Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists.

We convened a multidisciplinary Working Party on behalf of the Association of Anaesthetists to update the 2011 guidance on the peri-operative management of people with hip fracture. Importantly, these guidelines describe the core aims and principles of peri-operative management, recommending greater standardisation of anaesthetic practice as a component of multidisciplinary care. Although much of the 2011 guidance remains applicable to contemporary practice, new evidence and consensus inform the additional recommendations made in this document.

Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting: systematic review and meta-analysis.

Objective: To compare patient outcomes of restrictive versus liberal blood transfusion strategies in patients with cardiovascular disease not undergoing cardiac surgery.

Design: Systematic review and meta-analysis.

Data Sources: Randomised controlled trials involving a threshold for red blood cell transfusion in hospital.

Prediction of 30-day mortality after hip fracture surgery by the Nottingham Hip Fracture Score and the Surgical Outcome Risk Tool.

The care of the elderly with hip fractures and their outcomes might be improved with resources targeted by the accurate calculation of risks of mortality and morbidity. We used a multicentre national dataset to evaluate and recalibrate the Nottingham Hip Fracture Score and Surgical Outcome Risk Tool. We split 9,017 hip fracture cases from the Anaesthesia Sprint Audit of Practice into derivation and validation data sets and used logistic regression to derive new model co-efficients for death at 30 postoperative days.

Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2).

We re-analysed prospective data collected by anaesthetists in the Anaesthesia Sprint Audit of Practice (ASAP-1) to describe associations with linked outcome data. Mortality was 165/11,085 (1.5%) 5 days and 563/11,085 (5.

Current dilemmas and controversies in allergic contact dermatitis to ophthalmic medications.

Identifying contact allergens in ophthalmic medications can be a challenging and daunting experience. We summarize data on topical ophthalmic medications with the potential to cause periorbital contact dermatitis and allergic conjunctivitis, highlighting current dilemmas and controversies in this area. The following groups of allergens are reviewed: preservatives, antiglaucoma medications (prostaglandin analogues, β-blockers, carbonic anhydrase inhibitors, parasympathomimetics, sympathomimetics), antiinflammatory medications (nonsteroidal antiinflammatory drugs, corticosteroids), antibiotics, antivirals, antiallergic medications (antihistamines, cromones), anaesthetics, mydriatics, and cycloplegics.

Diabetes mellitus and hip fracture: a study of 5966 cases.

Introduction: Diabetes mellitus, and especially type II diabetes, is a widespread and increasing problem in the western world due to the high rates of obesity. It has also been shown in previous studies that diabetics have impaired fracture healing. The aim of this study was to see exactly what role diabetes plays in hip fracture because it is a partially modifiable disease, and to see whether there are any changes that we could make to our practice to improve patient outcome.

Vulvar and breast Paget's disease with synchronous underlying cancer: a unique association.

Background: We report a unique case of Paget's disease of vulva and breast. Sequentially the patient had invasive ductal carcinoma of the breast, 5 years later was diagnosed with vulvar Paget's with underlying adenocarcinoma and after another 2 years was diagnosed with Paget's disease of the breast.

Case: A 58-year-old woman with invasive ductal cancer of the left breast was treated with lumpectomy, lymph node dissection, radiation therapy and tamoxifen.

Analysis of the incidence and mortality of vulval cancer in women in South East England 1960-1999.

Objective: To investigate the age related trends in the incidence and mortality of vulval cancer in South East England between 1960 and 1999.

Methods: An analysis of systematically collected data by the Thames Cancer Registry from 26 health authorities in the Thames region. The study population included women diagnosed with vulval cancer in South East England between 1960 and 1999.

Incidence of fracture-healing complications after femoral neck fractures.

What is the relationship between the age or gender of the patient and the incidence of fracture-healing complications after internal fixation of intracapsular fractures? We aimed to determine the association between the age of the patient and fracture nonunion and also to establish if the gender of the patient had any influence on the occurrence of fracture nonunion. We prospectively studied 1133 patients with intracapsular fractures of the femoral neck treated by internal fixation. The overall incidence of nonunion was 19.

Reducing the risks of parenteral nutrition.

Parenteral nutrition is a vital method of delivering essential nutrients to some patients. But if used inappropriately it can increase the risk of catheter-related infection and incur unnecessary expense. Mary Bird explains how a nutritional support team's involvement transformed the quality of care for patients receiving the therapy at one trust.