Is cement still a fixation option for total hip arthroplasty?

Debate remains with regard to the best fixation method for total hip arthroplasty. Much of the argument supporting cementless fixation has been based upon the failure of cement fixation with earlier designs and surgical techniques. There are extensive published data supporting the clinical efficacy and durability of cement fixation. Recent meta-analyses support superior results of cement fixation when compared to cementless fixation in large subsets of patient populations.

An audit of chloramphenicol use in a large community hospital.

In a large community hospital during a six-month period, 238 of 19,670 hospitalized patients (1.2%) received chloramphenicol. The drug was administered exclusively by the intravenous route in 98% of these patients. In 78% of the patients, chloramphenicol was used for an appropriate indication, whereas in 22%, its use was inappropriate. Serious toxic effects and unexpected clinical failures were not observed.

A randomized controlled trial of hypnotherapy for smoking cessation.

A randomized controlled study in a family practice setting was conducted on the use of hypnosis in helping people quit smoking. In the hypnosis group 21 percent of patients quit smoking by the three month follow-up compared with 6 percent in the control group. By six months there were no significant differences between the two groups, and at one year 22 percent in the hypnosis group and 20 percent in the control group had quit. The only significant predictor of success with quitting was having a college education.

Chloramphenicol: A review of its use in clinical practice.

Chloramphenicol has certain notable characteristics: it penetrates reliably into the central nervous system; it is usually bacteriostatic, but is bactericidal for Hemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis; it is metabolized in the liver, and levels of drug in serum need to be monitored in patients with liver disease and in neonates. Potential toxicity limits the use of this drug. It has been estimated that death from aplastic anemia occurs in oe of 24,500-40,800 courses of treatment. The incidence of aplastic anemia after parenteral therapy is unknown; however, only a few cases have been reported. The gray baby syndrome occurred in premature and newborn infants receiving high or unmodified doses of chloramphenicol. This condition can be avoided by reduction of dosage and by monitoring levels of drug in the serum of these infants. The most common toxicity is a reversible, dose-related bone marrow suppression, which is identified by serial monitoring of reticulocyte and complete blood cell counts. Many of the indications for use of this drug are still controversial because studies comparing the toxicity and efficacy of chloramphenicol and of alternative antibiotics have not been done.

[The treatment of epileptic encephalopathies with gamma globulin in children (author's transl)]. / Traitement des encéphalopathies épileptiques de l'enfant par les gamma-globulines.

PRELIMINARY RESULTS: The authors have treated 10 children presenting with severe epilepsy with repeated large doses of gamma-globulin. They noted a marked improvement in 7 of the children with respect to behaviour and a disappearance of seizures in 8 with comparable EEG improvement. Four children have been able to reduce their conventional anticonvulsant therapy considerably and 2 others havers received no other medication at all for 8 months. The possibility of an immune disturbance in some childhood epilepsies is thus suggested.