The novel arthroscopic subscapular sling procedure grants better stability than an arthroscopic Bankart repair in a cadaveric study.

PURPOSE: This novel arthroscopic subscapular sling procedure stabilizes the shoulder using a semitendinosus graft to create a sling around the subscapular tendon, which provides both static and dynamic stability. The aim of the study was to evaluate the biomechanical stability of the subscapular sling procedure in human cadaveric shoulders. The hypothesis was that the sling offers an equal stabilizing effect and range of motion compared to an arthroscopic Bankart repair. METHODS: Sixteen shoulders were investigated using an industrial robot-based testing platform and four different conditions: the physiologically intact shoulder, after creating a Bankart lesion, after arthroscopic Bankart repair, and finally after applying the subscapular sling procedure using a semitendinosus tendon graft. Joint translation and external rotation were evaluated for each condition. RESULTS: The results show improved stability in the shoulders with the subscapular sling. The robot testing revealed a significant reduction in translation in anterior and anterior-inferior directions compared to the arthroscopic Bankart repair. None of the shoulders were dislocated by forced manual abduction and external rotation. No difficulties were encountered in performing the arthroscopic subscapular sling procedure. Thorough postoperative anatomical dissection showed no alterations to structures at risk. CONCLUSION: The biomechanical results show increased stability with the use of the subscapular sling method.

A new subscapular sling operation to stabilize the shoulder. A cadaver study.

INTRODUCTION: A new arthroscopic shoulder stabilisation procedure is proposed, which for some patients could be an alternative to the arthroscopic Latarjet procedure. METHODS: The objective was to stabilize the shoulder by making a sling around the subscapularis tendon, using a hamstring graft and enhancing the anterior rim of the glenoid with the same graft. The anatomical feasibility of the surgical procedure was tested to establish the surgical method. RESULTS: Four surgeons performed the surgery on six cadavers. After the surgery the cadavers were dissected to visualize the result. The sling was placed according to the intention and the nerves in the area (axillary and musculocutaneus) were not at risk, nor had they altered position during the procedure. CONCLUSION: The procedure is technically feasible and the risk of complications seems low. This procedure could be an alternative to the Latarjet procedure and to other operations used for anterior instability of the shoulder. A biomechanical study will be performed as the next stage of the development. CLINICAL RELEVANCE: This procedure could be an alternative to the Latarjet procedure and to other operations used for anterior instability of the shoulder. TRIAL REGISTRATION: 2012/1978/REK sør-øst.

Subacute and acute epidemic conjunctivitis due to neisseria gonorrhoeae SSP

An outbreak of acute conjunctivitis with profuse exudation was observed between November 1987 and June 1988 in Konso; North Omo. There were 9;075 registered cases and seven months later; 20 cases with mild; subacute conjunctivitis were observed. Neisseria gonorrhoeae and Neisseria gonorrhoeae subsp. kochii were the causative agents; while Haemophilus spp. behaved as opportunistic infection. The condition is resistant to topical antibiotics; but the outbreak could be controlled by mass treatment with single dose oral ampicillin and probenecid. Severe sequelae were observed in 36 patients treated with this regimen. This is the first isolation of N. gonorrhoeae subsp. kochii outside Egypt; and the first recorded outbreak of Neisseria gonorrhoeae conjunctivitis affecting thousands of patients in more than 40 years

Hydatid disease in the Hamar of Ethiopia: a public health problem for women.

A population-based study of hydatid disease was conducted among the Hamar of Ethiopia. Seven of 990 patients examined with a portable ultrasound scanner proved to have cysts (0.7% prevalence). Cysts were most common (4.7%) among women > or = 40 years of age. Only one male presented with a cyst. These results indicate a sex-specific hydatid public health problem in this tribe.

The epidemiology of blindness and visual loss in Hamar tribesmen of Ethiopia. The role of gender.

We conducted a population-based survey in the Hamar tribe of Ethiopia to assess the problem of blindness and ocular morbidity. Blindness was detected in 1.9% of the Hamar. Among the age group 40 and over < 1.0% of men and 13% of women were blind. Women with low vision or blindness comprised 30% of all women while men with low vision or blindness only comprised 8% of men in the age stratum. Cataract is responsible for the excess blindness in women. Even mild visual disability is less common in men. In Hamar society men have two roles: as herders and as warriors. Warriors with visual loss will be less successful in defending themselves. We suggest that Hamar men who develop visual loss have increased mortality compared to women with visual loss. Vision loss in women does not appear to have life-threatening consequences. Cessation of hostilities between the Hamar and their neighbours could, conceivably, lead to an 'increase' in the incidence of vision loss among men.

[Surgery in the Third World]. / Kirurgi i den tredje verden.

Possibilities of surgical treatment in the Third World are inadequate. A surgeon meets serious problems in connection with administration, supplies, equipment, maintenance, patient priorities, superstition and culture. He must engage himself in these problems in order to achieve good surgical results. The pattern of disease differs somewhat from that experienced in the Western world. Surgical techniques and priorities have to be modified adjusted to suit the available resources. The education of surgeons should preferably be arranged in the home country, with possibilities for special study abroad. The surgeons in western countries could support surgeons who work under difficult conditions in the Third World and also serve there for a time. Primary health care depends on a minimum availability of surgical care.

Rupture of uterus treated with suture.

Between August 1983 and August 1985, 63 patients in labor with uterine rupture were treated at Sidamo Regional Hospital, Yirgaalem, South Ethiopia, mainly by suture of the uterus. None of those operated on died. We recommend suturing as the treatment of choice. Hysterectomy is rarely indicated.