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

Soil-transmitted helminthiasis - challenges with discovery of novel anthelmintics

Soil‐transmitted helminths (STHs) are responsible for many millions of disability‐adjusted life‐years (DALYs) in the developing world; however, there is no research focused directly on development of new therapies, due to the high costs of research and development. Historically, anthelmintics for human helminthiases have been leveraged from the animal health industry, where the impact of helminth infections on production in ruminants, plus the health and zoonotic concerns for companion animals has driven significant sales. It is therefore highly probable that the next generation of anthelmintics for control of STHs will be leveraged from research in the animal health industry. A review of the state of the art in anthelmintic patents over the past 10 years highlights that there has been some progress in identifying and optimizing novel anthelmintic classes for management of emerging resistance in ruminants and companion animals. Although investment is low when compared to human health research and development, the animal health industry has been successful in optimizing lead series from pesticide research to animal health, and this is evident with some of the recent patents. Increased collaborative public–private partnerships will be required to help translate these discoveries into therapies for STHs