several describing their chosen response as the severity of their itch compared to their worst-ever itch. These findings align with participants' suggestion that "worst itch" be defined (eg, "rate your itching severity by circling the number that best describes your worst level of itching…"). Quantitative diary data demonstrated acceptable psychometric performance. Participants utilized the majority of the response scale on ≥ 1 days, with an even distribution across response options. Day 7 (test) versus Day 14 (retest) reliability was high, with an observed intraclass correlation coefficient= 0.94 among stable participants. Concurrent validity was acceptable, with strong correlations (0.55-0.76) observed with other diary AD symptom measures. There were no major overall differences between adults and adolescents. ConClusions: Adults and adolescents noted that the Itch NRS was easy to understand and relevant to their AD experiences, with clear alignment between item wording and language used by participants. Psychometrically, the Itch NRS was a valid and reliable measure of itch that applied to both adults and adolescents.

No abstract

several describing their chosen response as the severity of their itch compared to their worst-ever itch. These findings align with participants' suggestion that "worst itch" be defined (eg, "rate your itching severity by circling the number that best describes your worst level of itching…"). Quantitative diary data demonstrated acceptable psychometric performance. Participants utilized the majority of the response scale on ≥ 1 days, with an even distribution across response options. Day 7 (test) versus Day 14 (retest) reliability was high, with an observed intraclass correlation coefficient= 0.94 among stable participants. Concurrent validity was acceptable, with strong correlations (0.55-0.76) observed with other diary AD symptom measures. There were no major overall differences between adults and adolescents. ConClusions: Adults and adolescents noted that the Itch NRS was easy to understand and relevant to their AD experiences, with clear alignment between item wording and language used by participants. Psychometrically, the Itch NRS was a valid and reliable measure of itch that applied to both adults and adolescents.

Background No validated pre-operative cardiac risk stratification tool exists that is specific for total hip and total knee arthroplasty (THA and TKA, respectively). To reduce the risk of post-operative cardiac complication, surgeons need clear guidance on which patients are likely to benefit from pre-operative cardiac optimisation. This is particularly important for asymptomatic patients, where the need is harder to determine. Methods Primary THA and TKA performed between January 1, 2010, and December 31, 2017, were identified from a single orthopaedic practice. Over 25 risk factors were evaluated as predictors for patients requiring additional cardiac investigation beyond an ECG and echocardiogram, and for cardiac abnormality detected upon additional investigation. A multivariate logistic regression was conducted using significant predictor variables identified from inferential statistics. A series of predictive scores were constructed and weighted to identify the influence of each variable on the ability to predict the detection of cardiac abnormality pre-operatively. Results Three hundred seventy-four patients were eligible for inclusion. Increasing age (p < 0.001), history of cerebrovascular accident (p = 0.018), family history of cardiovascular disease (FHx of CVD) (p < 0.001) and decreased ejection fraction (EF) (p < 0.001) were significant predictors of additional cardiac investigation being required. Increasing age (p = 0.003), male gender (p = 0.042), FHx of CVD (p = 0.001) and a reduced EF (p < 0.001) were significantly predictive for the detection of cardiac abnormality upon additional cardiac investigation. Conclusions Increasing age, male gender, FHx of CVD and decreased ejection fraction are important risk factors to consider for pre-operative cardiac optimisation in THA and TKA patients. These findings can be applied towards future predictive models, to determine which asymptomatic patients are likely to benefit from pre-operative cardiac referral.

Prosthetic joint infection after total knee arthroplasty is an infrequent, yet serious complication. Antimicrobial prophylaxis plays an important role in reducing the rate of surgical site infections. To be effective as an antimicrobial prophylaxis, the serum, tissue and bone concentrations of the antibiotic must be greater than the target organism's minimum inhibitory concentration. As antibiotic resistance increases current intravenous prophylactic dosing has been shown to be subtherapeutic for some patients. Intravenous regional administration and intraosseous regional administration of prophylactic antibiotics are novel methods used to increase the antibiotic tissue concentrations, which may enhance the efficacy of prophylactic antibiotics in total knee arthroplasty. Currently, literature has shown both intravenous regional administration and intraosseous regional administration to be safe and effective techniques. However, there is no clinical evidence to show that it results in a reduction of prosthetic joint infection rates. This study summarizes the current knowledge base on the use of regional administration of prophylactic antibiotics in total knee arthroplasty.