Does early radiography alter remanipulation rates in paediatric forearm fractures?

BACKGROUND: In paediatric patients with a forearm fracture, treated with manipulation under anaesthesia with fluoroscopic guidance, protocol varies whether a day 1 post-operative radiograph is performed. The primary aim of this study is to evaluate whether this investigation changes the management of a patient. Secondary aims evaluated number of reinterventions and factors associated with loss of position. METHODS: A retrospective study design was used. Cases were identified from the Wellington Regional Hospital radiology database between 1 January 2010 and 30 July 2011. Ethical approval was obtained for this study. RESULTS: During the study period, 148 patients under 18 years old presented with a forearm fracture; after exclusion criteria were applied, 107 fractures were included. Sixty-five fractures were evaluated with a day 1 post-operative radiograph; no reinterventions were performed as a result of this investigation. Evaluating the total study population (107), only four reinterventions were performed. No reintervention was performed earlier than 1 week. All patients who required reintervention were investigated with a day 1 post-operative radiograph. No statistically significant associations were found between patient demographic, injury or treatment factors and need for reintervention (at any stage). CONCLUSIONS: The day 1 post-operative radiograph does not influence management, and cannot be justified given the further cost for hospitals, unnecessary radiation and additional time required.

Tectonic influences on ground water quality: insight from complementary methods.

A study using multiple techniques provided insight into tectonic influences on ground water systems; the results can help to understand ground water systems in the tectonically active western United States and other parts of the world. Ground water in the San Bernardino Valley (Arizona, United States and Sonora, Mexico) is the main source of water for domestic use, cattle ranching (the primary industry), and the preservation of threatened and endangered species. To improve the understanding of ground water occurrence, movement, and sustainability, an investigation was conducted using a number of complementary methods, including major ion geochemistry, isotope hydrology, analysis of gases dissolved in ground water, aquifer testing, geophysics, and an examination of surface and subsurface geology. By combining information from multiple lines of investigation, a more complete picture of the basin hydrogeology was assembled than would have been possible using fewer methods. The results show that the hydrogeology of the San Bernardino Valley is markedly different than that of its four neighboring basins in the United States. The differences include water quality, chemical evolution, storage, and residence time. The differences result from the locally unique geology of the San Bernardino Valley, which is due to the presence of a magmatically active accommodation zone (a zone separating two regions of normal faults with opposite dips). The geological differences and the resultant hydrological differences between the San Bernardino Valley and its neighboring basins may serve as a model for the distinctive nature of chemical evolution of ground water in other basins with locally distinct tectonic histories.

Near-synchronous interhemispheric termination of the last glacial maximum in mid-latitudes.

Isotopic records from polar ice cores imply globally asynchronous warming at the end of the last glaciation. However, 10Be exposure dates show that large-scale retreat of mid-latitude Last Glacial Maximum glaciers commenced at about the same time in both hemispheres. The timing of retreat is consistent with the onset of temperature and atmospheric CO2 increases in Antarctic ice cores. We suggest that a global trend of rising summer temperatures at the end of the Last Glacial Maximum was obscured in North Atlantic regions by hypercold winters associated with unusually extensive winter sea ice.

A reservoir of nitrate beneath desert soils.

A large reservoir of bioavailable nitrogen (up to approximately 10(4) kilograms of nitrogen per hectare, as nitrate) has been previously overlooked in studies of global nitrogen distribution. The reservoir has been accumulating in subsoil zones of arid regions throughout the Holocene. Consideration of the subsoil reservoir raises estimates of vadose-zone nitrogen inventories by 14 to 71% for warm deserts and arid shrublands worldwide and by 3 to 16% globally. Subsoil nitrate accumulation indicates long-term leaching from desert soils, impelling further evaluation of nutrient dynamics in xeric ecosystems. Evidence that subsoil accumulations are readily mobilized raises concern about groundwater contamination after land-use or climate change.