Objective To study the effect of lateral wedge insoles with different stiffness on the knee adduction moment (KAM) under walking condition.Methods The gait of 15 healthy males wearing lateral wedge insoles with different stiffness was tested.The kinetics and kinematics data were collected by optical motion capture system and ground reaction force platform.The KAM and its peak values were calculated by Visual 3D software.The differences in peak KAM under 3 walking conditions (shoes only,shoes with softer or harder lateral wedge insoles) were analyzed.Results Compared with walking with the softer lateral wedge insoles,walking with the harder lateral wedge insoles could reduce the 1st and 2nd peak KAM by 9.3％ and 9.7％,respectively,with significant statistic differences.Conclusions Increasing some stiffness of lateral wedge insoles can further reduce the pressure and wear on medial compartment of the knee joint,which may relieve the symptom of knee osteoarthritis.

Anastomotic and rectal stump leaks are feared complications of colorectal surgery. Diverting stomas are commonly used to protect low rectal anastomoses but can have adverse effects. Studies have reported favorable outcomes for transanal drainage devices instead of diverting stomas. We describe our use of the Heald anal stent and its potential impact in reducing anastomotic or rectal stump leak after elective or emergency colorectal surgery. We performed a single-center retrospective analysis of patients in whom a Heald anal stent had been used to “protect” a colorectal anastomosis or a rectal stump, in an elective or emergency context, for benign and malignant pathology. Intraoperative and postoperative outcomes were reviewed using clinical and radiological records. The Heald anal stent was used in 93 patients over 4 years. Forty-six cases (49%) had a colorectal anastomosis, and 47 (51%) had an end stoma with a rectal stump. No anastomotic or rectal stump leaks were recorded. We recommend the Heald anal stent as a simple and affordable adjunct that may decrease anastomotic and rectal stump leak by reducing intraluminal pressure through drainage of fluid and gas.

Background: and Purpose Changes to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to patients’ treatment setting (stroke unit or alternate ward). Methods: We conducted a retrospective cohort study of patients admitted with stroke or transient ischemic attack between January 2019 and June 2020 in the Australian Stroke Clinical Registry (AuSCR). The AuSCR monitors patients’ treatment setting, provision of allied health and nursing interventions, prescription of secondary prevention medications, and discharge destination. Weekly trends in the quality of care before and during the pandemic period were assessed using interrupted time series analyses. Results: In total, 18,662 patients in 2019 and 8,850 patients in 2020 were included. Overall, 75% were treated in stroke units. Before the pandemic, treatment in a stroke unit was superior to alternate wards for the provision of all evidence-based therapies assessed. During the pandemic period, the proportion of patients receiving a swallow screen or assessment, being discharged to rehabilitation, and being prescribed secondary prevention medications decreased by 0.58% to 1.08% per week in patients treated in other ward settings relative to patients treated in stroke units. This change represented a 9% to 17% increase in the care gap between these treatment settings during the period of the pandemic that was evaluated (16 weeks). Conclusions During the first 6 months of the pandemic, widening care disparities between stroke units and alternate wards have occurred.

Objective To study the effect of lateral wedge insoles with different stiffness on the knee adduction moment (KAM) under walking condition. Methods The gait of 15 healthy males wearing lateral wedge insoles with different stiffness was tested. The kinetics and kinematics data were collected by optical motion capture system and ground reaction force platform. The KAM and its peak values were calculated by Visual 3D software. The differences in peak KAM under 3 walking conditions (shoes only, shoes with softer or harder lateral wedge insoles) were analyzed. Results Compared with walking with the softer lateral wedge insoles, walking with the harder lateral wedge insoles could reduce the 1st and 2nd peak KAM by 9.3% and 9.7%, respectively, with significant statistic differences. Conclusions Increasing some stiffness of lateral wedge insoles can further reduce the pressure and wear on medial compartment of the knee joint, which may relieve the symptom of knee osteoarthritis.