Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Learned liking versus inborn delight. Can sweetness give sensual pleasure or is it just motivating?

In this study, we separated for the first time the learned liking for a particular level of sweetness in a familiar drink from the infantile delight in sweetness as such (“the sweeter, the better”). It is widely assumed that sensing a liked food or drink evokes a pleasurable experience, but the only psychological evidence for this assumption has been tongue movements that are elicited specifically by sweet taste in animals and human neonates. We found that adults felt such movements in response to drinking juice at both their personally preferred level of sweetness and levels they deemed so sweet as to be undrinkable. Yet only the intolerably strong level of sweetness elicited enjoyment of the experienced movements, elevation of mood, and a sense of smiling. Hence, the pleasure that adults experience during ingestion could be exclusively linked with the congenital sweetness reflex that sends mother’s milk down an infant’s throat