Brit J Hosp Med
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Developmental dysplasia of the hip encompasses a range of hip abnormalities in which the femoral head and acetabulum fail to develop and articulate anatomically. Developmental dysplasia of the hip is a clinically important condition, with a prevalence of 1-2/1000 in unscreened populations and 5-30/1000 in clinically screened populations. The pathology is incongruence between the femoral head and the acetabulum, which can be caused by an abnormally shaped femoral head, acetabulum, or both. ⋯ The physical examination of the newborn hip involves initial inspection of the infant for any of the clinical features of developmental dysplasia of the hip, followed by hip stability tests (Barlow's and Ortolani's tests). Hip ultrasound is the gold standard diagnostic and monitoring tool for developmental dysplasia of the hip in newborns and infants under 6 months of age, or until ossification of the femoral head. Some mild cases of developmental dysplasia of the hip (and the immature hip) resolve without requiring intervention; however, there are a number of treatments, both non-operative and operative, that may be used at various stages of this condition.
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Learning in the workplace maximises relevance to clinical practice and facilitates the education of the whole multiprofessional team. Provision of structured teaching is becoming increasingly challenging with shift pattern working and staff shortages. This article describes a simulation course designed to facilitate team learning to improve the care of nephrology patients, and presents outcome data over 2 years. ⋯ This course improved knowledge and confidence in managing nephrology scenarios across the multidisciplinary learning group, and the model could be used in other hospital specialties.
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Review Case Reports
Novel treatments for progressive multifocal leukoencephalopathy.
Progressive multifocal leukoencephalopathy is a rare demyelinating disorder of the CNS, caused by John Cunningham virus, that occurs in those with impaired immune systems. Existing treatment options are ineffective or unproven. This article reviews research into novel therapies: immune checkpoint-blocking antibodies (nivolumab and pembrolizumab), allogenic BK virus-specific T cell treatment and filgrastim. Results for these therapies in small clinical trials are promising, but further research is required to assess efficacy fully.
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Biography Historical Article
James Syme: distinguished Edinburgh surgeon of the 19th century.
This year marks the 150th anniversary of the death of James Syme, one of the most distinguished members of the Edinburgh school of surgery in the 19th century.