In vivo temperature measurement in the subacromial bursa during arthroscopic subacromial decompression.

Background: The purpose of the study was to evaluate whether use of a bi-polar radiofrequency (RF) ablation wand would cause excess heating, which may lead to collateral damage to the surrounding tissues during arthroscopic subacromial decompression. Cadaveric studies have shown that high temperatures can potentially be reached when using RF ablation wands in arthroscopic shoulder surgery. Only 1 other published study assesses these temperature rises in the clinical setting.

Lightening the load? A systematic review of community pharmacy-based weight management interventions.

The extent to which community pharmacies can increase capacity for weight management is unknown. Thus, the objective of the present paper was to evaluate the effectiveness and cost-effectiveness of community pharmacy weight management interventions. This paper used a design of systematic review and narrative synthesis.

Periprosthetic fractures in the distal femur following total knee replacement: A review and guide to management.

The management of distal femoral fractures following a total knee replacement can be complex and requires the equipment, perioperative support and surgical skills of both trauma and revision arthroplasty services. Recent advances in implant technology have changed the management options of these difficult fractures. This article describes the options available and discusses the latest evidence.

Associations between the anticholinergic risk scale score and physical function: potential implications for adverse outcomes in older hospitalized patients.

Objectives: The anticholinergic risk scale (ARS) score is associated with the number of anticholinergic side effects in older outpatients. We tested the hypothesis that high ARS scores are negatively associated with "global" parameters of physical function (Barthel Index, primary outcome) and predict length of stay and in-hospital mortality (secondary outcomes) in older hospitalized patients.

Design And Setting: Prospective study in 2 acute geriatric units.

Video instructions improve accuracy of self-measures of waist circumference compared with written instructions.

Objective: To determine whether video-based instructions improve the accuracy of self-measures of waist and hip circumference compared with written instructions.

Design: Population-based, cross-sectional study. Self-measurements of waist circumference (WC) and hip circumference (HC) of fifty-seven participants randomly allocated to receive either written instruction or video instruction were compared with those of a trained technician.

Flavonoid intake in relation to cognitive function in later life in the Lothian Birth Cohort 1936.

Previous studies have suggested a link between flavonoid intake and better cognitive function in later life but have not been able to control for possible confounding by prior intelligence quotient (IQ). The aim of the present study was to address this issue in a cross-sectional survey of 1091 men and women born in 1936, in whom IQ was measured at age 11 years. At the age of 70 years, participants carried out various neuropsychological tests and completed a FFQ.

Management of hyponatraemia in older people: old threats and new opportunities.

Hyponatraemia is the commonest electrolyte abnormality seen in clinical practice, and is especially prevalent in frail, older people. However, the serious implications of hyponatraemia in this age group are seldom recognized by clinicians. Hyponatraemia is associated with osteoporosis, impaired balance, falls, hip fractures and cognitive dysfunction.

EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo® WiiFit in community-dwelling fallers.

Background: Falls management programmes have been instituted to attempt to reduce falls. This pilot study was undertaken to determine whether the Nintendo® WiiFit was a feasible and acceptable intervention in community-dwelling older fallers.

Findings: Community-dwelling fallers over 70 years were recruited and attended for computer-based exercises (n = 15) or standard care (n = 6).

Volaemic assessment of the elderly hyponatraemic patient: reliability of clinical assessment and validation of bioelectrical impedance analysis.

Background: Hyponatraemia is the commonest electrolyte disturbance of hospital inpatients. Assessment of volaemic status is an important part of diagnosis and management.

Aim: To determine reliability of clinical assessment of volaemic state by assessing inter-observer variability of clinical measures of volaemic state.

Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder.

Meningeal carcinomatosis occurs in 1-18% of patients with solid tumours, most commonly carcinomas of the breast and lung or melanomas. There are relatively few reports of meningeal carcinomatosis in transitional cell carcinoma of the bladder. Isolated meningeal recurrence is particularly uncommon, and we present an unusual case of this in a 58-year-old man.

The increase in dural sac area is maintained at 2 years after X-stop implantation for the treatment of spinal stenosis with no significant alteration in lumbar spine range of movement.

Background Context: The X-stop interspinous process decompression (IPD) device has been used effectively in the management of symptomatic spinal stenosis. This study examines the radiological outcomes at 2 years postoperatively after X-stop implantation.

Purpose: To measure the effect of X-stop IPD device on the dural sac and foraminal areas at 24 months postoperatively at instrumented level in symptomatic lumbar canal stenosis.

Association between prescribing of antimuscarinic drugs and antimuscarinic adverse effects in older people.

Many commonly prescribed medications have antimuscarinic side effects. These can be severe and disabling, but it is not always possible to predict which patients will suffer these effects. The development of practical tools that predict the likelihood of adverse drug reactions would aid rational prescribing, thereby improving patient safety and outcomes.

Use of the augmentation index to predict short-term outcome after acute ischemic stroke.

Background: Simple, noninvasive measures of arterial disease may help to predict outcome after stroke. This observational study examined the relationship between measures of arterial function obtained from pulse wave analysis (PWA), stroke type, and in-hospital outcome after ischemic stroke.

Methods: The admission augmentation index (AIx) and computed central pulse pressure (CPP) in 60 volunteers admitted with acute ischemic stroke were assessed for associations with length of stay in hospital and with Barthel index at admission, 1 week poststroke, and at discharge.

Early catastrophic acetabular failure in Furlong total hip replacements.

The use of uncemented hip arthroplasty prostheses with ceramic articulations are popular, especially in the young, because of a perceived reduction in wear. We highlight a complication of ceramic on polyethylene articulating couples not previously described in the Furlong replacement. Despite widespread metalosis and particulate debris, osteolysis was not initially seen.

Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial.

Background: Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful vertebral fractures, which is intended to reduce pain and improve quality of life. We assessed the efficacy and safety of the procedure.

Methods: Adults with one to three acute vertebral fractures were eligible for enrolment in this randomised controlled trial at 21 sites in eight countries.

Genetic determinants of ageing processes and diseases in later life.

Objective: To investigate the role of genetic factors in diseases of later life.

Methods: Review of literature relevant to the role of genetic factors in variation of incidence of age-related diseases of later life using Medline, Web of Science, to search publications in English since 1980 and citations found in relevant publications.

Results: The identity of ageing and longevity genes remains unknown despite lively interest in lipoprotein metabolism, genomic instability, oxidative stress, cellular response to damage, inflammatory processes, insulin/IGF1-signalling and Sirtuins.

Disc changes in the bridged and adjacent segments after Dynesys dynamic stabilization system after two years.

Study Design: Prospective case series.

Objective: To study the radiologic changes in the intervertebral disc after Dynesys dynamic stabilization.

Summary Of Background Data: Adjacent segment disc degeneration is one of the potential complications of fusion surgery.

Novel use of Steinman pin in removal of broken interlocking screws.

Broken screws after interlocking nailing of long bones are commonly seen in Orthopaedic practice. Removal of such screws can be difficult particularly the distal part which is often held within the bone. We describe a simple technique of using Steinman pin to aid removal of broken screws in a case of non-union fracture tibia with broken interlocking nail and screws.

Needs assessment study for community pharmacy travel medicine services.

Background: Community pharmacists in the UK currently provide limited travel medicine services. An enhanced service could offer the traveling public general advice, provision of immunizations, and malaria prophylaxis. The assessment of need for a travel vaccine service from community pharmacies is key to the decision to develop the service.

Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry.

Objectives: This study examined the potential for measuring dynamic inducible micromotion (DIMM) between fragments in healing distal radial fractures using radiostereometry (RSA).

Design: Prospective imaging study.

Setting: University teaching hospital.

Spontaneous splenic rupture mimicking pneumonia: a case report.

A 74-year-old gentleman presented with a history of left-sided pleuritic chest and upper abdominal pain. Examination and chest x-ray findings were suggestive of pneumonia. An abdominal ultrasound was suggestive of spontaneous splenic rupture.

Impact of trochanteric heterotopic ossification on measurement of femoral bone density following cemented total hip replacement.

During a study of bone mineral density changes around cemented femoral implants, we recognized heterotopic ossification occurring regularly in a position anterior to the greater trochanter and proximal femur. The aim of this study was to describe the incidence, distribution, and effect of this ossification on periprosthetic DXA scans following primary cemented total hip replacement. One hundred eleven patients underwent postoperative DXA examinations measuring changes in bone mineral density with heterotopic ossification identified and localized on standard radiographs with confirmation using DXA subtraction imaging.