It has been suggested that schizophrenic patients have a lower risk of cancer than the general population. We therefore investigated the smoking patterns of 100 current chronic schizophrenic in-patients, and the causes of death in 122 recently deceased schizophrenics. We found that schizophrenics are heavy smokers, and that schizophrenics do die from carcinoma of the bronchus. Proportional mortality rates for all malignancies were not significantly lower in schizophrenics than in the general population but there was a significant absence of cancer of the gastro-intestinal tract. Proportional mortality rates for female mammary carcinoma, pneumonia, and suicide were raised, and that for cerebrovascular disease was low. These differences between schizophrenics and the general population warrant further investigation.
BackgroundPatients post total hip arthroplasty (THA) remain at high risk of developing Deep Vein Thrombosis (DVT) during the recovery period following surgery despite the availability of effective pharmacological and mechanical prophylactic methods. The use of calf muscle neuromuscular electrical stimulation (NMES) during the hospitalised recovery period on this patient group may be effective at preventing DVT. However, the haemodynamic effectiveness and comfort characteristics of NMES in post-THA patients immediately following surgery have yet to be established.MethodsThe popliteal veins of 11 patients, who had undergone unilateral total hip replacement surgery on the day previous to the study, were measured using Doppler ultrasound during a 4 hour neuromuscular electrical stimulation (NMES) session of the calf muscles. The effect of calf muscle NMES on peak venous velocity, mean venous velocity and volume flow were compared to resting values. Comfort was assessed using a 100mm non-hatched visual analogue scale taken before application of NMES, once NMES was initiated and before NMES was withdrawn.ResultsIn the operated limb NMES produced increases in peak venous velocity of 99% compared to resting. Mean velocity increased by 178% compared to resting and volume flow increased by 159% compared to resting. In the un-operated limb, peak venous velocity increased by 288%, mean velocity increased by 354% and volume flow increased by 614% compared to basal flow (p<0.05 in all cases). There were no significant differences observed between the VAS scores taken before the application of NMES, once NMES was initiated and before NMES was withdrawn (p=.211).ConclusionsNMES produces a beneficial hemodynamic response in patients in the early post-operative period following orthopaedic surgery. This patient group found extended periods of calf-muscle NMES tolerable.Trial registrationClinicalTrials.gov NCT01785251
At a mean follow-up of 35 months (minimum 24 months), there were no cases of recurrent prosthetic infection and no patient had required revision for aseptic loosening or mechanical instability on the femoral side. The combination of effective-staged surgical joint debridement, a shortened post-operative course of systemic antibiotic treatment and an adequate latent period before re-implantation has led to encourage early results in this series of revised chronic hip joint prosthetic infections.
In view of the importance placed on the first intermetatarsal angle in the assessment of surgical intervention in hallux valgus, we assessed the reliability with which one measures this angle. The study involved 10 observers of varying experience measuring the angle using a standard technique on 10 weightbearing AP X-rays of the foot on three separate occasions. The margin of error in measuring the angle was +/-3.60 degrees with a 95% confidence interval. Increasing and averaging the number of readings per observer or the readings of a number of observers, reduces the error. Experience doesn't improve reliability. In conclusion, improvement in the reliability of the measurements can be achieved by careful technique, performing the measurements at least twice, and averaging them.
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