Effects of gestational weight gain on pregnancy complications

Introduction and objective

Gestational weight gain (GWG) has been reported to be associated with pregnancy outcomes. The aim of this study was to evaluate the effects of GWG on maternal and birth complications.

An exploration of parents’ knowledge,attitudes and practices towards the use of antibiotics in childhood upper respiratory tract infections in a tertiary Jordanian Hospital

Objectives

The present study aimed to evaluate the parents' knowledge, attitudes and practices (KAP) towards the use of antibiotics for childhood upper respiratory tract infections (URTIs), at the Jordanian University Hospital.

Reduction of arthrofibrosis utilizing a collagen membrane drug-eluting scaffold with celecoxib and subcutaneous injections with ketotifen

The dense formation of abnormal scar tissue after total knee arthroplasty results in arthrofibrosis, an unfortunate sequela of inflammation. The purpose of this study was to use a validated rabbit model to assess the effects on surgically-induced knee joint contractures of two combined pharmacological interventions: celecoxib (CXB) loaded on an implanted collagen membrane, and subcutaneously (SQ) injected ketotifen. Thirty rabbits were randomly divided into five groups. The first group received no intervention after the index surgery. The remaining four groups underwent intra-articular implantation of collagen membranes loaded with or without CXB at the time of the index surgery; two of which were also treated with SQ ketotifen. Biomechanical joint contracture data were collected at 8, 10, 16, and 24 weeks. At the time of necropsy (24 weeks), posterior capsule tissue was collected for messenger RNA and histopathologic analyses. At 24 weeks, there was a statistically significant increase in passive extension among rabbits in all groups treated with CXB and/or ketotifen compared to those in the contracture control group. There was a statistically significant decrease in COL3A1, COL6A1, and ACTA2 gene expression in the treatment groups compared to the contracture control group (P < .001). Histopathologic data also demonstrated a trend towards decreased fibrous tissue density in the CXB membrane group compared to the vehicle membrane group. The present data suggest that intra-articular placement of a treated collagen membrane blunts the severity of contracture development in a rabbit model of arthrofibrosis, and that ketotifen and CXB may independently contribute to the prevention of arthrofibrosis. Statement of clinical significance: Current literature has demonstrated that arthrofibrosis may affect up to 5% of primary total knee arthroplasty patients. For that reason, novel pharmacologic prophylaxis and treatment modalities are critical to mitigating reoperations and revisions while improving the quality of life for patients with this debilitating condition.     

The impact of COVID-19 on the provision of cardiac surgical services

The global pandemic caused by COVID-19 has had a significant global impact on healthcare systems. One implication of this pandemic is the cancellation of elective cardiac surgeries and the centralization of services. As a result, hospitals in Europe, North America, and the United Kingdom have had to alter the services offered to patients to be able to cope with service provision for COVID infected patients. Data should be collected during this period to provide a good insight following the lockdown period to understand the implication of such service alteration. Future research should also focus on the effects on long-term mortality and morbidity as well as financial implications on hospitals as a result of these changes.     

An unusual cause of heart failure in a young female: a case of massive left atrial mxyoma

Benign cardiac tumors are rare; they can present with nonspecific symptoms and represent a diagnostic challenge to the clinician. We describe an interesting case of a 26-year-old female who presented with a 6-month history of cough, breathlessness, palpitations, dizziness, and fever. Despite repeated clinical reviews in the community, diagnosis of cardiac tumor was not made until she developed decompensated cardiac failure with bilateral pleural effusions and pulmonary edema. Echocardiogram revealed an enormous left atrial mass that extended one-third into left ventricle during systole. The patient underwent successful surgical resection with histological confirmation of a benign atrial myxoma.     

Lateral unicondylar knee arthroplasty (UKA): Contemporary indications,surgical technique,and results

Unicompartmental femoro-tibial osteoarthritis usually affects the medial compartment of the knee, but in 10 %, the lateral compartment is primarily involved. Femoral osteotomy is attractive to avoid TKA in younger patients with low-grade unicompartmental osteoarthritis and a valgus deformity. However, only limited functional results can be expected for patients with Ahlback grade 2 or greater osteoarthritis. Moreover, because of previous skin incisions and hardware removal, TKA after femoral osteotomy remains a complex procedure with poor functional results. Unicompartmental knee arthroplasty for both the medial and the lateral compartments has been performed since the 1970s. In a patient with involvement of only one compartment, a medial or a lateral UKA can provide a quicker recovery and enhanced function when compared to TKA. In addition, it preserves bone stock and can be “easily” revised by a TKA. Technical improvements, combined with strict patient selection, have resulted in ten year survivorships greater than 90 %. However, lateral UKA is technically more challenging than medial UKA due to the lower number of indications, as well as the functional anatomy of the lateral compartment. The goals of this article are to present up-to-date information concerning indications, patients’ selection, surgical technique and results of lateral compartment UKA.