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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Evaluation of autoclave assisted sulfuric-acid-catalyzed pretreatments for the liberation of reducing sugars from Parthenium hysterophorus: a response surface approach

Parthenium hysterophorus is a potential source of a wide range of value-added products. Sulfuric acid-catalyzed pretreatment of P. hysterophorus biomass was used to see how it affected the P. hysterophorus characteristics and the sugar yield from enzymatic hydrolysis. The optimised pretreatment (utilized 2% (w/v) of a substrate, 1.50% (v/v) sulfuric acid, and 45 (min) autoclaving times at 121°C) reduced lignin content by 50.98% (w/w), and increased the available cellulose content (20.72% w/w) over native biomass, which was confirmed by compositional studies of treated biomass. The saccharification rate was increased by 2.08-fold following statistical optimisation using response surface methods (167.17 ± 0.84 mg/g substrate after 12 h saccharification was significantly higher than control 80.16 ± 0.36 mg/g substrate). This justifies that P. hysterophorus is a promising non-conventional lignocellulosic candidate for the production of fermentable sugars

Transplantation of the abdominal wall

Closure of the abdomen in patients undergoing intestinal transplantation can be extremely difficult, if not impossible. We describe our initial experience with abdominal wall allotransplantation to facilitate abdominal closure. We undertook nine cadaveric abdominal wall composite allograft transplants in eight patients. The graft's blood supply was based on the inferior epigastric vessels left in continuity with the donor femoral and iliac vessels. Skin biopsies were undertaken randomly and when rejection was suspected. Vessel patency was monitored by doppler ultrasound. Six patients have survived, five of whom have intact, viable abdominal wall grafts. Two patients have had a clinically mild episode of acute rejection of the skin of the abdominal wall that resolved with corticosteroid therapy. No clinically apparent graft-versus-host disease has been noted. Transplantation of an abdominal wall composite allograft can facilitate reconstruction and closure of the abdominal compartment in intestinal transplant recipients with complex abdominal wall defects

Portal versus systemic drainage of small bowel allografts: comparative assessment of survival, function, rejection, and bacterial translocation

Portal venous drainage of small bowel grafts is theoretically more physiologic than systemic drainage, but is technically more demanding. Comparisons in animal models have not demonstrated a clear advantage of one technique over the other, but clinical data are lacking

Not Available

Not AvailableThe effect of increase in temperature on grain yield of some winter crops (wheat, mustard, barley and chickpea) in northwest India was evaluated on the basis of historic records and through a dynamic crop growth model, WTGROWS. The optimal date of sowing was also evaluated in view of the increase in seasonal temperature. The yield of these crops, especially wheat, already showing signs of stagnation in most places of northwest India, is most likely to be affected by temperature changes. The solar radiation–temperature interactions study in wheat reveals some interesting trends and is seen to vary from one location to another. Keeping in view the trends in global climate change, a shift in sowing time, as an adaptation strategy is recommended. The simple and empirical relations between yield and seasonal temperature change can be well used for a crude estimate of yield dependence of temperature rise of these winter crops.Not Availabl

Successful treatment of posttransplant lymphoproliferative disease with prolonged rituximab treatment in intestinal transplant recipients

Posttransplant Epstein-Barr virus-associated B-cell lymphoproliferative disease (PTLD) has a higher incidence after intestinal transplantation than after transplantation of other solid organs and is associated with a high mortality. A new anti-CD20 monoclonal antibody, rituximab, has shown efficiency in the treatment of B-cell lymphoma, including PTLD, but its use has not yet been reported in intestinal transplant recipients