Lack of regional pathways impact on surgical delay: Analysis of the Orthopaedic Trauma Hospital Outcomes-Patient Operative Delays (ORTHOPOD) study.

Introduction: Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital systems, particularly with regards to elective services. We demonstrate through a multicentre, multinational study, the impact of this at scale.

Association of Preexisting Triple Fusion and Arthroscopic Ankle Arthrodesis nonunion.

Background: Arthroscopic ankle arthrodesis (AAA) is a successful treatment for end-stage ankle arthritis. A significant early complication of AAA is symptomatic nonunion. Published nonunion rates range from 8% to 13%.

ORthopaedic trauma hospital outcomes - Patient operative delays (ORTHOPOD) Study: The management of day-case orthopaedic trauma in the United Kingdom.

Introduction: ORTHOPOD: Day Case Trauma is a multicentre prospective service evaluation of day-case trauma surgery across four countries. It is an epidemiological assessment of injury burden, patient pathways, theatre capacity, time to surgery and cancellation. It is the first evaluation of day-case trauma processes and system performance at nationwide scale.

Indirect effects of cytomegalovirus infection: Implications for vaccine development.

Development of a cytomegalovirus (CMV) vaccine is a high priority due to its significant global impact-contributing to mortality in immunosuppressed individuals, neurodevelopmental delay in infected neonates and non-genetic sensorineural hearing loss. The impact of CMV on the general population has been less well studied; however, a wide range of evidence indicates that CMV may increase the risk of atherosclerosis, cancer, immunosenescence, and progression of tuberculosis (TB) and human immunodeficiency virus. Due to the high seroprevalence of CMV worldwide, any modulation of risk by CMV is likely to have a significant impact on the epidemiology of these diseases.

The Fragility Fracture Postoperative Mobilisation multicentre audit : the reality of weightbearing practices following operations for lower limb fragility fractures.

Aims: The purpose of this study was to determine the weightbearing practice of operatively managed fragility fractures in the setting of publically funded health services in the UK and Ireland.

Methods: The Fragility Fracture Postoperative Mobilisation (FFPOM) multicentre audit included all patients aged 60 years and older undergoing surgery for a fragility fracture of the lower limb between 1 January 2019 and 30 June 2019, and 1 February 2021 and 14 March 2021. Fractures arising from high-energy transfer trauma, patients with multiple injuries, and those associated with metastatic deposits or infection were excluded.

Objectively quantified lower limb strength recovery in people treated surgically or non-surgically after patellar dislocation: A systematic review.

Objective: Synthesize evidence on objectively quantified lower limb strength recovery in people treated surgically or non-surgically after patellar dislocation.

Methods: MEDLINE, EMBASE, Cochrane Library, SPORTDiscus, PEDro, AMED and CINAHL databases were last searched on July 30th, 2020 for randomized controlled trials and observational studies that objectively quantified lower limb strength in people (any age or sex) treated surgically or non-surgically after patellar dislocation.

Results: 24 studies were included (877 participants, median age 20.

Interrogating the promise of technology in epilepsy care: systematic, hermeneutic review.

Technology development is gathering pace in epilepsy with seizure detection devices promising to transform self-care and service provision. However, such accounts often neglect the uncertainties, displacements and responsibilities that technology-supported care generates. This review brings together a heterogeneous literature, identified through systematic searches in 8 databases and snowball searching, to interrogate how technology becomes positioned in epilepsy care.

Direct Oral Anticoagulants in the Prevention of Venous Thromboembolism Following Surgery for Hip Fracture in Older Adults: A Population-Based Cohort Study.

Introduction: Direct oral anticoagulants (DOACs) decrease the risk of venous thromboembolism (VTE) without increasing the risk of hemorrhage in elective lower limb orthopedic surgery. However, the role of DOACs in preventing VTE following hip fracture surgery in the older adults remains unclear. This study aims to evaluate the efficacy and safety of DOACs in older adults undergoing surgery for hip fracture.

Predicting completion of follow-up in prospective orthopaedic trauma research.

Objective: Orthopaedic trauma studies that collect long-term outcomes are expensive and maintaining high rates of follow-up can be challenging. Knowing what factors influence completion of follow-up could allow interventions to improve this. We aimed to assess which factors influence completion of follow-up in the 12 months following surgery in prospective orthopaedic trauma research.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

SleepSure: a pilot randomized-controlled trial to assess the effects of eye masks and earplugs on the quality of sleep for patients in hospital.

Objective:: To determine the short-term effects of supplying hospital inpatients with earplugs and eye masks, preparatory to a full-scale trial.

Design:: A single-centre, open-label, two-arm, parallel group, randomized-controlled trial.

Setting:: A total of 13 medical and surgical wards in a large teaching hospital in the United Kingdom.

Medical device-related pressure ulcers: a clear case of iatrogenic harm.

There is growing evidence that medical device-related pressure ulcers (MDRPUs) are an increasing healthcare concern. Prevention and management is complicated, as they are caused by devices that are often an essential part of treatment. All clinical staff have a duty of care to do no harm.

International variations in primary care physician consultation time: a systematic review of 67 countries.

Objective: To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.

Design And Outcome Measures: This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.

Experience of directed living donor kidney transplant recipients: a literature review.

Unlabelled: A directed living donor is a healthy individual who donates an organ to a specific person. The number of living donor kidney transplantations in the UK has been increasing; however, living donation and the experience of kidney transplant recipients remain under-researched areas that are relevant to the provision of effective person-centred transplant care.

Aim: To understand the experience of directed living donor kidney transplant recipients to inform future nursing practice in the field.

A before-after study of multidisciplinary Out-of-Hours handover: combining management and frontline efforts to create sustainable improvement.

Objective: The importance of implementation strategy in systems improvement is increasingly recognized and both 'bottom-up' and 'top-down' approaches have significant barriers. A trial of a combined approach involving frontline and managerial staff therefore seems merited. We attempted to improve handover using a Human Factors-based approach integrated with a combined 'top and bottom' implementation strategy.

Shoulder injuries in adolescent rugby players.

Background: Rugby is a high-intensity contact sport, frequently causing shoulder injuries. Between the ages of 12 years to 18 years, academy and county level players are being selected for professional contracts, making this is a critical stage of their career. The present study aimed to describe the patterns of injury in adolescent rugby players with shoulder injuries.

Valvular heart disease and the military patient.

Valvular heart disease refers to all inherited and acquired abnormalities impairing the function of one or more of the four cardiac valves. Pathology may be of the valve leaflets themselves, of the subvalvular apparatus or of the annulus or other surrounding structures that influences valve function. This paper examines the most common valve lesions, with specific reference to a military population; it focuses on detection and initial management of valve disease in a young adult population and specifically describes how the diagnosis and treatment of valve disease impacts military medical grading.

Enterolithotomy for the treatment of large bowel obstruction secondary to gallstones.

We describe the case of an 81-year-old woman with large bowel-obstruction caused by an impacted gallstone. An 81-year-old, Caucasian, fully independent woman without significant comorbidities presented with absolute constipation, faecal vomiting and abdominal pain. Abdominal radiography revealed dilated small bowel, and a subsequent contrast CT demonstrated a 2.

Proteus Mediastinitis Causing Fatal Pseudoaneurysm following Aortic Valve Replacement.

We report an unusual case of Gram-negative mediastinitis following aortic valve replacement via median sternotomy. The patient presented two months after surgery following a urinary tract infection in septic shock with a discharging sternal wound and blood cultures positive for Proteus mirabilis. Imaging revealed a large anterior mediastinal abscess and aortic pseudoaneurysm which subsequently ruptured resulting in fatality.