Showing papers by "Leicester Royal Infirmary published in 1977"

Energy intake and physical activity in obese children.

Abstract: In both cases simultaneous administration of other potentially hypocalcaemic treatment makes it more difficult to assess additional treatment with calcitonin. Nevertheless, in case 1 intravenous calcitonin appears to have had an immediate effect followed by 36 hours without a further fall in the calcium concentration until the addition of intramuscular calcitonin. In case 2 a previous episode of hypercalcaemia (serum calcium concentration of 3 85 mmol/l (15 4 mg/100 ml)) was treated with steroids and rehydration alone with a fall in the serum calcium concentration to 3 05 mmol/l (12 2 mg/100 ml) taking 19 days. No side effects attributable to calcitonin were observed. Supernatants from tissue culture of bone marrow cells from patients with multiple myeloma have been found to secrete a calcium mobilising factor4 and parathyroid-hormone or prostaglandinmediated osteolytic activity has not been shown. Calcitonin lowers the plasma calcium concentration principally by reducing osteoclastic resorption, although it does have a small calciuric effect. Use of intravenous phosphate in hypercalcaemia is not always successful and may be complicated by soft tissue calcification. The use of intravenous sodium chloride or sulphate depends on good renal function. Mithramycin5 has been used successfully in small doses, although toxicity would theoretically be a problem if doses were repeated. Calcitonin offers a means of rapidly correcting hypercalcaemia associated with multiple myeloma, giving time for treatment of the primary condition to take effect.

The Abductor Digiti Minimi Muscle Flap

Abstract: The problems of extensive scarring involving the median and ulnar nerves at the wrist are discussed. Possible methods of separating the dermal cicatrix from the nerves are skin flaps or muscle flaps. A case is presented in which an abductor digiti minimi muscle flap was used. The reasons for this choice are discussed and the technique described.

Fractures of the tibial shaft: is medical audit possible?

Abstract: Eight reports dealing with fractures of the tibial shaft have been examined to ascertain whether an audit of the results could be made. This was possible in only two instances owing to wide variations in the systems of classification of fractures, in definitions of certain terms and in presentation of results. Histograms in the form of frequency distribution curves of healing time were not helpful for making comparisons but the presentation of results in the form of cumulative percentage curves appears to have advantages as a simple visual means of comparison. Statistical analysis is then still necessary. Little useful information is gained by attempting to compare reports which incorporate different systems of classification and definition as well as different methods of presenting results. A medical audit of different methods of treatment will only be made possible by standardization in these matters. A system of classification is required which will sub-classify serious fractures so that specific problem fracture types can be studied on a multicentre basis.

Bilateral simultaneous rupture of the quadriceps tendon: a case report

Abstract: We report a case of bilateral simultaneous rupture of the quadriceps tendon, in which there was no predisposing cause for the rupture. The condition is extremely rare, there being but five previously reported cases in the literature (Steiner and Palmer, 1949; Wetzler and Merkow, 1950; Preston and Adicoff, 1962; Dalal and Whittam, 1966; Levy et al., 1971). In only two of these cases (Steiner and Palmer, 1949; Dalal and Whittam, 1966) was there no predisposing cause.

Evaluation of skin tests and desensitization in allergic rhinitis.

Abstract: A study of thirty-seven cases of allergic rhinitis is presented. The effect of the treatment on patients' symptoms and on the state of their skin sensitivity has been assessed. From this study it is concluded that the skin tests do not form a reliable method of assessing nasal allergy, nor is there a useful correlation following desensitization by vaccine therapy between the state of the skin sensitivity and the symptomatic effectiveness of treatment.