Wishaw General Hospital

About: Wishaw General Hospital is a healthcare organization based out in Wishaw, Scotland, United Kingdom. It is known for research contribution in the topics: Population & Survival rate. The organization has 256 authors who have published 222 publications receiving 4324 citations.

Troponin for acute coronary syndromes.

Abstract: The personal view offered by Thomson et al.1 is both welcome and timely. The wholesale adoption of troponin measurements in risk stratification strategies for management of acute coronary syndrome (ACS) may rely as much on evangelism and fashion as reasoned critical appraisal, and the authors are right to sound a note of caution. Indeed. further evidence may have been cited which would reinforce the view that there are important shortfalls in the usefulness of troponin tests in the management of ACS. Firstly. although some trials of glycoprotein lIb/IlIa inhibitors have suggested that the benefits from drug therapy are concentrated in patients with raised troponln, in the only published trial in which patients were recruited prospectively by use of cardiac troponin measurements. treatment showed no benefit compared with placebo.r' Secondly. the clinical endpoint in many studies is a composite one of death and/or acute myocardial infarction (AMI) within 30 days of intervention. The concept of a primary endpoint of AMI when a substantial number of ACS patients have non-Q-wave AMI at presentation and enrolment in the study is a hard one to grasp. Definitions of AMI as an endpoint can be based on tortuous and arbitrary calculations of changes in serum creatine kinase and creatine kinase MB measurements. sometimes only 48 h after the subject has been enrolled in the trial and given treatment or placebo. I Misreporting of myocardial infarction endpoints in a clinical trial has recently been described.\" In 23% of cases there was disagreement between investigators and clinical events committees. Thirdly. a meta-analysis (in which seven of the 14 co-authors had links with the pharmaceutical companies that market the drugs of intervention) of relevant trials was recently published.\" Six trials. enrolling 31402 patients were included. Troponin results were available in 11059 cases (35%). Baseline troponin T was elevated in 4964 (45'Yr.) of these cases. a high proportion. suggesting either a non-random selection of cases with unstable angina or the inclusion of a substantial number of cases of AMIon enrolment. as opposed to as a clinical endpoint. In the troponin-positive group there was a reduction in the composite endpoint from 12·()% (placebo) to HH% (treatment). which was of marginal statistical significance and should be considered alongside the different definitions (and possibly clinical importance) of AMI

An audit on factors influencing infection in operated ankle fractures

Abstract: A prospective 1-year audit was carried out on consecutive patients admitted to a district general hospital of the UK with ankle fractures needing open reduction internal fixation in order to analyse the factors affecting infection. Ninety seven percent patients had had their operative procedure within 24 h from the time of injury. Eighty four percent patients were discharged in less than 7 days period from the day of admission. All but one patient received antibiotic prophylaxis in accordance with local microbiology policy guidelines. Four out of 32 patients received therapeutic antibiotics for wound cellulitis/superficial infection. No patient had a deep infection, osteomyelitis or septic arthritis. Complex ankle trauma, post-radiography preliminary reduction of ankle fracture-dislocation in the emergency department, prolonged operating time, delayed surgery, persistent ankle swelling and unsupervised operation were common denominators in four cases with infection in ankle fracture fixation.

Mini-invasive open surgery Bankart repair for recurrent traumatic shoulder instability: a single surgeon/single institution's experience

Abstract: Background Primary traumatic anterior dislocations of the shoulder are common injuries which are complicated by persistent instability in a high proportion of patients. Surgery is successful and has been well described in the literature. Current scientific debate centres on the role of open and arthroscopic techniques. We describe the outcomes of a mini-invasive open surgery modified Bankart technique which was developed within our institution.