While there is some evidence to suggest that early fixation of the fractured femur( ＜ 24 hours)may be associated with improved outcome, the lack of comparablestudy populations leaves this question largely unanswered. Prospective and/orrandomized studies that control for injury severity are needed to answer the question of optimal timing for fixation of the femur.

OBJECTIVE: Urolithiasis, a common problem in medicine, poses a significant burden with prevalenceof 1-15%. Potassium citrate therapy has become one of the cornerstones of medical stone managementwith hypocitraturia being the most common metabolic problem in stone formers. The authorsdetermined the effects of potassium citrate on urinary metabolic profiles and its impact on stoneburden among Filipino stone formers. PATIENTS AND METHODS: This is a prospective, cohort study in patients seen at the UST Hospital between2016 and 2018. Twenty-four hour urine citrate levels, stone sizes and urine pH pre-therapy and post-therapy were analyzed. RESULTS: Significant changes in urinary citrate, pH and stone sizes were noted as soon as 3 months afterthe onset of therapy. These changes included increase in urinary pH (6.1 to 6.7; p=0.001), increase inurinary citrate (109.1 to 253.4mg/day; p<0.001) and decrease in stone size (0.56 to 0.37cm; p=0.037).The changes in the urine citrate and the changes in the stone size were not correlated using the Pearsoncorrelation scatter plot. CONCLUSION Potassium citrate therapy provides a significant alkali and citraturic treatment among Filipino stone formers. However, there is no significant correlation between changes in stone size and changes in urine citrate level.

Taken together,these reports suggestsom e benefitfrom operative com pared with nonoperative treatm entinthe care of displaced calcaneal fractures.In particular,the suggestion that operative care m ay im prove function in certainsubgroups ofpatients who do notreceive workers com pensation m ay be ofparticularclinicalbenefit.Additionalstudies usingpatient-oriented quality oflife m easures to verify the positive results ofsurgery in these subgroups are needed.

Objective To investigate the relationship among interstitial infiltrating inflammatory cells (including CD4+, CD8+, CD25+, MAC387+ and 27E10+), renal function and pathological changes in IgA nephropathy (IgAN). Methods This study included 36 IgAN patients. PAS and immunohistochemistry method were applied to stain paraffin sections. The surface of interstitial tubules, the amount of CD4+, CD8+, CD25+, MAC387+, 27E10 + cells per unit were counted(cells/mm2), together with pathological changes (including glomerulosclerosis, tubular atrophy and interstitial sclerosis) and renal function during and after biopsy were determined by using image analysis system and SPSS software pack. Results In the renal tubulointerstitium, the number of CD4+ cells correlated with interstitial fibrosis (r=0.38 ,P

Purpose: Anastomotic leakage (AL) is the anathema of colorectal surgery. Its occurrence leads to increased morbidity and mortality and a prolonged hospital stay. Much work has gone into studying various biomarkers in drain fluid to facilitate early detection of AL. This stage 2a development study aims to assess the safety and feasibility of reliably detecting the iodine in Gastrografin (GG; Bayer Australia Ltd.) in drain fluid and stool samples by dual-energy computed tomography (DECT). Methods: This is a prospective, observational, controlled, consecutive cohort study establishing the safety and feasibility of the detection of GG in surgical drain fluid and stool as a biomarker of AL when patients with a low pelvic colorectal anastomosis undergo luminal flushing of the rectal tube with GG. Results: Ten consecutive patients were allocated to the saline flush group and the following 10 to the GG flush group. Three patients in the saline flush group developed an AL. One patient in the GG flush group developed an AL. An elevation in the drain fluid GG was detected using DECT on the day of clinical deterioration. None of the patients in the control group were found to have a positive result on DECT. Conclusion This study demonstrates the safety of a novel approach to the early detection of AL from extraperitoneal colorectal anastomoses. The technique requires validation in a larger cohort and a multicenter study is planned to investigate the efficacy of GG rectal tube flushes as an early biomarker of AL in low pelvic anastomoses.