Gunshot wound of the lumbar spine]

A case of 20 years old patient with the gunshot injury of the spine was presented. The bullet has stuck in the spinal canal at L3-L4 level causing no neurological disturbances. It was removed in our department gunshot wounds to do this in district hospital. No complication occurred in the postoperative course.     

Late results of surgical treatment of infantile idiopathic scoliosis by Harrington's method]

The late results of surgical treatment of infantile scoliosis by the Harrington method have been presented in 43 patients. The patients age at surgical treatment ranged from 11 to 21 years (14.1 years in the average). The patients age at final follow up examination ranged from 18 to 34 years (25.4 years on the average). The curvature angle at operation was 102.1 degrees according to Cobb on the average. 43.7 per cent of curvature was corrected. Although an improvement of posture was present in all the patients, only 51 per cent of the patients, had good posture. After the treatment 81 per cent of the patients worked.     

SINGLE-BLIND RANDOMIZED CONTROLLED TRIAL OF AN EDUCATIONAL BOOKLET FOR PATIENTS WITH CHRONIC ARTHRITIS

Consecutive new attendees at a rheumatology clinic were randomlyallocated to one of three groups. All groups received routinecare, but one received no other intervention, one an educationalbooklet on arthritis and one the booklet plus instruction froma health professional. Prior to intervention, all groups hadsimilar knowledge, Nottingham Health Profile (NHP) and HealthAssessment Questionnaire (HAQ) score. After 6 weeks, the knowledgescore was significantly increased in both groups given the booklet,but not in the control group. The group instructed by a healthprofessional showed no greater increase than the group giventhe booklet alone. Increased knowledge was not associated withimproved clinical status and no group showed a significant'change in NHP or HAQ scores. Nearly all patients said they foundthe booklet useful. KEY WORDS: Randomized controlled trial, Evaluation, Patient education, Booklet, Knowledge, Arthritis     

The value of CT in determining potential instability of simple wedge-compression fractures of the lumbar spine.

PURPOSETo determine whether plain films alone are sufficient in the evaluation of stability of simple wedge-compression fractures of the lumbar spine.METHODSPlain films and CT scans of 53 consecutive patients seen during a 2-year period with lumbar spine fractures were retrospectively reviewed. Six readers blinded to the CT diagnosis independently read each patient''s plain films. Plain-film findings were scored on a five-point graded response scale using criteria proposed by Gehweiler and Daffner. In addition, a fracture was considered to be possibly unstable if there was involvement of more than one vertebral level or greater than 50% loss of anterior vertebral body height. CT findings represented the standard for comparison. CT scans were independently evaluated by three additional readers. Two-column involvement, middle-column involvement alone but with retropulsion, multiple-level involvement, or greater than 50% loss of vertebral height indicated potential instability.RESULTSFor 14 stable and 39 potentially unstable lumbar spine fractures, the pooled (mean) plain-film negative predictive value for detection of potentially unstable fractures was 0.62 (95% confidence interval, 0.53 to 0.70), with a sensitivity of 0.83 (95%, confidence interval; 0.78 to 0.87), and specificity of 0.80 (95% confidence interval, 0.70 to 0.87).CONCLUSIONPlain films are not adequate for determining stability of lumbar spine fractures.     

Medical student abuse: perceptions and experience

Summary. A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first-and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.