Smoking prevalence and seizure control in Chinese males with epilepsy

Smoking has a negative effect on most diseases, yet it is under-investigated in people with epilepsy; thus its role is not clear in the general population with epilepsy. We performed a retrospective pilot study on males with epilepsy to determine the smoking rate and its relationship with seizure control using univariate analysis to calculate odds ratios (ORs) and also used a multi-variate logistic regression model. The smoking rate in our sample of 278 individuals was 25.5%, which is lower than the general Chinese population smoking rate among males of 52.1%. We used two classifications: the first classified epilepsy as generalized, or by presumed topographic origin (temporal, frontal, parietal and occipital). The second classified the dominant seizure type of an individual as generalized tonic clonic seizure (GTCS), myoclonic seizure (MS), complex partial seizure (CPS), simple partial seizure (SPS), and secondary GTCS (sGTCS). The univariable analysis of satisfactory seizure control profile and smoking rate in both classifications showed a trend towards a beneficial effect of smoking although most were not statistically significant. Considering medication is an important confounding factor that would largely influence seizure control, we also conducted multi-variable analysis for both classifications with drug numbers and dosage. The result of our model also suggested that smoking is a protective factor. Our findings seem to suggest that smoking could have a potential role in seizure control although confounders need exploration particularly in view of the potential long term health effects. Replication in a much larger sample is needed as well as case control studies to elucidate this issue.     

左侧肩胛骨肩胛下窝内侧缘骨软骨瘤1例报告

患儿,男,12岁,因"发现左肩部包块3个月余"入院,2009年6月无明显诱因出现左肩胛角向后突起,肩胛骨下可触及一包块且逐渐增大并左肩部畸形,无疼痛,无发热、不伴恶心、呕吐,无腹痛、腹胀等,为进一步诊疗来院.入院查体:全身一般情况可,左侧肩胛角较对侧明显向后高突,呈"翼状"畸形(见图1),左肩胛骨下缘腹面与肋骨之间可触及5 cm×4 cm大小肿块,质硬.无移动,包块轻压痛,左肩部活动度正常,上肢感觉、肌力及血运正常.     

Management of displaced inferior patellar pole fractures with modified tension band technique combined with cable cerclage using Cable Grip System

IntroductionWe present a modified tension band technique combined with cable cerclage using Cable Grip System for the treatment of displaced inferior patellar pole fractures and report the knee functional outcome.Patients and methodsThe patients who had had operative treatment of a displaced inferior patellar pole fracture (AO/OTA 34-A1) between December 2013 and December 2015 were studied retrospectively. Eleven consecutive patients had had open reduction and internal fixation with the modified technique using Cable Grip System, of whom, five males and six females with an average age of 60.9 years (range, 29–81 years). All fractures occurred from direct fall onto the knee. The average time from injury to surgery was 6.1 days (range, 2–12 days). The range of motion (ROM) was measured in degrees by goniometry at postoperative intervals of 1, 2, 4, 12, and 48 weeks; Knee function was evaluated using the Rasmussen scores at final follow-up.ResultsNo patients had nonunion, loss of reduction, migration of wire, irritation from the implant and fixation breakage during the follow-up period. Recovery of ROM was achieved at 12 weeks, with the average ROM at 1 week was 72° (range, 65°–78°), 86.4° (range, 78°–92°) at 2 weeks, 115.5° (range, 103°–122°) at 4 weeks, 129.6° (range, 122°–133°) at 12 weeks, 134.5° (range, 129°–139°) at 48 weeks after the operation. Concerning the knee function outcome assessment, all patients showed excellent results at final follow-up. The average Rasmussen scores was 27.9 out of 30 (range, 27–29).ConclusionsThe modified tension band technique combined with cable cerclage using Cable Grip System for displaced inferior patellar pole fractures can provide stable fixation with excellent results in knee function, allows for immediate mobilization and early weight-bearing, which is a simple and valuable technique in routine clinical practice.