Staffordconnor4472

Duration of surgery and intra-operative blood loss was significantly less in group B patients. Radiological and clinical outcomes were better in group B patients than group A patients. Implant loosening was more frequent in group A patients. Injury to the obturator vessels were more common in group B patients.

With a comparatively lesser surgical duration and blood loss, better clinical and radiological outcomes at least one year after the surgery, an infra-pectineal plate applied through the modified Stoppa approach can be considered the preferred treatment for most acetabular fractures with QLP involvement.

III.

III.Forced and coerced sterilization refers to the provision of permanent contraception without true informed consent. In Canada, this topic is particularly relevant to Indigenous Peoples because of this country's history of racialized eugenics programs. In this commentary, we briefly review the history of forced and coerced sterilization in Canada, describe the clinical considerations for health care providers who work with Indigenous patients in this context, and outline calls to action for health care providers and organizations to support the provision of culturally appropriate reproductive health care to Indigenous people.

Missed screening opportunities may contribute to the rising rates of sexually transmitted and blood borne infections (STBBIs) in Manitoba. This study sought to determine the proportion of women who are screened for syphilis and human immunodeficiency virus (HIV) when admitted with pelvic inflammatory disease (PID).

We performed a retrospective analysis of all inpatient admissions for PID over 3 discrete years (fiscal years 2007, 2012, 2017) at a single tertiary care centre. Data extracted from medical records included STBBI screening performed, clinical signs at presentation, and history of PID or STBBI. To improve the accuracy of our estimates, we complemented the records data with population data from Manitoba. We evaluated predictive factors influencing any or concurrent STBBI screening using bivariate analysis for significance (P < 0.05).

One hundred and five admissions met inclusion criteria. Syphilis and HIV screening was ordered concurrently with chlamydia and gonorrhoea screening in 6 (6%) of encounters and was ordered at any point during admission for PID in 28 (27%). A history of substance abuse (odds ratio [OR] 4.94 [95% CI 1.62-15.05] for syphilis screening and OR 6.94 [95% CI 2.38-20.23] for HIV screening) and a positive gonorrhea result while admitted (OR 3.40 [95% CI 1.06-10.88] for syphilis screening) were strongly associated with receiving any screening. Reporting multiple sexual partners was also strongly associated with receiving any STBBI screening while admitted (OR 19.44 [95% CI 2.01-187.92] and OR 15.00 [95% CI 1.58-142.70] for syphilis and HIV screening, respectively).

A minority of patients were screened for syphilis and HIV while admitted for PID. This study highlights a missed opportunity to screen for STBBI among sexually active women.

A minority of patients were screened for syphilis and HIV while admitted for PID. This study highlights a missed opportunity to screen for STBBI among sexually active women.

Older adults commonly face challenges in understanding, obtaining, administering, and monitoring medication regimens after hospitalization. These difficulties can lead to avoidable morbidity, mortality, and hospital readmissions. Pharmacist-led peri-discharge interventions can reduce adverse drug events, but few large randomized trials have examined their effectiveness in reducing readmissions. AZD1480 Demonstrating reductions in 30-day readmissions can make a financial case for implementing pharmacist-led programs across hospitals.

The PHARMacist Discharge Care, or the PHARM-DC intervention, includes medication reconciliation at admission and discharge, medication review, increased communication with caregivers, providers, and retail pharmacies, and patient education and counseling during and after discharge. The intervention is being implemented in two large hospitals Cedars-Sinai Medical Center and the Brigham and Women's Hospital. To evaluate the intervention, we are using a pragmatic, randomized clinical trial design with randomization at the patient level. The primary outcome is utilization within 30days of hospital discharge, including unforeseen emergency department visits, observation stays, and readmissions. Randomizing 9776 patients will achieve 80% power to detect an absolute reduction of 2.5% from an estimated baseline rate of 27.5%. Qualitative analysis will use interviews with key stakeholders to study barriers to and facilitators of implementing PHARM-DC. A cost-effectiveness analysis using a time-and-motion study to estimate time spent on the intervention will highlight the potential cost savings per readmission.

If this trial demonstrates a business case for the PHARM-DC intervention, with few barriers to implementation, hospitals may be much more likely to adopt pharmacist-led peri-discharge medication management programs.

ClinicalTrials.gov Identifier NCT04071951.

ClinicalTrials.gov Identifier NCT04071951.

Familial Mediterranean fever (FMF) is the most common interleukin 1 (IL-1)-driven monogenic autoinflammatory disease. Yet published data also suggest that tumor necrosis factor (TNF) may have a role in the pathogenesis of FMF and may serve as a target for treatment. In the present study we evaluate this hypothesis.

To this goal, we studied the incidental effect on FMF of TNF-directed treatment, administered to colchicine-refractory FMF patients for the management of a concurrent inflammatory disease. The rates of FMF patients and of treatments with complete or nearly complete FMF response were determined, based on the number of FMF attacks during TNF-blocker exposures. The possible effect of various FMF and non-FMF features on the outcome was determined using comparative analysis. Patients were identified and data were retrieved using electronic files from the FMF clinic.

Twenty-six patients were identified, each receiving ≥1 of four TNF-blockers for a mean duration of 27.6±16.4months. The TNF-blockers were found to induce complete or nearly complete FMF response in 10 (38.