Operative versus non-operative management of pediatric medial epicondyle fractures: a systematic review

There is ongoing debate about the management of medial epicondyle fractures in the pediatric population. This systematic review evaluated non-operative versus operative treatment of medial epicondyle fractures in pediatric and adolescent patients over the last six decades. A systematic review of the available literature was performed. Frequency-weighted mean union times were used to compare union rates for closed versus open treatments. Moreover, functional outcomes and range-of-motion variables were correlated with varying treatment modalities. Any complications, including ulnar nerve symptoms, pain, instability, infection, and residual deformity, were cataloged. Fourteen studies, encompassing 498 patients, met the inclusion/exclusion criteria. There were 261 males and 132 female patients; the frequency-weighted average age was 11.93 years. The follow-up range was 6–216 months. Under the cumulative random effects model, the odds of union with operative fixation was 9.33 times the odds of union with non-operative treatment (P < 0.0001). There was no significant difference between operative and non-operative treatments in terms of pain at final follow-up (P = 0.73) or ulnar nerve symptoms (P = 0.412). Operative treatment affords a significantly higher union rate over the non-operative management of medial epicondyle fractures. There was no difference in pain at final follow-up between operative and non-operative treatments. As surgical indications evolve, and the functional demands of pediatric patients increase, surgical fixation should be strongly considered to achieve stable fixation and bony union

Short-Lived Trace Gases in the Surface Ocean and the Atmosphere

The two-way exchange of trace gases between the ocean and the atmosphere is important for both the chemistry and physics of the atmosphere and the biogeochemistry of the oceans, including the global cycling of elements. Here we review these exchanges and their importance for a range of gases whose lifetimes are generally short compared to the main greenhouse gases and which are, in most cases, more reactive than them. Gases considered include sulphur and related compounds, organohalogens, non-methane hydrocarbons, ozone, ammonia and related compounds, hydrogen and carbon monoxide. Finally, we stress the interactivity of the system, the importance of process understanding for modeling, the need for more extensive field measurements and their better seasonal coverage, the importance of inter-calibration exercises and finally the need to show the importance of air-sea exchanges for global cycling and how the field fits into the broader context of Earth System Science

Pathology of Puumala hantavirus infection in macaques

Peer reviewe

O alcoolismo é uma doença contagiosa? Representações sobre o contágio e a doença de ex-bebedores Is alcoholism a contagious disease? Representations on contagion and disease of ex-drinkers

Este artigo busca estabelecer os contornos de uma teoria cultural do contágio a propósito da doença alcoólica. Assim, ao contrário do modelo biomédico, que circunscreve o contágio ao âmbito biológico e fisiológico atestado clinicamente, busca-se refletir sobre as concepções do contágio ligadas a um contexto sociocultural específico, tal como o proposto pela associação de ex-bebedores dos Alcoólicos Anônimos (AA). A partir de pesquisa etnográfica realizada com familiares e membros do grupo Sapopemba de AA, localizado em bairro da periferia da cidade de São Paulo, Brasil, enfatiza-se o papel desta entidade como um espaço privilegiado para o estudo antropológico da experiência do alcoolismo, entendido como uma doença "contagiosa", a partir de um estudo das representações culturais, das práticas sociais e da (re)construção da identidade, ligadas ao par alcoolismo/doença. Com efeito, evidencia-se que, para os membros de AA e seus familiares, as possibilidades de contágio da doença alcoólica estão diretamente ligadas às representações construídas sobre o álcool e o alcoolismo, entendido como uma doença física e moral e a seus efeitos sobre o conjunto de relações sociais - familiares e profissionais -, nas quais o ex-bebedor está envolvido.<br>This article is an attempt to set the contours of a cultural theory of contagion about alcoholism. This way, instead of the biomedical model, which circumscribes contagion to the clinically confirmed biological and physiological environment, we try to reflect on the conceptions of contagion associated to a specific social and cultural context, like the one proposed by the Alcoholics Anonymous (AA) association of ex-drinkers. From the ethnographic research conducted within family in the Sapopemba group of AA, located in a neighbourhood in the outskirts of the city of São Paulo, Brazil, the role of this agency as a privileged place for anthropological study of alcoholism is stressed. Here alcoholism is viewed as a "contagious" disease, from a study on cultural representations, social practices and the (re)building of identity, linked to the alcoholism/disease couple. In fact, it becomes clear that, for AA members and your family, the possibilities of contagion of the alcoholic disease are directly linked to representations built on alcohol and alcoholism, understood as a physical and moral disease and to its effects on the whole of socials relationships - both family and professional - in which ex-drinkers are involved