1/9. Arthroscopic monopolar radiofrequency thermal stabilization for chronic lateral ankle instability: a preliminary report on 10 cases.This study represents a preliminary review of 10 patients having undergone arthroscopic monopolar thermal stabilization for ankle instability from October 1996 to June 1998. All patients in this study expressed mild to moderate chronic ankle instability complaints and were dissatisfied with their attempts at conservative care. Subjective clinical results were evaluated in all patients having undergone this procedure utilizing a modified version of the American Orthopedic foot and ankle Society (AOFAS) ankle-Hindfoot Scale. In addition, eight of these patients underwent pre- and postoperative stress radiographs. The average age of the patient population in this study was 34.5 /- 9.26 years. The preoperative AOFAS scores averaged 58.3 /- 8.96 and the postoperative were 88.1 /- 11.09 points. patients returned to full activities on the average of 3 months. Postoperative ankle varus stress test reduced on the average of 2.8 degrees /- 2.77 degrees, while the anterior drawer measurements reduced 4.8 /- 1.83 mm. The reduction in anterior drawer test amounted to an approximate 60% decrease in talar excursion postoperatively. All patients who underwent this procedure achieved ankle stability and commented that they would undergo the procedure again.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
2/9. Major abdominal bleeding in chronic pancreatitis.This case report concerns a patient with chronic pancreatitis which led to extensive retroperitoneal haemorrhage from a rupture of the abdominal aorta. The rarity of this complication is emphasized, but other reported instances of bleeding in association with chronic pancreatitis are commented upon.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
3/9. Psychosis and epilepsy: a neurologist's perspective.epilepsy and psychosis are diseases of the brain which cause considerable impact on quality of life particularly when they occur in the same individual. This review comments on postictal psychosis, chronic schizophrenia like psychosis in epilepsy, and the psychoses related to the treatment of epilepsy with antiepileptic drugs and surgery. Possible mechanisms of psychosis including the concept of forced normalization and dopaminergic overactivity in the mesolimbic system are discussed.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
4/9. Chronic extradural haemorrhage. A case report and brief literature review.A case of chronic extradural haemorrhage with a presumed time interval of 5-6 weeks between injury and diagnosis at postmortem examination is presented. The literature relating to this entity has been reviewed, and relevant features commented upon, including time intervals, age, sex, location, clinical features, pathological findings, associated skull fractures, mechanisms involved, and the source of the bleeding.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
5/9. Primary rhabdomyosarcoma combined with chronic paragonimiasis in the cerebrum: a necropsy case and review of the literature.A necropsy case of a primary rhabdomyosarcoma with chronic paragonimiasis in the cerebrum of a 68-year-old man is reported. The clinical data showed a right hemiplegia and dysarthria which became lethal in 6 months even though operation and radiation therapy were performed. Computed tomography revealed a large low-density area associated with the peripheral enhancement in the left basal ganglia, and multiple conglomerated calcified masses in the left temporal and occipital lobes. Biopsied and necropsied materials of the tumor in the basal ganglia was reddish brown in color and histologically was composed of purely mesenchymal derivatives with both embryonal and mature striated muscle cells but neither neuronal nor glial elements. Some of the tumor cells with extending slender cytoplasms showed obvious cross striations at the light and electron microscope levels and immunohistochemical reactivity for myoglobin. All tumor cells were also positive for vimentin, but not for glial fibrillary acidic protein. The clinical and necropsy findings revealed no primary lesion anywhere but in the brain. In addition, numerous dead oval eggs of paragonimus westermani were found in many cystoid lesions encapsulated by thick connective tissues with calcification and/or ossification. Clinicopathological features of 24 cases of primary rhabdomyosarcoma of the central nervous system reported in the literature are reviewed briefly. The histogenesis of this tumor are discussed together with comments on cerebral paragonimiasis.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
6/9. Pulmonary sarcoidosis and chronic cutaneous atypical mycobacter ulcer.This interesting case of pulmonary sarcoidosis and mycobacterium ulcerans ulcers raises many issues: 1. Our paucity of knowledge of deficient immune status in individuals; the multifarious presentation as recognisable ill health, its early detection, treatment and its prevention. In this present case the management of the immune status of the patient has not yet been fully addressed. The relationship between his pulmonary sarcoidosis as being an 'immune' response to the mycobacterium ulcerans remains speculative; for example, did this patient have the Mycobacterium infection before he was diagnosed as having sarcoidosis? There is no evidence of this. With the history of repeated cellulitis associated with his business trips to asia and the middle east, the likelihood seems speculative--as would infection with mycobacterium ulcerans contracted from swimming in pools and rivers. 2. As sarcoidosis is thought to have an association with mycobacterium tuberculosis it is tempting to suggest that as, in this case, the mycobacterium ulcerans is the caus-ative agent for his sarcoidosis. Additionally, should we be looking for sarcoidosis in every other case of mycobacterium ulcerans infection? Other cases of mycobacterium ulcerans could be assessed. 3. It is suggested that corticosteroids do pave the way for opportunistic infection as in this case. How often does this occur in 'usual practice' where patients are exposed to corticosteroids? Further comments are invited. 4. The question of sterility techniques in the home (daily dressings), the surgery, and at work as a food handler, is noted as a matter of concern. 5. The implications of the problem having any work-related association is also noted in passing.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
7/9. Excluding gastroesophageal reflux disease as the cause of chronic cough.gastroesophageal reflux disease (GERD) is recognized to be present in 10-20% of cases of chronic cough. Proving that it is the cause of the cough is more difficult. This problem is illustrated by way of a case report demonstrating that GERD can still be the cause, even when the patient is unresponsive to conventional use of proton pump inhibitors. In the commentary following the case history, we review the medical literature to confirm that GERD and cough may each precipitate the other. The role of esophageal ph monitoring in difficult cases of chronic cough is explored; we emphasize the use of pH monitoring while the patient is on therapy to prove or disprove the link.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
8/9. Spiritual care of chronically ill patients.In this article, the spiritual features of chronic illness are identified and elaborated. Chronic illness can bring about disorganization and disruption in the sufferer, resulting in spiritual distress. Some guidance is offered to nurses on the skills required to provide spiritual care for chronically ill patients. An example of a problem-solving approach to spiritual care is given along with comments on evaluating the effectiveness of nursing intervention. It is within nurses' personal resources to provide effective spiritual care as part of their concern for quality of care for patients.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
9/9. Chronic pulmonary histoplasmosis in brazil: report of two cases with cavitation diagnosed by transthoracic needle biopsy.Two cases of Chronic Pulmonary histoplasmosis are reported and other eleven cases, collected from Brazilian literature, are commented. After being clinically cured, one of our patients presented an aspergillus fungus ball inside a cavitation in the wall of which H. capsulatum was disclosed. Comments are also done on the diagnosis of the mycosis.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |