Treatment of choice for bicondylar tibial plateau fractures between open reduction with internal fixation versus hybrid circular external fixator: a systematic review

The high complication rate is closely related to the incidence of bicondylar tibial plateau fractures (BTPF) due to the involvement of the articular surface. The aim of this study is to compare open reduction with internal fixation (ORIF) and hybrid circular external fixation (HCEF) as the choice of surgical procedure for BTPF because these two procedures is still controversial until now. A systematic review using Cochrane library, PubMed, and Google Scholar was conducted based on PRISMA guideline. Inclusion criteria were studies comparing HCEF and ORIF of BTPF. Studies of only one surgical technique modality, schatzker types I-IV tibial plateau fractures, and case reports were excluded, resulting in six included studies. There is no significant difference in radiographs, functional and anatomical outcomes in both group (ORIF vs HCEF). Complications that measured are higher infection rate found in the ORIF group. Blood loss was higher in the ORIF group, while both procedures have similar operation time and functional outcome. The mean of hospital length of stay (LoS) seems to be higher 6.83 days (95%CI 0.96-12.70; P<0.00001) on ORIF group from the random effect of forest plot evaluation. According to this study, HCEF is more beneficial in terms of blood loss and hospital LoS. But overall ORIF and HCEF carry similar operation time, functional outcome, union rate, and complication

Efficacy of Minimally Invasive Surgery on Giant Cell Tumour of the Bone: A Systematic Review

BACKGROUND: Although major reconstructive surgeries in the form of excision and reconstruction have been the mainstay treatment for Giant Cell Tumour (GCT) of the bone, its recurrence rate remains high and poses various morbidities such as implant failure or skin breakdown. Minimal invasive surgery (MIS) techniques, which has gained popularity mostly in other fields in orthopaedic surgery, are being introduced as an alternative to limit the surgical complications while achieving the best possible outcome. Until now, there has been no literature summarising the evidence of MIS outcome in treating GCT of the bone. AIM: The purpose of this systematic review was to investigate the efficacy of this relatively new treatment. METHODS: We comprehensively searched PubMed, EMBASE, and Cochrane Library to search for studies about MIS for GCT of the bone treatment up to March 1, 2019. The selection of appropriate studies was performed by two independent investigators based on PRISMA guideline. Given the limited number of studies, there was no restriction in terms of patient’s demographics, the specific minimally invasive surgical method, and publication status. RESULTS: We found 120 articles from the database. After evaluating full text, 5 articles (16 patients) were found to be eligible. The minimally invasive methods were curettage, cryosurgery, and argon beam coagulator. The visualisation methods include a computer-assisted navigation system, endoscope, otoscope, CT, and MRI. Location of tumours includes axial and long bones. The follow-up period ranges from 7 to 126 months. The functional and oncological outcome was found to be satisfying with no recurrence or complications. CONCLUSION: In conclusion, MIS is a familiar method in orthopaedic surgery with potential expansion in tumour field. The current evidence shows that this approach for GCT results in good functional outcome, with low risk of recurrence

THE BEHAVE APPLICATION: AN EVIDENCE-BASED TOOL TO MANAGE SOCIAL EMOTIONAL BEHAVIOURAL DIFFICULTIES

Social Emotional and Behavioural Difficulties (SEBD) are a persistent and multiple manifestation of maladaptive behaviours which interfere with the students’ learning, social functioning and development and/or that of their peers. They may become apparent through withdrawn, passive, aggressive or self-injurious tendencies. The prevalence of these disorders is 2-16% of the general population. Children with SEBD, diagnosed or not, are likely to live in social isolation, to receive a poor education, and they risk becoming deviant teenagers, or unemployed adults. A way to approach SEBD with consistent level of educational success is to equip teachers with proper training on practical and proven classroom management strategies, but also with evidence-based tools that can help them to effectively control difficult behaviours with confidence and competence. This contribution presents the web-based BEHAVE application aimed to ease the way for teachers to apply behavioural evidence-based interventions at school. The paper describes the main features of the BEHAVE application: the definition of the behaviour to be observed, the creation and selection of appropriate measures, the collection of behavioural data, and the statistical analysis to evaluate the direction and the power of the effect of the carried-out intervention

The UK's Global Health Respiratory Network: Improving respiratory health of the world's poorest through research collaborations.

Respiratory disorders are responsible for considerable morbidity, health care utilisation, societal costs and approximately one in five deaths worldwide [1-4]. Yet, despite this substantial health and societal burden – which particularly affects the world’s poorest populations and as such is a major contributor to global health inequalities – respiratory disorders have historically not received the policy priority they warrant. For example, despite causing an estimated 1000 deaths per day, less than half of the world’s countries collect data on asthma prevalence (http://www.globalasthmareport.org/). This is true for both communicable and non-communicable respiratory disorders, many of which are either amenable to treatment or preventable

Minimally Invasive Surgery vs. Open Surgery for Infectious Spondylodiscitis: A Systematic Review and Meta-Analysis

Objective Minimally Invasive Spinal (MIS) Procedure has long been used for treating degenerative spinal disorders, however its usage for infectious diseases of the spine has not been described a lot in literatures. Through this meta-analysis, we aim to objectively describe the efficacy of MIS as compared to traditional open surgery (OS) in treating infectious spondylodiscitis. Methods A systematic search was conducted based on PRISMA guideline to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 4 studies (301 patients) were included, divided into 8 meta-analysis, processed using Review Manager 5.3. Results OS requires significantly longer hospital length of stay (p=0.0009, I2=0%, MD=–6.64) and higher blood loss (p<0.00001, I2=40%, MD=–264.31) as well as more postoperative blood transfusion (p<0.00001, I2=0%, MD=–1.58). Moreover, MIS has benefit in significantly shorter operation time (p<0.00001, I2=46%, MD=–30.07) and less complication rate (p=0.0002, I2=38%, MD=0.32). However, the two procedures do not differ significantly in terms of neurological improvement, recurrence rate, and mortality rate. Conclusion Current systematic review and meta-analysis suggest that MIS offers comparable efficacy as well as less hospital length of stay, blood loss, operation time, and complication rate compared to OS

Polineuropatía desmielinizante inflamatoria crónica como forma de presentación de lupus eritematoso sistémico

Se describe el caso de una mujer de 35 años que presenta polineuropatía desmielinizante inflamatoria crónica como compromiso neurológico en su diagnóstico inicial de lupus eritematoso sistémico (LES). Si bien el compromiso neurológico es de una prevalencia variable en lupus, la asociación que se describe no es frecuente y tiene importantes connotaciones en el tratamiento