Journal of the Royal Society of Medicine
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Randomized Controlled Trial Clinical Trial
Wound drains in proximal femoral fracture surgery: a randomized prospective trial of 177 patients.
We report on the effect of wound drains on wound healing following surgery for proximal femoral fractures. One hundred and seventy-seven patients undergoing AO dynamic hip screw (DHS) or hemiarthroplasty were randomized whether or not to receive wound drainage. Patients who received wound drainage showed statistically better wound healing in terms of the ASEPSIS wound scoring system and a reduced infection rate. This study conflicts with previous smaller studies which failed to show an effect of wound drainage upon wound healing.
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The induction of oral tolerance by oral immunization has been well recognized. Accumulated evidence shows that oral tolerance can be mediated by orally activated humoral and cellular factors. ⋯ Oral tolerance to alloantigen also reduces graft rejection. In spite of these encouraging results, the usefulness of this approach for an alternative immunotherapy in humans needs to be investigated further.
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Patients with cystic fibrosis present a challenge to management post-transplantation but the results are comparable with those obtained in patients with other conditions. The increasing population of cystic fibrosis patients who have undergone transplantation will require joint management of such patients by cystic fibrosis specialists and pulmonary transplant specialists. The follow-up of patients with cystic fibrosis following pulmonary transplantation potentially affords us an exciting opportunity to study the natural history of this disease as it affects the extra pulmonary organs.
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This study aimed to investigate the diagnosis and consequences of pubic symphysis diastasis postpartum, in particular the use of ultrasonography to measure interpubic gap. It was a prospective follow-up study, which included an ultrasonographic comparison between symptomatic mothers and controls, set in Morriston Hospital, Swansea. Nine women presenting with unusual pubic pain post-partum were included: there were no exclusion criteria. ⋯ Diastasis is commoner than generally acknowledged and its consequences may be severe. Interpubic gap confirms diagnosis but does not appear to predict outcome. Ultrasonography aids diagnosis and follow up.