Feedback From Activity Trackers Improves Daily Step Count After Knee and Hip Arthroplasty: A Randomized Controlled Trial

Background

Commercial wrist-worn activity monitors have the potential to accurately assess activity levels and are being increasingly adopted in the general population. The aim of this study was to determine if feedback from a commercial activity monitor improves activity levels over the first 6 weeks after total hip arthroplasty (THA) or total knee arthroplasty (TKA).

The transition from fetus to neonate – an endocrine perspective

Gluckman PD, Sizonenko SV, Bassett NS. The transition from fetus to neonate - an endocrine perspective. Acta Pædiatr 1999; Suppl 428: 7–11. Stockholm. ISSN 0803–5326
The transition from fetus to neonate involves three phases: late gestation, parturition and the processes needed to establish independent homoeostatic regulation after separation from the placenta. These phases are regulated by a series of fetal and placental endocrine events. Glucocorticoids have an important role in the preparation for birth, including involvement in lung and cardiac development, and the maturation of enzymes in a variety of pathways. Fetal Cortisol production is, in turn, also under hormonal control. Parturition is a complex process, which is still poorly understood in humans. The final steps are largely dependent on the effect of prostaglandin F_2α on the myometrium associated with increased oxytocin activity. The transition to birth is accompanied by changes in respiration, circulation, glucose homoeostasis, and the onset of independent oral feeding and thermoregulation. Several examples of endocrine components of the transition from fetal to neonatal life are reviewed here: the role of prostanoids, the onset of thermogenesis, and changes in the thyroid hormone and growth hormone axes. The effects of hormone levels on prematurity and growth retardation are also discussed. □ Birth transition, fetus, gestation, hormonal control, neonate, parturition     

Feasibility of using Travenol sets in an IVAC 230 controller

The feasibility of using Travenol regular and minidrip sets to deliver intravenous solution with IVAC 230 controllers was investigated. Intravariability within Travenol regular sets proved to be negligible. Likewise, intervariability among IVAC controllers is negligible. The least squares fit obtained from drops per minute (dpm) versus flow rate (ml/hr) for Travenol regular sets using dextrose 5% in water was y = 4.50x + 0.8 (r greater than 0.99). Similarly, the least squares fit for sodium chloride 0.9% was y = 4.50x - 0.6 (r greater than 0.99). Therefore, the calculated dpm for the required flow rate for both solutions is similar using Travenol regular sets. Also, no significant difference is found between the drip rate of dextrose 5% in water and sodium chloride 0.9% with Travenol minidrip at 5, 30, and 60 dpms. This study shows that interchangeability of IVAC administration sets with Travenol regular and minidrip sets is possible for dextrose 5% in water and sodium chloride 0.9% solutions.     

Spinal and general anaesthesia for emergency caesarean section: effects on neonatal Apgar score and maternal haematocrit

This is a prospective comparative study to determine the effect of the type of anaesthesia used for emergency Caesarean section on neonatal and maternal outcome. The patients were recruited into the study after being given either general or spinal anaesthesia. Neonatal outcome was assessed using Apgar scores and need for respiratory assistance at birth. Maternal outcome was assessed using the difference between pre- and post-operative packed cell volumes (PCV), need for blood transfusion and estimated blood loss. The groups were matched for pre-existing risk factors. Apgar scores at 1 and 5 minutes were found to be significantly lower for the general anaesthesia group (GA) than the spinal anaesthesia group (SA) and need for respiratory assistance was greater for the GA group. Difference between pre- and post-operative PCV and need for blood transfusion were also significantly greater in the GA group. This study confirms that the current practice of spinal anaesthesia for Caesarean section in the Lagos University Teaching Hospital is a good one, but further studies need to be done to assess other outcome variables.