THE ROLE of a BIKE FIT in CYCLISTS with HIP PAIN. A CLINICAL COMMENTARY.

Hip pathology is common amongst athletes and the general population. The mechanics of cycling have the potential to exacerbate symptomatic hip pathology and progress articular pathology in patients with morphologic risk factors such as femoroacetabular impingement. A professional fit of the bicycle to the individual which aims to optimize hip joint function can allow patients with hip pathology to exercise in comfort when alternative high impact exercise such as running may not be possible.

A Dose-Response Analysis of Crystalloid Administration during Esophageal Resection.

Objectives: The purpose of this retrospective study was to investigate the role of intraoperative crystalloid administration on postoperative hospital length of stay (phLOS) and on the incidence of previously reported adverse events in 100 consecutive patients who underwent esophageal resection.

Methods: The role of previously reported patient demographics, clinical characteristics, and intraoperative crystalloid administration on the duration of phLOS underwent statistical screening criteria for multivariable analysis, including the use of an instrumental variable to measure the role of unmeasured confounders on phLOS. Tests to assess the likelihood of causality also were performed.

Safety and effectiveness of cannabinoids for the treatment of neuropsychiatric symptoms in dementia: a systematic review.

Background: Neuropsychiatric symptoms (NPS) in dementia impact profoundly on the quality of life of people living with dementia and their care givers. Evidence for the effectiveness and safety of current therapeutic options is varied. Cannabinoids have been proposed as an alternative therapy, mainly due to their activity on CB1 receptors in the central nervous system.

Incidence, predictors and impact of stroke on mortality among patients with acute coronary syndromes following percutaneous coronary intervention-Results from the PROMETHEUS registry.

Background: Stroke represents a potentially calamitous complication among patients with acute coronary syndrome (ACS) undergoing percutaneous intervention (PCI). Data on the distribution of stroke occurrence post-PCI and its impact on mortality are scarce.

Objectives: We sought to determine the incidence, predictors and impact of stroke on mortality in ACS patients undergoing PCI.

Sleep duration and self-rated health in Chinese university students.

Purpose: Little is known about the association between sleep duration and health status in Chinese university students. This study examined the association between sleep duration and self-rated health in university students in China.

Methods: Altogether, 2312 subjects (928 in Macao, 446 in Hong Kong, and 938 in mainland China) were recruited.

Immunogenicity and Safety of a Quadrivalent Meningococcal ACWY-tetanus Toxoid Conjugate Vaccine 6 Years After MenC Priming as Toddlers.

Background: We assessed immunogenicity, antibody persistence and safety of the meningococcal serogroups A, C, W and Y-tetanus toxoid (TT) conjugate vaccine (MenACWY-TT) in children primed as toddlers with MenC vaccine.

Methods: This open, multicenter extension study enrolled children 84-95 months of age who had received one dose of the combined Haemophilus influenzae type b (Hib)-MenC-TT conjugate vaccine (HibMenC group) or Hib-TT and monovalent MenC (MCC)-CRM197 vaccines (Hib+MCC group) at 12-18 months of age, in the primary study. All participants received one dose of MenACWY-TT.

Derivation of a clinical decision-making aid to improve the insertion of clinically indicated peripheral intravenous catheters and promote vessel health preservation. An observational study.

Background: It is well established that the idle peripheral intravenous catheter (PIVC) provides no therapeutic value and is a clinical, economic and above all, patient concern. This study aimed to develop a decision aid to assist with clinical decision making to promote clinically indicated peripheral intravenous catheter (CIPIVC) insertion in the emergency department (ED) setting. Providing evidence for a uniform process could assist clinicians in a decision-making process for PIVC insertion.

Emergency department non-invasive cardiac output study (EDNICO): a feasibility and repeatability study.

Background: There is little published data investigating non-invasive cardiac output monitoring in the emergency department (ED). We assessed six non-invasive fluid responsiveness monitoring methods which measure cardiac output directly or indirectly for their feasibility and repeatability of measurements in the ED: (1) left ventricular outflow tract echocardiography derived velocity time integral, (2) common carotid artery blood flow, (3) suprasternal aortic Doppler, (4) bioreactance, (5) plethysmography with digital vascular unloading method, and (6) inferior vena cava collapsibility index.

Methods: This is a prospective observational study of non-invasive methods of assessing fluid responsiveness in the ED.

Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial.

Importance: There are currently no approved treatments for peanut allergy.

Objective: To assess the efficacy and adverse events of epicutaneous immunotherapy with a peanut patch among peanut-allergic children.

Design, Setting, And Participants: Phase 3, randomized, double-blind, placebo-controlled trial conducted at 31 sites in 5 countries between January 8, 2016, and August 18, 2017.

Qualitative research: An overview of emerging approaches for data collection.

Objective: The aim of this study was to introduce new approaches to conduct qualitative research that may provide valuable insight into issues related to education, training and patient care in psychiatry.

Conclusions: A variety of data-collection tools is available for researchers and practitioners in psychiatry. These can be used independently or in conjunction with other quantitative and qualitative methods.

Sporadic late onset nemaline myopathy (SLONM) in an adult presenting with progressive muscle weakness.

Sporadic late onset nemaline myopathy (SLONM) is a rare, intractable acquired myopathy that is characterised by progressive muscle weakness and the presence of nemaline rods in myofibres. Unlike the congenital form of nemaline myopathy (NM), there are only few case reports and series on SLONM in the scientific literature. We present a case report of SLONM in a 62-year-old male from a rural town in Western Australia, without any of the conditions often associated with SLONM such as monoclonal gammopathy of uncertain significance or HIV infection.

The Use of Continuous Glucose Monitoring With Remote Monitoring Improves Psychosocial Measures in Parents of Children With Type 1 Diabetes: A Randomized Crossover Trial.

Objective: This study aimed to explore the effect of continuous glucose monitors with remote monitoring on psychosocial outcomes in parents of children with type 1 diabetes.

Research Design And Methods: Children with type 1 diabetes, aged 2-12 years, along with their parents, were studied in a randomized crossover study. They participated in two 3-month periods using conventional blood glucose monitoring (control) or the Dexcom G5 Mobile continuous glucose monitoring (CGM) system with remote monitoring (intervention).

Silent lesions on MRI imaging - Shifting goal posts for treatment decisions in multiple sclerosis.

Background: The current best practice suggests yearly magnetic resonance imaging (MRI) to monitor treatment response in multiple sclerosis (MS) patients.

Objective: To evaluate the current practice of clinicians changing MS treatment based on subclinical new MRI lesions alone.

Methods: Using MSBase, an international MS patient registry with MRI data, we analysed the probability of treatment change among patients with clinically silent new MRI lesions.

Ischaemic Stroke and the Echocardiographic "Bubble Study": Are We Screening the Right Patients?

Background: Patent foramen ovale (PFO) is a potential mechanism for paradoxical embolism in cryptogenic ischaemic stroke or transient ischaemic attack (TIA). PFO is typically demonstrated with agitated saline ("bubble study", BS) during echocardiography. We hypothesised that the BS is frequently requested in patients that have a readily identifiable cause of stroke, that any PFO detected is likely incidental, and its detection often does not alter management.

Exploring the Quality of Anticoagulant Prescribed for Patients With Atrial Fibrillation at the St John of God Hawkesbury District Health Centre, New South Wales, Australia.

Background: Limited data are available on the clinical management of atrial fibrillation (AF) and its outcomes from an Australian perspective.

Objective: To describe the appropriateness of antithrombotic prescribing for patients who presented with a diagnosis of AF to the Hawkesbury St John of God Hospital, New South Wales, Australia.

Methods: This retrospective observational study reviewed patients admitted to St John of God Hawkesbury Hospital with AF between June 2016 and June 2017.

Wheat Intolerance and Chronic Gastrointestinal Symptoms in an Australian Population-based Study: Association Between Wheat Sensitivity, Celiac Disease and Functional Gastrointestinal Disorders.

Objectives: Wheat avoidance in the absence of celiac disease (CD) is common but occurrence of concurrent functional gastrointestinal disorders (FGIDs) in this group is uncertain. The aims of this study were to determine the prevalence of self-reported wheat or gluten sensitivity and doctor diagnosed CD in an Australian population, define the associated gastrointestinal (GI) symptoms and FGIDs, and determine the relationship between self-reported wheat sensitivity, demographic and medical factors.

Methods: A total of 3542 people randomly selected from the Australian population returned a mail survey which contained questions on wheat avoidance, GI symptoms, demographic, medical, and lifestyle factors.

The Rise and Rise of Eosinophilic Gut Diseases Including Eosinophilic Esophagitis Is Probably Not Explained by the Disappearance of Helicobacter pylori, so Who or What's to Blame?

A dramatic increase in eosinophilic esophagitis (EoE) and atopic disease and a dramatic decline in Helicobacter pylori infection has been observed in the last few decades. Previously, it was speculated that the immune response to H. pylori may protect against allergic diseases including EoE, but this study by Molina-Infante et al.

Association of Circulating Wnt Antagonists With Severe Abdominal Aortic Calcification in Elderly Women.

Context: There is great interest in the biology of vascular calcification. Wnt/-catenin signaling is an important mediator of mineralization and may play a role in vascular calcification.

Objective: We assessed the association between circulating Wnt antagonists and abdominal aortic calcification (AAC) severity in elderly women.

Unmet Needs of Aboriginal Australians With Musculoskeletal Pain: A Mixed-Method Systematic Review.

Objective: Musculoskeletal pain (MSP) conditions are the biggest cause of disability, and internationally, indigenous peoples experience a higher burden. There are conflicting reports about Aboriginal Australians and MSP. We conducted a systematic review to describe the prevalence, associated factors, impacts, care access, health care experiences, and factors associated with MSP among Aboriginal Australians.

Peripheral Arterial Disease.

Peripheral arterial disease (PAD) affects 15% of the Australian population and is a powerful and serious predictor of cardiovascular mortality yet continues to be under-recognised and undertreated. Diagnosis is simple and management is centred upon symptom relief and risk minimisation. While novel and specialised therapies play a role, the bulk of management is approachable and feasible.

A RhoA-FRET Biosensor Mouse for Intravital Imaging in Normal Tissue Homeostasis and Disease Contexts.

The small GTPase RhoA is involved in a variety of fundamental processes in normal tissue. Spatiotemporal control of RhoA is thought to govern mechanosensing, growth, and motility of cells, while its deregulation is associated with disease development. Here, we describe the generation of a RhoA-fluorescence resonance energy transfer (FRET) biosensor mouse and its utility for monitoring real-time activity of RhoA in a variety of native tissues in vivo.