Does the orientation of the distal radioulnar joint influence the force in the joint and the tension in the interosseous membrane?

OBJECTIVE: To investigate the effect of change in the orientation of the distal radioulnar joint on the force in the joint and the strain in the interosseous membrane. DESIGN: Biomechanical study in fresh frozen cadavers. BACKGROUND: The articular surfaces of the distal radioulnar joint may be orientated in parallel with the long axis of the forearm (a Type I joint) or at an oblique angle opening distally to the ulnar side (a Type II joint). METHODS: Three cadaveric upper limbs were held on a custom built frame allowing measured rotation and axial loading across the wrist. Measurements of force in the distal radioulnar joint and strain in the interosseous membrane were taken and repeated after replacement of the distal radioulnar joint with prosthetic Type I and Type II joints. FINDINGS: The force in the joint and the strain in the interosseous membrane increased with increasing load across the wrist (P < 0.0001). The force in the Type I joint was reduced compared to the normal or Type II joint. This difference was greater with increasing load and was significant at 8 kg (P < 0.001). The strain in the interosseous membrane was maximal at neutral forearm rotation and decreased with increasing pronation and supination. INTERPRETATION: The force in the joint is greater with the Type II distal radioulnar joint. We believe this compressive force increases joint stability and this orientation of the articular surfaces should be considered in the design of a total distal radioulnar joint arthroplasty.     

Does the positive keying of the TAS inflate the absorption-hypnotizability link?

The search for correlates of hypnotic responsiveness has been largely unsuccessful, with the notable exception of the construct "absorption." The Tellegen Absorption Scale (TAS) has been shown to correlate with hypnotic responsiveness, particularly if the two measures are administered in the same testing context or setting. The present study set out to determine whether the all-true, positively keyed format of the TAS inflates the absorption-hypnotizability link. With a sample of 466 participants, the authors show that wording the TAS items in either a positive or negative direction does not affect the correlation between the TAS and the Harvard Group Scale of Hypnotic Susceptibility, Form A.     

Does the Positive Keying of the TAS Inflate the Absorption-Hypnotizability Link?

The search for correlates of hypnotic responsiveness has been largely unsuccessful, with the notable exception of the construct "absorption." The Tellegen Absorption Scale (TAS) has been shown to correlate with hypnotic responsiveness, particularly if the two measures are administered in the same testing context or setting. The present study set out to determine whether the all-true, positively keyed format of the TAS inflates the absorption-hypnotizability link. With a sample of 466 participants, the authors show that wording the TAS items in either a positive or negative direction does not affect the correlation between the TAS and the Harvard Group Scale of Hypnotic Susceptibility, Form A.     

Pneumonia in the elderly--what makes the difference?

Pneumonia has a particularly high incidence in the elderly, the cardinal risk factors being comorbidity and malnutrition. The independent bearing of age on the aetiology of pneumonia is a matter of controversy and is probably limited. Streptococcus pneumoniae is uniformly the most frequent pathogen. Elderly patients with pneumonia are frequently oligosymptomatic. Quite often, mental confusion may be the only clinical symptom. Physical and chest radiograph examination have specific and important pitfalls. Mental confusion as a surrogate marker of severe sepsis should be added to the criteria for assessing the severity of disease. Pneumonia in the elderly is associated with a considerably increased mortality, but age does not appear to be an independent predictor of death. The disease continues to be the old man's friend: survivors of a pneumonia episode are more likely to die during follow-up as compared to controls. Antimicrobial treatment in the elderly should follow a risk-adopted approach. When selecting antimicrobial agents for the treatment of the elderly, peculiarities in pharmacokinetics, drug interactions and side effects should be considered. The rate of radiographic clearance is inversely correlated with age. All elderly individuals are candidates for vaccination against pneumococci and influenza, particularly in the presence of cardiopulmonary comorbidity and any degree of immunosuppression.