Accuracy of passive ankle joint positioning during quiet stance in young and elderly subjects

Age-related postural deficits elicit compensatory mechanisms such as ankle dorsiflexion in the elderly. To gain further insight into this problem, the ability to match an ankle angle during quiet stance was studied in 12 elderly and 12 young subjects. Following an initial single limb angular perturbation presented in the ±4° range, a subject had to return a tilt platform to level, as determined by the nonperturbed limb. Elderly subjects exhibited significant positive (0.9°) over-shoot of the level position, in contrast to young subjects who matched ankle angle with a mean error of −0.1°. The elderly group also exhibited an increase in positioning error for angular displacements in the range between −1 and +1°. The results document age-related postural changes in ankle positioning which might affect postural stability in older adults.     

Multiple myeloma: evaluation by CT

Although patients who have multiple myeloma usually have straightforward clinical symptoms and corroborative radiographs, in some instances, these patients will present atypically, with symptoms suggesting active disease but radiographs that are normal or nonspecific. We reviewed the records of 32 patients who had documented multiple myeloma and had undergone CT examinations, assessing the value of those examinations. Although CT is not indicated in all patients who have multiple myeloma, it is especially useful in patients who have bone pain and normal or nonspecific radiographs. CT provided confirmatory information in all cases in which lesions were seen on radiographs. CT also frequently demonstrated a greater extent of disease than could be appreciated on the radiographs.     

Supraacetabular insufficiency fractures

Insufficiency fractures in the supraacetabular region were identified in five women, aged 55-83 years. Factors contributing to the diminished resistance of their bones included postmenopausal osteoporosis, steroid therapy, radiation therapy, and rheumatoid arthritis. The supraacetabular fractures were seen on routine radiographs as hazy bands of sclerosis located immediately above and parallel to the acetabular roof. All five patients had additional fractures in the spine or pelvis. Supraacetabular insufficiency fractures may be an unsuspected cause of hip pain, especially in older women.     

Allergic side-effects of antimicrobial chemotherapy and possibilities in their diagnosis

In antimicrobial chemotherapy the allergic reactions are in the first place of the side-effects appearing. The most frequent cause of the iatrogenic contact eczema antimycotics and chloramphenicol are to be taken into consideration. Penicillin and its derivations and chloramphenicol form the main proportion of the allergic in systematic administration. The serologico-nephelometric two-step-method and the lymphocyte transformation test are useful methods for the diagnostics of drug allergies. In a use adequate to indication they are valuable adjuvants in the hand of the clinician.     

Percutaneous transluminal dilatation of transplant renal artery stenosis

Percutaneous transluminal angioplasty has been applied to the treatment of transplant renal artery stenosis in 3 patients, 2 with severe hypertension resistant to medical therapy, and one with graft dysfunction related to the presence of the stenosis in the early post-transplant period. The clinical courses of the patients before and after angioplasty are illustrated and the usefulness of the technique in this difficult situation stressed.     

Trends in patient populations contrasted by two methods of diagnosis

The distribution of psychiatric diagnoses was examined in samples of patients attending an emergency clinic, a short-stay unit, and a long-stay unit of the same hospital system. Two sets of diagnoses were analyzed, namely routine hospital and standard project diagnoses of proven reliability.A comparison of the two methods showed that routine hospital diagnoses, even when made by psychiatrists in the same hospital system, may give a misleading picture of distribution changes. However, both sets of diagnoses agreed that patients with affective disorders tend to be treated in the short-stay unit, while schizophrenics tend to be sent on to the long-stay unit.