A comparative assessment of the efficacy of thiophosphamide electrophoresis and ultrasound in the combined therapy of reactive arthritis

The results of the treatment of patients suffering from rheumatoid arthritis with ultrasound (group I), thiophosphamide electrophoresis (group II), ultrasound and thiophosphamide (group III) and with medicamentous agents alone (group IV) are compared. The positive therapeutic effect was recorded in patients of all 4 groups, with that effect being most remarkable in group III.     

Spurious hyperchloremia and decreased anion gap in a patient with dextromethorphan bromide.

Although cold syrup containing dextromethorpan bromide is widely administered, the bromism due to cold syrup has not been reported. We report a patient who had negative anion gap with hyperchloremia and conscious loss because of daily intake of cold complex syrup (containing dextromethorphan bromide 0.4 mg/ml, acetaminophen 8.33 mg/ml) for headache for 4-5 years. The bromide content in cold complex syrup resulted in serum levels of bromide that interfered with the automated analyzers for chloride content. When conscious change is due to bromism, hemodialysis instead of forced hydration and diuresis should be performed immediately. Therefore, patients with a markedly negative anion gap with hyperchloremia should be considered as having halide intoxication.     

Status of nitrogen balance and parenteral feeding in peritonitis

Under study were parameters of protein metabolism and state of nitrogen balance in 83 patients with peritonitis, in 29 of them (with diffuse peritonitis) partial parenteral nutrition was performed. It reduced the degree of protein catabolism, facilitated elimination of metabolic disorders. Reinforcement of the ration of the caloric-nitrogen nutrition in order to completely fill up the energetic and plastic expenditures of the organism at the early postoperative period will entail danger of superflous transfusion load.     

Contraindications regarding total prosthesis of the hip joint

The authors have made an analysis of unsatisfactory remote results in 83 (21.5%) out of 387 patients operated for endoprosthezing of the hip joint which resulted from shaking loose the endoprostheses in the bone tissue. A conclusion is made that the following factors may be considered as contraindications to endoprosthesis of the hip joints: coxarthrosis against the background of arthroso-arthritis, neglected stages of protrusive coxarthrites, deforming osteoarthrosis due to the use of corticosteroids, pronounced senile osteoporosis.     

Acinetobacter skin abscess in a neonate.

Although Acinetobacter is usually a species of low virulence, it is becoming increasingly more important as a cause of hospital outbreaks, particularly on intensive care units. Antibiotic resistance can develop rapidly. This organism has not been reported to cause skin abscesses previously. We describe a case of a neonate who developed an Acinetobacter abscess on our neonatal intensive care unit.     

Endocrinology: Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome in an in-vitro fertilization programme

A cohort study was undertaken to compare the effect at the timeof oocyte retrieval of the i.v. administration of either 1000ml of lactated Ringer' solution or 1000 ml of a 5% solutionof human albumin on in-vitro fertilization patients at riskfor severe ovarian hyperstimulation syndrome (OHSS). A totalof 207 patients with an oestradiol concentration > 10 000pmol/l and/or > 15 follicles (>10 mm diameter) on theday of human chorionic gonadotrophin (HCG) injection were reviewed.Of these, 158 women received 500 ml of lactated Ringer’ssolution both before and after egg retrieval, and 49 women receivedtwo infusions of 500 ml of 5% human albumin in normal salineat the time of egg retrieval. Severe OHSS developed in two patientswho received human albumin and in 10 women who did not receivethe albumin. This difference was not statistically significant.There were no differences between the two groups in terms ofage, number of follicles punctured at transvaginal oocyte retrievalor oestradiol concentration at the time of HCG injection. Theadministration of a 5% human albumin solution does not preventthe development of severe OHSS in at risk patients. It doesappear to blunt the severity of the condition.