Brace with a lateral pad for patellar pain. 2-year follow-up of 25 patients

A patellar brace with a lateral pad was used in 25 patients with unilateral retropatellar pain syndrome. The patients were told to use the brace in activities that loaded the patella, and they were followed for 1 to 2 years. At follow-up, 8 patients were improved, while the symptoms were unchanged or worse in 17. The level of activity was increased in 4 patients, reduced in 3, and unchanged in the others. It is concluded that treatment with a patellar brace with a lateral pad is not likely to succeed in the majority of patients with retropatellar pain syndrome.     

The usefulness of transesophageal echocardiography in the diagnosis of pulmonary thromboembolism]

Three cases with suspected pulmonary artery embolism are presented, in which transesophageal echocardiography showed a mass in the right pulmonary artery consistent with thrombus. The relevant diagnostic contributions of transesophageal echocardiography are discussed.     

The effect of preconceptional multivitamin supplementation on the menstrual cycle

The database of the Hungarian randomised controlled trial of periconceptional multivitamin supplementation for the prevention of neural-tube defects was used to evaluate the length of the pre- and postovulatory phases of the menstrual cycle before and during multivitamin supplementation. The female cycle was more regular (i.e., the variance was lower) during the multivitamin supplementation.     

Locked intramedullary nailing of fractures of femur and tibia

The results of 194 consecutive interlocking nailings for 95 fractures in the tibia and 99 fractures in the femur with a median observation time of 22 months are presented. Three fractures were not consolidated radiologically at follow-up; three deep infections were recorded, all of which healed. Shortening > 1cm was recorded in 17 fractures, rotatory malalignment > 5 ° in 21, and angular malalignment > 5 ° occurred in 17. The end result was excellent in 121 fractures, good in 41, fair in 28, and poor in 4.     

Orbital CT in the management of blow-out fractures of the orbital floor

The CT-examinations of 15 patients with blow-out fractures of the orbital floor were reviewed. All patients were examined with coronal/semicoronal CT-imaging, and 7 patients also were evaluated with semisagittal projections. Only in one case the semisagittal images gave more information than coronal sections when using the classification of Gilbard et al. (1985) of the inferior rectus muscle/fracture relationship. The anterior and posterior fracture margins were better delineated with semisagittal imaging. Two patients exhibiting positive traction tests with hooked, and not entrapped muscles on CT still had diplopia 5 1/2 and 12 weeks after the trauma.     

Success and complications of pneumatic retinopexy

Fifty-eight consecutive patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluoropropane gas. Reattachment was achieved in 29 of 35 eyes (83%) having single retinal breaks (up to 45 degrees in extent), including dialyses (up to 60 degrees), and groups of breaks within one clock hour. The cumulative reattachment rate was 37 of 58 eyes (64%), including eyes with detachments with multiple breaks 30 to 120 degrees apart and vitreous hemorrhage as well as aphakic and pseudophakic eyes. Pneumatic retinopexy was successful in 18 of 22 (82%) myopic eyes (-3 to -11 diopters). Virtually all complications developed in the inferior retinal quadrants, and included preretinal vitreous condensations or membranes in 27 of 58 eyes (47%), new retinal breaks in seven eyes (12%), and rhegmatogenous or tractional detachments in previously attached areas in 14 eyes (24%). Postoperative proliferative vitreoretinopathy occurred in six eyes (10%) and macular pucker in two (3%).     

Acute pericarditis as the initial manifestation in Still's disease in an adult

Almost 90% of primary acute pericarditis are idiopathic. Between specifics forms, a very low percentage of cases are due to chronic rheumatic diseases. A case of adult Still's disease (juvenile chronic rheumatoid arthritis) with acute pericarditis being the first clinical manifestation (besides fever and general syndrome) is presented. Therapy with oral prednisone was rapidly effective, and pericardial effusion resolved after 3 weeks of treatment, as echocardiography showed.