Trapezial Resection Arthroplasty: More Is Not Necessarily Better

Introduction: Thumb carpometacarpal joint arthritis can cause significant pain and limitation in activity. Patients who are unable to obtain symptomatic relief from anti-inflammatories, splinting, and cortisone injections may be indicated for surgical treatment. The earliest form of surgical intervention was trapeziectomy alone;since, numerous adjunctive procedures have evolved. In this study, we conduct a literature review comparing outcomes of simple trapeziectomy to other interventions for thumb carpometacarpal arthritis. Methods: A literature search using the PubMed/Medline database was conducted. Inclusion criteria were the following: 1) the study was a primary study written in English, 2) treatment options were surgical and compared trapeziectomy with other forms of surgical treatment for thumb carpometacarpal arthritis, 3) the study was a randomized controlled trial, 4) the study included outcomes such as pain, physical function, range of motion, and/or strength. Included studies were then compiled into a table for further review. Results: 11 studies met inclusion criteria. All studies were randomized controlled trials and demonstrated level II evidence. Surgical procedures in these studies included ligament reconstruction and tendon interposition (LRTI), flexor carpi radialis suspension, carpometacarpal joint denervation, and carpometacarpal joint arthroplasty. No significant differences were found between trapeziectomy alone versus adjunctive surgical procedures when comparing patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength with follow-up ranging from 1 year to 18 years post-operative. Discussion/Conclusions: In our review of the evidence, we find no significant differences in patient-reported outcomes, patient satisfaction, range of motion, grip strength, and key/tip pinch strength both in the short- and long-term post-operative periods. This raises the question of whether adjunctive procedures are necessary for the treatment of thumb carpometacarpal arthritis, as they may lead to increased operative time, costs, and complications compared to trapeziectomy alone.

Study of Vitamin D Status in Pneumonia among Children between 6 Months to 3 Years of Age

Background: In the developing world, pneumonia is not only more common than it is in Europe or North America;it is also more severe and considered the leading cause of under-five mortality. Effective management of pneumonia in children under 3-year-old-age is still challenging due to various causes. Some authors believed in non-calcemic role of vitamin D as a potential factor in the pathogenesis, prevention, or therapy of pneumonia in this specific age. Purpose: Investigate the Vitamin D status in pneumonia among children between 6 months to 3 years of age. Subjects and Methods: This study was conducted in a Pediatric point of care at Al-Zahraa University Hospital on 90 children aged 6 months to 3 years old;divided into two groups: group I (study group) including 47 patients presented with pneumonia and group II (control group) including 43 apparently healthy children of matched age and sex with no evidence of pneumonia. Serum vitamin D was estimated with specific inclusion and exclusion criteria. Results: The vitamin D level showed no significant difference between the two groups of the study. Conclusion: Possible role of vitamin D in disease process of pneumonia in children between 6 months to 3 years could not be assured.

莫西沙星序贯疗法对老年下呼吸道感染患者的临床疗效及其对炎症因子的影响

目的:评价莫西沙星序贯疗法对老年下呼吸道感染(LRTI)患者的疗效及其对炎症因子改善的影响。方法:选取2017年8月-2018年7月期间收治的老年LRTI患者150例资料,按治疗方法的不同将其分为对照组和观察组,每组75例;对照组患者给予左氧氟沙星序贯疗法治疗,观察组患者给予莫西沙星序贯疗法治疗,比较两组患者治疗7 d后的总有效率差异,以及治疗前后血清炎性因子(IL-6、IL-8及TNF-α)水平测得值的变化情况。结果:观察组患者治疗后的总有效率(90.67%)高于对照组(78.67%()P<0.05),治疗后的血清IL-6、IL-8及TNF-α水平测得值均低于对照组(P<0.05);两组患者用药期间均未发生严重药物不良反应。结论:采用莫西沙星序贯疗法治疗老年LRTI患者的疗效优于左氧氟沙星序贯疗法,有助于改善了血清炎症因子水平,且安全性较高。