Right on target?

Targets have become an integral part of health care, whether we agree with them or not. Many accept the progress made with the use of targets, but our duty as health professionals is to ensure that their use and interpretation is undertaken with the same care and understanding of their limitations that we apply to our clinical practice, and that they are not mis-interpreted or used to justify the latest political idioms. Currently the healthcare profession is failing to understand the consequences of setting targets, or the wider implications of hitting them. This article aims to summarise how we can learn from past experiences to become more aware of the benefits and draw-backs of targets in healthcare, and how we can utilise them more efficiently in health care.     

Thinking on trauma research

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Study on the effect of glucocorticoid on apoptosis of rat spermatogenic cells

The effect of glucocoiticoid on the apoptosis of rat spermato-genic cells labeled with TUNEL was observed in vivo by laser con-focal microscopy and electron microscopy. The results showed thatlarge doses of glucocorticoid increased the apoptosis of rat spermto-genic cell. (Chin J Androl 2001; 2: 98-101)     

Hallux Valgus Evaluation on MRI: Can Measurements Validated on Radiographs Be Used?

Hallux valgus (HV) is a common deformity of the great toe affecting >23% of adults in the United States. The severity of the deformity is traditionally analyzed using radiographs to determine measurements such as the HV and intermetatarsal angles. We sought to determine the relationship between the radiographic and magnetic resonance imaging (MRI) measurements because this is not yet known. Two of us analyzed a series of 56 consecutive patients who had had radiographs and MRI performed on the same foot between April 27, 2015 and March 9, 2016 and who satisfied all other inclusion and exclusion criteria (age 18 to 100 years, no history of recent foot trauma, and no metal hardware in the foot). We found excellent interreader reliability (intraclass correlation 0.89 to 0.96) and intermodality agreement (intraclass correlation 0.83 to 0.91). The HV angle measured 15.0°?±?8.8° on the MRI scans and 13.8°?±?8.7° on the radiographs (mean difference ?1.15°?±?3.89°), and the intermetatarsal angle was 9.0°?±?3.1° on the MRI scans and 8.8°?±?2.9° on the radiographs (mean difference ?0.22°?±?2.10°). The HV measurements were reliable on both radiographs and MRI for the range of values tested. Small intermodality statistically significant differences in HV angle measurements were found; however, these might not be enough to be clinically significant.     

Does the impact of urinary incontinence on quality of life differ based on age?

Introduction and hypothesis

The purpose of this study was to evaluate if the impact of urinary incontinence (UI) on quality of life (QOL) differs between women based on age.

Methods

A retrospective review of patients presenting for the management of UI was performed. Patients with UI and their corresponding degree of bother were identified by their responses to validated questionnaires. Distributions of comorbidities and types of UI were presented as frequencies and compared between age cohorts with a chi-square test. Mean scale scores were assessed for normality and a one-way analysis of variance with a post hoc Scheffé’s test was used to compare the scores.

Results

Of 765 patients meeting inclusion criteria, 22.4 % were <45, 28.9 % were 45–55, and 48.8 % were >55 years of age. Women older than 55 were significantly more likely to have urge UI and mixed UI than their counterparts (p?<?0.001). Women <45 and 45–55 were more negatively impacted in their ability to perform physical activities compared to women >55 (p?=?0.004), whereas women >55 were significantly less likely to feel frustrated by their incontinence than women <45 (p?=?0.022). However, there was no significant difference in overall impact of incontinence among groups (p?=?0.585).

Conclusions

UI equally impacts the functional and psychological QOL in women regardless of age. UI in women <55 results in a greater negative impact on level of physical activity, whereas women <45 are significantly more frustrated.     

Culture of osteoblasts on bio-derived bones

Thegoalofrepairingbonedefectsistofacilitatenewbonesgrowingintotheosseousdefects.Therefore, thematerialsusedforboneregenerationshouldsupporttheattachmentandproliferationofosteoblasts. Avarietyofbio derivedandchemosyntheticmaterialsareavailableforthesurgicaltreatmentofalveolarboneloss.1 Autogenousbonegraftsanddemineralizedfreeze driedboneallografts(DFDBA) fromhumancadavershavebeenusedwithadegreeofsuccess. However, neitherisideal. Autogenousbonegraftsinvolveanadditionalproceduretoharvestthebon…