Rapid access microscopy and real-time case discussion via a secure messaging app improves diagnostic accuracy and management of acute hot swollen joints.

Patients with acute swollen joints are often presumed to have septic arthritis, leading to intravenous antibiotics and arthroscopic washout. Previously at our centre, joint fluid aspirates often lacked crystal analysis, resulting in excess culture-negative septic arthritis diagnoses. We developed a 'Hot Joint Pathway', hypothesising that since acute crystal arthropathy can be misdiagnosed as 'culture-negative septic arthritis', introducing the pathway would improve diagnostic accuracy.

Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review.

Links between heat exposure and congenital anomalies have not been explored in detail despite animal data and other strands of evidence that indicate such links are likely. We reviewed articles on heat and congenital anomalies from PubMed and Web of Science, screening 14,880 titles and abstracts in duplicate for articles on environmental heat exposure during pregnancy and congenital anomalies. Thirteen studies were included.

Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis.

Objective: To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.

Design: Systematic review and random effects meta-analysis.

Data Sources: Medline and Web of Science searched up to September 2018, updated in August 2019.

Body Fluid Testing at John F. Kennedy Medical Center in Liberia.

Objectives: To apply a simple method to validate testing for albumin, glucose, lactate dehydrogenase (LDH) and total protein (TP) in peritoneal, pleural, and cerebrospinal fluids (CSF) at a hospital in Liberia.

Methods: Serum and body fluid specimens were mixed to create 100% serum and 25%, 50%, 75%, and 100% fluid tubes, which were tested on a Biotecnica BT3500. Differences less than 10% between calculated and measured concentrations were considered acceptable.

'Never say never': the first successful management of a type A aortic dissection in Liberia.

The West African country of Liberia ranks as one of the lowest in the world in most measures of health. The diagnosis and management of complex surgical cases such as aortic dissection is extremely challenging, for reasons ranging from lack of diagnostic imaging capabilities to the high resources required for definitive surgical intervention. We present the first known successfully managed case of aortic dissection in the country's history and with it highlight the challenges faced and a number of lessons learned that are beneficial to anyone working in resource-limited environments.