Dendrite enlightenment

Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type. Conclusion Hospital treatment data were most prominent, which emphasised injuries of a more serious nature or requiring acute care. These injuries were primarily fractures, dislocation/sprain and strains, bruising and open wounds with the majority resulting from players being struck by the ball. Research into whether properly fitted protective equipment, at an approved standard, is worn and is effective, is recommended. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. check details Published by BMJ.Background The most common management strategy for tinnitus provided in the UK audiology clinics is education and advice. This may also be combined with some form of sound therapy (e.g. digital hearing aids). While education and advice is generally provided by all clinics, there is a marked variability in provision of hearing aids that depends very much on clinical decisions. A recent Cochrane review concluded a lack of evidence to support or refute hearing aid use as a routine intervention for people with tinnitus and hearing loss. This lack of evidence is reflected in the inconsistency of tinnitus management in the UK. The aim of the HUSH trial is to determine the feasibility of conducting a definitive randomised controlled trial (RCT) of the effectiveness and cost-effectiveness of hearing aids for adults with tinnitus and hearing loss. Methods This is a multicentre randomised controlled feasibility trial. Up to 100 adults, aged 18 and over, presenting to 5 UK audiology clinics with a complaint of tinnitus ids as a tinnitus management strategy. Trial registration ISRCTN, ISRCTN14218416. Registered on 30 July 2018. © The Author(s) 2020.Case summary A 15-week-old kitten presented with a 1-month history of intermittent generalised tremors and abdominal distension. Hypocalcaemia associated with increased 1,25-vitamin D3 was consistent with vitamin D3-dependent rickets type II. The bone appearance on CT scan was most consistent with the changes typically seen with nutritional secondary hyperparathyroidism and less typical of the changes seen with rickets. Our patient had a positive response to high vitamin D3 therapy as it remained normocalcaemic 16 months after diagnosis, supporting the diagnosis of rickets. Relevance and novel information This case report is an unusual and interesting presentation of rickets in a kitten. Despite the characteristic vitamin D3 disturbance for rickets type II, the atypical radiographic changes have not been previously reported. In the literature, a positive response to treatment is not commonly seen or follow-up is short. Our case responded well to treatment and was followed for 16 months from the time of diagnosis. This emphasises that the pathophysiology of the condition is not well understood, and that different types of vitamin D3-dependent rickets type II may exist. Although the genetic defects responsible for some cases of rickets type I have been identified, this has still not been determined for rickets type II. © The Author(s) 2020.Case summary A 12-week-old intact male domestic shorthair kitten presented for dysuria. The patient had a urethral obstruction that was relieved with urinary catheter placement. A cutaneous opening at the umbilicus was identified. Three-view abdominal radiographs and a contrast study revealed a patent urachus with no evidence of urine leakage into the abdomen. An exploratory laparotomy was performed that confirmed a patent urachus, which was excised, and cystic and urethral calculi, which were removed via cystotomy. The patient recovered well from surgery, with a 12 h period of stranguria occurring 2 days postoperatively, attributed to residual inflammation. Calculi analysis revealed struvite stones, likely secondary to infection and inflammation. At the time of writing, 3 months postoperatively, the kitten had one episode of hematuria and inappropriate urination, which resolved with a short course of non-steroidal anti-inflammatory drugs, but had been otherwise been asymptomatic and healthy. Relevance and novel information To our knowledge, this is the first report of urolithiasis and patent urachus in a pediatric feline patient. Based on the occurrence of struvite stones in the presence of a patent urachus in an animal of this age, we suspect that chronic infection and inflammation led to the development of urolithiasis. Correction of the patent urachus resulted in almost complete resolution of clinical signs and no crystal formation was appreciated on recheck urinalysis. © The Author(s) 2020.in English, French Les outils de la médecine de précision et les mesures de résultats fondées sur des données probantes suscitent de plus en plus d’intérêt pour le couplage donneur-receveur afin d’optimiser le résultat d’une transplantation. Bien qu’une plus grande précision offre des avantages sur la santé et pour les ressources, elle peut être perçue comme entrant en conflit avec les normes d’attribution des organes axées sur l’équité, et avec les obligations éthiques et juridiques des fournisseurs de soins et des établissements auxquels ils sont rattachés. Avec le nombre croissant de preuves indiquant que diverses formes d’incompatibilité HLA ou de biomarqueurs pronostiques peuvent affecter les résultats, le différend opposant l’augmentation de leur utilisation au respect de l’équité risque de s’accentuer. Au Canada, les fournisseurs de soins sont légalement tenus de placer l’intérêt du patient, tel que l’accès à un organe, devant les besoins du système de santé et des autres patients. De plus, la mise en œuvre d’approches de précision est susceptible d’être influencée par les poursuites liées aux droits d’accès à une transplantation qui ont abouti dans le passé. Ces tensions juridiques pourraient être exacerbées par les représentations qu’en donnent les médias, ces derniers ayant historiquement favorisé le droit à l’accès. Ainsi, au moment de mettre en œuvre de nouvelles technologies de précision pour l’attribution des organes, les décideurs devront constamment revoir l’équilibre entre équité et pertinence, de même que la façon d’élaborer des règles reflétant notre conception sociétale d’un système équitable d’attribution des organes.