Establishment of status epilepticus by limbic system stimulation in previously unstimulated rats

A syndrome of convulsive status epilepticus developed in 4 of 18 rats which had been treated with continuous sine wave stimulation incrementally raised to 40 microA through limbic system electrodes. The syndrome was characterized by recurrent behavioral seizures, continuous EEG spiking, and marked neuropathology. In three other animals, the stimulation treatment produced a syndrome of nonconvulsive status epilepticus manifested by an electrophysiologic record of continuous seizure activity, without accompanying tonic-clonic movements. The poststimulatory effect was correlated with the animals' response to the stimulation, and was independent of whether the electrode was positioned in the hippocampus or amygdala. If an animal developed repeated convulsive seizures during the stimulation, such seizures were likely to persist after the stimulation offset. These results indicate that persistent limbic system activation can produce a syndrome of recurrent seizures similar to that caused by either neurotoxic drugs or by limbic system activation in kindled rats.     

Treatment of septic arthritis of the hip joint by repeated ultrasound-guided aspirations

Arthrotomy of the hip joint followed by a variable period of drainage or continuous irrigation and drainage is considered the accepted treatment of septic arthritis of the hip joint (SAHJ). The authors reviewed the results of a cohort of children with SAHJ with repeated aspirations of the hip joint. Thirty-four children diagnosed with SAHJ were treated with repeated aspirations of the hip joint. The aspirations were performed under ultrasound guidance and topical anesthesia or under sedation. After the aspiration the joint was irrigated using the same needle, and the procedure was repeated daily. Six of the patients were operated on and then treated with aspirations because of drain dislodgement or clogging. Twenty-eight of the patients were treated primarily with repeated aspirations. Four of those patients did not improve and underwent arthrotomies, and 24 were treated only by repeated aspirations and healed completely. The mean number of aspirations was 3.6 (range 3-5), and 75% of the patients resumed walking after 24 hours. The mean follow-up time was 7.4 years (range 3-18). No complications were seen. Repeated aspiration is a safe and efficacious method of treatment for SAHJ. This method of treatment is not associated with surgery and its complications and prevents scarring of the skin and the need for general anesthesia. Faster return to normal activity was noted in this series.     

Indicators of a healthy and sustainable community. The Central Florida experience

The society, economy, and health and well-being of residents in the Central Florida region create a holistic perspective of a healthy community. This article discusses the important role health care organizations play in developing and creating healthy communities. It also discusses the responsibility health care providers in the Central Florida region have to the communities they serve using this broad-based approach to a healthy community. A history is presented showing how a local initiative to develop a healthier community led to the development of several healthy community indicators for the Central Florida region. The article delineates how the indicators reflect the health and long-term viability of the 7 counties comprising the Central Florida region. A number of public policy implications and the role of the region's health care system in furthering these indicators are presented for the broadly defined categories of crime, education, the local economy, and transporation.