Function after spinal treatment,exercise and rehabilitation (FASTER): improving the functional outcome of spinal surgery

Background  

The life-time incidence of low back pain is high and diagnoses of spinal stenosis and disc prolapse are increasing. Consequently, there is a steady rise in surgical interventions for these conditions. Current evidence suggests that while the success of surgery is incomplete, it is superior to conservative interventions. A recent survey indicates that there are large differences in the type and intensity of rehabilitation, if any, provided after spinal surgery as well as in the restrictions and advice given to patients in the post-operative period.     

Effect of Cassia alata leaf extract on hyperglycemic rats

The oral effectiveness of Cassia alata leaf extract on streptozotocin-induced hyperglycemia in rats has been studied and the results compared with glybenclamide. While the extract has no effect on glucose levels in normoglycemic animals, it reduced the blood sugar value in streptozotocin-induced hyperglycemic animals.     

Profunda femoris pseudoaneurysm rupture post dynamic hip screw fixation after physiotherapy

This case discusses an elderly female who presented acutely with compromised profunda femoris pseudoaneurysm and massive haematoma five weeks after dynamic hip screw insertion for a left neck of femur fracture. The only precipitating factor leading to this presentation was ongoing physiotherapy. She was referred from a rehabilitation hospital to the nearest vascular surgical unit for acute and definitive surgical intervention. Post-operatively, she fared incredibly well, regaining her baseline level of functioning. History taking is complex in a patient with dementia. Clinical examination should follow with a focused approach to the site of recent operation and also where complications are likely to manifest when an alteration from baseline cognitive function is noted. This is of course in addition to the complete work up required from a holistic perspective with any acute deterioration. Imaging should be arranged and prompt referral made if a treatable acute cause is identified. It is imperative to involve family and/or next of kin if possible, but this should not impede prompt decision-making in the patient’s best interests by the clinical team if delays are likely to occur.     

Safe splenoportography

The records of 37 patients who had undergone splenoportography, including one group of 12 who were studied before 1976 and a second group of 25 who were studied after 1977, were reviewed. The primary difference was that in the second group, the tract in the spleen was occluded with absorbable gelatin sponge (Gelfoam) plugs as the needle was withdrawn. In addition, there were minor changes in technique, such as changes in the needle puncture angle and entry site. When the new technique was used, there was a significant decrease in the complications traditionally associated with splenoportography. This procedure is safe and deserves to be considered the procedure of choice in patients in whom precise anatomic information is needed preoperatively that cannot be obtained with noninvasive procedures such as ultrasound or magnetic resonance imaging.     

External quality assessment of clinical laboratories in the United Kingdom

A review is given of the National External Quality Assessment Schemes (NEQASs) in various pathology disciplines in the United Kingdom, with a discussion of the relative roles of the DHSS, individual laboratory scientists, and the relevant professional bodies. Principles of operation and scientific problems in the design of NEQASs in different disciplines are described and contrasted, and some comparisons with the experience in other European countries and the USA are drawn.     

Changes in enzymes of hepatic rough and smooth microsomes during postnatal development and ageing of rats

Significant changes are observed in wet weight, microsomal protein content and enzymes of purified rough and smooth microsomes of liver during postnatal development and ageing of female Wistar rats. Protein content of total microsomes increases up to 15 days of age and remains steady during subsequent development, unlike that of rough and smooth microsomes which shows changes throughout the same period. Activities of cytochrome P-450, cytochrome b5 and NADPH-cytochrome c reductase increase during the period of maturation and decline during senescence. The decrease during senescence is at different rates in the two microsomal fractions. Microsomal glucose-6-phosphatase, but not adenosine triphosphatase, shows a similar increase during development and decrease during senescence.