Risk Factors and Clinical Outcomes of Perioperative Hypotension in the Neck of Femur Fracture Surgery: A Case-Control and Cohort Analysis.

Introduction Neck-of-femur (NOF) fractures have high prevalence rates and require prompt surgical intervention for better outcomes. Perioperative hypotension (POH) in the geriatric population has poor outcomes with several contributing factors. The study intends to explore these risk factors and their correlation with patient outcomes.

An Audit of Tracheostomy in Traumatic Brain Injury.

Introduction: The timing of tracheostomy in traumatic brain injury is controversial. The benefits of early tracheostomy are early weaning from ventilation, and reduction in pneumonia. But some studies demonstrated increase in intracranial pressure during tracheostomy.

Magnetic Ion Channel Activation (MICA)-Enabled Screening Assay: A Dynamic Platform for Remote Activation of Mechanosensitive Ion Channels.

This study reports results of a mechanical platform-based screening assay (MICA) to evaluate the remote activation of mechanosensitive ion channels. Here, we studied ERK pathway activation and the elevation in intracellular Ca levels in response to the MICA application using the Luciferase assay and Fluo-8AM assay, respectively. Functionalised magnetic nanoparticles (MNPs) targeting membrane-bound integrins and mechanosensitive TREK1 ion channels were studied with HEK293 cell lines under MICA application.

A multicentre comparative analysis of fixation versus revision surgery for periprosthetic femoral fractures following total hip arthroplasty with a cemented polished taper-slip femoral component.

Aims: The aim of this study was to compare open reduction and internal fixation (ORIF) with revision surgery for the surgical management of Unified Classification System (UCS) type B periprosthetic femoral fractures around cemented polished taper-slip femoral components following primary total hip arthroplasty (THA).

Methods: Data were collected for patients admitted to five UK centres. The primary outcome measure was the two-year reoperation rate.

Two-dimensional chlorinated vapour intrusion model involving advective transport of vapours with a highly permeable granular layer in the vadose zone serving as the preferential pathway.

Vapour intrusion (VI) is the process through which volatile organic compounds migrate from the subsurface source to the soil predominantly by diffusion, entering the overlying buildings through joints, cracks or other openings. This activity poses potentially serious health hazards for the occupants. Because of these health risks, recommendations for site closure are often made by quantifying the VI risks using mathematical models known as 'vapour intrusion models' (VIM).

Spondylodiscitis-a cohort analysis of its identification and management.

Purpose: Discitis represents infection of the intervertebral disc and osteomyelitis of the adjacent end plates. Classically, patients present with fever and back pain. Varied presentations and lack of adherence to guidelines lead to great variation in its identification and management.

Outpatient Parenteral Antimicrobial Therapy Practice in United Kingdom: A Single-center Experience.

Objectives: This study sought to analyze the outpatient parenteral antimicrobial therapy (OPAT) services provided by a tertiary hospital, in terms of types and duration of antimicrobials administered, and assess whether these services were in line with current good practice recommendations.

Methods: The electronic healthcare records of all stable patients with infectious diseases, aged ≥ 18 years, who received OPAT services between January 2019 and March 2021, were analyzed. For statistical analysis, the patients were divided into younger (< 65 years) and older (≥ 65 years) adults and the difference between them, in terms of healthcare resources utilization, was assessed.

Clinical efficacy of the virtual fracture clinic: analysis of 17,269 referrals by type of injury.

Introduction: Numerous studies have deemed the virtual fracture clinic (VFC) model to be both cost and clinically effective. However, very few of these studies have analysed the type of injuries seen in the VFC. The objectives of this study were to assess the clinical effectiveness of the VFC and analyse the types of injuries that lead to patients re-presenting in the face-to-face fracture clinic after being discharged virtually.

Periprosthetic Femoral Fractures and Their Surgical Outcomes Between 2011 and 2021: A Single-Centre Observational Study.

Introduction Periprosthetic femoral fractures (PFFs) present a significant burden on the health service. The incidence continues to rise globally as a result of an ageing population and an increase in the number of primary hip and knee arthroplasties being performed. This is a 10-year, retrospective, observational study that aims to better understand the outcomes of PFF in our district general hospital.

Acculturation of international medical graduates into the NHS.

Since the inception of the NHS, international medical graduates (IMGs) have been recognised as integral to the NHS long-term plan. These diverse groups of doctors make up approximately a fifth of all licensed doctors in the UK. The NHS has a history of reliance on IMGs to fill shortages and add to the workforce.

A case of neurenteric cyst of spine mimicking an arachnoid cyst.

Background: Intradural cysts of the spine are arachnoid cysts, neuroenteric cysts, and ependymal cysts. The usual finding in case of a neurenteric cyst is a ventrally located non-contrast-enhancing lesion that is isointense on T1-weighted sequence and hyperintense on T2-weighted imaging. An arachnoid cyst is hypointense in T1-weighted image and hyperintense in T2-weighted image, mimicking cerebrospinal fluid(CSF), and the location is dorsal to the cord.

Insights into vapour intrusion phenomena: Current outlook and preferential pathway scenario.

Vapour intrusion (VI) is the phenomenon by which volatile organic compounds (VOCs) migrate from the subsurface source through the soil and enter into the overlying buildings, affecting the indoor air quality and ultimately causing health hazards to the occupants. Health risk assessments associated with hydrocarbon contaminated sites and recommendations of site closure are often made by quantifying the VI risks using mathematical models known as 'vapour intrusion models' (VIM). In order to predict the health risk, various factors such as the lithological and geochemical conditions of the subsurface, environmental conditions, building operational conditions etc.

Pre-Visit Education on Pain Management Options Prior to the First Clinic Visit Improves Chronic Pain Patient Satisfaction with Proposed Treatment Plans.

Objective: This study sought to evaluate if actively informing new chronic pain patients about treatment options and setting realistic expectations for care, through the use of a pre-visit informational handout prior to the first clinic visit, improved patient satisfaction with subsequently proposed treatment plans.

Methods: The study was divided into two 3-month periods. During the first 3 months, with our current pain clinic practices in place, new patients (n = 147) were given surveys to establish a baseline of patient satisfaction with treatment plans proposed on their first visit.

The safety and efficacy of day-case total joint arthroplasty.

Introduction: The popularity of day-case arthroplasty has been fuelled by focus on its cost effectiveness for the healthcare system. Safety concerns still remain. The aim of this review was to compare readmission rates after total joint arthroplasty for patients undergoing day-case surgery and for inpatients.

A brief review of the neurological manifestations of the coronavirus disease.

Introduction: It has been demonstrated experimentally that the coronavirus can enter the central nervous system through olfactory nerves and can even reach medulla. Neurological manifestations are observed more frequently in patients with coronavirus disease.

Main Text: The aim of the review is to seek evidence for infection of the nervous system by the human coronavirus and study the neurological manifestations of the coronavirus and its treatment.

The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis.

Background: Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior. Uncemented prostheses have typically been used in younger, healthier patients and cemented prostheses in older patients with less-stable bone. Also, earlier research has suggested that bone cement has cytotoxic effects and may trigger cardiovascular and respiratory adverse events.

Tackling the elective case backlog generated by Covid-19: the scale of the problem and solutions.

Background: In April 2020, Covid-19 brought NHS elective procedures to a halt. The aim of this paper is to produce accurate forecasts on the building backlog, highlight the state of waiting lists currently and propose solutions required to prevent a public health crisis.

Method: Using data published by NHS digital and NHS England on previous years, we have analysed and used this to produce estimates of cancellations and missed cases.

Outcome of trauma and orthopaedic surgery at a UK District General Hospital during the Covid-19 pandemic.

Introduction: There are suggestions that elective surgery performed during the incubation period of COVID-19 infection may cause an immediate impairment of cell-mediated immunity, leading to high morbidity and mortality. However is contrasting data about the associated mortality. Since the outbreak, our unit has maintained a prospective database recording Trauma and Orthopaedic surgical activity.