimum of 2-Year Followup.

We have developed a novel technique for managing rotator cuff calcific tendonitis, involving arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance. While we have demonstrated encouraging results at six-month follow-up, the medium-term outcomes and the long-term outcomes of this technique at 2 years or beyond are unknown. The aim of this paper was to determine if this technique was successful in resolving symptoms after two years and beyond.

Reliability of a Novel Preoperative Protocol for Determining Graft Sizes for Superior Capsular Reconstruction Using Plain Film Radiography.

Background: Superior capsular reconstruction (SCR) for massive, irreparable rotator cuff tears involves anchoring a graft between the superior glenoid and the greater tuberosity of the humerus. Optimizing the graft size is important. We aimed (1) to evaluate the reliability of plain film radiography in determining graft size for SCR and (2) to create a database to help predict future graft sizes.

Determinants of Operative Time in Arthroscopic Rotator Cuff Repair.

Arthroscopic rotator cuff repairs have been reported to take between 72 and 113 min to complete. This team has adopted its practice to reduce rotator cuff repair times. We aimed to determine (1) what factors reduced operative time, and (2) whether arthroscopic rotator cuff repairs could be performed in under 5 min.

A Systematic Temporal Assessment of Changes in Tendon Stiffness Following Rotator Cuff Repair.

Objectives: How the material properties of the human supraspinatus tendon change following arthroscopic rotator cuff repair is undetermined. Shear wave elastography ultrasound is a relatively new, noninvasive measure of tissue stiffness. We aimed to evaluate any temporal changes in stiffness and/or thickness of supraspinatus tendons in humans following primary arthroscopic rotator cuff repair.

Predictors of Return to Work Following Primary Arthroscopic Rotator Cuff Repair: An Analysis of 1502 Cases.

Background: It is undetermined which factors predict return to work after arthroscopic rotator cuff repair.

Purpose: To identify which factors predicted return to work at any level and return to preinjury levels of work 6 months after arthroscopic rotator cuff repair.

Study Design: Case-control study; Level of evidence, 3.

Biomechanical Comparison of Synthetic Polytetrafluoroethylene (PTFE) vs Human Dermal Allograft (HDA), 2 vs 3 Glenoid Anchors, and Suture vs Minitape in Superior Capsule Reconstruction.

Superior capsule reconstruction (SCR) is an option for the treatment of massive, irreparable rotator cuff tears. However, which materials yield the strongest constructs remains undetermined. : We sought to investigate whether SCR with polytetrafluoroethylene (PTFE) or human dermal allograft (HDA), 2 or 3 glenoid anchors, and suture or minitape resulted in better failure load properties at the patch-glenoid interface.

An evaluation of shear wave elastographic characteristics of the supraspinatus tendon after rotator cuff repair.

Background: The main complication of rotator cuff repair is retear, which is most common in older patients and patients with greater tear sizes. However, it is unknown why these factors are associated with increased rates of retear. The aim of this study was to determine whether the factors associated with rotator cuff retear (age, tear size, sex, history of trauma, and duration of symptoms) are also associated with decreased mechanical stiffness of the supraspinatus tendon after repair, as assessed by shear wave elastography.

Superior and Anterior Glenoid Labral Tears Are Associated With Increased Neurofilament Concentration.

Background: Pain is a common presentation after glenohumeral labral injuries. However, the source of that pain is undetermined.

Purpose/hypothesis: We aimed to determine if there is a differential expression of nerve fibers around the glenoid labrum and if torn labra have increased neuronal expression compared with untorn labra (rotator cuff repair labra).

Biomechanical and morphological comparison of two interposition graft rotator cuff repair techniques.

Background: Interposition graft rotator cuff repair is one option for the treatment of massive, otherwise irreparable rotator cuff tears. It is undetermined how different suturing techniques influence morphology at the patch-tendon interface in interposition rotator cuff repairs, particularly with respect to increased cross-sectional area at the repair site post-exposure to cyclic loading, which may influence healing. We aimed to analyze how the morphology of the grafts used in polytetrafluoroethylene (PTFE) interposition rotator cuff repairs differed according to whether the graft was secured using the multiple mattress technique or the weave technique respectively.

Fibrillar matrix, Echogenicity, Contour, Thickness, and Suture (FECTS) vs. Global: A comparison of 2 scales developed to assess ultrasound images post rotator cuff repair.

Background: Ultrasound is commonly used to assess rotator cuff repair (RCR), but no standardized criterion exists to characterize the tendon.

Purpose: The aims of this study were to (1) develop content validity for ultrasound specific criteria to grade the postoperative appearance of a tendon after RCR, (2) assess the reliability of the criteria, and (3) assess the feasibility to use these assessments.

Methodology: Following expert consultation and literature review for content validity, 2 scales were created: 1) the Fibrillar matrix, Echogenicity, Contour, Thickness, and Suture (FECTS) scale and 2) the Rotator Cuff Repair-Investigator Global Assessment (RCR-IGA).

Factors influencing clinical outcomes in superior capsular reconstruction: A scoping review.

Background: It is undetermined how effective superior capsule/capsular reconstruction (SCR) is, and which factors influence clinical outcomes.

Questions/purposes: (1) To identify which factors influence outcomes in SCR, (2) to evaluate the effect of graft integrity on clinical outcomes, and (3) to compare SCR to other procedures for irreparable rotator cuff tears.

Methods: PubMed and EMBASE databases were searched for clinical SCR studies.

Sports Participation After Reverse Total Shoulder Replacement.

Background: Reverse total shoulder replacement (RTSR) is becoming a popular and reliable treatment for rotator cuff arthropathy. However, little is known about the ability to participate in sports after surgery.

Purpose: To determine to what extent RTSR will allow patients to participate in sporting activities and identify the associated factors that could affect postoperative sports participation.