Injury
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We sought to determine if the magnitude of anterior physeal separation (APS) in slipped upper femoral epiphysis was a predictor for the subsequent development of avascular necrosis (AVN). Anterior Physeal Separation (APS) is defined as the distance between the anterior lip of the bony capital epiphysis and the lateral corresponding point of the adjacent bony metaphysis on the Lauenstein radiographic view. It represents hinging of the posterior aspect of the metaphysis with the anterior epiphysis lifting away from its adjacent metaphysis, indicating instability and potential vulnerability of the vessels. ⋯ APS is sensitive, specific, accurate and reliable for the association with AVN in SUFE. Its values closely reflect the high AVN rates seen in acute and unstable SUFE. This risk is greatest if the magnitude of APS exceeds the critical value of 7.5 mm.
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Displaced acetabular fractures in the elderly present significant treatment challenges. The 'fix and replace' concept involves open reduction and internal fixation of the acetabulum, providing bony stability to accept the press-fit of an acetabular cup, with a cemented femoral stem. This allows early mobilisation and the advantages this confers. This study of 57 patients treated with fix and replace describes our technique, outcomes, and survival analysis. ⋯ While fix and replace is conceptually attractive, this medically complex patient group requires considerable support peri‑ and post-operatively. Further studies are required to provide clinicians with more information to decide on how best to provide a holistic management strategy for such injuries in this frail patient cohort.
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Mesenchymal stem cells (MSCs) play a key role in wound healing, and the advantages of pretreated MSCs in wound healing have previously been reported. In the present study, we investigated the impact of LPS pretreated human adipose-derived MSCs on skin wound healing in diabetic rats. We found that some improvements occurred through improving angiogenesis. ⋯ In addition, significantly higher cell viability (proliferation/colonie), and elevated VEGF and DNMT1 protein expression were observed when MSCs were treated with LPS (10 ng/ml, 6 h) in HG culture media. Based on these findings, it is suggested that LPS pre-MSCs could promote wound repair and skin regeneration, in some major processes, via the improvement of cellular behaviors of MSCs in the diabetic microenvironment. The beneficial advantages of LPS treated with mesenchymal stem cells on wound healing may lead to establishing a novel approach as an alternative therapeutic procedure to cure chronic wounds in diabetic conditions.
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Educators are exposed to several work-related hazards. Evidence suggests musculoskeletal pain, psychological distress, and student-inflicted violence-related injuries are common. However, there is little evidence on the burden of workplace injury among Australian educators. ⋯ Though surveys indicate Australians in the education sector have higher incidences of work-related injuries, this study found lower incidence of injury claims and shorter disability durations than others. Educators' injury-reporting and absenteeism behaviors may be constrained by ethical, social, and administrative attitudes. Educators had higher rates of claims for mental health and assault-related injury, particularly special educators, and education aides, which suggests a need for targeted prevention efforts.