Predictors of mortality in periprosthetic fractures of the hip: Results from the national PPF study.

Introduction: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip.

Methods: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period.

Tips from the shop floor: postgraduate doctors working in trauma and orthopaedics.

Trauma and orthopaedics is a useful rotation for junior doctors to undertake. Experience in the specialty allows doctors to feel more confident in the diagnosis and treatment of conditions affecting the entire musculoskeletal system. Many junior doctors cover on-calls in trauma and orthopaedics departments, often with no prior specialist experience.

PEEK Versus Ti Interbody Fusion Devices: Resultant Fusion, Bone Apposition, Initial and 26-Week Biomechanics.

Study Design: Comparative evaluation of in vitro and in vivo biomechanics, resulting fusion and histomorphometric aspects of polyetheretherketone (PEEK) versus titanium (Ti) interbody fusion devices in an animal model with similar volumes of bone graft.

Objective: Identify differences in the characteristics of fusion and biomechanics immediately following implantation (time 0) and at 26 weeks with each interbody implant.

Summary Of Background Data: PEEK has been well accepted in spinal surgery, it provides a closer match to the mechanical properties of bone than metallic implants such as Ti.

Membrane interaction of Pasteurella multocida toxin involves sphingomyelin.

Pasteurella multocida toxin (PMT) is an AB toxin that causes pleiotropic effects in targeted host cells. The N-terminus of PMT (PMT-N) is considered to harbor the membrane receptor binding and translocation domains responsible for mediating cellular entry and delivery of the C-terminal catalytic domain into the host cytosol. Previous studies have implicated gangliosides as the host receptors for PMT binding.

A biomechanical comparison of lateral and posterior approaches to sacroplasty.

Study Design: Biomechanical cadaveric bench study.

Objective: To measure the augmentation effect and extravasation risk of posterior and lateral approaches to sacroplasty.

Summary Of Background Data: The biomechanical stabilizing effect of sacroplasty is unknown.

Biomechanical comparison of expandable and locked intramedullary femoral nails.

Objectives: The expandable intramedullary (IM) nail does not require locking and fluoroscopy use is minimized. However, the lack of cross-locking screws may adversely affect the fixation's rotational stability. The purpose of our study was to compare the rotational stability afforded by an expandable nail with that of a standard locked nail.

Percutaneous Achilles tendon lengthening: a cadaver-based study of failure of the triple hemisection technique.

Background And Purpose: Modern descriptions of the percutaneous triple hemisection technique for Achilles tendon lengthening do not take into account the axial twist in the ligament. We were concerned that technical failures of the lengthening technique might occur more often than has been reported, and analyzed the results of the triple hemisection technique in cadaveric tendons in quantitative and qualitative terms, focusing on insufficient or complete tenotomies.

Methods: We performed a percutaneous triple hemisection of the Achilles tendon in 20 legs from adult cadavers, and measured the increase in ankle dorsiflexion in degrees, the length of the cuts in mm, and the depth of the cuts as a percentage of the total diameter of the tendon.

The strength of the osteoporotic sacrum.

Study Design: Biomechanical cadaveric bench study.

Objective: To determine the strength of the osteoporotic sacrum subjected to vertical force.

Summary Of Background Data: Sacral insufficiency fractures are thought to be caused by vertical shear forces acting in the sacral ala.

Evaluation of a computerized measurement technique for joint alignment before and during periacetabular osteotomy.

Periacetabular osteotomy (PAO) is intended to treat a painful dysplastic hip. Manual radiological angle measurements are used to diagnose dysplasia and to define regions of insufficient femoral head coverage for planning PAO. No method has yet been described that recalculates radiological angles as the acetabular bone fragment is reoriented.

Biomechanical comparison of the interosseous tibiofibular ligament and the anterior tibiofibular ligament.

Background: The mechanical importance of the interosseous tibiofibular ligament of the ankle is unclear. The purpose of the current study was to compare the stiffness and strength of the interosseous tibiofibular ligament to that of the anterior tibiofibular ligament.

Methods: Twelve pairs of ankles were obtained from the Maryland State Anatomy Board.

The use of a template to improve the management of distal radial fractures.

Objectives: The aim of this study was to reduce the number of inappropriately managed distal radial fractures with the use of a template.

Methods: A template has been developed to aid junior doctors and emergency nurse practitioners (ENPs) to decide which distal radial fractures require manipulation. Emergency Department (ED) junior doctors and ENPs were asked to review the radiographs of 12 distal radial fractures with and without the template and comment on whether the fracture required manipulation.

Cyclic neutropenia and pyomyositis: a rare cause of overwhelming sepsis.

Primary pyomyositis is a pyogenic infection of skeletal muscle with abscess formation, which traditionally lacks an identifiable cause. We present a case of pyomyositis for which a cause was established. This was largely due to the fact that the patient was young and fit, enabling him to survive such overwhelming sepsis long enough for cycling of his neutrophil count to become apparent.

The delusion of possession in chronically psychotic patients.

Sixty-one chronically psychotic outpatients were grouped according to the presence or absence of a history of delusional possession. Compared with patients without a history of delusional possession (N = 36), possessed patients (N = 25) had significantly more self-reported childhood sexual abuse, higher dissociation scores, more cannabis abuse, more experiences of thought control, and more voices heard inside their heads. These findings support the hypothesis that in some psychotic patients, possession beliefs may reflect childhood trauma and dissociation.

An open trial of buspirone added to neuroleptics in schizophrenic patients.

Twenty chronic schizophrenic patients completed at least 2 weeks of a 6-week trial of buspirone (mean dose 23.8 mg/day) added to a stable dose of neuroleptic. At week 6, mean scores were significantly improved (p less than 0.

Elevation of plasma concentrations of haloperidol after the addition of fluoxetine.

Fluoxetine (20 mg/day) was added for 7-10 days to stable doses of haloperidol given to eight psychotic patients. Mean plasma concentrations of haloperidol were elevated by 20% (p less than 0.05), but extrapyramidal side effects did not increase appreciably, indicating a relatively minor interaction between these agents.

Self-reports of childhood abuse in chronically psychotic patients.

A heterogeneous sample of 61 chronically psychotic patients were subgrouped according to the presence or absence of a self-reported history of childhood abuse. Patients reporting childhood abuse (n = 27) had an earlier age of onset, scored higher on the Dissociative Experiences Scale, reported more amnesia, and relapsed more frequently than patients not reporting abuse histories. Histories of childhood abuse and of past stimulant abuse predicted the score on the Dissociative Experiences Scale.

Trial of fluoxetine added to neuroleptics for treatment-resistant schizophrenic patients.

Mean ratings of positive and negative symptoms and depression significantly improved in nine treatment-resistant schizophrenic patients who completed a 6-week open trial of fluoxetine added to their neuroleptics. The authors identify differences between responders and nonresponders and recommend controlled trials.

Simultaneous assay of dihydroxyacetone synthase and transketolase in a methylotrophic yeast grown in continuous culture. A cautionary note.

The methylotrophic yeast Candida boidinii CBS 5777 was grown in continuous culture under carbon limitation on glucose, glucose plus methanol, and methanol as carbon and energy sources. During adaptation from glucose to methanol there was a rapid rise in the specific activities of triokinase, fructose-1,6-bisphosphatase and dihydroxyacetone synthase, which are key enzymes of the xylulose phosphate cycle of formaldehyde fixation. The specific activity of classical transketolase fell during this adaptation.

The interrelation transketolase and dihydroxyacetone synthase activities in the methylotrophic yeast Candida boidinii.

Crude extracts of Candida boidinii grown on glucose, xylose or ethanol gave single peaks of classical transketolase activity following chromatography, on columns of hydroxylapatite; the enzyme was heat-stable and showed no appreciable activity with formaldehyde as acceptor in place of ribose 5-phosphate. Extracts of methanol-grown cells showed two peaks of transketolase activity following chromatography on both hydroxylapatite and DEAE-cellulose. One peak was identified with that found for the cells grown on substrates other than methanol; the other peak showed dihydroxyacetone synthase activity in addition to transketolase activity.