Prescription medication use by emergency department doctors to improve work and academic performance, and to manage stress and anxiety.

OBJECTIVE: To determine medications used by ED doctors to improve work and academic performance, and to manage stress and anxiety. METHODS: We undertook an online, voluntary, anonymous survey of ACEM fellows and trainees. RESULTS: One hundred and thirty-nine (46.5%) respondents used a medication under examination. Sleep aids included melatonin (19.1% of respondents) and benzodiazepines (8.7%). Medications to improve performance included modafinil (4.7%), pseudoephedrine (2.0%), melatonin (2.0%) and beta blockers (1.3%). Some medications were taken prior to shifts. Medications to manage stress and anxiety included benzodiazepines (3.0%) and beta blockers (2.0%). CONCLUSION: Medication use is common and support for some doctors may be required.

Mid-term (2-8 years) follow-up of open reduction and internal fixation of patella fractures: does the surgical technique influence the outcome?

OBJECTIVE: The objective of the study was to evaluate the clinical and radiological results of internal fixation of patella fractures, comparing tension band wiring techniques with proximal only and proximally and distally bend Kirschner wires (K-wires). METHODS: Over a period of 6 years, 60 patients met the criteria to be included in this study of which 40 were available for mid-term (2-8 years) clinical and radiological follow-up. RESULTS: Out of 60, 9 failures of fixation occurred, 3 due to migration of the K-wires and 6 because of insufficient tensioning of the tension band. Failure due to migration, only occurred in the group with the proximally bend only K-wire technique. CONCLUSION: Our recommendation is to distally bend the K-wires as well as proximally to prevent migration of K-wires.