The osseus manifestation of acute leukemias in Pakistani children

Bone changes were analyzed in 84 children diagnosed as having leukemia by skeletal Xrays at different stages of diagnosis, remisison, consolidation and after 1 year. The types, frequency and distribution of lesions was related to the types of leukemia, bone symptoms if present and short term (1 - year) survival. No clear relationship could be detected between the type of leukemia and type of lesions. Cortical and periosteal lesions were more common in children complaining of bone pains. The spectrum of osseus manifestations in the order of frequency comprised reduced bone density, metaphyseal lucencies, bone destruction — permeative and focal, periosteal reactions, sutural diastasis and vertebral collapse. The commonest sites of involvement were distal radius and metacarpals. A comprehensive review of radiologically-manifest bone involvement in childhood leukemia is presented in the end

Knowledge Management for Adult and Higher Education: Mapping the Recent Literature

The recent literature shows that the field of knowledge management (KM) has a potential importance for the education area. It has been argued that KM concepts, models, and practices may be beneficial to teachers, learners, and university managers. An open issue, however, is whether and how the research and practice in these two distinct fields\u2014education and KM\u2014are really converging. This chapter proposes a systematic analysis of the literature to shed light onto the intersection between the fields of KM and adult and higher education. The main research trends are detected and highlighted. The analysis shows that there are promising applications of KM to higher education and university management. However, there is still the need to carry out more theoretical or applicative research with the purpose to facilitate the effective incorporation of KM notions, concepts, or practices into the education field

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. Trial registration number NCT0432364