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Objective To investigate the effect of residential location and socioeconomic deprivation on the provision of bariatric surgery. Design Retrospective cross-sectional ecological study. Setting Patients resident local to one of two specialist bariatric units, in different regions of the UK, who received obesity surgery between 2003 and 2013. Methods Demographic data were collected from prospectively collected databases. Index of Multiple Deprivation (IMD 2010) was used as a measure of socioeconomic status. Obesity prevalences were obtained from Public Health England (2006). Patients were split into three IMD tertiles (high, median, low) and also tertiles of time. A generalised linear model was generated for each time period to investigate the effect of socioeconomic deprivation on the relationship between bariatric case count and prevalence of obesity. We used these to estimate surgical intervention provided in each population in each period at differing levels of deprivation. Results Data were included from 1163 bariatric cases (centre 1-414, centre 2-749). Incidence rate ratios (IRRs) were calculated to measure the associations between predictor and response variables. Associations were highly non-linear and changed over the 10-year study period. In general, the relationship between surgical case volume and obesity prevalence has weakened over time, with high volumes becoming less associated with prevalence of obesity. Discussion As bariatric services have matured, the associations between demand and supply factors have changed. Socioeconomic deprivation is not apparently a barrier to service provision more recently, but the positive relationships between obesity and surgical volume we would expect to find are absent. This suggests that interventions are not being taken up in the areas of need. We recommend a more detailed national analysis of the relationship between supply side and demand side factors in the provision of bariatric surgery. [ABSTRACT FROM AUTHOR]

In the recent past, laparoscopic adjustable gastric bands (LAGBs) have been used extensively in bariatric surgery. Despite questionable long-term efficacy, they are generally safe and reversible. We report a possibly unique presentation of a potential hazard of the insertion technique; a misplaced LAGB encircling the abdominal aorta, which was confirmed radiologically and on operative removal of the gastric band. This is a dramatic complication of LAGB, representing an important anatomical hazard for gastric band insertion. [ABSTRACT FROM AUTHOR]

Background Hospitalised sport and active recreation injuries can have serious long-term consequences. Despite this, few studies have examined the long-term outcomes of these injuries. The purpose of this study was to establish whether patients hospitalised with orthopaedic sport and active recreation injuries, have returned to their pre-injury levels of health status and function, 12 months post injury and identify factors associated with poor outcomes. The present work was a cohort study with retrospective assessment of preinjury status and prospective assessment of outcome at 12 months post injury. Methods Adults with orthopaedic sport and active recreation injuries, captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Pre-injury and 12-month outcomes were assessed using the 36-item Short Form Health Survey (SF-36) and the extended Glasgow Outcome Scale. Differences in preinjury and post-injury SF-36 scores were examined and demographic, injury, hospital and physical activity variables were assessed for associations with outcome using multivariate linear regression. Results Of the 324 participants 98% were followed-up at 12 months post injury. At 12 months, participants reported a mean 7.0-point reduction in physical health (95% CI 5.8 to 7.8) and a 2.5-point reduction in mental health (95% CI 1.2 to 3.0), with 58% (95% CI 52.6% to 63.4%) reporting reduced function. Sporting group (p=0.001), Injury Severity Score >15 (p=0.007) and high pre-injury vigorous activity levels (p=0.04), were related to poorer physical health outcomes. Conclusions At 12 months post injury, most participants reported large reductions in physical health and reduced function. This information is important for furthering our understanding of the burden of sport and active recreation injury and setting priorities for treatment and rehabilitation. [ABSTRACT FROM AUTHOR]

The article discusses significance of fever in pediatrics, citing its physiological aspects. It states that fever is one of the three most concerned health conditions for parents of and mentions lack scientific evidence inferring fever itself as a dangerous clinical condition. It notes findings of a cohort study related to association of fever with serious illness in children. It highlights topics like benefits of reducing a child's fever, fever as a natural response of the body to infection.

The article offers information on key recommendations from the 2013 update of the National Institute for Health and Care Excellence (NICE) guidelines on feverish illness in children. The suggestions of NICE are based on the organized reviews of the best available evidence and explicit consideration of cost-effectiveness. Moreover, the article has a traffic light table that shows the clinical assessment of feverish children.

The authors reflect on the significance of white blood count (WBC) as a tool to determine the treatment order for children with feverish illness by referring to a study by S. De and colleagues. Topics discussed include role of chest X-rays, WBC analysis and urine analysis in determining the treatment order, role of the National Institute for Health and Care Excellence (NICE) guidelines to manage feverish illness, and role of paediatricians in examining children for viral or bacterial illness.

The article focuses on guidelines which have been established by Great Britain's National Institute for Health & Clinical Excellence (NICE) concerning the assessment and initial management of feverish illness in children younger than five years of age. A discussion of risk assessment policies that are contained in the guidelines is presented. Barriers which physicians may encounter when attempting to follow the NICE guidelines, and a leaflet which the Guideline Development Group has created which helps physicians follow the guidelines, are discussed.

Presents a letter to the editor about the association between sudden infant death syndrome and H pyroli.