Late-onset major depression with delusions after metoclopramide treatment.

The authors describe major depression with delusions occurring for the first time in an elderly man receiving metoclopramide and review the literature concerning metoclopramide and depression.

Weight bearing after hip fracture: a prospective series of 596 geriatric hip fracture patients.

Five hundred ninety-six patients age > or = 65 with femoral neck or intertrochanteric fractures were allowed immediate unrestricted weight bearing after surgery and were prospectively followed. Follow-up data and hospital records were examined to identify those patients who required additional hip surgery owing to failure of fixation, nonunion, osteonecrosis, or prosthetic dislocation. Four hundred seventy-three patients were available for 1-year minimum follow-up; 16 patients (3.4%) required additional hip surgery. The revision surgery rate after intertrochanteric fracture due to loss of fixation was 2.9%. The revision surgery rate after internal fixation of the femoral neck from loss of fixation/nonunion was 5.3%; the revision rate from osteonecrosis for patients with 2-year follow-up was 5.4%. The revision rate after hemiarthroplasty due to prosthetic dislocation was 0.6%. These results support the use of unrestricted weight bearing in elderly patients after hip fracture surgery.

Calcium accumulation in experimental hypertension.

At present, the significance of calcium accumulation in the aetiology of coronary artery disease (CAD) in humans is not known, except only to exacerbate the condition. In an attempt to understand ionic disturbances in vasculature derived from cardiovascular abnormalities, soft tissues from hypertensive models were examined. The study hypothesis was to see if basic cardiovascular regulatory sites in hypertensive models accumulated greater amounts of Ca2+. Calcium levels were measured by flame atomic absorption spectrophotometry in tissue derived from two types of hypertensive rabbits. Both models of hypertension developed mean arterial pressures of at least 50 mm Hg greater than those of controls over a 5-wk period. Significant increases in calcium levels were found in left ventricle and aorta derived from both hypertensive groups compared with controls. Renal cortex and medulla were not significantly different among any of the groups. These levels corroborate the findings of others which show increased calcium levels in cardiovascular tissues in experimental hypertension in rabbits. Although there have been several studies that have shown the relationship between calcium, hypertension and CAD, this is the first study to look at calcium accumulation rather that the effects of calcium channel blockers. The link between hypertension and calcium accumulation in a number of tissues may be important in the development of CAD and other cardiac dysfunction.

Fracture of the iliac crest following bone grafting: a case report and literature review.

Fracture of the anterior iliac crest following bone grafting is an extremely rare occurrence. Five cases have been reported in the literature, none of which were internally stabilized. We are reporting a sixth case. Of the six cases, our harvest site is the furthest posterior from the anterior superior iliac spine. The fracture resulted in a large displaced anterior fragment that required open reduction and internal fixation with plates and screws. Osteoporosis increases the risk of anterior iliac crest fractures following bone grafting, but preventive procedures can be performed.

Divalent cations in hypertension with implications to heart disease: calcium, cadmium interactions.

Heart disease still pervades all socioeconomic classes within the United States. Understanding the effects of environmentally-related pathogenesis (e.g., heavy metal accumulation) may aid in developing novel treatments for the prevention of heart dysfunction. The aim of this report was to use experimental investigation in an attempt to expand upon the multivariate importance of divalent cation interactions in the development of heart disease. Calcium and cadmium levels were measured by flame atomic absorption spectrophotometry in various tissues derived from two types of hypertensive rabbit models. Both models of hypertension developed mean arterial pressures of at least 50 mm mercury greater than those of controls over a 5 week period. Interrelationships between calcium and cadmium levels were found to exist for both hypertensive groups in the left ventricle, aorta, and renal medulla. The renal cortex showed no such interrelationship for the renal hypertensive group. Multiple interrelationships between calcium and cadmium levels and hypertrophy were also observed. These studies related the importance of endogenous or exogenous (viz, environmental) factors governing cadmium and calcium accumulation in hypertensive rabbits. The resulting relationships between divalent cations and hypertrophy were presented to draw attention to areas which remain unexplored with perspective to cardiovascular disease.

Modification of calcium flux of twitch skeletal muscle in mice subjected to 20% body surface area burn.

One systemic effect of burn trauma is skeletal muscle weakness. This is the result of changes in second messenger systems involving calcium (Ca2+). Kinetic analysis of Ca2+ from cellular compartments of skeletal muscle of mice that were subjected to small burn injury (20% body surface area) was performed. Muscles of the burn group showed an increased 45Ca2+ uptake maxima compared with those of time-matched control groups. Also, 45Ca2+ efflux analysis showed a lack of differentiation between electrically stimulated tissues and nonstimulated tissues that was easily observed in time-matched control groups. This lack of differentiation indicated changes in intracellular compartmentation. It can be speculated that burn trauma may have a regulatory role in the excitation-contraction coupling mechanism by altering myoplasmic levels of Ca2+ even before skeletal muscle dysfunction occurs. These findings suggest that agents capable of controlling myoplasmic Ca2+ levels may aid in alleviating chronic skeletal muscle dysfunction in patients with burns.