Introduction
The Micronail
®
is a minimally invasive intramedullar titanium locking screw fixation for two-part dislocated extra-articular fractures and average displaced intra-articular fractures.
...Patients and methods
In a retrospective study we analyzed the outcome of 20 distal radius fractures in 18 patients (17 female, mean age 78 years), which were treated by Micronail
®
. Average follow-up time was 4 months. We describe the operative technique. All fractures were classified according to AO guidelines. We studied the radiologic and clinical outcome.
Results
According to the AO classification there were 12 A2, 3 A3, 1 B1, and 1 B3 fracture. Three patients had an antebrachii fracture. Mean American Society of Anesthesiologists (ASA) score was 2.4. Eight patients had associated lesions. Average operative time was 58 min. All fractures healed without major loss of alignment. There were two major complications: one patient developed a carpal tunnel syndrome and one device secondary dislocated. With the use of the Micronail
®
, we found no infections or complications due to the insertion of the osteosynthesis materials. Patients experienced good to excellent results, on an analogue scale, in function of their wrist from the procedure. All patients had a good range of motion of the operated wrist; the difference between their two wrists was maximal 10° in all directions.
Conclusion
This intramedullary implant intends to minimize some of the disadvantages of other surgical options in the treatment of distal radius fracture; the Micronail
®
causes less tissue damage and has early load-carrying capacity. This minimally invasive technique seems suitable in selected, two-part dislocated extra-articular and average displaced intra-articular, distal radius fractures.
This collection of articles provides an account of the papers delivered at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAVP)(held in ...New Orleans, LA, USA, from 10 to 14 August 2003) in a symposium session on assessing the burden of Taenia solium cysticercosis and echinococcosis organised and chaired by A. Lee Willingham III from the WHO/FAO Collaborating Center for Research and Training on Emerging and other Parasitic Zoonoses in Denmark and Peter M. Schantz from the Parasitic Diseases Division of the US Centers for Disease Control and Prevention, USA. The focus was on the persistence of the zoonotic parasitic diseases cysticercosis, caused by the pork tapeworm T. solium, and echinococcosis,caused by species of the tapeworm Echinococcus, and why these diseases are given very little attention on the national and international agendas in spite of the availability of tools to detect, treat,control and prevent them when it is quite clear in most instances that they are clearly associated with and help perpetuate poverty. A major reason for this is that in many endemic areas the presence and impact of these diseases are not known due to the lack of investigation and information thus policymakers are not aware of their burden and benefits of their control. Documentation is also needed to help increase awareness of the international community and hopefully result in financial and technical support being made available. Thus, burden assessments of cysticercosis and echinococcosis provide an essential evidence base for securing political will and financial and technical support as well as providing a basis for cost-benefit analysis of prevention and control efforts. In order to make an appropriate and full burden assessment one must consider the health, agricultural, social and other impacts of these parasitic zoonoses comprehensively. During the symposium presentations were given concerning current ongoing initiatives to assess the burden of cysticercosis and echinococcosis and examples of the impact of these diseases in both developing and developed countries were provided. In addition, cost factors related to vaccines for these cestode diseases were discussed and the possibilities for technical and financial support from multilateral agencies for assessments and interventions presented.
The Micronail^sup ®^ is a minimally invasive intramedullar titanium locking screw fixation for two-part dislocated extra-articular fractures and average displaced intra-articular fractures. In a ...retrospective study we analyzed the outcome of 20 distal radius fractures in 18 patients (17 female, mean age 78 years), which were treated by Micronail^sup ®^. Average follow-up time was 4 months. We describe the operative technique. All fractures were classified according to AO guidelines. We studied the radiologic and clinical outcome. According to the AO classification there were 12 A2, 3 A3, 1 B1, and 1 B3 fracture. Three patients had an antebrachii fracture. Mean American Society of Anesthesiologists (ASA) score was 2.4. Eight patients had associated lesions. Average operative time was 58 min. All fractures healed without major loss of alignment. There were two major complications: one patient developed a carpal tunnel syndrome and one device secondary dislocated. With the use of the Micronail^sup ®^, we found no infections or complications due to the insertion of the osteosynthesis materials. Patients experienced good to excellent results, on an analogue scale, in function of their wrist from the procedure. All patients had a good range of motion of the operated wrist; the difference between their two wrists was maximal 10° in all directions. This intramedullary implant intends to minimize some of the disadvantages of other surgical options in the treatment of distal radius fracture; the Micronail^sup ®^ causes less tissue damage and has early load-carrying capacity. This minimally invasive technique seems suitable in selected, two-part dislocated extra-articular and average displaced intra-articular, distal radius fractures.PUBLICATION ABSTRACT
Taenia solium is endemic in the Andean region of Ecuador. The recent rediscovery of
Taenia saginata in humans urges to reconsider some assumptions in relation to the epidemiology of the ...taeniosis/cysticercosis complex in this country.
Therefore, data were compiled on the infection of both tapeworms in man and animals in Pichincha and Imbabura provinces in the Andean region, north of Quito. On post mortem inspection 3 out of 806 (0.37%) carcasses had
T. saginata metacestodes, however, 35 sera out of 869 (4.03%) showed circulating antigen in a monoclonal antibody-based sandwich ELISA (Ag-ELISA). Porcine cysticercosis was detected in 15 out of 2896 (0.52%) carcasses and 93 out of 1032 serum samples (9.01%) were positive in Ag-ELISA. In humans, 4.99% (215 out of 4306) cases of antigen positives were found, whereas coprological examination of 1935 stools resulted in 30 positive cases (1.55%). The limited number of adult tapeworms (29) that were collected does not allow firm conclusions on the proportion of each species, but in total 21 specimen were identified as
T. saginata and 8 as
T. solium. These data have been discussed in view of the epidemiology of human cysticercosis.
Erythromycin is receiving renewed attention as an alternative for treatment of neonatal infections caused by Ureaplasma urealyticum because of recently proved abilities of this organism to produce ...systemic disease in this population. Although erythromycin has been used clinically for almost 40 years, very little is known about its activity in the preterm neonate. Fourteen neonates, birth weights < or = 1500 g and < or = 15 days of age, from whom U. urealyticum was isolated from the lower respiratory tract were randomized to receive erythromycin lactobionate either 25 or 40 mg/kg/day in four divided doses at 6-hour intervals scheduled for a total of 10 days. Blood samples collected at multiple time points after initial and steady state doses were assayed for erythromycin by liquid chromatography. Minimal inhibitory concentrations (MICs) of erythromycin for the U. urealyticum isolates were determined. MICs ranged from 0.031 to 2 micrograms/ml; MIC90 = 2 micrograms/ml. Serum erythromycin concentrations met or exceeded most MICs, with peak values of 3.05 to 3.69 and 1.92 to 2.9 micrograms/ml for the 40- and 25-mg/kg/day dosage groups, respectively. Pharmacokinetic parameters were calculated after the initial dose and at steady state for both dosage groups and compared. No adverse effects thought to be related to administration of erythromycin were observed. These preliminary findings showed that erythromycin is well-tolerated, has favorable pharmacokinetic activity in the preterm neonate and should be further investigated for treatment of ureaplasmal infections.
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