Good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years

Background When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice. Patients and methods We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) between 1994 and 2001. We used the ilio-inguinal (I-I) approach in 32 hips and a modified Smith-Petersen (S-P) approach in 4. The patients were followed for mean 4 (1.5-8) years. In 1 patient with coxa valga, a varus femoral osteotomy was performed 1 year after PAO. 2 hips, in which we used the modified S-P approach, necessitated a capsulotomy. Results The median Merle d'Aubigne score increased from 13 points preoperatively to 16 points postoperatively. This improvement in terms of pain, motion and ambulation was accompanied by spatial reorientation and correction. The lateral center edge angle of Wiberg (CE) improved from an average of 7° to 28°. The anterior center edge angle of Lequesne (FP) improved from an average of 18° to 28°. The acetabular index angle (AC) improved from an average of 22° to 10°. Major complications included 1 partial lesion of the sciatic nerve, 1 malunion and 1 combined nonunion of the pubic and ischiatic osteotomy. 2 patients underwent subsequent total hip replacement (THR) for progressive osteoarthrosis with pain. Interpretation We found good radiographic correction of deformities, improvement of hip function and pain relief with an acceptable complication rate. With appropriate patient selection, this procedure is the most physiological treatment of symptomatic hip dysplasia in young adults. In addition to relieving symptoms, it may prevent and postpone the development of secondary osteoarthrosis

Personal protection and tailor-made deities: the use of individual epithets

The use of epithets was a fundamental component of Greek polytheism. The present study brings attention to a small subgroup of such divine bynames, referred to as individual epithets because they stem from the names of mortal individuals. The function of these epithets is to designate a deity specifically concerned with the individual in question, thereby providing a close relationship and personal benefits for the eponymous worshipper and his or her close kin. The article exemplifies the phenomenon through the investigation of a goddess Isis Aphrodite Dikaia identified in Hellenistic Delos. Through the epithet Dikaia, two Athenian brothers, Dikaios and Asklepiades, sons of Dikaios, intimately tie the deity to themselves and their family. It is moreover proposed that a positioning of the epithet in its historical and physical context furthers our understanding of its origins and significance.L’usage des épithètes était une composante fondamentale du polythéisme grec. Cet article se penche sur un petit groupe de surnoms de ce genre, que l’on appelle des épithètes individuelles, dans la mesure où elles dérivent du nom d’individus mortels. Ces épithètes ont pour fonction de montrer qu’une divinité est particulièrement concernée par l’individu en question, fournissant dès lors une relation étroite et des bienfaits personnels pour le fidèle éponyme et sa famille proche. L’étude illustre le phénomène en investigant la déesse Isis Aphrodite Dikaia que l’on rencontre dans la Délos hellénistique. Par l’épithète Dikaia, deux frères athéniens, Dikaios et Asklépiadès, fils de Dikaios, associent intimement la divinité à eux-mêmes et à leur famille. Il est en outre proposé qu’un replacement de l’épithète dans son contexte historique et physique approfondit notre compréhension de ses origines et de sa signification

Spatial, temporal, and species variation in prevalence of influenza A viruses in wild migratory birds

Although extensive data exist on avian influenza in wild birds in North America, limited information is available from elsewhere, including Europe. Here, molecular diagnostic tools were employed for high-throughput surveillance of migratory birds, as an alternative to classical labor-intensive methods of virus isolation in eggs. This study included 36,809 samples from 323 bird species belonging to 18 orders, of which only 25 species of three orders were positive for influenza A virus. Information on species, locations, and timing is provided for all samples tested. Seven previously unknown host species for avian influenza virus were identified: barnacle goose, bean goose, brent goose, pink-footed goose, bewick's swan, common gull, and guillemot. Dabbling ducks were more frequently infected than other ducks and Anseriformes; this distinction was probably related to bird behavior rather than population sizes. Waders did not appear to play a role in the epidemiology of avian influenza in Europe, in contrast to the Americas. The high virus prevalence in ducks in Europe in spring as compared with North America could explain the differences in virus-host ecology between these continents. Most influenza A virus subtypes were detected in ducks, but H13 and H16 subtypes were detected primarily in gulls. Viruses of subtype H6 were more promiscuous in host range than other subtypes. Temporal and spatial variation in influenza virus prevalence in wild birds was observed, with influenza A virus prevalence varying by sampling location; this is probably related to migration patterns from northeast to southwest and a higher prevalence farther north along the flyways. We discuss the ecology and epidemiology of avian influenza A virus in wild birds in relation to host ecology and compare our results with published studies. These data are useful for designing new surveillance programs and are particularly relevant due to increased interest in avian influenza in wild birds

Secretin, a stimulus for duodenal and pancreatic "gastrin" release: Possible pathogenetic significance in Zollinger-Ellison (ZE) syndrome

Ex vivo hemoperfused pancreaticoduodenal preparations from dogs have been used to study intraluminal and circulatory patterns of release of immunoreactive gastrin under basal conditions and after secretin stimulation. Bidirectional release of immunoreactive gastrin was maximal at 3 U/min secretin infusion, and release into pancreatic and duodenal juice exceeded that into portal venous blood. Molecular sieving chromatography of peptides with gastrin-like immunoreactivity recovered from duodenal and pancreatic juice indicated a single species of a molecular size equivalent to CCK8 and smaller than minigastrin (G-14). The exact identity has not been defined. This study demonstrates that secretin stimulates release of gastrin-like peptides into blood and lumen of extra-antral gastrin-producing tissues in the dog. Unidirectional gastrin release patterns from gastrinoma tissue may explain the paradoxical increase in plasma gastrin levels in response to secretin in patients with gastrinomas (Zollinger-Ellison syndrome).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23280/1/0000217.pd

Q Fever in France, 1985–2009

To assess Q fever in France, we analyzed data for 1985–2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous increase. Periodic variations were observed in monthly distribution during January 2000–December 2009; cases peaked during April–September. Q fever was diagnosed more often in patients in southeastern France, where our laboratory is situated, than in other areas. Reevaluation of the current positive predictive value of serologic analysis for endocarditis was performed. We propose a change in the phase I (virulent bacteria) immunoglobulin G cutoff titer to >1,600. Annual incidences of acute Q fever and endocarditis were 2.5/100,000 persons and 0.1/100,000 persons, respectively. Cases and outbreaks of Q fever have increased in France

Invasions by Eurasian Avian Influenza Virus H6 Genes and Replacement of Its North American Clade

This study showed frequent cross-hemisphere virus movement, which can affect the risk posed to poultry and humans

Multiyear Surveillance for Avian Influenza Virus in Waterfowl from Wintering Grounds, Texas Coast, USA

This surveillance can help in assessments of the prevalence of wild animal-to-human transmission