Steroids Significantly Decrease Postoperative Postural Hypotension in Total Knee Replacement
J Knee Surg DOI: 10.1055/s-0041-1731722Total knee replacement (TKR) is one of the most common orthopaedic procedures performed, and enhanced recovery after surgery (ERAS) has been developed and incorporated into inpatient surgical pathways to improve patient outcomes. Under ERAS recommendations, multimodal prophylaxis has been used to help manage postoperative nausea and vomiting (PONV) following TKR. Dexamethasone is one of the commonly used for this and the anti-inflammatory properties could depress vagal activity, reducing postural hypotension (PH). The hypothesis of this study is that postoperative dexamethasone use is associated with lower rates of early postoperative PH following TKR surgery. In our institution, patients who undergo elective primary TKR are admitted on the day of surgery and follow a standardized ERAS protocol. Data on patients who underwent elective primary TKR under a single adult reconstruction team from September 2017 to March 2020 were reviewed and analyzed. A review of demographic characteristics, surgical data, postoperative medications, and postoperative notes was performed. Binary logistic regression was used to assess the effect of the use of dexamethasone on PH, with an adjusted odds ratio (OR) calculated after accounting for potential confounders. Of the 149 patients were included in the study, 78 had dexamethasone postoperatively, and 71 did not. Patients who had received dexamethasone were statistically less likely to suffer from PH (OR&th...
Conclusion Visual estimation had excellent intra-rater reliability in the assessment of neck active rotation and head tilt on infants with congenital muscular torticollis. Visual estimation had acceptable inter-rater reliability in the assessment of neck active rotation but not of head tilt. There was a wide variation in reliability with no correlation between reliability and clinical experience. Assessment tools for head tilt that are more psychometrically robust should be developed.What is Known:• A thorough assessment of infants presenting with torticollis is essential, using assessment tools with robust psychometr...
Conclusion: It appears that the knee OA pain and disability can be decreased after a dual-frequency LLLT applied to acupoints (SP9, SP10, and EX-LE2). The clinical efficacy of LLLT is highly related to the therapeutic settings of the laser apparatus; hence, more clinical trials with diffident parameter settings are needed to be further clarified. PMID: 33029170 [PubMed]
Conclusion. Approximately one in three patients with LSS experience a poor clinical outcome consistent with surgical non-response. Demographic, health, and clinical factors were more predictive of clinical outcome than surgery-related factors. These predictors may assist surgeons with patient selection and inform shared decision-making for patients with symptomatic LSS. Level of Evidence: 2
CONCLUSION: DN is effective in improving hamstring flexibility compared with SS. One session of DN can be an effective treatment for hamstring tightness and increase hamstring flexibility. The improvements suggest that DN is a novel treatment for hamstring flexibility. PMID: 33027765 [PubMed - as supplied by publisher]
ConclusionsThe results suggest an overall positive response to EMR implementation. Minimal staff reported effects such as stress or anxiety in the workplace related to EMR implementation, and a perception of 'comfort' was cited once EMR was part of usual practice. However, responders did not report a significant effect on speed, efficiency or quality of patient care following EMR implementation.What is known about the topic?A growing body of literature exists regarding the perceptions of staff (particularly medical officers) in moving towards EMRs, but there is limited evidence regarding the perceptions of AHPs, and the ba...
ConclusionsService provision, support and pessary training in the UK vary greatly. This calls for the standardisation of care, training and development of a national guideline. We present a clear rationale and need for a UK guideline on pessary management of vaginal prolapse and a standardised pessary training model for multi-professional use.
Publication date: Available online 6 October 2020Source: Journal of PhysiotherapyAuthor(s): Pek Ling Teo, Kim L Bennell, Belinda J Lawford, Thorlene Egerton, Krysia S Dziedzic, Rana S Hinman
Publication date: Available online 6 October 2020Source: Journal of PhysiotherapyAuthor(s): Nia Luxton, Julie Redfern
Conclusion: Our findings show how the women explain their recovery in terms of overcoming fear of movement, making sense of their symptoms and becoming more active in everyday life. The close analysis reveals a recovery narrative portraying a complex and ambiguous process consisting of small dramas about the efforts trying to rebuild a meaningful life. PMID: 33026930 [PubMed - as supplied by publisher]