What physical exam techniques are useful to detect malingering?

No examination technique objectively proves malingering (strength of recommendation [SOR]: C, expert opinion). Waddell's signs are associated with poor treatment outcomes but cannot discriminate organic from nonorganic causes (SOR: B, systematic review of low-quality studies). Hoover's and the Abductor sign indicate nonorganic paralysis (SOR: C, small, lower-quality case-control studies)

How should you treat trochanteric bursitis?

Conservative measures--followed by corticosteroid injection, if necessary--are best. Conservative therapy includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching exercises focused on the lower back and sacroiliac joints (strength of recommendation [SOR]: C, usual practice). Patients whose symptoms persist despite conservative therapy are likely to benefit from an injection of 24 mg betamethasone and 1% lidocaine (or equivalent) into the inflamed bursa (SOR: B, limited-quality, patient-oriented evidence)

How should you treat a child with flat feet?

Flexible flatfoot (FFF)doesn�۪t increase the risk of injury or pain during exercise (strength of recommendation [SOR]: B, 2 small prospective cohort studies). Treating FFF with orthotics doesn�۪t change the course of arch development (SOR: B, 2 small randomized controlled trials [RCTs]). FFF is usually asymptomatic, but symptomatic FFF may respond to activity modification, orthoses, and stretching (SOR: C, expert opinion). Rigid flatfoot results from trauma, neuromuscular disorders, or congenital bone malformations (SOR: C, expert opinion). Treatment may require surgery, including osteotomy and arthrodesis, depending on the underlying pathology (SOR: C, expert opinion). No long-term outcome studies of surgical treatment have been performed

Does warfarin prevent deep venous thrombosis in high-risk patients?

Warfarin (Coumadin) is effective in preventing deep venous thrombosis (DVT) among patients with a history of DVT. Conventional dosing and longer durations are the most effective, but the ideal length of therapy is unknown (strength of recommendation [SOR]: A, based on large randomized controlled trials and meta-analysis). Warfarin is useful in preventing DVT in patients with cancer, specifically those treated with chemotherapy (SOR: B, based on small randomized controlled trials). Warfarin may be effective in preventing DVT in immobilized patients such as those with trauma, spinal cord injury, or stroke (SOR: B, based on an underpowered randomized controlled trial and uncontrolled studies)

Flavin mononucleotide: the coenzyme of reduced diphosphopyridine nucleotide dehydrogenase

This article does not have an abstract

An electron transport particle from yeast: purification and properties

This article does not have an abstract

Total Knee Arthroplasty Assessments Should Include Strength and Performance-Based Functional Tests to Complement Range-of-Motion and Patient-Reported Outcome Measures

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to fully capture functional limitations after TKA; and (4) performance-based functional tests are critical to evaluate function objectively after TKA. This Perspective also addresses studies that question the need for or benefit of physical therapy after TKA because their conclusions focus only on ROM and PRO measures. Future research is needed to determine the optimal timing, delivery, intensity, and content of physical therapy

Identifying wildlife reservoirs of neglected taeniid tapeworms : non-invasive diagnosis of endemic Taenia serialis infection in a wild primate population

Despite the global distribution and public health consequences of Taenia tapeworms, the life cycles of taeniids infecting wildlife hosts remain largely undescribed. The larval stage of Taenia serialis commonly parasitizes rodents and lagomorphs, but has been reported in a wide range of hosts that includes geladas (Theropithecus gelada), primates endemic to Ethiopia. Geladas exhibit protuberant larval cysts indicative of advanced T. serialis infection that are associated with high mortality. However, non-protuberant larvae can develop in deep tissue or the abdominal cavity, leading to underestimates of prevalence based solely on observable cysts. We adapted a non-invasive monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) to detect circulating Taenia spp. antigen in dried gelada urine. Analysis revealed that this assay was highly accurate in detecting Taenia antigen, with 98.4% specificity, 98.5% sensitivity, and an area under the curve of 0.99. We used this assay to investigate the prevalence of T. serialis infection in a wild gelada population, finding that infection is substantially more widespread than the occurrence of visible T. serialis cysts (16.4% tested positive at least once, while only 6% of the same population exhibited cysts). We examined whether age or sex predicted T. serialis infection as indicated by external cysts and antigen presence. Contrary to the female-bias observed in many Taenia-host systems, we found no significant sex bias in either cyst presence or antigen presence. Age, on the other hand, predicted cyst presence (older individuals were more likely to show cysts) but not antigen presence. We interpret this finding to indicate that T. serialis may infect individuals early in life but only result in visible disease later in life. This is the first application of an antigen ELISA to the study of larval Taenia infection in wildlife, opening the doors to the identification and description of infection dynamics in reservoir populations