Osteoid osteoma of the pisiform bone: A rare cause of wrist pain.

Non-traumatic wrist pain remains a diagnostic challenge. An accurate diagnosis is crucial in order to choose the appropriate treatment. We report the case of a 23-year-old female with a four-month history of mainly nocturnal wrist pain. There was no history of trauma or prior surgery. Radiographs and CT scans showed a lytic lesion with central nidus and sclerotic margins in the pisiform bone. Bone scan showed increased uptake in the pisiform bone. The diagnosis of osteoid osteoma was confirmed by histopathological analysis after complete surgical resection. Osteoid osteoma of the carpal bones is a rare cause of wrist pain and can raise diagnostic issues. Diagnosis is based on both clinical and radiological features; histopathological analysis can confirm the diagnosis. Treatment depends on several criteria and multiple options are possible, but surgical excision is often preferred for the wrist. Osteoid osteoma should always be considered in young patients presenting with chronic unexplained wrist pain.

Evaluation of the Stratus CS fluorometer for the determination of plasma myoglobin.

Circulating myoglobin is recognized as an early and sensitive marker of acute coronary diseases. Long turnaround time of myoglobin assays jeopardize their clinical utility. We evaluated the analytical performance of the Stratus CS fluorometric enzyme immunoassay based on dendrimer technology, and claimed to achieve a fast and reliable determination of plasma myoglobin concentrations. Precision complied with the recommended analytical performance criteria. Method comparison and recovery experiments indicated, that despite good between-method correlations, the Stratus CS method overestimated myoglobin concentrations in comparison with values obtained on Cobas Integra 400 and BN A. However, since the manufacturers' cut-off for elevated plasma myoglobin levels was higher for Stratus CS than for other techniques, few discrepant results were observed between methods. Elevated levels of hemoglobin, triglycerides and rheumatoid factors did not interfere in the Stratus CS method but hyperbilirubinemia caused a positive difference.

Mitral insufficiency with congenital double-orifice mitral valve in an elderly patient.

We describe the case of a 79-year-old woman with mitral insufficiency and a double-orifice mitral valve (DOMV), discovered by echocardiography. Transthoracic echocardiography showed two insufficiency jets. Transesophageal echocardiography revealed a DOMV. Each orifice was provided with a subvalvular apparatus. No associated congenital abnormalities were present. Our case demonstrates that even in elderly patients with a double regurgitant jet, DOMV should be suspected and assessed by transesophageal echocardiography.

Progesterone increases airway eosinophilia and hyper-responsiveness in a murine model of allergic asthma.

BACKGROUND: Sex hormones might affect the severity and evolution of bronchial asthma. From existing literature, there exists, however, no convincing evidence for either exacerbation or improvement of allergic symptoms by progesterone. OBJECTIVE: This study was aimed to explore the effect of exogenously administered progesterone in a mouse model of allergic asthma. METHODS: BALB/c mice were sensitized to ovalbumin (OVA) by intraperitoneal injections with OVA followed by chronic inhalation of nebulized OVA or physiologic saline (Sal). Medroxyprogesterone acetate or placebo was instilled daily into the oesophagus before and during the inhalatory OVA challenge phase. RESULTS: Progesterone worsened allergic airway inflammation in OVA-challenged mice, as evidenced by enhanced bronchial responsiveness to inhaled metacholine and increased bronchial eosinophilia. Elevated airway eosinophilia corresponded with higher bronchial and systemic IL-5 levels in the progesterone group. The ratio of IL-4/IFN-gamma levels in bronchoalveolar lavage fluid and numbers of eosinophil colony-forming units in the bone marrow were also elevated in the latter group. Progesterone, however, did not influence allergen-specific IgE production, nor did it affect bronchial responses in Sal-challenged mice. CONCLUSION: Our data show that exogenously administered progesterone aggravates the phenotype of eosinophilic airway inflammation in mice by enhancing systemic IL-5 production. Progesterone also increases bronchial hyper-reactivity.

Reference values for the five electrophoretic serum protein fractions in Caucasian children by capillary zone electrophoresis.

We report age-related reference intervals for capillary zone electrophoresis for children between 1 and 14 years of age.

Prevalencia de sensibilización a lepidoglyphus destructor, tyrophagus putrescentiae y chortoglyphus arcuatus en pacientes con asma y/o rinitis residentes en Rosario / Prevalence of sensitization to lepidoglyphus destructor, tyrophagus putrescentiae and chortoglyphus arcuatus in patients with asthma and/or rhinitis living in Rosario, Argentine

El objetivo del presente trabajo fue evaluar la prevalencia de la sensibilización a Lepidoglyphus destructor (Ld), Tyrophagus putrescentiae (Tp) y Chortoglyphus arcuatus (Cha) en pacientes con asma y/o rinitis que residen exclusivamente en Rosario y compararla con otros ácaros estudiados previamente. En tres centros privados y tres hospitales públicos, se estudiaron 216 pacientes, 54,6 por ciento de sexo femenino, con edades comprendidas entre los 5 y 55 años (x 23,3 años). El 20,8 por ciento de ellos presentaba asma, el 38,9 por ciento rinitis y el 40,3 por ciento ambas patologías. Se confeccionó un cuestionario tipo y se realizaron prick tests (SPT) con extractos de Ld, Tp, Cha, Dermatophagoides pteronsyssinus (Dp) y Blomia tropicalis (Bt) obtenidos a partir de aislamiento y cultivos locales, y con una batería de aeroalergenos comerciales. El 79,6 por ciento (n = 172) de los pacientes presentó al menos un STP (+) y de ellos, el 94,8 por ciento mostró sensibilidad a algún ácaro y el 48,3 por ciento a otros alergenos. La prevalencia de sensibilización a alguno de los tres ácaros en estudio fue de 76,2 por ciento (Ld 69,2 por ciento, Cha 64,0 por ciento y Tp 61,6 por ciento), siendo de 66,1 por ciento en los pacientes con rinitis, de 78,9 por ciento en asma y de 82,7 por ciento para ambas patologías. No se observaron diferencias entre centros públicos y privados. El 54,6 por ciento de los pacientes (n=89) tuvo SPT (+) para los 5 ácaros testeados, el 6 por ciento (n=13) fue (-) para Dp y (+) para alguno de los otros 4 ácaros y el 3 por ciento (n=6) fue (+) sólo a Ld, Tp ó Cha. Se concluye que la prevalencia de sensibilización a Ld, Tp y Cha hallada en Rosario justifica ampliamente su inclusión en el panel de aeroalergenos, lo que permitiría identificar sensibilizaciones inaparentes

Prevalencia de sensibilización a lepidoglyphus destructor, tyrophagus putrescentiae y chortoglyphus arcuatus en pacientes con asma y/o rinitis residentes en Rosario / Prevalence of sensitization to lepidoglyphus destructor, tyrophagus putrescentiae and chortoglyphus arcuatus in patients with asthma and/or rhinitis living in Rosario, Argentine

El objetivo del presente trabajo fue evaluar la prevalencia de la sensibilización a Lepidoglyphus destructor (Ld), Tyrophagus putrescentiae (Tp) y Chortoglyphus arcuatus (Cha) en pacientes con asma y/o rinitis que residen exclusivamente en Rosario y compararla con otros ácaros estudiados previamente. En tres centros privados y tres hospitales públicos, se estudiaron 216 pacientes, 54,6 por ciento de sexo femenino, con edades comprendidas entre los 5 y 55 años (x 23,3 años). El 20,8 por ciento de ellos presentaba asma, el 38,9 por ciento rinitis y el 40,3 por ciento ambas patologías. Se confeccionó un cuestionario tipo y se realizaron prick tests (SPT) con extractos de Ld, Tp, Cha, Dermatophagoides pteronsyssinus (Dp) y Blomia tropicalis (Bt) obtenidos a partir de aislamiento y cultivos locales, y con una batería de aeroalergenos comerciales. El 79,6 por ciento (n = 172) de los pacientes presentó al menos un STP (+) y de ellos, el 94,8 por ciento mostró sensibilidad a algún ácaro y el 48,3 por ciento a otros alergenos. La prevalencia de sensibilización a alguno de los tres ácaros en estudio fue de 76,2 por ciento (Ld 69,2 por ciento, Cha 64,0 por ciento y Tp 61,6 por ciento), siendo de 66,1 por ciento en los pacientes con rinitis, de 78,9 por ciento en asma y de 82,7 por ciento para ambas patologías. No se observaron diferencias entre centros públicos y privados. El 54,6 por ciento de los pacientes (n=89) tuvo SPT (+) para los 5 ácaros testeados, el 6 por ciento (n=13) fue (-) para Dp y (+) para alguno de los otros 4 ácaros y el 3 por ciento (n=6) fue (+) sólo a Ld, Tp ó Cha. Se concluye que la prevalencia de sensibilización a Ld, Tp y Cha hallada en Rosario justifica ampliamente su inclusión en el panel de aeroalergenos, lo que permitiría identificar sensibilizaciones inaparentes (AU)

[The muscular pump of the calf. Video-phlebography and simultaneous EMG]. / La pompe musculaire du mollet. Vidéophlébographie et EMG simultanée.

Gastrocnemical insufficiency is a common syndrome (in modern society mainly affecting young females who have been taking the pill for several years). Often it is the starting point for superficial varicosis. The clinical diagnosis is easy, provided the doctor is informed of its symptoms. Phlebography or Duplex scan are compulsory, deciding surgical treatment. Varicose muscular veins have two different causes: avalvulation at the popliteal vein or compression by the Post. Tib. nerve. Persistent pain, deterioration of the superficial network or neuromyositis are the main reasons for deciding upon surgical treatment. The results are gratifying and lasting.

Familial idiopathic dilated cardiomyopathy (IDC).

A three-generation family is presented in which several relatives died from or are affected by idiopathic dilated cardiomyopathy (IDC). The transmission pattern is autosomal dominant. Although familial instances of IDC have been reported the proportion of familial cases tends to be underestimated. Moreover, different transmission patterns have been associated with IDC. This report adds further evidence to the fact that an autosomal dominant form of IDC clearly exists and that early screening of asymptomatic first degree relatives is mandatory for accurate genetic counselling of patients and their family members.

[Activities of the leg muscles in daily life]. / Activités de la musculature jambière dans la vie courante.

This article is the result of an electromyographic analysis of the leg and thigh muscles in a standing position, during walking, pedalling on an ergocycle and during movements when venous return is activated. In a standing position, the leg muscles show no intermittent activity; while standing on the tip of the toes, the activity of the calf muscles is almost maximum; during walking and pedalling, the muscles are contracted intermittently and alternatively but also with non negligible periods of contraction.

The analysis of ground reaction forces in pathological gait secondary to disorders of the foot.

A description is given of the vertical and horizontal components of the forces applied to the floor by the foot in walking. Information about the characteristics of the normal force pattern was obtained from the analysis of the gait of 214 normal subjects (108 young adults, 63 elderly people and 43 children). It is suggested that the normal gait pattern is characterised by a marked population variability, a considerable step-to-step consistency and symmetry of the forces from both feet. The force pattern in pathological gait secondary to disorders of the foot also shows a marked repeatability but is characterised by a pronounced asymmetry. A specific disorder of the foot does not necessarily result in a typical corresponding force pattern. The measured data allow a functional diagnosis and show how the patient is reacting to his disability. A force visualisation system is proposed permitting the immediate comparison between the normal and the affected foot and allowing long term assessment of subsequent changes. The force plates used also allow the recording of the progression of the centre of pressure in the foot and the measurement of the torque around the ankle joint.

Diagnostic performance of segmental plethysmography and Doppler ultrasound in obliterating vascular diseases in the lower limbs.

The diagnostic value of three noninvasive techniques was evaluated in a group of 100 "normal" and 100 "abnormal" limbs. The choice of segmental plethysmography, systolic pressure determination, and Doppler velocity curve was based on the fact that these methods are noninvasive, inexpensive, and atraumatic; they can easily be performed by paramedical personnel. There was a statistically significant difference between the ankle-to-arm systolic blood pressure ratio of normals and abnormals as measured by Doppler ultrasound with 0.96 as the dividing line, no false positives and only 11% false negatives were found. However, there was a large overlap for many parameters calculated from the velocity curve. The general morphological aspect of the velocity curve shows a better diagnostic performance than the calculated parameters of this curve: a monophasis curve had an 85% chance of being normal. The ankle segmental plethysmogram yielded only 5% false negatives, but 20% false positives; moreover, a biphasic curve has a 90% chance of being normal. Thus large-scale screening in clinical practice or in epidemiologic studies can best be done by Doppler pressure measurements; the velocity curve performs less satisfactorily. Segmental plethysmography is more sensitive, but it yields more false positive results.

Chlorinated pesticides and polychorinated biphenyls in marine species, Oregon/Washington Coast, 1972.

Concentrations of chlorinated pesticides and polychlorinated biphenyls (PCB's) were determined in three offshore marine species from the Oregon/Washington coast: pink shrimp, euphausiids, and flatfish; five species of bivalve mollusks from five estuaries along the Oregon coast; several fish species from the Coos Bay and Columbia River estuaries; and a summer run of steelhead from the Rogue River. The compounds p,p'-DDE and PCB's were detected most frequently. Euphausiids and pink shrimp contained approximately 2 ppb (mug/kg) wet-weight DDE and 8 and 25 ppb PCB's, respectively. Offshore flatfish contained an average of 9 ppb DDE and 29 ppb PCB's. DDE residues in estuarine mollusks approximated 0.5 ppb. PCB levels were not detectable (greater than 3 ppb) except in collections from the mouth of the Columbia River where the levels averaged 400 ppb PCB's and 17 ppb DDT. Selected Columbia River where levels averaged 400 ppb PCB's and 17 ppb DDT. Selected Columbia River fish species contained 38 ppb DDE and 480 ppb PCB's; summer-run steel-head in the Rogue River contained 97 ppb DDE and 125 ppb PCB's. PCB chromatograms of most euphausiids closely resembled those of Aroclor 1254. Chromatograms of shrimp and flatfish indicated selective metabolism of two compounds in the Aroclor 1254 formulation. Biphenyls of higher chlorine content were also detected in the shrimp and flatfish.