Revision hip arthroscopic surgery: outcome at three years

Purpose

This study describes the medium-term results of revision hip arthroscopy.

Methods

Patients with persistent hip pain and a positive impingement sign were considered for revision surgery after the exclusion of other causes of groin pain. Seventy-four consecutive patients were prospectively assessed using the modified Harris hip score for a period of 3 years after surgery. Of the 74 patients, 11 had inadequate follow-up data; thus, a total of 63 patients were qualified for the study. The mean age at index surgery was 37 years, comprising 27 males and 36 females.

Results

Revision surgery was performed at a mean of 3 years from index surgery. Chondral lesion associated with labral re-injury was the most common finding at revision arthroscopy. In contrast to other authors, however, only 31 % of our patients underwent revision for persistent femoroacetabular impingement. The mean pre-operative mHHS for all 63 patients was 54 (SD 14.5). The mean post-operative mHHS was 53 (SD 14.9) at 6 weeks, 62 (SD 17.5) at 6 months, 63 (SD 16.5) at 1 year, 64 (SD 16.5) at 2 years and 59 (SD 16.5) at 3 years (p = n.s., 0.02, 0.045, 0.039 and n.s., respectively).

Conclusions

Revision arthroscopy results in improvement in outcome in the first 3 years after revision surgery with a success rate of 63.4 % at 1 year, falling to 55.6 % by 3 years.

Level of evidence

IV.     

Accounting for effects of system dynamics to improve accuracy of emissions reported in e-cig vaping machines

Abstract

Laboratory emissions testing of electronic cigarettes continues to be a focus in the tobacco research community. In particular, to inform policy regarding appropriate test protocols to regulate the manufacture, marketing and sale of tobacco products. This study aims to enhance current understanding of the way laboratory systems used to generate topography profiles and capture resultant emissions from inhaled tobacco products may interact with the device under test. A programmable emission system (vaping machine) is introduced and characterized. The operating envelope of this system is presented. This study demonstrates that the performance of an emissions system may be influenced by various factors, resulting in discrepancies between command puff parameter inputs and the observed puffs generated. The study findings conclude that any emissions system should be characterized with the desired test device to determine the effective operating range of the system under “Load” conditions. Furthermore, reporting emissions from electronic cigarettes as a function of “command” puff flow rate and cumulative volume result in under-estimation bias and may give rise to incorrect conclusions regarding the impact of product characteristics on emissions. Conversely, reporting emissions in terms of “observed” puff flow rate and cumulative volume reduces bias errors and limits opportunity for intentional misrepresentation of results.     

Inhibition of chemically induced liver carcinogenesis in Wistar rats by garlic (Allium sativum)

The effects of garlic on diethylnitrosoamine (DEN)-induced hepatocarcinogenesis were examined in male Wistar rats using the medium term bioassay system of Ito based on the two-step model of hepatocarcinogenesis. Carcinogenic potential was scored by comparing the number and area/cm(2) of induced glutathione S-transferase placental form (GST-P) positive foci in the liver with those of the corresponding group (control) of rats given diethylnitrosoamine alone. Treatment with garlic (therapeutic dose 20 mg/kg body wt/day) reduced significantly the number (50% reduction, p < 0.003) and area (48% reduction, p < 0.0007) of GST-P positive foci compared with the control group of animals receiving distilled water. Histopathological examination of rat livers using H & E staining indicated that there was no significant difference between the control group and the garlic treated group in the two pathological parameters namely granularity and vacuolation of the cytoplasm. Our results provide strong supportive evidence for the anticarcinogenic activity of garlic.     

Increasing importance of Balamuthia mandrillaris

Balamuthia mandrillaris is an emerging protozoan parasite, an agent of granulomatous amoebic encephalitis involving the central nervous system, with a case fatality rate of >98%. This review presents our current understanding of Balamuthia infections, their pathogenesis and pathophysiology, and molecular mechanisms associated with the disease, as well as virulence traits of Balamuthia that may be potential targets for therapeutic interventions and/or for the development of preventative measures.     

Simple methods for the correction of T2 maps of phantoms.

Two simple methodologies for correcting the errors in T2 maps for phantom measurements are presented; they both give accurate MRI maps with a low coefficient of variation (CV). The rate correction method is based on an equation relating the true T2 (T2,t) and that determined experimentally (T2,exp) for homogenous phantoms. The response matrix method is a phenomenological analysis of the difference between T2,exp and T2,t, from which correction factors are computed for a range of T2 values and for every pixel of an image. The factors were obtained from phantoms filled with a homogeneous gelatin gel and having different T2,t values. The CV in homogeneous phantom measurements were reduced from 2.5-4.0% to approximately 0.6-2.0% for T2,t values ranging from 180-600 ms. Examples are shown for the correction of T2 maps of phantoms filled with polymer dosimeter gel irradiated with photon beams from a linear accelerator. The methodologies presented can easily be implemented on a clinical MRI scanner.     

Trauma reception and resuscitation in Sri Lanka: The Health for the South Capacity‐Building project

In response to the Indian Ocean tsunami of 2004, the Health for the South project, Capacity‐Building programme was implemented in Galle, Sri Lanka. The objectives of the Capacity‐Building programme were to develop the emergency and trauma service capability at Teaching Hospital Karapitiya in Galle. Over 15 months, ED clinicians, from the Alfred Hospital and Royal Children's Hospital in Melbourne, provided training in the Emergency Treatment Unit of the main referral hospital for the south of Sri Lanka. This programme, completed in June 2008, significantly improved the hospital's ability to conduct trauma resuscitation, and to attain an increased level of disaster preparedness. In addition, valuable lessons were noted that will guide future initiatives in trauma care training in similar contexts.