Irish journal of medical science
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Healthcare systems have increasingly limited and stretched budgets. Clinicians have a key role in budget allocation. Awareness of the costs of high-use clinical items is important. ⋯ We demonstrate variable and limited levels of cost awareness. Seniority and better self-perceived knowledge were not found to be associated with better estimate accuracy.
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We present key information from international registries in relation to primary total hip arthroplasty. The specific questions of interest include which bearings are superior in total hip arthroplasty (THA), which fixation types are optimal, do any specific implants perform better than others, and what is the latest update in the hip fracture setting? This is a comprehensive review of the major English-speaking hip arthroplasty registries across the globe. Key trends and developments in implant performance are identified and presented in the current article. Key points from review of all registries confirm that ceramic-on-polyethylene and metal-on-polyethylene continue to be the commonest bearings. ⋯ Dual mobility (DM) bearings are increasing in use and show higher early revision rates than unipolar bearings-they tend to be used for more complex indications (fracture/tumor/revision) and show similar revision rates to unipolar bearings when used exclusively in primary elective THA for osteoarthritis. We present current trends in THA based on current registry data from across the globe. Clinical signals of concern are emerging for THA uncemented femoral stem fixation and DM bearings in specific clinical contexts. These signals should be monitored across the literature in order to reduce the overall revision burden.
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Heart failure (HF) is the only cardiovascular disease with an ever-increasing incidence. ⋯ A novel and comprehensive personalized "GLVC" scoring system is an easily available and effective tool for predicting the adverse outcomes in HF.
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Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates inflammatory response and CD4+ T cell differentiation in autoimmune diseases, while its clinical role in rheumatoid arthritis (RA) lacks sufficient evidence. Subsequently, this study intended to explore the vertical change of PCSK9, and its linkage with T helper (Th) cells, regulatory T (Treg) cells, clinical features, and treatment outcomes in RA patients. ⋯ Circulating PCSK9 shows the potency as a biomarker for disease management and treatment outcome prediction of csDMARDs in RA.
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Randomized Controlled Trial
Effects of perceptive rehabilitation and mobilization methods on symptoms and disability in patients with fibromyalgia: A preliminary randomized control trial.
Currently, there is no definitive cure for fibromyalgia. Instead, treatments focus of reducing symptoms and disability. ⋯ This study shows that perceptive rehabilitation and mobilization therapy are similarly effective in improving fibromyalgia symptoms and disability, but the effects disappear within 3 months. Further research is needed to understand how the improvements could be maintained longer.