Neurosurgery activity levels in the United Kingdom and republic of Ireland during the first wave of the covid-19 pandemic - a retrospective cross-sectional cohort study.

The impact of Covid-19 on surgical patients worldwide has been substantial. In the United Kingdom (UK) and the Republic of Ireland (RoI), the first wave of the pandemic occurred in March 2020. The aims of this study were to: (1) evaluate the volume of neurosurgical operative activity levels, Covid-19 infection rate and mortality rate in April 2020 with a retrospective cross-sectional cohort study conducted across 16 UK and RoI neurosurgical centres, and (2) compare patient outcomes in a single institution in April-June 2020 with a comparative cohort in 2019.

Non-contraceptive oestrogen-containing preparations for controlling symptoms of premenstrual syndrome.

Background: Premenstrual syndrome (PMS) is a psychological and somatic disorder of unknown aetiology, with symptoms typically including irritability, depression, mood swings, bloating, breast tenderness and sleep disturbances. About 3% to 10% of women who experience these symptoms may also meet criteria for premenstrual dysphoric disorder (PMDD). PMS symptoms recur during the luteal phase of the menstrual cycle and reduce by the end of menstruation.

The Society of Thoracic Surgeons Expert Consensus for the Resuscitation of Patients Who Arrest After Cardiac Surgery.

The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet. In gathering evidence for this consensus paper, searches were conducted using the MEDLINE keywords "cardiac surgery," "resuscitation," "guideline," "thoracic surgery," "cardiac arrest," and "cardiac massage.

Maternal and child health after assisted vaginal delivery: five-year follow up of a randomised controlled study comparing forceps and ventouse.

Objective: To undertake a five year follow up of a cohort of women and children delivered by forceps or vacuum extractor in a randomised controlled study.

Design: Follow up of a randomised controlled trial.

Setting: District general hospital in the West Midlands.

WITHDRAWN: Soft versus rigid vacuum extractor cups for assisted vaginal delivery.

Background: The original cups used for vacuum extraction delivery of the fetus were rigid metal cups. Subsequently, soft cups of flexible materials such as silicone rubber or plastic were introduced. Soft cups are thought to have a poorer success rate than metal cups.

WITHDRAWN: Vacuum extraction versus forceps for assisted vaginal delivery.

Background: Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother.

Objectives: The objective of this review was to assess the effects of vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity.

Search Strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register.

Longitudinal relationships between fluid status, inflammation, urine volume and plasma metabolites of icodextrin in patients randomized to glucose or icodextrin for the long exchange.

Background: Randomized trials have shown that icodextrin reduces the volume of extra-cellular fluid (ECFv) with variable effects on residual renal function. To explore this fluid shift and its possible mechanisms in more detail, prospectively collected data from one such trial, including measures of inflammation (C-reactive protein, tumour necrosis factor-alpha, albumin and low and high molecular weight hyaluronan) ANP (atrial naturetic peptide), an indirect marker of intra-vascular volume, plasma concentrations of icodextrin metabolites and alpha-amylase activity were analysed.

Methods: 50 patients were randomized to either 2.

Molecular genetics of pituitary tumours.

The last several years have seen a significant increase in our understanding of the molecular and biochemical changes associated with pituitary tumour initiation and progression. The combined data, from several groups, now allow a tentative map to be drawn showing that reduction to hemizygosity at several chromosomal loci (10q, 11q13 and 13q) is associated with the transition to the invasive phenotype, while loss on chromosome 9p and methylation of the tumour suppressor gene p16 appear to occur early in pituitary tumorigenesis. Changes in the expression/status of several genes and/or proteins including p53, the cAMP response element-binding factor (CREB), growth hormone-releasing hormone (GHRH), nm23, p16 and p27 have also been identified along this multi-step pathway.

Continuous versus interrupted sutures for repair of episiotomy or second degree tears.

Background: Millions of women worldwide undergo perineal suturing after childbirth and the type of repair may have an impact on pain and healing. For more than 70 years, researchers have been suggesting that continuous non-locking suture techniques for repair of the vagina, perineal muscles and skin are associated with less perineal pain than traditional interrupted methods.

Objectives: To assess the effects of continuous versus interrupted absorbable sutures for repair of episiotomy and second degree perineal tears following childbirth.

Clinical evidence shows no difference between single- and double-row repair for rotator cuff tears.

Tears of the rotator cuff may be repaired by single- or double-row techniques. Single-row methods do not restore the rotator cuff footprint but do provide a good functional outcome. We surveyed the literature to ascertain the origin of the current trend of using double-row methods of repair.

Cost considerations in the use of anaesthetic drugs.

Measuring the direct drug costs of an anaesthetic is relatively easy, but assessing increased expenditure in relation to clinical benefits and indirect costs is not. This review examines a number of papers that have attempted just such a task and tries to illustrate some of the difficulties inherent in this important area of cost-effective analyses.

Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy.

Objective: Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied the effects of eccentric exercises in sedentary non-athletic patients with Achilles tendinopathy.

Methods: Thirty-four sedentary patients (18 males, average age 44 years, range 23-67; 16 females, average age 51 years, range 20-76; average BMI: 28.

Ten-year survivorship of rough-surfaced femoral stem with geometry similar to Charnley femoral stem.

The aim of this study is to review the 10-year results of 269 cemented total hip arthroplasties performed using the Harvard femoral stem with matte surface finish and Charnley stem-like geometry. This is a retrospective cross-sectional survivorship study. We retrospectively reviewed the results of 269 cemented total hip arthroplasties performed using the Harvard femoral stem in 257 patients (men/women 93:164, mean age 71.

Gonadal shields in pelvic radiographs in pediatric patients.

We performed a retrospective study of pelvic radiographs of children between August 2003 and January 2004 to determine whether gonadal shields effectively protected the gonads during pelvic radiographs in pediatric patients. We considered 1,047 radiographs of 111 children under the age of 16 years who were examined by the orthopaedic department at the University Hospital of North Staffordshire. The presence and absence of gonadal shields in all the pelvic radiographs was recorded.

Staged bilateral total hip arthroplasty using rough and smooth surface femoral stems with similar design: 10-year survivorship of 48 cases.

Background: Various studies have reported good long-term results using femoral stems with either smooth or rough surfaces. In this retrospective cross-sectional survivorship study, we reviewed the 10-year results of 51 bilateral staged cemented total hip arthroplasties using the Harvard or the Charnley femoral stems-which have almost similar geometry but a different surface finish.

Methods: 51 patients were reviewed at median interval of 10 (Harvard group) and 11 years (Charnley group) after the primary operation.

The short term effects of a single corticosteroid injection on the range of motion of the shoulder in patients with isolated acromioclavicular joint arthropathy.

This study is aimed at evaluating the short-term effects of a single corticosteroid injection of the acromioclavicular joint on the range of motion of the shoulder joint using a three dimensional electromagnetic tracking system (FASTRAK) in patients with isolated unilateral acromioclavicular joint (ACJ) arthropathy. Eighteen patients (16 male, 2 female; mean age: 47.53 years), with isolated unilateral ACJ arthropathy were included in the study.

Tailor's bunion: a review.

The tailor's bunion is a painful bony prominence on the lateral aspect of the fifth metatarsal head that occurs in many individuals, but seldom causes symptoms. This article reviews the current literature regarding the presentation, etiology, and management of the tailor's bunion. The first line of management should be conservative, with advice on shoe wear.

Achilles tendon rupture and tendinopathy: management of complications.

Ailments of the Achilles tendon are on the increase and present in athletic and sedentary patients. The management of tendinopathy and rupture is not codified; Achilles tendon rupture and tendinopathy can be managed conservatively or surgically. Tackling the complications that arise from the management of these conditions provides a formidable challenge to the surgeon.

Free gracilis tendon graft in neglected tears of the achilles tendon.

Objective: To report the results of a longitudinal study on reconstruction of neglected Achilles tendon rupture using a free autologous gracilis tendon graft.

Design: Cohort study.

Participants: Twenty-one patients underwent surgery for a neglected rupture of the Achilles tendon occurring between 65 days and 9 months before the operation.

Longitudinal membrane function in functionally anuric patients treated with APD: data from EAPOS on the effects of glucose and icodextrin prescription.

Background: Peritoneal dialysis is associated with changes in membrane function that can lead eventually to ultrafiltration (UF) failure. Factors driving these changes are thought to include hypertonic glucose exposure, but previously reported associations are confounded by the presence of residual renal function.

Methods: Longitudinal membrane function (solute transport and UF capacity) were measured annually in a prospective cohort of 177 functionally anuric patients as part of the European Automated Peritoneal Dialysis Outcomes Study (EAPOS).

Development of the European Colposcopy Core Curriculum: use of the Delphi technique.

The objective of this study was to develop a European competence-based colposcopy core curriculum using the Delphi technique. Thirty expert colposcopists from 21 countries participated. A four-round iterative questionnaire was used.

Improving the standards of care for women having caesarean sections.

Improvement in the uptake of prophylactic antibiotics at caesarean section was chosen as a priority at the 1994 ASQUAM (Achieving Sustainable Quality in Maternity) meeting. The interventions used were guidelines, cyclical audit of cases and a patient-specific reminder stamp in the notes. A more detailed qualitative assessment of standards of communication and outcome was undertaken on a smaller cohort of women.