Clavicular hook plate for lateral end fractures:- a prospective study

AIM: A prospective study was undertaken over a period of 4 years to evaluate the clinical and radiological outcomes following fixation with a clavicular hook plate for Neer types II and III fractures of lateral end clavicle. MATERIALS: Thirty-one patients (M:F; 24:7) with a mean age of 49 years (range 25-86 years) were recruited for the study. The mean follow-up duration was 40 months (range 18-68 months). Twenty-three patients were treated primarily and eight patients were treated for symptomatic delayed union. RESULTS: All the patients achieved clinical and radiological union over a mean of 12 weeks (range 6-18 weeks). Mean constant score at and after 3 months was 94 (range 82-100). Mean ASES score at and after 3 months was 26 out of a maximum of 30. CONCLUSION: The clinical result of fracture fixation of lateral end clavicle using hook plate appeared good in terms of fracture union and function. The principal advantages of this method were anatomical reduction of the fracture and early rehabilitation which lead to good shoulder girdle function.     

Induction of DNA strand breaks in peripheral lymphocytes by soluble chromium compounds.

1. Incubation of human lymphocytes with sodium dichromate (CrVI) at 37 degrees C for 3 h resulted in a dose-dependent increase in DNA strand breaks without concurrent cytotoxicity. In contrast, chromium acetate hydroxide (CrIII) failed to induce DNA strand breaks at sub-cytotoxic concentrations. 2. DNA strand breaks were also detected in the peripheral lymphocytes of Wistar rats, 24 h after intratracheal instillation of sodium dichromate (1.3 and 2.5 mg kg-1). Instillation of chromium acetate hydroxide (up to 21.8 mg kg-1) failed to induce DNA strand breaks in peripheral lymphocytes. In accord with previous studies, hexavalent chromium was found to be more readily absorbed from the lungs into the peripheral blood than chromium in its trivalent form. 3. The results of this study indicate that fluorometric analysis of DNA unwinding (FADU) in peripheral lymphocytes might be a convenient method of measuring an important biological effect of chromium in occupationally-exposed workers.     

The p53 story: layers of complexity

This report is a summary of the presentations at the 12th International p53 Workshop, held in November 2004, Dunedin, New Zealand. The Convenor of the organizing committee was Antony Braithwaite, University of Otago, Dunedin. Janice Royds and Paul Jackson were also members of the organizing committee. There were 61 oral presentations and 101 posters.     

Are external management consultancies effective in healthcare improvement,do they reflect value for money and what are the alternative models?

Despite the increasing use and costs associated with external management consultancy for healthcare improvement, there is a paucity of formal evaluations examining impact. This paper aims to: (i) discuss the potential benefits and disadvantages of external consultancies in addressing complex healthcare challenges and delivering healthcare improvement in Australia; and (ii) explore potential alternative models, including internal consultancy and hybrid models delivered through platforms of collaborative expertise. We propose that the substantive reliance on high cost external management consultancies without demonstrating value or benefit, is unsustainable. An integrative approach that embeds research and capacity building within healthcare services may be of value.