Quantification of the Learning Curve for Arthroscopic Os Trigonum Excision

The purpose of the present study was to quantify the learning curve for arthroscopic os trigonum excision using the log-linear model. Twenty-three consecutive feet underwent arthroscopic os trigonum excision and release of the flexor hallucis longus. The required time from the beginning of shaving of the soft tissue until completion of os trigonum excision and release of the flexor hallucis longus (van Dijk time) was recorded. Regression analysis was applied to predict the required time on the basis of the cumulative case volume after logarithmic transformation of both statistics. The mean required time was 35.2 (range 9 to 90) minutes. After logarithmic transformation, a significant linear correlation was observed between the required time and the cumulative case volume (p?=?.0043). The best-fit linear equation was calculated as log (y, estimated required time)? = ?0.41 log (x, case volume) + 1.86, resulting in an estimated learning rate of 75.3% (= 2^?0.41). The results showed an overall time reduction in arthroscopic os trigonum excision in support of a learning curve effect with an ~75% learning rate, indicating that the required time for arthroscopic os trigonum excision can decrease by ≤25% when the cumulative volume of cases has doubled.     

Effects of vitamin D supplementation to children diagnosed with pneumonia in Kabul: a randomised controlled trial

Objectives To determine whether (i) supplementation of oral 100 000 iu of vitamin D₃ (cholecalciferol) along with antibiotics will reduce the duration of illness in children with pneumonia; (ii) supplementation will reduce the risk of repeat episodes. Methods Double‐blind individually randomised placebo‐controlled trial in an inner‐city hospital in Kabul, of 453 children aged 1–36 months, diagnosed with non‐severe or severe pneumonia at the outpatient clinic. Children with rickets, other concurrent severe diseases, very severe pneumonia or wheeze, were excluded. Children were given vitamin D₃ or placebo drops additional to routine pneumonia treatment. Results Two hundred and twenty‐four children received vitamin D_3; and 229 received placebo. There was no significant difference in the mean number of days to recovery between the vitamin D₃ (4.74 days; SD 2.22) and placebo arms (4.98 days; SD 2.89; P = 0.17). The risk of a repeat episode of pneumonia within 90 days of supplementation was lower in the intervention (92/204; 45%) than the placebo group [122/211; (58%; relative risk 0.78; 95% CI 0.64, 0.94; P = 0.01]. Children in the vitamin D₃ group survived longer without experiencing a repeat episode (72 days vs. 59 days; HR 0.71; 95% CI 0.53–0.95; P = 0.02). Conclusion A single high‐dose oral vitamin D₃ supplementation to young children along with antibiotic treatment for pneumonia could reduce the occurrence of repeat episodes of pneumonia.     

复方尼阿措提取物对高脂血症大鼠的调血脂作用

目的:探讨复方尼阿措提取物(CNAE)的调血脂作用。方法:通过灌胃脂肪乳剂制备实验性高脂血症大鼠模型。随机分为正常对照组、模型对照组、阳性对照组(1 mL.kg-1)、柳茶水提物(SAE)低、高剂量组(6.01,2.0 g.kg-1)、CNAE低、高剂量组(8.0,16.0 g.kg-1)。除正常组外,各给药组大鼠灌胃给予脂肪乳剂,基础饲料喂养,末次给药后,腹主动脉采血测定血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和丙二醛(MDA)的含量及超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性。结果:CNAE能明显降低TC、TG、LDL-C和MDA含量(P<0.01),升高HDL-C浓度,显著提高SOD及GSH-Px酶活性(P<0.01),且降血脂作用优于SAE。结论:CNAE具有明显的调血脂和抗氧化作用,提示其可用于高脂血症的防治。     

哈尼族医药特点浅析

从哈尼族医药“药物的特有性”、“植物药为主”、“神医合一”、“用药的独特性”、“经验医药”5个方面,初步探讨了哈尼族医药的特点,希望能起到抛砖引玉之作用,引起更多的同仁关注哈尼族医药。     

Body packer: review and experience in a referral hospital

Smuggling of illicit drugs by concealing them within the human body (body packer) is a medical-legal issue that has increased in the last few decades. Physicians, especially those working in the emergency department, should be familiar with the diagnostic and therapeutic management -usually conservative management- of this type of patient and their possible complications. The present article reviews the general concepts and physiopathology associated with transport of packages in the digestive tract and describes the experience of a referral hospital with a protocol specifically designed for these patients.     

Safety and healing efficacy of Sea buckthorn (Hippophae rhamnoides L.) seed oil on burn wounds in rats

The present investigation was undertaken to determine the safety and efficacy of supercritical CO₂-extracted Hippophae rhamnoides L. (Sea buckthorn) (SBT) seed oil on burn wound model. SBT seed oil was co-administered by two routes at a dose of 2.5 ml/kg body weight (p.o.) and 200 μl (topical) for 7 days on experimental burn wounds in rats. The SBT seed oil augmented the wound healing process as indicated by significant increase in wound contraction, hydroxyproline, hexosamine, DNA and total protein contents in comparison to control and reference control treated with silver sulfadiazine (SS) ointment. Histopathological findings further confirmed the healing potential of SBT seed oil. SBT seed oil treatment up-regulated the expression of matrix metalloproteinases (MMP-2 and 9), collagen type-III and VEGF in granulation tissue. It was observed that SBT seed oil also possesses antioxidant properties as evidenced by significant increase in reduced glutathione (GSH) level and reduced production of reactive oxygen species (ROS) in wound granulation tissue. In acute and sub-acute oral toxicity studies, no adverse effects were observed in any of the groups administered with SBT seed oil. These results suggest that the supercritical CO₂-extracted Sea buckthorn seed oil possesses significant wound healing activity and have no associated toxicity or side effects.     

Comparison of the bone protective effects of an isoflavone-rich diet with dietary and subcutaneous administrations of genistein in ovariectomized rats

Administration of the isoflavone genistein (GEN) has been described to result in bone protection but also to induce uterotrophic responses. To compare bone protective effects of GEN with an isoflavone-rich diet (IRD) and to further elucidate molecular mechanisms involved in bone-protection, ovariectomized rats (OVX) received either a diet low in isoflavone content (IDD) enriched with GEN (42 mg kg⁻¹ b.wt d⁻¹) (GEN^d), an IRD (14 mg kg⁻¹ b.wt d⁻¹ GEN, 14 mg kg⁻¹ b.wt d⁻¹ daidzein) or were treated subcutaneously (s.c.) with GEN (10 mg kg⁻¹ b.wt d⁻¹) (GEN^sc) for 12 weeks. Intact (SHAM), vehicle treated OVX animals and those substituted with 17β-estradiol (2 μg kg⁻¹ b.wt d⁻¹) (E₂), served as controls.     

The inferior radiolucent area within the cardiac silhouette: validation as a landmark for coronary sinus catheterization

Background: Catheterization of the coronary sinus (CS) plays a preponderant role in device implantation and electrophysiology. Nevertheless, catheterization of this structure can be time-consuming and is related to operator experience. An inferior radiolucent area of the cardiac right anterior oblique (RAO) view has been suggested as a landmark to guide CS catheterization. However, the true relationship of this area with the CS ostium (CSO) has not been studied.
Methods: Thirty-five consecutive patients who underwent right coronary angiography were prospectively enrolled in the study. Fluoroscopic images of the heart in the right anterior oblique, both immediately before and during the venous phase of right coronary angiography, were recorded and digitally stored. Postprocedure measurements of the inferior radiolucent area within the cardiac silhouette and, subsequently, the distance of this area to the CSO, were performed by two independent observers.
Results: A radiolucent area of 9.5 ± 3.0 × 11.0 ± 3.4 mm was identified in the inferior annulus by the two evaluators in all patients. No significant differences in the dimensions of this area were found between the two observers. The CSO was 9.6 ± 7.2 mm superior and 0.1 ± 9.0 mm posterior to the radiolucent area and no statistically significant differences were found between the two observers.
Conclusion: An inferior radiolucent area can be identified within the cardiac silhouette in most patients in the RAO view. This area is slightly anterior and inferior to the CSO and can be used for catheterization guidance of this latter structure.