An objective measure of response on whole-body MRI in metastatic hormone sensitive prostate cancer treated with androgen deprivation therapy, external beam radiotherapy, and radium-223.

Objectives: The aim of this study was to generate an objective method to describe MRI data to assess response in the vertebrae of patients with metastatic hormone sensitive prostate cancer (mHSPC), treated with external beam radiation therapy and systemic therapy with Radium-223 and to correlate changes with clinical outcomes.

Methods: Three sets of whole-body MRI (WBMRI) images were utilized from 25 patients from the neo-adjuvant Androgen Deprivation Therapy pelvic Radiotherapy and RADium-223 (ADRRAD) clinical trial: MRI1 (up to 28 days before Radium-223), MRI2, and MRI3 (2 and 6 months post completion of Radium-223). Radiological response was assessed based on post baseline MRI images.

Toxicity and Efficacy of Concurrent Androgen Deprivation Therapy, Pelvic Radiotherapy, and Radium-223 in Patients with Metastatic Hormone-Sensitive Prostate Cancer.

Purpose: Radium-223 is an alpha-emitting radionuclide associated with overall survival (OS) improvement in metastatic castration-resistant prostate cancer (mCRPC). External beam radiotherapy (EBRT) to prostate extends OS in men with metastatic hormone-sensitive prostate cancer (mHSPC) limited to less than 4 metastases. We hypothesized that combination radium-223 + pelvic EBRT could safely deliver maximal radiotherapy doses to primary and metastatic prostate cancer and may improve disease control.

Management of the first-time lateral patellar dislocation.

Background: Little guidance exists on the management of the first-time patellar dislocation. The aim of this article was to review current guidance for management of this condition.

Methods: Recent meta-analyses, systematic reviews and current consensus documents relating to first-time patellar dislocation were sourced.

Replacement for patellofemoral arthritis.

Background: Patellofemoral osteoarthritis (PFOA) is relatively common, affecting 24% females and 11% males over the age of 55 years. Most patients can be treated conservatively. Arthroplasty remains the ultimate procedure for end stage PFOA.

Development and Evaluation of a New Formative Assessment of Surgical Performance.

Background: Formative assessment of operative performance is a mandatory part of surgical training. Engagement with assessment is limited in part by the time-consuming nature and the high perceived stakes of current assessment tools.

Objectives: Our aims were to develop and collect validity evidence for a new operative assessment tool that addresses barriers to assessment that current trainers and trainees experience.

Racial and Gender Influences on Pass Rates for the UK and Ireland Specialty Board Examinations.

Introduction: We explored effects of gender, ethnic origin, first language, and training status on scores in the Intercollegiate Specialty Board examinations in the UK and Ireland across the computer-marked written section and in the face-to-face oral and clinical section.

Methods: Demographic characteristics and examination results from 9987 attempts across 177 sittings from 2009 to 2013 were analyzed in an analysis of variance by training status, gender, ethnic origin, first language, and section (computer-marked multiple-choice examination vs face-to-face oral and clinical examination).

Results: We found increasing alignment between examiner and candidate characteristics during this period, with a 50% increase in examiners of Asian ethnic origin and a 60% increase in examiners whose first language is not English.

Radium-223 dichloride for the treatment of metastatic prostate cancer.

Introduction: Bone metastases are a frequent complication of many malignancies and are particularly common in metastatic prostate cancer, where they are associated with a high degree of morbidity. Until recently, treatments relied on palliative bone targeting measures with no proven survival-prolonging action or on systemic agents with general anti-prostate cancer activity but significant toxicities. Radium-223 dichloride is a bone-seeking, α-emitting, radionuclide that has recently been licensed in the US and Europe for the treatment of men with castration-resistant prostate cancer, bone metastases and no known visceral metastases.

Epidemiology of hospitalised osteochondritis dissecans in young people: incidence, geographical variation and trends over time in England from 2002 to 2010.

Background: Osteochondritis dissecans (OCD) is an important cause of knee pain in physically active adolescents, but its aetiology remains controversial. Modern data on its epidemiology are lacking. The aim of this study was to analyse the hospitalised incidence, age and sex distribution, trends over time and geographical variation in OCD in the whole of England.

Arterial injury in total knee arthroplasty.

Arterial complications associated with knee arthroplasty are relatively rare, although probably underreported, complications of knee arthroplasty that carry a risk of significant morbidity. Thorough preoperative assessment and close liaison with a vascular surgeon, combined with an appreciation of common anatomical variants or distorted anatomy, may help prevent both thromboembolic and direct injuries from occurring. Clinical features of arterial complications following knee arthroplasty may vary significantly from acute hemorrhage or ischemia in the immediate postoperative period to chronic pain and swelling presenting even months following the procedure.